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Yu R, Deochand C, Krotow A, Leão R, Tong M, Agarwal AR, Cadenas E, de la Monte SM. Tobacco Smoke-Induced Brain White Matter Myelin Dysfunction: Potential Co-Factor Role of Smoking in Neurodegeneration. J Alzheimers Dis 2016; 50:133-48. [PMID: 26639972 PMCID: PMC5577392 DOI: 10.3233/jad-150751] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Meta-analysis studies showed that smokers have increased risk for developing Alzheimer's disease (AD) compared with non-smokers, and neuroimaging studies revealed that smoking damages white matter structural integrity. OBJECTIVE The present study characterizes the effects of side-stream (second hand) cigarette smoke (CS) exposures on the expression of genes that regulate oligodendrocyte myelin-synthesis, maturation, and maintenance and neuroglial functions. METHODS Adult male A/J mice were exposed to air (8 weeks; A8), CS (4 or 8 weeks; CS4, CS8), or CS8 followed by 2 weeks recovery (CS8 + R). The frontal lobes were used for histology and qRT-PCR analysis. RESULTS Luxol fast blue, Hematoxylin and Eosin stained histological sections revealed CS-associated reductions in myelin staining intensity and narrowing of the corpus callosum. CS exposures broadly decreased mRNA levels of immature and mature oligodendrocyte myelin-associated, neuroglial, and oligodendrocyte-related transcription factors. These effects were more prominent in the CS8 compared with CS4 group, suggesting that molecular abnormalities linked to white matter atrophy and myelin loss worsen with duration of CS exposure. Recovery normalized or upregulated less than 25% of the suppressed genes; in most cases, inhibition of gene expression was either sustained or exacerbated. CONCLUSION CS exposures broadly inhibit expression of genes needed for myelin synthesis and maintenance. These adverse effects often were not reversed by short-term CS withdrawal. The results support the hypothesis that smoking contributes to white matter degeneration, and therefore could be a key risk factor for a number of neurodegenerative diseases, including AD.
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Affiliation(s)
- Rosa Yu
- Liver Research Center, Divisions of Rhode Island Hospital and the Warren Alpert Medical School of Brown University, Providence, RI, USA
- Gastroenterology and Rhode Island Hospital and the Warren Alpert Medical School of Brown University, Providence, RI, USA
- Medicine, Rhode Island Hospital and the Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Chetram Deochand
- Liver Research Center, Divisions of Rhode Island Hospital and the Warren Alpert Medical School of Brown University, Providence, RI, USA
- Gastroenterology and Rhode Island Hospital and the Warren Alpert Medical School of Brown University, Providence, RI, USA
- Medicine, Rhode Island Hospital and the Warren Alpert Medical School of Brown University, Providence, RI, USA
- Molecular Pharmacology and Physiology Graduate Program at Brown University, Providence, RI, USA
| | - Alexander Krotow
- Molecular Pharmacology and Physiology Graduate Program at Brown University, Providence, RI, USA
| | - Raiane Leão
- Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Ming Tong
- Liver Research Center, Divisions of Rhode Island Hospital and the Warren Alpert Medical School of Brown University, Providence, RI, USA
- Gastroenterology and Rhode Island Hospital and the Warren Alpert Medical School of Brown University, Providence, RI, USA
- Medicine, Rhode Island Hospital and the Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Amit R. Agarwal
- Department of Pharmacology and Pharmaceutical Sciences, School of Pharmacy, University of Southern California, Los Angeles, CA, USA
| | - Enrique Cadenas
- Department of Pharmacology and Pharmaceutical Sciences, School of Pharmacy, University of Southern California, Los Angeles, CA, USA
| | - Suzanne M. de la Monte
- Liver Research Center, Divisions of Rhode Island Hospital and the Warren Alpert Medical School of Brown University, Providence, RI, USA
- Gastroenterology and Rhode Island Hospital and the Warren Alpert Medical School of Brown University, Providence, RI, USA
- Neuropathology, and Departments of Rhode Island Hospital and the Warren Alpert Medical School of Brown University, Providence, RI, USA
- Medicine, Rhode Island Hospital and the Warren Alpert Medical School of Brown University, Providence, RI, USA
- Pathology, Rhode Island Hospital and the Warren Alpert Medical School of Brown University, Providence, RI, USA
- Neurology, Rhode Island Hospital and the Warren Alpert Medical School of Brown University, Providence, RI, USA
- Neurosurgery, Rhode Island Hospital and the Warren Alpert Medical School of Brown University, Providence, RI, USA
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Melzer TR, Myall DJ, MacAskill MR, Pitcher TL, Livingston L, Watts R, Keenan RJ, Dalrymple-Alford JC, Anderson TJ. Tracking Parkinson's Disease over One Year with Multimodal Magnetic Resonance Imaging in a Group of Older Patients with Moderate Disease. PLoS One 2015; 10:e0143923. [PMID: 26714266 PMCID: PMC4694717 DOI: 10.1371/journal.pone.0143923] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2015] [Accepted: 11/11/2015] [Indexed: 11/19/2022] Open
Abstract
Background & Objectives Cross-sectional magnetic resonance imaging (MRI) suggests that Parkinson’s disease (PD) is associated with changes in cerebral tissue volume, diffusion tensor imaging metrics, and perfusion values. Here, we performed a longitudinal multimodal MRI study—including structural, diffusion tensor imaging (DTI), and perfusion MRI—to investigate progressive brain changes over one year in a group of older PD patients at a moderate stage of disease. Methods Twenty-three non-demented PD (mean age (SD) = 69.5 (6.4) years, disease duration (SD) = 5.6 (4.3) years) and 23 matched control participants (mean age: 70.6 (6.8)) completed extensive neuropsychological and clinical assessment, and multimodal 3T MRI scanning at baseline and one year later. We used a voxel-based approach to assess change over time and group-by-time interactions for cerebral structural and perfusion metrics. Results Compared to controls, in PD participants there was localized grey matter atrophy over time in bilateral inferior and right middle temporal, and left orbito-frontal cortices. Using a voxel-based approach that focused on the centers of principal white matter tracts, the PD and control cohorts exhibited similar levels of change in DTI metrics. There was no significant change in perfusion, cognitive, or motor severity measures. Conclusions In a cohort of older, non-demented PD participants, macrostructural MRI detected atrophy in the PD group compared with the control group in temporal and orbito-frontal cortices. Changes in diffusion MRI along principal white matter tracts over one year were found, but this was not differentially affected by PD.
