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Srejic U, Larson P, Bickler PE. Little Black Boxes: Noncardiac Implantable Electronic Medical Devices and Their Anesthetic and Surgical Implications. Anesth Analg 2017; 125:124-138. [DOI: 10.1213/ane.0000000000001983] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Vann-Ward T, Morse JM, Charmaz K. Preserving Self: Theorizing the Social and Psychological Processes of Living With Parkinson Disease. QUALITATIVE HEALTH RESEARCH 2017; 27:964-982. [PMID: 28818020 DOI: 10.1177/1049732317707494] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
The purpose of this constructivist grounded theory article is to identify, explore, and theorize the social and psychological processes used by people with Parkinson disease. Analytic procedures generated the five-stage theory of Preserving self of people with Parkinson disease: (a) making sense of symptoms, (b) defining turning points, (c) experiencing identity dilemmas, (d) reconnecting the self, and (e) envisioning a future. Reminders of former selves and capabilities were painful; participants desperately sought normalcy. Participants developed creative methods for maintaining independence but frequently overestimated their abilities and took risks. Participants were 15 men and 10 women (ages 40-95), most of whom lived with their families. Disease status was ascertained through medication logs and two scales: Hoehn and Yahr staging and Activities of Daily Living. Data included 62 in-depth interviews, nonparticipant observation, and participant photos, videos, and related documents. Recommendations were derived from the theory to support processes of Preserving Self as interventions designed to reduce the loss of self and to enhance Preserving self. These recommendations included developing relationships, teaching expected and unexpected feelings and behaviors, and involvement with sensory integrating activities.
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Affiliation(s)
| | | | - Kathy Charmaz
- 2 Sonoma State University, Rohnert Park, California, USA
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Patil AL, Sood SK, Goyal V, Kochhar KP. Cortical Potentials Prior to Movement in Parkinson's Disease. J Clin Diagn Res 2017; 11:CC13-CC16. [PMID: 28511378 DOI: 10.7860/jcdr/2017/25520.9598] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 01/30/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Recording cortical potentials prior to movement (bereitschaftspotentials, BP) offer a good non invasive method for studying activity of motor related cortices in Parkinson's Disease (PD). Dopaminergic medications provide some symptomatic relief in advanced stages but they do not stop the progression of the disease. Assessing BP may be a good idea to see the response of anti PD drugs. It remains unclear whether the anti PD medications also improve cortical activity prior to movement even in advanced stages of the disease. AIM In this study we recorded scalp BP in patients with varying grades of severity to study the relationship between disease severity and various components of BP. MATERIALS AND METHODS We successfully recorded BP at Cz, C3 and C4 sites during self-initiated 100 right wrist movements in 12 male patients with PD having severity Hoehn and Yahn (H&Y) scale 4 (PD3 group). These potentials were compared with age matched patients with H&Y scale 2 (PD1) and scale 3 (PD2) and also with age matched healthy controls. RESULTS We found flatter waveforms with increasing severity of disease. Amplitude is first to be affected in mild severity as compared to controls (p=0.011); while with increasing severity early as well as late part of potentials is affected. Such changes are prominently seen at Cz site across the groups. CONCLUSION These findings imply that there is increasing defect in cortical activity during movement especially in supplementary motor area with increasing severity in PD in spite of dopaminergic medications. This dynamic nature of dysfunction in supplementary motor cortices must be taken in account while treating advanced cases using newer stimulation techniques.
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Affiliation(s)
- Ashlesh Laxman Patil
- Senior Resident, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Sanjay Kumar Sood
- Professor, Department of Physiology, RAK College of Medical Sciences (RAKMHSU), Ras Al Khaimah, United Arab Emirates
| | - Vinay Goyal
- Professor, Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Kanwal Preet Kochhar
- Professor, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
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Yan H, Wang J. Quantification of motor network dynamics in Parkinson's disease by means of landscape and flux theory. PLoS One 2017; 12:e0174364. [PMID: 28350890 PMCID: PMC5370118 DOI: 10.1371/journal.pone.0174364] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 03/08/2017] [Indexed: 01/18/2023] Open
Abstract
The basal ganglia neural circuit plays an important role in motor control. Despite the significant efforts, the understanding of the principles and underlying mechanisms of this modulatory circuit and the emergence of abnormal synchronized oscillations in movement disorders is still challenging. Dopamine loss has been proved to be responsible for Parkinson's disease. We quantitatively described the dynamics of the basal ganglia-thalamo-cortical circuit in Parkinson's disease in terms of the emergence of both abnormal firing rates and firing patterns in the circuit. We developed a potential landscape and flux framework for exploring the modulatory circuit. The driving force of the circuit can be decomposed into a gradient of the potential, which is associated with the steady-state probability distributions, and the curl probability flux term. We uncovered the underlying potential landscape as a Mexican hat-shape closed ring valley where abnormal oscillations emerge due to dopamine depletion. We quantified the global stability of the network through the topography of the landscape in terms of the barrier height, which is defined as the potential difference between the maximum potential inside the ring and the minimum potential along the ring. Both a higher barrier and a larger flux originated from detailed balance breaking result in more stable oscillations. Meanwhile, more energy is consumed to support the increasing flux. Global sensitivity analysis on the landscape topography and flux indicates how changes in underlying neural network regulatory wirings and external inputs influence the dynamics of the system. We validated two of the main hypotheses(direct inhibition hypothesis and output activation hypothesis) on the therapeutic mechanism of deep brain stimulation (DBS). We found GPe appears to be another effective stimulated target for DBS besides GPi and STN. Our approach provides a general way to quantitatively explore neural networks and may help for uncovering more efficacious therapies for movement disorders.
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Affiliation(s)
- Han Yan
- State Key Laboratory of Electroanalytical Chemistry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun, Jilin, P.R.China
| | - Jin Wang
- State Key Laboratory of Electroanalytical Chemistry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun, Jilin, P.R.China
- Department of Chemistry and Physics, State University of New York at Stony Brook, Stony Brook, New York, United States of America
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Lee KJ, Shim I, Sung JH, Hong JT, Kim IS, Cho CB. Striatal Glutamate and GABA after High Frequency Subthalamic Stimulation in Parkinsonian Rat. J Korean Neurosurg Soc 2017; 60:138-145. [PMID: 28264233 PMCID: PMC5365293 DOI: 10.3340/jkns.2016.0202.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 07/28/2016] [Accepted: 09/12/2016] [Indexed: 02/04/2023] Open
Abstract
Objective High frequency stimulation (HFS) of the subthalamic nucleus (STN) is recognized as an effective treatment of advanced Parkinson’s disease. However, the neurochemical basis of its effects remains unknown. The aim of this study is to investigate the effects of STN HFS in intact and 6-hydroxydopamine (6-OHDA)-lesioned hemiparkinsonian rat model on changes of principal neurotransmitters, glutamate, and gamma-aminobutyric acid (GABA) in the striatum. Methods The authors examined extracellular glutamate and GABA change in the striatum on sham group, 6-OHDA group, and 6-OHDA plus deep brain stimulation (DBS) group using microdialysis methods. Results High-pressure liquid chromatography was used to quantify glutamate and GABA. The results show that HFS-STN induces a significant increase of extracellular glutamate and GABA in the striatum of 6-OHDA plus DBS group compared with sham and 6-OHDA group. Conclusion Therefore, the clinical results of STN-HFS are not restricted to the direct STN targets but involve widespread adaptive changes within the basal ganglia.
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Affiliation(s)
- Kyung Jin Lee
- Department of Neurosurgery, Yeoido Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Insop Shim
- Acupuncture & Meridian Science Research Center, College of Oriental Medicine, Kyung Hee University, Seoul, Korea
| | - Jae Hoon Sung
- Department of Neurosurgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jae Taek Hong
- Department of Neurosurgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Il Sup Kim
- Department of Neurosurgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chul Bum Cho
- Department of Neurosurgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Heo H, Ahn JB, Lee HH, Kwon E, Yun JW, Kim H, Kang BC. Neurometabolic profiles of the substantia nigra and striatum of MPTP-intoxicated common marmosets: An in vivo proton MRS study at 9.4 T. NMR IN BIOMEDICINE 2017; 30:e3686. [PMID: 28028868 DOI: 10.1002/nbm.3686] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 11/16/2016] [Accepted: 11/22/2016] [Indexed: 06/06/2023]
Abstract
Given the strong coupling between the substantia nigra (SN) and striatum (STR) in the early stage of Parkinson's disease (PD), yet only a few studies reported to date that have simultaneously investigated the neurochemistry of these two brain regions in vivo, we performed longitudinal metabolic profiling in the SN and STR of 1-methyl-1,2,3,6-tetrahydropyridine (MPTP)-intoxicated common marmoset monkey models of PD (n = 10) by using proton MRS (1 H-MRS) at 9.4 T. T2 relaxometry was also performed in the SN by using MRI. Data were classified into control, MPTP_2weeks, and MPTP_6-10 weeks groups according to the treatment duration. In the SN, T2 of the MPTP_6-10 weeks group was lower than that of the control group (44.33 ± 1.75 versus 47.21 ± 2.47 ms, p < 0.05). The N-acetylaspartate to total creatine ratio (NAA/tCr) and γ-aminobutyric acid to tCr ratio (GABA/tCr) of the MPTP_6-10 weeks group were lower than those of the control group (0.41 ± 0.04 versus 0.54 ± 0.08 (p < 0.01) and 0.19 ± 0.03 versus 0.30 ± 0.09 (p < 0.05), respectively). The glutathione to tCr ratio (GSH/tCr) was correlated with T2 for the MPTP_6-10 weeks group (r = 0.83, p = 0.04). In the STR, however, GABA/tCr of the MPTP_6-10 weeks group was higher than that of the control group (0.25 ± 0.10 versus 0.16 ± 0.05, p < 0.05). These findings may be an in vivo depiction of the altered basal ganglion circuit in PD brain resulting from the degeneration of nigral dopaminergic neurons and disruption of nigrostriatal dopaminergic projections. Given the important role of non-human primates in translational studies, our findings provide better understanding of the complicated evolution of PD.