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Affiliation(s)
- Tracy R. Melzer
- New Zealand Brain Research Institute, Christchurch, New Zealand
- Department of Medicine, University of Otago, Christchurch, New Zealand
- * E-mail:
| | - Daniel J. Myall
- New Zealand Brain Research Institute, Christchurch, New Zealand
| | - Michael R. MacAskill
- New Zealand Brain Research Institute, Christchurch, New Zealand
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Toni L. Pitcher
- New Zealand Brain Research Institute, Christchurch, New Zealand
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Leslie Livingston
- New Zealand Brain Research Institute, Christchurch, New Zealand
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Richard Watts
- College of Medicine, University of Vermont, Burlington, VT, United States of America
| | - Ross J. Keenan
- New Zealand Brain Research Institute, Christchurch, New Zealand
- Christchurch Radiology Group, Christchurch, New Zealand
| | - John C. Dalrymple-Alford
- New Zealand Brain Research Institute, Christchurch, New Zealand
- Department of Medicine, University of Otago, Christchurch, New Zealand
- Department of Psychology, University of Canterbury, New Zealand
| | - Tim J. Anderson
- New Zealand Brain Research Institute, Christchurch, New Zealand
- Department of Medicine, University of Otago, Christchurch, New Zealand
- Department of Neurology, Christchurch Hospital, Christchurch, New Zealand
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Weingarten CP, Sundman MH, Hickey P, Chen NK. Neuroimaging of Parkinson's disease: Expanding views. Neurosci Biobehav Rev 2015; 59:16-52. [PMID: 26409344 PMCID: PMC4763948 DOI: 10.1016/j.neubiorev.2015.09.007] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 09/07/2015] [Accepted: 09/15/2015] [Indexed: 12/14/2022]
Abstract
Advances in molecular and structural and functional neuroimaging are rapidly expanding the complexity of neurobiological understanding of Parkinson's disease (PD). This review article begins with an introduction to PD neurobiology as a foundation for interpreting neuroimaging findings that may further lead to more integrated and comprehensive understanding of PD. Diverse areas of PD neuroimaging are then reviewed and summarized, including positron emission tomography, single photon emission computed tomography, magnetic resonance spectroscopy and imaging, transcranial sonography, magnetoencephalography, and multimodal imaging, with focus on human studies published over the last five years. These included studies on differential diagnosis, co-morbidity, genetic and prodromal PD, and treatments from L-DOPA to brain stimulation approaches, transplantation and gene therapies. Overall, neuroimaging has shown that PD is a neurodegenerative disorder involving many neurotransmitters, brain regions, structural and functional connections, and neurocognitive systems. A broad neurobiological understanding of PD will be essential for translational efforts to develop better treatments and preventive strategies. Many questions remain and we conclude with some suggestions for future directions of neuroimaging of PD.
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Affiliation(s)
- Carol P Weingarten
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, United States.
| | - Mark H Sundman
- Brain Imaging and Analysis Center, Duke University Medical Center, United States
| | - Patrick Hickey
- Department of Neurology, Duke University School of Medicine, United States
| | - Nan-kuei Chen
- Brain Imaging and Analysis Center, Duke University Medical Center, United States; Department of Radiology, Duke University School of Medicine, United States
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Goldman JG, Aggarwal NT, Schroeder CD. Mild cognitive impairment: an update in Parkinson's disease and lessons learned from Alzheimer's disease. Neurodegener Dis Manag 2015; 5:425-43. [PMID: 26517759 DOI: 10.2217/nmt.15.34] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Cognitive dysfunction is an important focus of research in Parkinson's disease (PD) and Alzheimer's disease (AD). While the concept of amnestic mild cognitive impairment (MCI) as a prodrome to AD has been recognized for many years, the construct of MCI in PD is a relative newcomer with recent development of diagnostic criteria, biomarker research programs and treatment trials. Controversies and challenges, however, regarding PD-MCI's definition, application, heterogeneity and different trajectories have arisen. This review will highlight current research advances and challenges in PD-MCI. Furthermore, lessons from the AD field, which has witnessed an evolution in MCI/AD definitions, relevant advances in biomarker research and development of disease-modifying and targeted therapeutic trials will be discussed.