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Affiliation(s)
- Hwon Heo
- Department of Biomedical Sciences, Seoul National University, Seoul, South Korea
| | - Jae-Bum Ahn
- Department of Experimental Animal Research, Biomedical Research Institute, Seoul National University Hospital, Seoul, South Korea
- Graduate School of Translational Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Hyeong Hun Lee
- Department of Biomedical Sciences, Seoul National University, Seoul, South Korea
| | - Euna Kwon
- Department of Experimental Animal Research, Biomedical Research Institute, Seoul National University Hospital, Seoul, South Korea
| | - Jun-Won Yun
- Department of Experimental Animal Research, Biomedical Research Institute, Seoul National University Hospital, Seoul, South Korea
| | - Hyeonjin Kim
- Department of Biomedical Sciences, Seoul National University, Seoul, South Korea
- Department of Experimental Animal Research, Biomedical Research Institute, Seoul National University Hospital, Seoul, South Korea
- Department of Radiology, Seoul National University Hospital, Seoul, South Korea
- Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, South Korea
| | - Byeong-Cheol Kang
- Department of Experimental Animal Research, Biomedical Research Institute, Seoul National University Hospital, Seoul, South Korea
- Graduate School of Translational Medicine, Seoul National University College of Medicine, Seoul, South Korea
- Designed Animal and Transplantation Research Institute, Institute of GreenBio Science and Technology, Seoul National University, Pyeongchang, South Korea
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Stefani A, Trendafilov V, Liguori C, Fedele E, Galati S. Subthalamic nucleus deep brain stimulation on motor-symptoms of Parkinson's disease: Focus on neurochemistry. Prog Neurobiol 2017; 151:157-174. [PMID: 28159574 DOI: 10.1016/j.pneurobio.2017.01.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 01/20/2017] [Accepted: 01/22/2017] [Indexed: 12/19/2022]
Abstract
Deep brain stimulation (DBS) has become a standard therapy for Parkinson's disease (PD) and it is also currently under investigation for other neurological and psychiatric disorders. Although many scientific, clinical and ethical issues are still unresolved, DBS delivered into the subthalamic nucleus (STN) has improved the quality of life of several thousands of patients. The mechanisms underlying STN-DBS have been debated extensively in several reviews; less investigated are the biochemical consequences, which are still under scrutiny. Crucial and only partially understood, for instance, are the complex interplays occurring between STN-DBS and levodopa (LD)-centred therapy in the post-surgery follow-up. The main goal of this review is to address the question of whether an improved motor control, based on STN-DBS therapy, is also achieved through the additional modulation of other neurotransmitters, such as noradrenaline (NA) and serotonin (5-HT). A critical issue is to understand not only acute DBS-mediated effects, but also chronic changes, such as those involving cyclic nucleotides, capable of modulating circuit plasticity. The present article will discuss the neurochemical changes promoted by STN-DBS and will document the main results obtained in microdialysis studies. Furthermore, we will also examine the preliminary achievements of voltammetry applied to humans, and discuss new hypothetical investigational routes, taking into account novel players such as glia, or subcortical regions such as the pedunculopontine (PPN) area. Our further understanding of specific changes in brain chemistry promoted by STN-DBS would further disseminate its utilisation, at any stage of disease, avoiding an irreversible lesioning approach.
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Affiliation(s)
- A Stefani
- Department of System Medicine, University of Rome "Tor Vergata", Via Montpellier 1, 00133 Rome, Italy
| | - V Trendafilov
- Laboratory for Biomedical Neurosciences (LBN), Neurocenter of Southern Switzerland (NSI), Lugano, Switzerland
| | - C Liguori
- Department of System Medicine, University of Rome "Tor Vergata", Via Montpellier 1, 00133 Rome, Italy
| | - E Fedele
- Department of Pharmacy, Pharmacology and Toxicology Unit and Center of Excellence for Biomedical Research, University of Genoa, 16148 Genoa, Italy
| | - S Galati
- Laboratory for Biomedical Neurosciences (LBN), Neurocenter of Southern Switzerland (NSI), Lugano, Switzerland.
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Bologna M, Berardelli I, Paparella G, Marsili L, Ricciardi L, Fabbrini G, Berardelli A. Altered Kinematics of Facial Emotion Expression and Emotion Recognition Deficits Are Unrelated in Parkinson's Disease. Front Neurol 2016; 7:230. [PMID: 28018287 PMCID: PMC5155007 DOI: 10.3389/fneur.2016.00230] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 12/01/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Altered emotional processing, including reduced emotion facial expression and defective emotion recognition, has been reported in patients with Parkinson's disease (PD). However, few studies have objectively investigated facial expression abnormalities in PD using neurophysiological techniques. It is not known whether altered facial expression and recognition in PD are related. OBJECTIVE To investigate possible deficits in facial emotion expression and emotion recognition and their relationship, if any, in patients with PD. METHODS Eighteen patients with PD and 16 healthy controls were enrolled in this study. Facial expressions of emotion were recorded using a 3D optoelectronic system and analyzed using the facial action coding system. Possible deficits in emotion recognition were assessed using the Ekman test. Participants were assessed in one experimental session. Possible relationship between the kinematic variables of facial emotion expression, the Ekman test scores, and clinical and demographic data in patients were evaluated using the Spearman's test and multiple regression analysis. RESULTS The facial expression of all six basic emotions had slower velocity and lower amplitude in patients in comparison to healthy controls (all Ps < 0.05). Patients also yielded worse Ekman global score and disgust, sadness, and fear sub-scores than healthy controls (all Ps < 0.001). Altered facial expression kinematics and emotion recognition deficits were unrelated in patients (all Ps > 0.05). Finally, no relationship emerged between kinematic variables of facial emotion expression, the Ekman test scores, and clinical and demographic data in patients (all Ps > 0.05). CONCLUSION The results in this study provide further evidence of altered emotional processing in PD. The lack of any correlation between altered facial emotion expression kinematics and emotion recognition deficits in patients suggests that these abnormalities are mediated by separate pathophysiological mechanisms.
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Affiliation(s)
- Matteo Bologna
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy; Neuromed Institute IRCCS, Pozzilli, Isernia, Italy
| | - Isabella Berardelli
- Department of Neurology and Psychiatry, Sapienza University of Rome , Rome , Italy
| | - Giulia Paparella
- Department of Neurology and Psychiatry, Sapienza University of Rome , Rome , Italy
| | - Luca Marsili
- Department of Neurology and Psychiatry, Sapienza University of Rome , Rome , Italy
| | | | - Giovanni Fabbrini
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy; Neuromed Institute IRCCS, Pozzilli, Isernia, Italy
| | - Alfredo Berardelli
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy; Neuromed Institute IRCCS, Pozzilli, Isernia, Italy
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Srejic LR, Wood KM, Zeqja A, Hashemi P, Hutchison WD. Modulation of serotonin dynamics in the dorsal raphe nucleus via high frequency medial prefrontal cortex stimulation. Neurobiol Dis 2016; 94:129-38. [DOI: 10.1016/j.nbd.2016.06.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 04/28/2016] [Accepted: 06/16/2016] [Indexed: 01/04/2023] Open
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Mofakham S, Fink CG, Booth V, Zochowski MR. Interplay between excitability type and distributions of neuronal connectivity determines neuronal network synchronization. Phys Rev E 2016; 94:042427. [PMID: 27841569 PMCID: PMC5837280 DOI: 10.1103/physreve.94.042427] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Indexed: 11/07/2022]
Abstract
While the interplay between neuronal excitability properties and global properties of network topology is known to affect network propensity for synchronization, it is not clear how detailed characteristics of these properties affect spatiotemporal pattern formation. Here we study mixed networks, composed of neurons having type I and/or type II phase response curves, with varying distributions of local and random connections and show that not only average network properties, but also the connectivity distribution statistics, significantly affect network synchrony. Namely, we study networks with fixed networkwide properties, but vary the number of random connections that nodes project. We show that varying node excitability (type I vs type II) influences network synchrony most dramatically for systems with long-tailed distributions of the number of random connections per node. This indicates that a cluster of even a few highly rewired cells with a high propensity for synchronization can alter the degree of synchrony in the network as a whole. We show this effect generally on a network of coupled Kuramoto oscillators and investigate the impact of this effect more thoroughly in pulse-coupled networks of biophysical neurons.