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Affiliation(s)
- Jennifer G Goldman
- Rush University Medical Center, Department of Neurological Sciences, Section of Parkinson Disease & Movement Disorders, 1725 W. Harrison Street, Suite 755, Chicago, IL 60612, USA
| | - Neelum T Aggarwal
- Rush University Medical Center, Department of Neurological Sciences & Rush Alzheimer's Disease Center, 600 South Paulina, Suite 1038, Chicago, IL 60612, USA
| | - Cynthia D Schroeder
- Rush University Medical Center, Department of Neurological Sciences, 1735 W. Harrison Street, Suite 306, Chicago, IL 60612, USA
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Harrison IF, Crum WR, Vernon AC, Dexter DT. Neurorestoration induced by the HDAC inhibitor sodium valproate in the lactacystin model of Parkinson's is associated with histone acetylation and up-regulation of neurotrophic factors. Br J Pharmacol 2015; 172:4200-15. [PMID: 26040297 DOI: 10.1111/bph.13208] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Revised: 05/11/2015] [Accepted: 06/01/2015] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND AND PURPOSE Histone hypoacetylation is associated with Parkinson's disease (PD), due possibly to an imbalance in the activities of enzymes responsible for histone (de)acetylation; correction of which may be neuroprotective/neurorestorative. This hypothesis was tested using the anti-epileptic drug sodium valproate, a known histone deacetylase inhibitor (HDACI), utilizing a delayed-start study design in the lactacystin rat model of PD. EXPERIMENTAL APPROACH The irreversible proteasome inhibitor lactacystin was unilaterally injected into the substantia nigra of Sprague-Dawley rats that subsequently received valproate for 28 days starting 7 days after lactacystin lesioning. Longitudinal motor behavioural testing, structural MRI and post-mortem assessment of nigrostriatal integrity were used to track changes in this model of PD and quantify neuroprotection/restoration. Subsequent cellular and molecular analyses were performed to elucidate the mechanisms underlying valproate's effects. KEY RESULTS Despite producing a distinct pattern of structural re-modelling in the healthy and lactacystin-lesioned brain, delayed-start valproate administration induced dose-dependent neuroprotection/restoration against lactacystin neurotoxicity, characterized by motor deficit alleviation, attenuation of morphological brain changes and restoration of dopaminergic neurons in the substantia nigra. Molecular analyses revealed that valproate alleviated lactacystin-induced histone hypoacetylation and induced up-regulation of brain neurotrophic/neuroprotective factors. CONCLUSIONS AND IMPLICATIONS The histone acetylation and up-regulation of neurotrophic/neuroprotective factors associated with valproate treatment culminate in a neuroprotective and neurorestorative phenotype in this animal model of PD. As valproate induced structural re-modelling of the brain, further research is required to determine whether valproate represents a viable candidate for disease treatment; however, the results suggest that HDACIs could hold potential as disease-modifying agents in PD.
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Affiliation(s)
- Ian F Harrison
- UCL Centre for Advanced Biomedical Imaging, Division of Medicine, University College London, London, UK.,Parkinson's Disease Research Group, Centre for Neuroinflammation and Neurodegeneration, Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK
| | - William R Crum
- Department of Neuroimaging, The James Black Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Anthony C Vernon
- Department of Basic and Clinical Neuroscience, The James Black Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - David T Dexter
- Parkinson's Disease Research Group, Centre for Neuroinflammation and Neurodegeneration, Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK
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de Celis Alonso B, Hidalgo-Tobón SS, Menéndez-González M, Salas-Pacheco J, Arias-Carrión O. Magnetic Resonance Techniques Applied to the Diagnosis and Treatment of Parkinson's Disease. Front Neurol 2015; 6:146. [PMID: 26191037 PMCID: PMC4490248 DOI: 10.3389/fneur.2015.00146] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Accepted: 06/18/2015] [Indexed: 12/26/2022] Open
Abstract
Parkinson's disease (PD) affects at least 10 million people worldwide. It is a neurodegenerative disease, which is currently diagnosed by neurological examination. No neuroimaging investigation or blood biomarker is available to aid diagnosis and prognosis. Most effort toward diagnosis using magnetic resonance (MR) has been focused on the use of structural/anatomical neuroimaging and diffusion tensor imaging (DTI). However, deep brain stimulation, a current strategy for treating PD, is guided by MR imaging (MRI). For clinical prognosis, diagnosis, and follow-up investigations, blood oxygen level-dependent MRI, DTI, spectroscopy, and transcranial magnetic stimulation have been used. These techniques represent the state of the art in the last 5 years. Here, we focus on MR techniques for the diagnosis and treatment of Parkinson's disease.
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Affiliation(s)
- Benito de Celis Alonso
- Facultad de Ciencias Físico Matemáticas, Benemérita Universidad Autónoma de Puebla , Puebla , Mexico ; Fundación para el Desarrollo Carlos Sigüenza , Puebla , Mexico
| | - Silvia S Hidalgo-Tobón
- Departamento de Imagenología, Hospital Infantil de México "Federico Gómez" , Mexico City , Mexico ; Departamento de Física, Universidad Autónoma Metropolitana Iztapalapa , Mexico City , Mexico
| | | | - José Salas-Pacheco
- Instituto de Investigación Científica, Universidad Juárez del Estado de Durango , Durango , Mexico
| | - Oscar Arias-Carrión
- Unidad de Trastornos del Movimiento y Sueño (TMS), Hospital General Dr. Manuel Gea González , Mexico City , Mexico
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Cosgrove J, Alty JE, Jamieson S. Cognitive impairment in Parkinson's disease. Postgrad Med J 2015; 91:212-20. [PMID: 25814509 DOI: 10.1136/postgradmedj-2015-133247] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 02/26/2015] [Indexed: 11/03/2022]
Abstract
Cognitive impairment is a significant non-motor symptom of Parkinson's disease (PD). Longitudinal cohort studies have demonstrated that approximately 50% of those with PD develop dementia after 10 years, increasing to over 80% after 20 years. Deficits in cognition can be identified at the time of PD diagnosis in some patients and this mild cognitive impairment (PD-MCI) has been studied extensively over the last decade. Although PD-MCI is a risk factor for developing Parkinson's disease dementia there is evidence to suggest that PD-MCI might consist of distinct subtypes with different pathophysiologies and prognoses. The major pathological correlate of Parkinson's disease dementia is Lewy body deposition in the limbic system and neocortex although Alzheimer's related pathology is also an important contributor. Pathological damage causes alteration to neurotransmitter systems within the brain, producing behavioural change. Management of cognitive impairment in PD requires a multidisciplinary approach and accurate communication with patients and relatives is essential.
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Affiliation(s)
- Jeremy Cosgrove
- Department of Neurology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK Hull York Medical School, University of York, York, UK
| | - Jane Elizabeth Alty
- Department of Neurology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK Hull York Medical School, University of York, York, UK
| | - Stuart Jamieson
- Department of Neurology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK
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Vercruysse S, Leunissen I, Vervoort G, Vandenberghe W, Swinnen S, Nieuwboer A. Microstructural changes in white matter associated with freezing of gait in Parkinson's disease. Mov Disord 2015; 30:567-76. [PMID: 25640958 DOI: 10.1002/mds.26130] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2014] [Revised: 12/03/2014] [Accepted: 12/05/2014] [Indexed: 11/09/2022] Open
Abstract
In Parkinson's disease (PD), freezing of gait (FOG) is associated with widespread functional and structural gray matter changes throughout the brain. Previous study of freezing-related white matter changes was restricted to brainstem and cerebellar locomotor tracts. This study was undertaken to determine the spatial distribution of white matter damage associated with FOG by combining whole brain and striatofrontal seed-based diffusion tensor imaging. Diffusion-weighted images were collected in 26 PD patients and 16 age-matched controls. Parkinson's disease groups with (n = 11) and without freezing of gait (n = 15) were matched for age and disease severity. We applied tract-based spatial statistics to compare fractional anisotropy and mean diffusivity of white matter structure across the whole brain between groups. Probabilistic tractography was used to evaluate fractional anisotropy and mean diffusivity of key subcortico-cortical tracts. Tract-based spatial statistics revealed decreased fractional anisotropy in PD with FOG in bilateral cerebellar and superior longitudinal fascicle clusters. Increased mean diffusivity values were apparent in the right internal capsule, superior frontal cortex, anterior corona radiata, the left anterior thalamic radiation, and cerebellum. Tractography showed consistent white matter alterations in striatofrontal tracts through the putamen, caudate, pallidum, subthalamic nucleus, and in connections of the cerebellar peduncle with subthalamic nucleus and pedunculopontine nucleus bilaterally. We conclude that FOG is associated with diffuse white matter damage involving major cortico-cortical, corticofugal motor, and several striatofrontal tracts in addition to previously described cerebello-pontine connectivity changes. These distributed white matter abnormalities may contribute to the motor and non-motor correlates of FOG.
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Affiliation(s)
- Sarah Vercruysse
- Katholieke Universiteit Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
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Halliday GM, Leverenz JB, Schneider JS, Adler CH. The neurobiological basis of cognitive impairment in Parkinson's disease. Mov Disord 2014; 29:634-50. [PMID: 24757112 DOI: 10.1002/mds.25857] [Citation(s) in RCA: 240] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Revised: 02/08/2014] [Accepted: 02/13/2014] [Indexed: 12/13/2022] Open
Abstract
The recent formalization of clinical criteria for Parkinson's disease with dementia (PDD) codifies many studies on this topic, including those assessing biological correlates. These studies show that the emergence of PDD occurs on the background of severe dopamine deficits with, the main pathological drivers of cognitive decline being a synergistic effect between alpha-synuclein and Alzheimer's disease pathology. The presence of these pathologies correlates with a marked loss of limbic and cortically projecting dopamine, noradrenaline, serotonin, and acetylcholine neurons, although the exact timing of these relationships remains to be determined. Genetic factors, such as triplications in the α-synuclein gene, lead to a clear increased risk of PDD, whereas others, such as parkin mutations, are associated with a reduced risk of PDD. The very recent formalization of clinical criteria for PD with mild cognitive impairment (PD-MCI) allows only speculation on its biological and genetic bases. Critical assessment of animal models shows that chronic low-dose MPTP treatment in primates recapitulates PD-MCI over time, enhancing the current biological concept of PD-MCI as having enhanced dopamine deficiency in frontostriatal pathways as well as involvement of other neurotransmitter systems. Data from other animal models support multiple transmitter involvement in cognitive impairment in PD. Whereas dopamine dysfunction has been highlighted because of its obvious role in PD, the role of the other neurotransmitter systems, neurodegenerative pathologies, and genetic factors in PD-MCI remains to be fully elucidated.