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Affiliation(s)
- Sima Mofakham
- Biophysics Program, University of Michigan, Ann Arbor, Michigan 48109, USA
| | - Christian G Fink
- Physics and Astronomy Department and Neuroscience Program, Ohio Wesleyan University, Delaware, Ohio 43015, USA
| | - Victoria Booth
- Mathematics Department and Anesthesiology Department, University of Michigan, Ann Arbor, Michigan 48109, USA
| | - Michal R Zochowski
- Biophysics Program, University of Michigan, Ann Arbor, Michigan 48109, USA
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109, USA
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61
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Bradykinesia in early and advanced Parkinson's disease. J Neurol Sci 2016; 369:286-291. [DOI: 10.1016/j.jns.2016.08.028] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Revised: 07/24/2016] [Accepted: 08/12/2016] [Indexed: 11/22/2022]
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Zwart CR, Lamberts JT. Not all dopamine neurons are created equal: Functional heterogeneity of midbrain dopamine axons. Mov Disord 2016; 31:1481. [PMID: 27643922 DOI: 10.1002/mds.26801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 08/09/2016] [Accepted: 08/18/2016] [Indexed: 11/09/2022] Open
Affiliation(s)
- Colton R Zwart
- Department of Pharmaceutical Sciences, College of Pharmacy, Ferris State University, Big Rapids, Michigan, USA
| | - Jennifer T Lamberts
- Department of Pharmaceutical Sciences, College of Pharmacy, Ferris State University, Big Rapids, Michigan, USA
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Oliveira RDA, Sande de Souza LAP. Single-Joint Movements in Parkinson's Disease: A Pulse-Width and Pulse-Height Theory Review. J Mot Behav 2016; 49:235-243. [PMID: 27588412 DOI: 10.1080/00222895.2016.1204261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The process by which the brain controls single-joint movements (SJM) is still not well understood. Some studies have defined rules describing the duration and magnitude of the agonist and antagonist muscles. Therefore, the purpose of this study was to analyze scientific publications about the electromyographic characteristics of SJM performed by patients with Parkinson's disease. A bibliographical review of the years 1989-2015 was performed using keywords such as electromyography, upper limb, and Parkinson's disease. After applying the inclusion criteria, 8 articles were included for analysis. The literature indicates that despite the lack of studies, it is possible to assume that considering the SJM, those with Parkinson's disease only control the magnitude of electromyography activation, being consistent only with the pulse-height theory control.
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Affiliation(s)
- Rafael de Almeida Oliveira
- a Physical Education , Laboratory of Biomechanics and Motor Control, Federal University of Triangulo Mineiro , Uberaba , Brazil
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Subthalamic beta oscillations are attenuated after withdrawal of chronic high frequency neurostimulation in Parkinson's disease. Neurobiol Dis 2016; 96:22-30. [PMID: 27553876 DOI: 10.1016/j.nbd.2016.08.003] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 07/27/2016] [Accepted: 08/16/2016] [Indexed: 12/20/2022] Open
Abstract
Subthalamic nucleus (STN) local field potential (LFP) recordings demonstrate beta (13-30Hz) band oscillations in Parkinson's disease (PD) defined as elevations of spectral power. The amount of attenuation of beta band power on therapeutic levels of high frequency (HF) deep brain stimulation (DBS) and/or dopaminergic medication has been correlated with the degree of improvement in bradykinesia and rigidity from the therapy, which has led to the suggestion that elevated beta band power is a marker of PD motor disability. A fundamental question has not been answered: whether there is a prolonged attenuation of beta band power after withdrawal of chronic HF DBS and whether this is related to a lack of progression or even improvement in the underlying motor disability. Until now, in human PD subjects, STN LFP recordings were only attainable in the peri-operative period and after short periods of stimulation. For the first time, using an investigational, implanted sensing neurostimulator (Activa® PC+S, Medtronic, Inc.), STN LFPs and motor disability were recorded/assessed after withdrawal of chronic (6 and 12month) HF DBS in freely moving PD subjects. Beta band power was similar within 14s and 60min after stimulation was withdrawn, suggesting that "off therapy" experiments can be conducted almost immediately after stimulation is turned off. After withdrawal of 6 and 12months of STN DBS, beta band power was significantly lower (P<0.05 at 6 and 12months) and off therapy UPDRS scores were better (P<0.05 at 12months) compared to before DBS was started. The attenuation in beta band power was correlated with improvement in motor disability scores (P<0.05). These findings were supported by evidence of a gradual increase in beta band power in two unstimulated STNs after 24months and could not be explained by changes in lead impedance. This suggests that chronic HF DBS exerts long-term plasticity in the sensorimotor network, which may contribute to a lack of progression in underlying motor disability in PD.
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65
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Wilson D, Moehlis J. Isostable reduction with applications to time-dependent partial differential equations. Phys Rev E 2016; 94:012211. [PMID: 27575127 DOI: 10.1103/physreve.94.012211] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Indexed: 06/06/2023]
Abstract
Isostables and isostable reduction, analogous to isochrons and phase reduction for oscillatory systems, are useful in the study of nonlinear equations which asymptotically approach a stationary solution. In this work, we present a general method for isostable reduction of partial differential equations, with the potential power to reduce the dimensionality of a nonlinear system from infinity to 1. We illustrate the utility of this reduction by applying it to two different models with biological relevance. In the first example, isostable reduction of the Fokker-Planck equation provides the necessary framework to design a simple control strategy to desynchronize a population of pathologically synchronized oscillatory neurons, as might be relevant to Parkinson's disease. Another example analyzes a nonlinear reaction-diffusion equation with relevance to action potential propagation in a cardiac system.
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Affiliation(s)
- Dan Wilson
- Department of Mechanical Engineering, University of California, Santa Barbara, California 93106, USA
| | - Jeff Moehlis
- Department of Mechanical Engineering, University of California, Santa Barbara, California 93106, USA
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66
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Wichmann T, DeLong MR. Deep Brain Stimulation for Movement Disorders of Basal Ganglia Origin: Restoring Function or Functionality? Neurotherapeutics 2016; 13:264-83. [PMID: 26956115 PMCID: PMC4824026 DOI: 10.1007/s13311-016-0426-6] [Citation(s) in RCA: 95] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Deep brain stimulation (DBS) is highly effective for both hypo- and hyperkinetic movement disorders of basal ganglia origin. The clinical use of DBS is, in part, empiric, based on the experience with prior surgical ablative therapies for these disorders, and, in part, driven by scientific discoveries made decades ago. In this review, we consider anatomical and functional concepts of the basal ganglia relevant to our understanding of DBS mechanisms, as well as our current understanding of the pathophysiology of two of the most commonly DBS-treated conditions, Parkinson's disease and dystonia. Finally, we discuss the proposed mechanism(s) of action of DBS in restoring function in patients with movement disorders. The signs and symptoms of the various disorders appear to result from signature disordered activity in the basal ganglia output, which disrupts the activity in thalamocortical and brainstem networks. The available evidence suggests that the effects of DBS are strongly dependent on targeting sensorimotor portions of specific nodes of the basal ganglia-thalamocortical motor circuit, that is, the subthalamic nucleus and the internal segment of the globus pallidus. There is little evidence to suggest that DBS in patients with movement disorders restores normal basal ganglia functions (e.g., their role in movement or reinforcement learning). Instead, it appears that high-frequency DBS replaces the abnormal basal ganglia output with a more tolerable pattern, which helps to restore the functionality of downstream networks.
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Affiliation(s)
- Thomas Wichmann
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA.
- Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA.
| | - Mahlon R DeLong
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
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Bologna M, Suppa A, Conte A, Latorre A, Rothwell JC, Berardelli A. Are studies of motor cortex plasticity relevant in human patients with Parkinson’s disease? Clin Neurophysiol 2016; 127:50-59. [DOI: 10.1016/j.clinph.2015.02.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 02/08/2015] [Accepted: 02/11/2015] [Indexed: 10/23/2022]
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Wilson D, Moehlis J. Clustered Desynchronization from High-Frequency Deep Brain Stimulation. PLoS Comput Biol 2015; 11:e1004673. [PMID: 26713619 PMCID: PMC4694718 DOI: 10.1371/journal.pcbi.1004673] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 11/25/2015] [Indexed: 11/18/2022] Open
Abstract
While high-frequency deep brain stimulation is a well established treatment for Parkinson’s disease, its underlying mechanisms remain elusive. Here, we show that two competing hypotheses, desynchronization and entrainment in a population of model neurons, may not be mutually exclusive. We find that in a noisy group of phase oscillators, high frequency perturbations can separate the population into multiple clusters, each with a nearly identical proportion of the overall population. This phenomenon can be understood by studying maps of the underlying deterministic system and is guaranteed to be observed for small noise strengths. When we apply this framework to populations of Type I and Type II neurons, we observe clustered desynchronization at many pulsing frequencies. While high-frequency deep brain stimulation (DBS) is a decades old treatment for alleviating the motor symptoms Parkinsons disease, the way in which it alleviates these symptoms is not well understood. Making matters more complicated, some experimental results suggest that DBS works by making neurons fire more regularly, while other seemingly contradictory results suggest that DBS works by making neural firing patterns less synchronized. Here we present theoretical and numerical results with the potential to merge these competing hypotheses. For predictable DBS pulsing rates, in the presence of a small amount of noise, a population of neurons will split into distinct clusters, each containing a nearly identical proportion of the overall population. When we observe this clustering phenomenon, on a short time scale, neurons are entrained to high-frequency DBS pulsing, but on a long time scale, they desynchronize predictably.