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Affiliation(s)
- Glenda M Halliday
- Neuroscience Research Australia and the University of New South Wales, Sydney, Australia
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Kim SR, So HY, Choi E, Kang JH, Kim HY, Chung SJ. Influencing effect of non-motor symptom clusters on quality of life in Parkinson's disease. J Neurol Sci 2014; 347:310-5. [DOI: 10.1016/j.jns.2014.10.032] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Revised: 10/01/2014] [Accepted: 10/20/2014] [Indexed: 10/24/2022]
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Abstract
The basal ganglia were originally thought to be associated purely with motor control. However, dysfunction and pathology of different regions and circuits are now known to give rise to many clinical manifestations beyond the association of basal ganglia dysfunction with movement disorders. Moreover, disorders that were thought to be caused by dysfunction of the basal ganglia only, such as Parkinson's disease and Huntington's disease, have diverse abnormalities distributed not only in the brain but also in the peripheral and autonomic nervous systems; this knowledge poses new questions and challenges. We discuss advances and the unanswered questions, and ways in which progress might be made.
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Affiliation(s)
- Jose A Obeso
- Movement Disorders Laboratory, Department of Neurology and Neuroscience Area, Clínica Universitaria and Medical School, and CIMA, University of Navarra, Pamplona, Spain; Centro de Investigación en Redes sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.
| | - Maria C Rodriguez-Oroz
- Centro de Investigación en Redes sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain; Department of Neurology, University Hospital Donostia and Neuroscience Unit BioDonostia Research Institute, San Sebastian, Ikerbasque, Basque Foundation for Science, Bilbao, Spain
| | - Maria Stamelou
- Movement Disorders Clinic, Second Department of Neurology, Attiko Hospital, University of Athens, Greece; Sobell Department of Motor Neurosciences and Movement Disorders, UCL Institute of Neurology, London, UK
| | - Kailash P Bhatia
- Sobell Department of Motor Neurosciences and Movement Disorders, UCL Institute of Neurology, London, UK
| | - David J Burn
- Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, UK
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O'Callaghan C, Shine J, Lewis S, Hornberger M. Neuropsychiatric symptoms in Parkinson's disease: Fronto-striatal atrophy contributions. Parkinsonism Relat Disord 2014; 20:867-72. [DOI: 10.1016/j.parkreldis.2014.04.027] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 04/23/2014] [Accepted: 04/29/2014] [Indexed: 10/25/2022]
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Moore SF, Barker RA. Predictors of Parkinson's disease dementia: towards targeted therapies for a heterogeneous disease. Parkinsonism Relat Disord 2014; 20 Suppl 1:S104-7. [PMID: 24262158 DOI: 10.1016/s1353-8020(13)70026-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Parkinson's disease dementia (PDD) has become an increasing area of research as treatments for the motor features of Parkinson's disease (PD) have improved and the population of patients with PD grows and ages. If predictors could be used to identify a sub-population of patients at risk of developing an early PDD then research into its neuropathological basis and treatment could be more effectively targeted to specific individuals. At present the predictors with the most evidence have arisen from longitudinal studies tracking the development of dementia in populations of incident, newly diagnosed patients with PD. Evidence exists for predictors across multiple domains: clinical, biological, neuroimaging and genetic. Some of the most robust of these suggest that PDD may develop as the result of an age and tau dependent, posterior cortically based process driven in some cases by mutations in the gene for glucocerebrosidase (GBA). It is clear, though, that more research needs to be undertaken into finding reliable predictors of PDD. At present the best approach may be to combine a set of predictors already identified in order to provide a basis for understanding why and how it occurs. Through this, new therapeutic strategies may emerge.
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Affiliation(s)
- Sarah F Moore
- John Van Geest Centre for Brain Repair, University of Cambridge, Cambridge, CB2 0PY, UK.
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González-Redondo R, García-García D, Clavero P, Gasca-Salas C, García-Eulate R, Zubieta JL, Arbizu J, Obeso JA, Rodríguez-Oroz MC. Grey matter hypometabolism and atrophy in Parkinson's disease with cognitive impairment: a two-step process. ACTA ACUST UNITED AC 2014; 137:2356-67. [PMID: 24951642 DOI: 10.1093/brain/awu159] [Citation(s) in RCA: 100] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The pathophysiological process underlying cognitive decline in Parkinson's disease is not well understood. Cerebral atrophy and hypometabolism have been described in patients with Parkinson's disease and dementia or mild cognitive impairment with respect to control subjects. However, the exact relationships between atrophy and hypometabolism are still unclear. To determine the extension and topographical distribution of hypometabolism and atrophy in the different cognitive states of Parkinson's disease, we examined 46 patients with Parkinson's disease (19 female, 27 male; 71.7 ± 5.9 years old; 14.6 ± 4.2 years of disease evolution; modified Hoehn and Yahr mean stage 3.1 ± 0.7). Cognitive status was diagnosed as normal in 14 patients, as mild cognitive impairment in 17 and as dementia in 15 patients. Nineteen normal subjects (eight female, 11 male; 68.1 ± 3.2 years old) were included as controls. (18)F-fluorodeoxyglucose positron emission tomography and magnetic resonance imaging scans were obtained, co-registered, corrected for partial volume effect and spatially normalized to the Montreal Neurological Institute space in each subject. Smoothing was applied to the positron emission tomography and magnetic resonance imaging scans to equalize their effective smoothness and resolution (10 mm and 12 mm full-width at half-maximum and Gaussian kernel, respectively). Z-score maps for atrophy and for hypometabolism were obtained by comparing individual images to the data set of control subjects. For each group of patients, a paired Student's t-test was performed to statistically compare the two Z-map modalities (P < 0.05 false discovery rate corrected) using the direct voxel-based comparison technique. In patients with mild cognitive impairment, hypometabolism exceeded atrophy in the angular gyrus, occipital, orbital and anterior frontal lobes. In patients with dementia, the hypometabolic areas observed in the group with mild cognitive impairment were replaced by areas of atrophy, which were surrounded by extensive zones of hypometabolism. Areas where atrophy was more extended than hypometabolism were found in the precentral and supplementary motor areas in both patients with mild cognitive impairment and with dementia, and in the hippocampus and temporal lobe in patients with dementia. These findings suggest that there is a gradient of severity in cortical changes associated with the development of cognitive impairment in Parkinson's disease in which hypometabolism and atrophy represent consecutive stages of the same process in most of the cortical regions affected.
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Affiliation(s)
- Rafael González-Redondo
- 1 Department of Neurology, Clinica Universidad de Navarra Medical School, Pamplona, Spain2 Neuroscience Centre, CIMA, Pamplona, Spain3 Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - David García-García
- 2 Neuroscience Centre, CIMA, Pamplona, Spain3 Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Pedro Clavero
- 1 Department of Neurology, Clinica Universidad de Navarra Medical School, Pamplona, Spain2 Neuroscience Centre, CIMA, Pamplona, Spain3 Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Carmen Gasca-Salas
- 1 Department of Neurology, Clinica Universidad de Navarra Medical School, Pamplona, Spain2 Neuroscience Centre, CIMA, Pamplona, Spain3 Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Reyes García-Eulate
- 4 Department of Radiology, Clinica Universidad de Navarra Medical School, Pamplona, Spain
| | - José L Zubieta
- 4 Department of Radiology, Clinica Universidad de Navarra Medical School, Pamplona, Spain
| | - Javier Arbizu
- 5 Department of Nuclear Medicine, Clinica Universidad de Navarra Medical School, Pamplona, Spain
| | - José A Obeso
- 1 Department of Neurology, Clinica Universidad de Navarra Medical School, Pamplona, Spain2 Neuroscience Centre, CIMA, Pamplona, Spain3 Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - María C Rodríguez-Oroz
- 1 Department of Neurology, Clinica Universidad de Navarra Medical School, Pamplona, Spain2 Neuroscience Centre, CIMA, Pamplona, Spain3 Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
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Pereira JB, Svenningsson P, Weintraub D, Brønnick K, Lebedev A, Westman E, Aarsland D. Initial cognitive decline is associated with cortical thinning in early Parkinson disease. Neurology 2014; 82:2017-25. [PMID: 24808018 DOI: 10.1212/wnl.0000000000000483] [Citation(s) in RCA: 138] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Our aim was to assess cortical thickness in a large multicenter cohort of drug-naive patients with early Parkinson disease (PD), with and without mild cognitive impairment (MCI), and explore the cognitive correlates of regional cortical thinning. METHODS One hundred twenty-three newly diagnosed patients with PD and 56 healthy controls with 3-tesla structural MRI scans and complete neuropsychological assessment from the Parkinson's Progression Markers Initiative were included. Modified Movement Disorders Society Task Force level II criteria were applied to diagnose MCI in PD. FreeSurfer image processing and analysis software was used to measure cortical thickness across groups and the association with cognitive domains and tests. RESULTS In patients with MCI, atrophy was found in temporal, parietal, frontal, and occipital areas compared with controls. Specific regional thinning in the right inferior temporal cortex was also found in cognitively normal patients. Memory, executive, and visuospatial performance was associated with temporoparietal and superior frontal thinning, suggesting a relationship between cognitive impairment and both anterior and posterior cortical atrophy in the whole patient sample. CONCLUSIONS These findings confirm that MCI is associated with widespread cortical atrophy. In addition, they suggest that regional cortical thinning is already present at the time of diagnosis in patients with early, untreated PD who do not meet the criteria for MCI. Together, the results indicate that cortical thinning can serve as a marker for initial cognitive decline in early PD.