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Affiliation(s)
- Dan Wilson
- Department of Mechanical Engineering, University of California, Santa Barbara, Santa Barbara, Calfornia, United States of America
- * E-mail:
| | - Jeff Moehlis
- Department of Mechanical Engineering, University of California, Santa Barbara, Santa Barbara, Calfornia, United States of America
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70
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Maurice N, Deltheil T, Melon C, Degos B, Mourre C, Amalric M, Kerkerian-Le Goff L. Bee Venom Alleviates Motor Deficits and Modulates the Transfer of Cortical Information through the Basal Ganglia in Rat Models of Parkinson's Disease. PLoS One 2015; 10:e0142838. [PMID: 26571268 PMCID: PMC4646345 DOI: 10.1371/journal.pone.0142838] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 10/27/2015] [Indexed: 11/19/2022] Open
Abstract
Recent evidence points to a neuroprotective action of bee venom on nigral dopamine neurons in animal models of Parkinson’s disease (PD). Here we examined whether bee venom also displays a symptomatic action by acting on the pathological functioning of the basal ganglia in rat PD models. Bee venom effects were assessed by combining motor behavior analyses and in vivo electrophysiological recordings in the substantia nigra pars reticulata (SNr, basal ganglia output structure) in pharmacological (neuroleptic treatment) and lesional (unilateral intranigral 6-hydroxydopamine injection) PD models. In the hemi-parkinsonian 6-hydroxydopamine lesion model, subchronic bee venom treatment significantly alleviates contralateral forelimb akinesia and apomorphine-induced rotations. Moreover, a single injection of bee venom reverses haloperidol-induced catalepsy, a pharmacological model reminiscent of parkinsonian akinetic deficit. This effect is mimicked by apamin, a blocker of small conductance Ca2+-activated K+ (SK) channels, and blocked by CyPPA, a positive modulator of these channels, suggesting the involvement of SK channels in the bee venom antiparkinsonian action. In vivo electrophysiological recordings in the substantia nigra pars reticulata (basal ganglia output structure) showed no significant effect of BV on the mean neuronal discharge frequency or pathological bursting activity. In contrast, analyses of the neuronal responses evoked by motor cortex stimulation show that bee venom reverses the 6-OHDA- and neuroleptic-induced biases in the influence exerted by the direct inhibitory and indirect excitatory striatonigral circuits. These data provide the first evidence for a beneficial action of bee venom on the pathological functioning of the cortico-basal ganglia circuits underlying motor PD symptoms with potential relevance to the symptomatic treatment of this disease.
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Affiliation(s)
- Nicolas Maurice
- Aix Marseille Université, CNRS, IBDM UMR 7288, Marseille, France
- * E-mail:
| | | | - Christophe Melon
- Aix Marseille Université, CNRS, IBDM UMR 7288, Marseille, France
| | - Bertrand Degos
- INSERM, CNRS, Collège de France, CIRB UMR 7241 U-1050, Paris, France
- APHP, Département des Maladies du Système Nerveux, Centre Expert Inter-Régional Ile de France de la Maladie de Parkinson, Hôpital Pitié-Salpêtrière, Paris, France
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71
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Perez XA. Preclinical Evidence for a Role of the Nicotinic Cholinergic System in Parkinson's Disease. Neuropsychol Rev 2015; 25:371-83. [PMID: 26553323 DOI: 10.1007/s11065-015-9303-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 11/02/2015] [Indexed: 10/22/2022]
Abstract
One of the primary deficits in Parkinson's disease (PD) is the loss of dopaminergic neurons in the substantia nigra pars compacta which leads to striatal dopaminergic deficits that underlie the motor symptoms associated with the disease. A plethora of animal models have been developed over the years to uncover the molecular alterations that lead to PD development. These models have provided valuable information on neurotransmitter pathways and mechanisms involved. One such a system is the nicotinic cholinergic system. Numerous studies show that nigrostriatal damage affects nicotinic receptor-mediated dopaminergic signaling; therefore therapeutic modulation of the nicotinic cholinergic system may offer a novel approach to manage PD. In fact, there is evidence showing that nicotinic receptor drugs may be useful as neuroprotective agents to prevent Parkinson's disease progression. Additional preclinical studies also show that nicotinic receptor drugs may be beneficial for the treatment of L-dopa induced dyskinesias. Here, we review preclinical findings supporting the idea that nicotinic receptors are valuable therapeutic targets for PD.
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Affiliation(s)
- Xiomara A Perez
- Center for Health Sciences, SRI International, 333 Ravenswood Ave, Menlo Park, CA, 94025, USA.
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72
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A fronto–striato–subthalamic–pallidal network for goal-directed and habitual inhibition. Nat Rev Neurosci 2015; 16:719-32. [DOI: 10.1038/nrn4038] [Citation(s) in RCA: 352] [Impact Index Per Article: 39.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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73
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Rothe T, Deliano M, Wójtowicz AM, Dvorzhak A, Harnack D, Paul S, Vagner T, Melnick I, Stark H, Grantyn R. Pathological gamma oscillations, impaired dopamine release, synapse loss and reduced dynamic range of unitary glutamatergic synaptic transmission in the striatum of hypokinetic Q175 Huntington mice. Neuroscience 2015; 311:519-38. [PMID: 26546830 DOI: 10.1016/j.neuroscience.2015.10.039] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 10/20/2015] [Accepted: 10/21/2015] [Indexed: 11/28/2022]
Abstract
Huntington's disease (HD) is a severe genetically inherited neurodegenerative disorder. Patients present with three principal phenotypes of motor symptoms: choreatic, hypokinetic-rigid and mixed. The Q175 mouse model of disease offers an opportunity to investigate the cellular basis of the hypokinetic-rigid form of HD. At the age of 1 year homozygote Q175 mice exhibited the following signs of hypokinesia: Reduced frequency of spontaneous movements on a precision balance at daytime (-55%), increased total time spent without movement in an open field (+42%), failures in the execution of unconditioned avoidance reactions (+32%), reduced ability for conditioned avoidance (-96%) and increased reaction times (+65%) in a shuttle box. Local field potential recordings revealed low-frequency gamma oscillations in the striatum as a characteristic feature of HD mice at rest. There was no significant loss of DARPP-32 immunolabeled striatal projection neurons (SPNs) although the level of DARPP-32 immunoreactivity was lower in HD. As a potential cause of hypokinesia, HD mice revealed a strong reduction in striatal KCl-induced dopamine release, accompanied by a decrease in the number of tyrosine hydroxylase-(TH)- and VMAT2-positive synaptic varicosities. The presynaptic TH fluorescence level was also reduced. Patch-clamp experiments were performed in slices from 1-year-old mice to record unitary EPSCs (uEPSCs) of presumed cortical origin in the absence of G-protein-mediated modulation. In HD mice, the maximal amplitudes of uEPSCs amounted to 69% of the WT level which matches the loss of VGluT1+/SYP+ synaptic terminals in immunostained sections. These results identify impairment of cortico-striatal synaptic transmission and dopamine release as a potential basis of hypokinesia in HD.
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Affiliation(s)
- T Rothe
- Leibniz Institute for Neurobiology Magdeburg, Germany
| | - M Deliano
- Leibniz Institute for Neurobiology Magdeburg, Germany
| | | | - A Dvorzhak
- Cluster of Excellence NeuroCure, Berlin, Germany
| | - D Harnack
- Department of Experimental Neurology, University Medicine Charité, Berlin, Germany
| | - S Paul
- Cluster of Excellence NeuroCure, Berlin, Germany
| | - T Vagner
- Cluster of Excellence NeuroCure, Berlin, Germany
| | - I Melnick
- Cluster of Excellence NeuroCure, Berlin, Germany; Bogomoletz Institute of Physiology, Kiev, Ukraine
| | - H Stark
- Leibniz Institute for Neurobiology Magdeburg, Germany
| | - R Grantyn
- Cluster of Excellence NeuroCure, Berlin, Germany; Department of Experimental Neurology, University Medicine Charité, Berlin, Germany.
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74
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Benninger DH, Hallett M. Non-invasive brain stimulation for Parkinson’s disease: Current concepts and outlook 2015. NeuroRehabilitation 2015; 37:11-24. [DOI: 10.3233/nre-151237] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- David H. Benninger
- Service de Neurologie, Départment des Neurosciences Cliniques, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Mark Hallett
- Medical Neurology Branch, National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), Bethesda, MD, USA
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75
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Affiliation(s)
- Alim Louis Benabid
- Clinatec–CEA, Edmond J Safra Research Center, CEA Grenoble, 17 avenue des Martyrs, Grenoble 38054, France
| | - Mahlon Delong
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - Marwan Hariz
- Institute of Neurology, University College London, London, UK
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76
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Woolley S, Kao M. Variability in action: Contributions of a songbird cortical-basal ganglia circuit to vocal motor learning and control. Neuroscience 2015; 296:39-47. [DOI: 10.1016/j.neuroscience.2014.10.010] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 10/07/2014] [Accepted: 10/08/2014] [Indexed: 10/24/2022]
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77
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Dagur G, Warren K, Schwamb R, Dalpiaz A, Gandhi J, Khan S. Neuro-urological manifestations of Parkinson's disease. Int J Neurosci 2015; 126:481-487. [DOI: 10.3109/00207454.2015.1048548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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78
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Mathai A, Ma Y, Paré JF, Villalba RM, Wichmann T, Smith Y. Reduced cortical innervation of the subthalamic nucleus in MPTP-treated parkinsonian monkeys. Brain 2015; 138:946-62. [PMID: 25681412 PMCID: PMC5014077 DOI: 10.1093/brain/awv018] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2014] [Revised: 11/30/2014] [Accepted: 12/05/2014] [Indexed: 11/12/2022] Open
Abstract
The striatum and the subthalamic nucleus are the main entry points for cortical information to the basal ganglia. Parkinson's disease affects not only the function, but also the morphological integrity of some of these inputs and their synaptic targets in the basal ganglia. Significant morphological changes in the cortico-striatal system have already been recognized in patients with Parkinson's disease and in animal models of the disease. To find out whether the primate cortico-subthalamic system is also subject to functionally relevant morphological alterations in parkinsonism, we used a combination of light and electron microscopy anatomical approaches and in vivo electrophysiological methods in monkeys rendered parkinsonian following chronic exposure to low doses of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). At the light microscopic level, the density of vesicular glutamate transporter 1-positive (i.e. cortico-subthalamic) profiles in the dorsolateral part of the subthalamic nucleus (i.e. its sensorimotor territory) was 26.1% lower in MPTP-treated parkinsonian monkeys than in controls. These results were confirmed by electron microscopy studies showing that the number of vesicular glutamate transporter 1-positive terminals and of axon terminals forming asymmetric synapses in the dorsolateral subthalamic nucleus was reduced by 55.1% and 27.9%, respectively, compared with controls. These anatomical findings were in line with in vivo electrophysiology data showing a 60% reduction in the proportion of pallidal neurons that responded to electrical stimulation of the cortico-subthalamic system in parkinsonian monkeys. These findings provide strong evidence for a partial loss of the hyperdirect cortico-subthalamic projection in MPTP-treated parkinsonian monkeys.
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Affiliation(s)
- Abraham Mathai
- 1 Yerkes National Primate Research Centre, Emory University, Atlanta, GA 30329, USA 2 Morris K. Udall Centre of Excellence for Parkinson's Disease Research, Emory University, Atlanta, GA 30329, USA
| | - Yuxian Ma
- 1 Yerkes National Primate Research Centre, Emory University, Atlanta, GA 30329, USA 2 Morris K. Udall Centre of Excellence for Parkinson's Disease Research, Emory University, Atlanta, GA 30329, USA
| | - Jean-Francois Paré
- 1 Yerkes National Primate Research Centre, Emory University, Atlanta, GA 30329, USA 2 Morris K. Udall Centre of Excellence for Parkinson's Disease Research, Emory University, Atlanta, GA 30329, USA
| | - Rosa M Villalba
- 1 Yerkes National Primate Research Centre, Emory University, Atlanta, GA 30329, USA 2 Morris K. Udall Centre of Excellence for Parkinson's Disease Research, Emory University, Atlanta, GA 30329, USA
| | - Thomas Wichmann
- 1 Yerkes National Primate Research Centre, Emory University, Atlanta, GA 30329, USA 2 Morris K. Udall Centre of Excellence for Parkinson's Disease Research, Emory University, Atlanta, GA 30329, USA 3 Department of Neurology, Emory University, Atlanta, GA 30322, USA
| | - Yoland Smith
- 1 Yerkes National Primate Research Centre, Emory University, Atlanta, GA 30329, USA 2 Morris K. Udall Centre of Excellence for Parkinson's Disease Research, Emory University, Atlanta, GA 30329, USA 3 Department of Neurology, Emory University, Atlanta, GA 30322, USA
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79
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Tremblay L, Worbe Y, Thobois S, Sgambato-Faure V, Féger J. Selective dysfunction of basal ganglia subterritories: From movement to behavioral disorders. Mov Disord 2015; 30:1155-70. [DOI: 10.1002/mds.26199] [Citation(s) in RCA: 144] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Revised: 01/14/2015] [Accepted: 02/06/2015] [Indexed: 12/14/2022] Open
Affiliation(s)
- Léon Tremblay
- Centre de Neurosciences Cognitives-UMR 5229; CNRS-Université de Lyon 1; Bron France
| | - Yulia Worbe
- UPMC Université Paris 6, UMR-S975, CRICM-Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière; Paris France
| | - Stéphane Thobois
- Centre de Neurosciences Cognitives-UMR 5229; CNRS-Université de Lyon 1; Bron France
- Hospices Civils de Lyon, Hopital Neurologique Pierre Wertheimer, Neurologie C; Lyon France
- Université de Lyon, Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Sud Charles Mérieux; Lyon France
| | | | - Jean Féger
- UPMC Université Paris 6, UMR-S975, CRICM-Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière; Paris France
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80
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Yoshida A, Tanaka M. Two Types of Neurons in the Primate Globus Pallidus External Segment Play Distinct Roles in Antisaccade Generation. Cereb Cortex 2015; 26:1187-99. [PMID: 25577577 DOI: 10.1093/cercor/bhu308] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The globus pallidus external segment (GPe) constitutes part of the indirect pathway of the basal ganglia. Because of inhibitory projections from the striatum, most GPe neurons are expected to reduce activity during movements. However, many GPe neurons in fact display increased activity. We previously found that both excitatory and inhibitory responses were modulated during antisaccades, when eyes were directed away from a visual stimulus. To elucidate the roles of these neurons during antisaccades, we examined neuronal activities as monkeys performed antisaccades, prosaccades, and NoGo tasks under 2 conditions. In the Deliberate condition, the task-rule was instructed by color of the fixation point, while in the Immediate condition, it was given by color of the target. Under both conditions, the increase-type neurons exhibited greater activity during antisaccades compared with the other tasks and neuronal activity negatively correlated with saccade latency. The decrease-type neurons also showed greater modulation during antisaccades but their activity was comparable between NoGo and antisaccade trials in the Immediate condition. These results suggest that the increase-type neurons might play a role in facilitating antisaccades, whereas the decrease-type neurons could mediate signals for reflexive saccade suppression. We propose that these GPe neurons are differently involved in basal ganglia pathways.
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Affiliation(s)
- Atsushi Yoshida
- Department of Physiology Department of Diagnostic and Interventional Radiology, Hokkaido University School of Medicine, Sapporo 060-8638, Japan
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81
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Amano S, Kegelmeyer D, Hong SL. Rethinking energy in parkinsonian motor symptoms: a potential role for neural metabolic deficits. Front Syst Neurosci 2015; 8:242. [PMID: 25610377 PMCID: PMC4285053 DOI: 10.3389/fnsys.2014.00242] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Accepted: 12/07/2014] [Indexed: 11/25/2022] Open
Abstract
Parkinson’s disease (PD) is characterized as a chronic and progressive neurodegenerative disorder that results in a variety of debilitating symptoms, including bradykinesia, resting tremor, rigidity, and postural instability. Research spanning several decades has emphasized basal ganglia dysfunction, predominantly resulting from dopaminergic (DA) cell loss, as the primarily cause of the aforementioned parkinsonian features. But, why those particular features manifest themselves remains an enigma. The goal of this paper is to develop a theoretical framework that parkinsonian motor features are behavioral consequence of a long-term adaptation to their inability (inflexibility or lack of capacity) to meet energetic demands, due to neural metabolic deficits arising from mitochondrial dysfunction associated with PD. Here, we discuss neurophysiological changes that are generally associated with PD, such as selective degeneration of DA neurons in the substantia nigra pars compacta (SNc), in conjunction with metabolic and mitochondrial dysfunction. We then characterize the cardinal motor symptoms of PD, bradykinesia, resting tremor, rigidity and gait disturbance, reviewing literature to demonstrate how these motor patterns are actually energy efficient from a metabolic perspective. We will also develop three testable hypotheses: (1) neural metabolic deficits precede the increased rate of neurodegeneration and onset of behavioral symptoms in PD; (2) motor behavior of persons with PD are more sensitive to changes in metabolic/bioenergetic state; and (3) improvement of metabolic function could lead to better motor performance in persons with PD. These hypotheses are designed to introduce a novel viewpoint that can elucidate the connections between metabolic, neural and motor function in PD.
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Affiliation(s)
- Shinichi Amano
- Department of Biomedical Sciences, Ohio University Athens, OH, USA ; Ohio Musculoskeletal and Neurological Institute, Ohio University Athens, OH, USA
| | - Deborah Kegelmeyer
- Division of Physical Therapy, College of Medicine, The Ohio State University Columbus, OH, USA
| | - S Lee Hong
- Department of Biomedical Sciences, Ohio University Athens, OH, USA ; Ohio Musculoskeletal and Neurological Institute, Ohio University Athens, OH, USA
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82
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Dopamine midbrain neurons in health and Parkinson’s disease: Emerging roles of voltage-gated calcium channels and ATP-sensitive potassium channels. Neuroscience 2015; 284:798-814. [DOI: 10.1016/j.neuroscience.2014.10.037] [Citation(s) in RCA: 104] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Revised: 10/20/2014] [Accepted: 10/22/2014] [Indexed: 12/14/2022]
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83
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Quik M, Bordia T, Zhang D, Perez XA. Nicotine and Nicotinic Receptor Drugs. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2015; 124:247-71. [DOI: 10.1016/bs.irn.2015.07.005] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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84
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Ebert M, Hauptmann C, Tass PA. Coordinated reset stimulation in a large-scale model of the STN-GPe circuit. Front Comput Neurosci 2014; 8:154. [PMID: 25505882 PMCID: PMC4245901 DOI: 10.3389/fncom.2014.00154] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Accepted: 11/05/2014] [Indexed: 11/15/2022] Open
Abstract
Synchronization of populations of neurons is a hallmark of several brain diseases. Coordinated reset (CR) stimulation is a model-based stimulation technique which specifically counteracts abnormal synchrony by desynchronization. Electrical CR stimulation, e.g., for the treatment of Parkinson's disease (PD), is administered via depth electrodes. In order to get a deeper understanding of this technique, we extended the top-down approach of previous studies and constructed a large-scale computational model of the respective brain areas. Furthermore, we took into account the spatial anatomical properties of the simulated brain structures and incorporated a detailed numerical representation of 2 · 104 simulated neurons. We simulated the subthalamic nucleus (STN) and the globus pallidus externus (GPe). Connections within the STN were governed by spike-timing dependent plasticity (STDP). In this way, we modeled the physiological and pathological activity of the considered brain structures. In particular, we investigated how plasticity could be exploited and how the model could be shifted from strongly synchronized (pathological) activity to strongly desynchronized (healthy) activity of the neuronal populations via CR stimulation of the STN neurons. Furthermore, we investigated the impact of specific stimulation parameters especially the electrode position on the stimulation outcome. Our model provides a step forward toward a biophysically realistic model of the brain areas relevant to the emergence of pathological neuronal activity in PD. Furthermore, our model constitutes a test bench for the optimization of both stimulation parameters and novel electrode geometries for efficient CR stimulation.