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Affiliation(s)
- Joana B Pereira
- From the Department of Neurobiology, Care Sciences and Society (J.B.P., E.W.), and Centre for Alzheimer's Disease Research, Department of Neurobiology, Care Sciences and Society (D.A.), Karolinska Institutet, Stockholm; Centre for Molecular Medicine (P.S.), Department of Neurology and Clinical Neuroscience, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden; Department of Psychiatry and Neurology (D.W.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia VA Medical Center; and The Norwegian Center for Movement Disorders (K.B.), and Centre for Age-Related Medicine, Department of Psychiatry (A.L., D.A.), Stavanger University Hospital, Stavanger, Norway.
| | - Per Svenningsson
- From the Department of Neurobiology, Care Sciences and Society (J.B.P., E.W.), and Centre for Alzheimer's Disease Research, Department of Neurobiology, Care Sciences and Society (D.A.), Karolinska Institutet, Stockholm; Centre for Molecular Medicine (P.S.), Department of Neurology and Clinical Neuroscience, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden; Department of Psychiatry and Neurology (D.W.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia VA Medical Center; and The Norwegian Center for Movement Disorders (K.B.), and Centre for Age-Related Medicine, Department of Psychiatry (A.L., D.A.), Stavanger University Hospital, Stavanger, Norway
| | - Daniel Weintraub
- From the Department of Neurobiology, Care Sciences and Society (J.B.P., E.W.), and Centre for Alzheimer's Disease Research, Department of Neurobiology, Care Sciences and Society (D.A.), Karolinska Institutet, Stockholm; Centre for Molecular Medicine (P.S.), Department of Neurology and Clinical Neuroscience, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden; Department of Psychiatry and Neurology (D.W.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia VA Medical Center; and The Norwegian Center for Movement Disorders (K.B.), and Centre for Age-Related Medicine, Department of Psychiatry (A.L., D.A.), Stavanger University Hospital, Stavanger, Norway
| | - Kolbjørn Brønnick
- From the Department of Neurobiology, Care Sciences and Society (J.B.P., E.W.), and Centre for Alzheimer's Disease Research, Department of Neurobiology, Care Sciences and Society (D.A.), Karolinska Institutet, Stockholm; Centre for Molecular Medicine (P.S.), Department of Neurology and Clinical Neuroscience, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden; Department of Psychiatry and Neurology (D.W.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia VA Medical Center; and The Norwegian Center for Movement Disorders (K.B.), and Centre for Age-Related Medicine, Department of Psychiatry (A.L., D.A.), Stavanger University Hospital, Stavanger, Norway
| | - Alexander Lebedev
- From the Department of Neurobiology, Care Sciences and Society (J.B.P., E.W.), and Centre for Alzheimer's Disease Research, Department of Neurobiology, Care Sciences and Society (D.A.), Karolinska Institutet, Stockholm; Centre for Molecular Medicine (P.S.), Department of Neurology and Clinical Neuroscience, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden; Department of Psychiatry and Neurology (D.W.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia VA Medical Center; and The Norwegian Center for Movement Disorders (K.B.), and Centre for Age-Related Medicine, Department of Psychiatry (A.L., D.A.), Stavanger University Hospital, Stavanger, Norway
| | - Eric Westman
- From the Department of Neurobiology, Care Sciences and Society (J.B.P., E.W.), and Centre for Alzheimer's Disease Research, Department of Neurobiology, Care Sciences and Society (D.A.), Karolinska Institutet, Stockholm; Centre for Molecular Medicine (P.S.), Department of Neurology and Clinical Neuroscience, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden; Department of Psychiatry and Neurology (D.W.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia VA Medical Center; and The Norwegian Center for Movement Disorders (K.B.), and Centre for Age-Related Medicine, Department of Psychiatry (A.L., D.A.), Stavanger University Hospital, Stavanger, Norway
| | - Dag Aarsland
- From the Department of Neurobiology, Care Sciences and Society (J.B.P., E.W.), and Centre for Alzheimer's Disease Research, Department of Neurobiology, Care Sciences and Society (D.A.), Karolinska Institutet, Stockholm; Centre for Molecular Medicine (P.S.), Department of Neurology and Clinical Neuroscience, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden; Department of Psychiatry and Neurology (D.W.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia VA Medical Center; and The Norwegian Center for Movement Disorders (K.B.), and Centre for Age-Related Medicine, Department of Psychiatry (A.L., D.A.), Stavanger University Hospital, Stavanger, Norway
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Goldman JG, Stebbins GT, Dinh V, Bernard B, Merkitch D, deToledo-Morrell L, Goetz CG. Visuoperceptive region atrophy independent of cognitive status in patients with Parkinson's disease with hallucinations. ACTA ACUST UNITED AC 2014; 137:849-59. [PMID: 24480486 DOI: 10.1093/brain/awt360] [Citation(s) in RCA: 115] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Visual hallucinations are frequent, disabling complications of advanced Parkinson's disease, but their neuroanatomical basis is incompletely understood. Previous structural brain magnetic resonance imaging studies suggest volume loss in the mesial temporal lobe and limbic regions in subjects with Parkinson's disease with visual hallucinations, relative to those without visual hallucinations. However, these studies have not always controlled for the presence of cognitive impairment or dementia, which are common co-morbidities of hallucinations in Parkinson's disease and whose neuroanatomical substrates may involve mesial temporal lobe and limbic regions. Therefore, we used structural magnetic resonance imaging to examine grey matter atrophy patterns associated with visual hallucinations, comparing Parkinson's