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Affiliation(s)
- Martin Ebert
- Institute of Neuroscience and Medicine - Neuromodulation, Juelich Research Center GmbH Juelich, Germany ; Department of Physics, Institute of Nuclear Physics, University of Cologne Cologne, Germany
| | - Christian Hauptmann
- Institute of Neuroscience and Medicine - Neuromodulation, Juelich Research Center GmbH Juelich, Germany
| | - Peter A Tass
- Institute of Neuroscience and Medicine - Neuromodulation, Juelich Research Center GmbH Juelich, Germany ; Department of Neurosurgery, Stanford University Stanford, CA, USA ; Department of Neuromodulation, University of Cologne Cologne, Germany
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85
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Dopamine agonist modifies cortical activity in Parkinson disease: a functional neuroimaging study. Clin Neuropharmacol 2014; 37:166-72. [PMID: 25384074 DOI: 10.1097/wnf.0000000000000052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To investigate, using functional magnetic resonance imaging, the influence of a long-term dopaminergic therapy on brain activation during a simple motor task in early, previously untreated patients with Parkinson disease. METHODS Thirteen patients with Parkinson disease in Hoehn-Yahr stage 1 or 2, with a right predominance of the disease, underwent functional magnetic resonance imaging during self-paced continuous right-hand tapping before and after 6 months of therapy with ropinirole 15 mg/d. The task was monitored online with a dedicated device, which measures the strength and frequency of the tapping. RESULTS All patients with Parkinson disease on ropinirole treatment showed a clinically significant improvement, and their functional magnetic resonance imaging pattern after treatment showed a reduced activation in the right postcentral (primary sensory-motor area), supramarginal and inferior parietal gyri compared with the activation pattern before treatment. No area of increased activation was observed after therapy. CONCLUSIONS In line with the classical functional deafferentation hypothesis, dopaminergic stimulation should increase motor cortex activity as a result of restoration of the striatocortical loops. On the contrary, our results challenge this hypothesis as we found decreased cerebral activity after a short-term chronic dopaminergic treatment. We suggest that the recruitment of cortical motor circuits aimed to overcome the functional deficit of the striatocortical loops lessens after dopaminergic treatment.
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86
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Abstract
Deep brain stimulation (DBS) has provided remarkable therapeutic benefits for people with a variety of neurological disorders. Despite the uncertainty of the precise mechanisms underlying its efficacy, DBS is clinically effective in improving motor function of essential tremor, Parkinson's disease and primary dystonia and in relieving obsessive-compulsive disorder. Recently, this surgical technique has continued to expand to other numerous neurological diseases with encouraging results. This review highlighted the current and potential future clinical applications of DBS.
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Affiliation(s)
- X L Chen
- Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Y Y Xiong
- Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - G L Xu
- Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - X F Liu
- Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
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87
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Zhang D, McGregor M, Decker MW, Quik M. The α7 nicotinic receptor agonist ABT-107 decreases L-Dopa-induced dyskinesias in parkinsonian monkeys. J Pharmacol Exp Ther 2014; 351:25-32. [PMID: 25034405 DOI: 10.1124/jpet.114.216283] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Previous studies in Parkinsonian rats and monkeys have shown that β2-selective nicotinic acetylcholine receptor (nAChR) agonists reduce l-Dopa-induced dyskinesias (LIDs), a serious complication of l-Dopa therapy for Parkinson's disease. Since rodent studies also suggested an involvement of α7 nAChRs in LIDs, we tested the effect of the potent, selective α7 agonist ABT-107 [5-(6-[(3R)-1-azabicyclo[2.2.2]oct-3-yloxy] pyridazin-3-yl)-1H-indole]. MPTP (1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine)-lesioned monkeys were gavaged with l-Dopa/carbidopa (10 and 2.5 mg/kg, respectively) twice daily, which resulted in stable LIDs. A dose-response study (0.03-1.0 mg/kg) showed that oral ABT-107 decreased LIDs by 40-60%. LIDs returned to control levels only after a 6-week ABT-107 washout, suggesting that long-term molecular changes were involved. Subsequent readministration of ABT-107 decreased LIDs by 50-60%, indicating that tolerance did not develop. ABT-107 had no effect on Parkinsonism or cognitive performance. We next tested ABT-107 together with the β2 agonist ABT-894 [(3-(5,6-dichloro-pyridin-3-yl)-1(S),5 (S)-3,6-diazabicyclo[3.2.0]heptane], previously shown to reduce LIDs in Parkinsonian monkeys. In one study, the monkeys were first given oral ABT-894 (0.01 mg/kg), which maximally decreased LIDs by 50-60%; they were then also treated with 0.1 mg/kg ABT-107, a dose that maximally reduced LIDs. The effect of combined treatment on LIDs was similar to that with either drug alone. Comparable results were observed in a group of monkeys first treated with ABT-107 and then also given ABT-894. Thus, α7 and β2 nAChR-selective drugs may function via a final common mechanism to reduce LIDs. The present results suggest that drugs targeting either α7 or β2 nAChRs may be useful as antidyskinetic agents in Parkinson's disease.
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Affiliation(s)
- Danhui Zhang
- Center for Health Sciences, SRI International, Menlo Park, California (D.Z., M.M., M.Q.); and AbbVie, Inc., North Chicago, Illinois (M.W.D.)
| | - Matthew McGregor
- Center for Health Sciences, SRI International, Menlo Park, California (D.Z., M.M., M.Q.); and AbbVie, Inc., North Chicago, Illinois (M.W.D.)
| | - Michael W Decker
- Center for Health Sciences, SRI International, Menlo Park, California (D.Z., M.M., M.Q.); and AbbVie, Inc., North Chicago, Illinois (M.W.D.)
| | - Maryka Quik
- Center for Health Sciences, SRI International, Menlo Park, California (D.Z., M.M., M.Q.); and AbbVie, Inc., North Chicago, Illinois (M.W.D.)
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88
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Wilson D, Moehlis J. Locally optimal extracellular stimulation for chaotic desynchronization of neural populations. J Comput Neurosci 2014; 37:243-57. [PMID: 24899243 PMCID: PMC4159599 DOI: 10.1007/s10827-014-0499-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2013] [Revised: 03/02/2014] [Accepted: 03/10/2014] [Indexed: 10/26/2022]
Abstract
We use optimal control theory to design a methodology to find locally optimal stimuli for desynchronization of a model of neurons with extracellular stimulation. This methodology yields stimuli which lead to positive Lyapunov exponents, and hence desynchronizes a neural population. We analyze this methodology in the presence of interneuron coupling to make predictions about the strength of stimulation required to overcome synchronizing effects of coupling. This methodology suggests a powerful alternative to pulsatile stimuli for deep brain stimulation as it uses less energy than pulsatile stimuli, and could eliminate the time consuming tuning process.
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Affiliation(s)
- Dan Wilson
- Department of Mechanical Engineering, University of California, Santa Barbara, CA, 93106, USA,
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89
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Tarazi FI, Sahli ZT, Wolny M, Mousa SA. Emerging therapies for Parkinson's disease: from bench to bedside. Pharmacol Ther 2014; 144:123-33. [PMID: 24854598 DOI: 10.1016/j.pharmthera.2014.05.010] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Accepted: 05/01/2014] [Indexed: 02/08/2023]
Abstract
The prevalence of Parkinson's disease (PD) increases with age and is projected to increase in parallel to the rising average age of the population. The disease can have significant health-related, social, and financial implications not only for the patient and the caregiver, but for the health care system as well. While the neuropathology of this neurodegenerative disorder is fairly well understood, its etiology remains a mystery, making it difficult to target therapy. The currently available drugs for treatment provide only symptomatic relief and do not control or prevent disease progression, and as a result patient compliance and satisfaction are low. Several emerging pharmacotherapies for PD are in different stages of clinical development. These therapies include adenosine A2A receptor antagonists, glutamate receptor antagonists, monoamine oxidase inhibitors, anti-apoptotic agents, and antioxidants such as coenzyme Q10, N-acetyl cysteine, and edaravone. Other emerging non-pharmacotherapies include viral vector gene therapy, microRNAs, transglutaminases, RTP801, stem cells and glial derived neurotrophic factor (GDNF). In addition, surgical procedures including deep brain stimulation, pallidotomy, thalamotomy and gamma knife surgery have emerged as alternative interventions for advanced PD patients who have completely utilized standard treatments and still suffer from persistent motor fluctuations. While several of these therapies hold much promise in delaying the onset of the disease and slowing its progression, more pharmacotherapies and surgical interventions need to be investigated in different stages of PD. It is hoped that these emerging therapies and surgical procedures will strengthen our clinical armamentarium for improved treatment of PD.
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Affiliation(s)
- F I Tarazi
- Department of Psychiatry and Neuroscience Program, Harvard Medical School, McLean Hospital, Belmont, MA 02478, USA.
| | - Z T Sahli
- Department of Psychiatry and Neuroscience Program, Harvard Medical School, McLean Hospital, Belmont, MA 02478, USA; School of Medicine, American University of Beirut, Beirut, Lebanon
| | - M Wolny
- The Pharmaceutical Research Institute at Albany College of Pharmacy and Health Sciences, Rensselaer, NY 12144, USA
| | - S A Mousa
- The Pharmaceutical Research Institute at Albany College of Pharmacy and Health Sciences, Rensselaer, NY 12144, USA
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90
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Quik M, Zhang D, Perez XA, Bordia T. Role for the nicotinic cholinergic system in movement disorders; therapeutic implications. Pharmacol Ther 2014; 144:50-9. [PMID: 24836728 DOI: 10.1016/j.pharmthera.2014.05.004] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Accepted: 04/23/2014] [Indexed: 01/04/2023]
Abstract
A large body of evidence using experimental animal models shows that the nicotinic cholinergic system is involved in the control of movement under physiological conditions. This work raised the question whether dysregulation of this system may contribute to motor dysfunction and whether drugs targeting nicotinic acetylcholine receptors (nAChRs) may be of therapeutic benefit in movement disorders. Accumulating preclinical studies now show that drugs acting at nAChRs improve drug-induced dyskinesias. The general nAChR agonist nicotine, as well as several nAChR agonists (varenicline, ABT-089 and ABT-894), reduces l-dopa-induced abnormal involuntary movements or dyskinesias up to 60% in parkinsonian nonhuman primates and rodents. These dyskinesias are potentially debilitating abnormal involuntary movements that arise as a complication of l-dopa therapy for Parkinson's disease. In addition, nicotine and varenicline decrease antipsychotic-induced abnormal involuntary movements in rodent models of tardive dyskinesia. Antipsychotic-induced dyskinesias frequently arise as a side effect of chronic drug treatment for schizophrenia, psychosis and other psychiatric disorders. Preclinical and clinical studies also show that the nAChR agonist varenicline improves balance and coordination in various ataxias. Lastly, nicotine has been reported to attenuate the dyskinetic symptoms of Tourette's disorder. Several nAChR subtypes appear to be involved in these beneficial effects of nicotine and nAChR drugs including α4β2*, α6β2* and α7 nAChRs (the asterisk indicates the possible presence of other subunits in the receptor). Overall, the above findings, coupled with nicotine's neuroprotective effects, suggest that nAChR drugs have potential for future drug development for movement disorders.
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Affiliation(s)
- Maryka Quik
- Center for Health Sciences, SRI International, 333 Ravenswood Ave., Menlo Park, CA 94025, USA.
| | - Danhui Zhang
- Center for Health Sciences, SRI International, 333 Ravenswood Ave., Menlo Park, CA 94025, USA
| | - Xiomara A Perez
- Center for Health Sciences, SRI International, 333 Ravenswood Ave., Menlo Park, CA 94025, USA
| | - Tanuja Bordia
- Center for Health Sciences, SRI International, 333 Ravenswood Ave., Menlo Park, CA 94025, USA
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91
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Nakanishi S, Hikida T, Yawata S. Distinct dopaminergic control of the direct and indirect pathways in reward-based and avoidance learning behaviors. Neuroscience 2014; 282:49-59. [PMID: 24769227 DOI: 10.1016/j.neuroscience.2014.04.026] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Revised: 04/01/2014] [Accepted: 04/16/2014] [Indexed: 01/13/2023]
Abstract
The nucleus accumbens (NAc) plays a pivotal role in reward and aversive learning and learning flexibility. Outputs of the NAc are transmitted through two parallel routes termed the direct and indirect pathways and controlled by the dopamine (DA) neurotransmitter. To explore how reward-based and avoidance learning is controlled in the NAc of the mouse, we developed the reversible neurotransmission-blocking (RNB) technique, in which transmission of each pathway could be selectively and reversibly blocked by the pathway-specific expression of transmission-blocking tetanus toxin and the asymmetric RNB technique, in which one side of the NAc was blocked by the RNB technique and the other intact side was pharmacologically manipulated by a transmitter agonist or antagonist. Our studies demonstrated that the activation of D1 receptors in the direct pathway and the inactivation of D2 receptors in the indirect pathway are key determinants that distinctly control reward-based and avoidance learning, respectively. The D2 receptor inactivation is also critical for flexibility of reward learning. Furthermore, reward and aversive learning is regulated by a set of common downstream receptors and signaling cascades, all of which are involved in the induction of long-term potentiation at cortico-accumbens synapses of the two pathways. In this article, we review our studies that specify the regulatory mechanisms of each pathway in learning behavior and propose a mechanistic model to explain how dynamic DA modulation promotes selection of actions that achieve reward-seeking outcomes and avoid aversive ones. The biological significance of the network organization consisting of two parallel transmission pathways is also discussed from the point of effective and prompt selection of neural outcomes in the neural network.
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Affiliation(s)
- S Nakanishi
- Department of Systems Biology, Osaka Bioscience Institute, 6-2-4 Furuedai, Suita, Osaka 565-0874, Japan.
| | - T Hikida
- Medical Innovation Center, Kyoto University Graduate School of Medicine, 53, Shogoin Kawahara-chou, Sakyo-ku, Kyoto 606-8507, Japan
| | - S Yawata
- Department of Systems Biology, Osaka Bioscience Institute, 6-2-4 Furuedai, Suita, Osaka 565-0874, Japan
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92
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Quantitative electromyographic analysis of reaction time to external auditory stimuli in drug-naïve Parkinson's disease. PARKINSONS DISEASE 2014; 2014:848035. [PMID: 24724037 PMCID: PMC3958792 DOI: 10.1155/2014/848035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 01/09/2014] [Indexed: 11/21/2022]
Abstract
Evaluation of motor symptoms in Parkinson's disease (PD) is still based on clinical rating scales by clinicians. Reaction time (RT) is the time interval between a specific stimulus and the start of muscle response. The aim of this study was to identify the characteristics of RT responses in PD patients using electromyography (EMG) and to elucidate the relationship between RT and clinical features of PD. The EMG activity of 31 PD patients was recorded during isometric muscle contraction. RT was defined as the time latency between an auditory beep and responsive EMG activity. PD patients demonstrated significant delays in both initiation and termination of muscle contraction compared with controls. Cardinal motor symptoms of PD were closely correlated with RT. RT was longer in more-affected side and in more-advanced PD stages. Frontal cognitive function, which is indicative of motor programming and movement regulation and perseveration, was also closely related with RT. In conclusion, greater RT is the characteristic motor features of PD and it could be used as a sensitive tool for motor function assessment in PD patients. Further investigations are required to clarify the clinical impact of the RT on the activity of daily living of patients with PD.
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93
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Albaugh DL, Shih YYI. Neural circuit modulation during deep brain stimulation at the subthalamic nucleus for Parkinson's disease: what have we learned from neuroimaging studies? Brain Connect 2014; 4:1-14. [PMID: 24147633 PMCID: PMC5349222 DOI: 10.1089/brain.2013.0193] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Deep brain stimulation (DBS) targeting the subthalamic nucleus (STN) represents a powerful clinical tool for the alleviation of many motor symptoms that are associated with Parkinson's disease. Despite its extensive use, the underlying therapeutic mechanisms of STN-DBS remain poorly understood. In the present review, we integrate and discuss recent literature examining the network effects of STN-DBS for Parkinson's disease, placing emphasis on neuroimaging findings, including functional magnetic resonance imaging, positron emission tomography, and single-photon emission computed tomography. These techniques enable the noninvasive detection of brain regions that are modulated by DBS on a whole-brain scale, representing a key experimental strength given the diffuse and far-reaching effects of electrical field stimulation. By examining these data in the context of multiple hypotheses of DBS action, generally developed through clinical and physiological observations, we define a multitude of consistencies and inconsistencies in the developing literature of this rapidly moving field.
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Affiliation(s)
- Daniel L. Albaugh
- Department of Neurology, University of North Carolina, Chapel Hill, North Carolina
- Biomedical Research Imaging Center, University of North Carolina, Chapel Hill, North Carolina
- Curriculum in Neurobiology, University of North Carolina, Chapel Hill, North Carolina
| | - Yen-Yu Ian Shih
- Department of Neurology, University of North Carolina, Chapel Hill, North Carolina
- Biomedical Research Imaging Center, University of North Carolina, Chapel Hill, North Carolina
- Curriculum in Neurobiology, University of North Carolina, Chapel Hill, North Carolina
- Department of Biomedical Engineering, University of North Carolina, Chapel Hill, North Carolina
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94
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95
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Parlato R, Liss B. How Parkinson's disease meets nucleolar stress. Biochim Biophys Acta Mol Basis Dis 2014; 1842:791-7. [PMID: 24412806 DOI: 10.1016/j.bbadis.2013.12.014] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Revised: 12/13/2013] [Accepted: 12/31/2013] [Indexed: 12/19/2022]
Abstract
Parkinson's disease (PD) is the second most common neurodegenerative disorder. Although the causes of PD are still not understood, aging is a predisposing factor and metabolic stress seems to be a common trigger. Interestingly, the response to stress conditions and quality control mechanisms is impaired in PD, as well as in other neurodegenerative disorders. Downregulation of rRNA transcription is one major strategy to maintain cellular homeostasis under stress conditions, as it limits energy consumption in disadvantageous circumstances. Altered rRNA transcription and disruption of nucleolar integrity are associated with neurodegenerative disorders, and with aging. Nucleolar stress can be triggered by genetic and epigenetic factors, and by specific signaling mechanisms, that are altered in neurodegenerative disorders. The consequences of neuronal nucleolar stress seem to depend on p53 function, the mammalian target of rapamycin (mTOR) activity and deregulation of protein translation. In this review, we will summarize findings identifying an emerging role of nucleolar stress for the onset and progression of in particular PD. Emphasis is given to similarities in molecular causes and consequences of nucleolar stress in other neurodegenerative disorders. The mechanisms by which nucleolar stress participates in PD could help identify novel risk factors, and develop new therapeutic strategies to slow down the progressive loss of neurons in neurodegenerative diseases. This article is part of a Special Issue entitled: Role of the Nucleolus in Human Disease.
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Affiliation(s)
- Rosanna Parlato
- Institute of Applied Physiology, University of Ulm, Ulm, Germany; Institute of Anatomy and Cell Biology, Department of Medical Biology, University of Heidelberg, Heidelberg, Germany; Dept. of Molecular Biology of the Cell I, DKFZ-ZMBH Alliance, German Cancer Research Center, Heidelberg, Germany.
| | - Birgit Liss
- Institute of Applied Physiology, University of Ulm, Ulm, Germany
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96
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Schjerling L, Hjermind LE, Jespersen B, Madsen FF, Brennum J, Jensen SR, Løkkegaard A, Karlsborg M. A randomized double-blind crossover trial comparing subthalamic and pallidal deep brain stimulation for dystonia. J Neurosurg 2013; 119:1537-45. [DOI: 10.3171/2013.8.jns13844] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Object
The authors' aim was to compare the subthalamic nucleus (STN) with the globus pallidus internus (GPi) as a stimulation target for deep brain stimulation (DBS) for medically refractory dystonia.
Methods
In a prospective double-blind crossover study, electrodes were bilaterally implanted in the STN and GPi of 12 patients with focal, multifocal, or generalized dystonia. Each patient was randomly selected to undergo initial bilateral stimulation of either the STN or the GPi for 6 months, followed by bilateral stimulation of the other nucleus for another 6 months. Preoperative and postoperative ratings were assessed by using the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) and video recordings. Quality of life was evaluated by using questionnaires (36-item Short Form Health Survey). Supplemental Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) scores were assessed for patients with focal dystonia (torticollis) by examining the video recordings.
Results
On average for all patients, DBS improved the BFMDRS movement scores (p < 0.05) and quality of life physical scores (p < 0.01). After stimulation of the STN, the mean 6-month improvement in BFMDRS movement score was 13.8 points; after stimulation of the GPi, this improvement was 9.1 points (p = 0.08). Quality of life did not differ significantly regardless of which nucleus was stimulated. All 12 patients accepted 6 months of stimulation of the STN, but only 7 accepted 6 months of stimulation of the GPi. Among those who rejected stimulation of the GPi, 3 accepted concomitant stimulation of both the STN and GPi for 6 months, resulting in improved quality of life physical and mental scores and BFMDRS movement scores. Among the 4 patients who were rated according to TWSTRS, after 6 months of stimulation of both the STN and GPi, TWSTRS scores improved by 4.7% after stimulation of the GPi and 50.8% after stimulation of the STN (p = 0.08).
Conclusions
The STN seems to be a well-accepted, safe, and promising stimulation target in the treatment of dystonia, but further studies are necessary before the optimal target can be concluded. Simultaneous stimulation of the STN and GPi should be further investigated. Clinical trial registration no.: KF 01-110/01 (Committees on Biomedical Research Ethics of the Capital Region of Denmark).
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Affiliation(s)
- Lisbeth Schjerling
- 1Department of Neurosurgery, Rigshospitalet, Copenhagen University Hospital
- 2Department of Emergency, Hilleroed Hospital, Copenhagen University Hospital
| | - Lena E. Hjermind
- 3Section of Neurogenetics, Memory Disorders Research Group, Department of Neurology, Rigshospitalet, Copenhagen University Hospital
- 4Department of Cellular and Molecular Medicine, Section of Neurogenetics, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Bo Jespersen
- 1Department of Neurosurgery, Rigshospitalet, Copenhagen University Hospital
| | - Flemming F. Madsen
- 1Department of Neurosurgery, Rigshospitalet, Copenhagen University Hospital
| | - Jannick Brennum
- 1Department of Neurosurgery, Rigshospitalet, Copenhagen University Hospital
| | - Steen R. Jensen
- 5Department of Neurology, Bispebjerg, Copenhagen University Hospital, Copenhagen, Denmark; and
| | - Annemette Løkkegaard
- 5Department of Neurology, Bispebjerg, Copenhagen University Hospital, Copenhagen, Denmark; and
| | - Merete Karlsborg
- 5Department of Neurology, Bispebjerg, Copenhagen University Hospital, Copenhagen, Denmark; and
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97
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Mehanna R, Lai EC. Deep brain stimulation in Parkinson's disease. Transl Neurodegener 2013; 2:22. [PMID: 24245947 PMCID: PMC4177536 DOI: 10.1186/2047-9158-2-22] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 11/11/2013] [Indexed: 11/10/2022] Open
Abstract
For the last 50 years, levodopa has been the cornerstone of Parkinson's disease management. However, a majority of patients develop motor complications a few years after therapy onset. Deep brain stimulation has been approved by the FDA as an adjunctive treatment in Parkinson disease, especially aimed at controlling these complications. However, the exact mechanism of action of deep brain stimulation, the best nucleus to target as well as the best timing for surgery are still debatable. We here provide an in-depth and critical review of the current literature on this topic.
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Affiliation(s)
| | - Eugene C Lai
- Department of Neurology, Houston Methodist Neurological Institute, 6560 Fannin, Suite 802, Houston 77030, TX, USA.
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98
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Subthalamic neurostimulation for Parkinson's disease with early fluctuations: balancing the risks and benefits. Lancet Neurol 2013; 12:1025-34. [PMID: 24050735 DOI: 10.1016/s1474-4422(13)70151-0] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Electrical stimulation of the subthalamic nucleus is an established treatment for patients with advanced Parkinson's disease with pharmacologically unresponsive fluctuations. Compared with pharmacological treatment, subthalamic neurostimulation significantly improves motor symptoms, particularly during the phases of poor response to drug treatment, and reduces the severity of dyskinesias. Importantly, it also significantly improves quality of life and other integral measures of disease severity. The treatment response can last for more than 10 years, although there is no evidence that levodopa-resistant symptoms are delayed by subthalamic neurostimulation. At present, the mean disease duration for patients at the time of implantation is 12 years. In a recent study (EARLYSTIM) in patients with a disease duration of 7·5 years and fluctuations for 1·5 years, similar improvements in clinical outcomes were reported. These findings suggest that neurostimulation of the subthalamic nucleus could be used earlier in the disease course for carefully selected patients if the benefits of the treatment are weighed against the surgical risks and the lifelong need for specialised care by an experienced team. As mobility is consistently improved during the times with poor mobility by reducing fluctuations and delaying levodopa-sensitive complications, we propose that this treatment changes the disease course.
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99
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Abstract
For the last 50 years, levodopa has been the cornerstone of Parkinson's disease management. However, a majority of patients develop motor complications a few years after therapy onset. Deep brain stimulation has been approved by the FDA as an adjunctive treatment in Parkinson disease, especially aimed at controlling these complications. However, the exact mechanism of action of deep brain stimulation, the best nucleus to target as well as the best timing for surgery are still debatable. We here provide an in-depth and critical review of the current literature on this topic.
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Affiliation(s)
| | - Eugene C Lai
- Department of Neurology, Houston Methodist Neurological Institute, 6560 Fannin, Suite 802, Houston 77030, TX, USA.
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100
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Schwab BC, Heida T, Zhao Y, Marani E, van Gils SA, van Wezel RJA. Synchrony in Parkinson's disease: importance of intrinsic properties of the external globus pallidus. Front Syst Neurosci 2013; 7:60. [PMID: 24109437 PMCID: PMC3789943 DOI: 10.3389/fnsys.2013.00060] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Accepted: 09/13/2013] [Indexed: 12/15/2022] Open
Abstract
The mechanisms for the emergence and transmission of synchronized oscillations in Parkinson's disease, which are potentially causal to motor deficits, remain debated. Aside from the motor cortex and the subthalamic nucleus, the external globus pallidus (GPe) has been shown to be essential for the maintenance of these oscillations and plays a major role in sculpting neural network activity in the basal ganglia (BG). While neural activity of the healthy GPe shows almost no correlations between pairs of neurons, prominent synchronization in the β frequency band arises after dopamine depletion. Several studies have proposed that this shift is due to network interactions between the different BG nuclei, including the GPe. However, recent studies demonstrate an important role for the properties of neurons within the GPe. In this review, we will discuss these intrinsic GPe properties and review proposed mechanisms for activity decorrelation within the dopamine-intact GPe. Failure of the GPe to desynchronize correlated inputs can be a possible explanation for synchronization in the whole BG. Potential triggers of synchronization involve the enhancement of GPe-GPe inhibition and changes in ion channel function in GPe neurons.
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Affiliation(s)
- Bettina C Schwab
- Applied Analysis and Mathematical Physics, MIRA Institute of Technical Medicine and Biomedical Technology, University of Twente Enschede, Netherlands ; Biomedical Signals and Systems, MIRA Institute of Technical Medicine and Biomedical Technology, University of Twente Enschede, Netherlands
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