disease hallucinators to Parkinson's disease non-hallucinators of comparable cognitive function. We studied 50 subjects with Parkinson's disease: 25 classified as current and chronic visual hallucinators and 25 as non-hallucinators, who were matched for cognitive status (demented or non-demented) and age (± 3 years). Subjects underwent (i) clinical evaluations; and (ii) brain MRI scans analysed using whole-brain voxel-based morphometry techniques. Clinically, the Parkinson's disease hallucinators did not differ in their cognitive classification or performance in any of the five assessed cognitive domains, compared with the non-hallucinators. The Parkinson's disease groups also did not differ significantly in age, motor severity, medication use or duration of disease. On imaging analyses, the hallucinators, all of whom experienced visual hallucinations, exhibited grey matter atrophy with significant voxel-wise differences in the cuneus, lingual and fusiform gyri, middle occipital lobe, inferior parietal lobule, and also cingulate, paracentral, and precentral gyri, compared with the non-hallucinators. Grey matter atrophy in the hallucinators occurred predominantly in brain regions responsible for processing visuoperceptual information including the ventral 'what' and dorsal 'where' pathways, which are important in object and facial recognition and identification of spatial locations of objects, respectively. Furthermore, the structural brain changes seen on magnetic resonance imaging occurred independently of cognitive function and age. Our findings suggest that when hallucinators and non-hallucinators are similar in their cognitive performance, the neural networks involving visuoperceptual pathways, rather than the mesial temporal lobe regions, distinctively contribute to the pathophysiology of visual hallucinations and may explain their predominantly visual nature in Parkinson's disease. Identification of distinct structural MRI differences associated with hallucinations in Parkinson's disease may permit earlier detection of at-risk patients and ultimately, development of therapies specifically targeting hallucinations and visuoperceptive functions.
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Affiliation(s)
- Jennifer G Goldman
- 1 Rush University Medical Center, Department of Neurological Sciences, Chicago, IL, USA
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Uchida SI, Kadowaki-Horita T, Kanda T. Effects of the adenosine A2A receptor antagonist on cognitive dysfunction in Parkinson's disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2014; 119:169-89. [PMID: 25175966 DOI: 10.1016/b978-0-12-801022-8.00008-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Parkinson's disease (PD) is primarily characterized by motor abnormalities, but cognitive changes also occur in the early and late stages of the disease process. In PD patients, cognitive dysfunction is associated with reduced quality of life, as well as increased morbidity and mortality, resulting in increases in caregiver burden, and health-related costs. Therefore, safe and effective approaches are needed to treat cognitive dysfunction in PD patients. The underlying pathophysiology of cognitive dysfunction is complex and not fully understood, however. α-Synuclein, amyloid-related proteins, and cholinergic deficits have been reported to partially contribute to cognitive dysfunction. Changes in cortical dopamine (DA) content may also be responsible for early cognitive changes in patients with PD. Certainly, dopaminergic afferents to the frontal cortex degenerate in PD, and there is a reduction of DA content in the prefrontal cortex (PFC). It has also been reported that PFC dopaminergic input plays an important role in working memory performance. Moreover, PFC DA levels and working memory performance are significantly reduced by a 6-hydroxydopamine lesion in the PFC of a rat. Recent findings in the areas of pharmacological manipulation and genetic ablation suggest that the adenosine A2A receptor is also related to cognitive functions, especially working memory. In addition, the blockade of adenosine A2A receptors reverses cognitive dysfunction in PFC-lesioned rats, and this blocking effect may be due to an increase in PFC DA content. Therefore, adenosine A2A receptor antagonists not only improve motor performance, but they may also lead to improved cognitive function in those with PD.
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Affiliation(s)
- Shin-ichi Uchida
- Central Nervous System Research Laboratories, Research & Development Division, Kyowa Hakko Kirin Co., Ltd., Sunto-gun, Shizuoka, Japan.
| | - Takako Kadowaki-Horita
- Central Nervous System Research Laboratories, Research & Development Division, Kyowa Hakko Kirin Co., Ltd., Sunto-gun, Shizuoka, Japan
| | - Tomoyuki Kanda
- Central Nervous System Research Laboratories, Research & Development Division, Kyowa Hakko Kirin Co., Ltd., Sunto-gun, Shizuoka, Japan
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Early morphological brain abnormalities in patients with amnestic mild cognitive impairment. Transl Neurosci 2014. [DOI: 10.2478/s13380-014-0234-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
AbstractPatients with amnestic mild cognitive impairment (aMCI) are at an increased risk of further deterioration and eventually developing Alzheimer’s disease (AD). Therefore, the identification of specific markers for this disease such as radiological markers is of great diagnostic and clinical significance. Our previous work has shown that magnetic resonance imaging (MRI) is a powerful tool to identify unique imaging features in patients with aMCI. Herein, we calculated the gray matter volume by structural magnetic resonance imaging (sMRI), and spontaneous low frequency fluctuations (LFF) using resting-state functional MRI (rs-fMRI) in 11 patients with aMCI and 22 normal control patients. Compared with the control group, patients with aMCI showed significant reduction of gray matter volume in the inferior frontal gyrus, inferior parietal lobule, anterior cingulated cortex, and insula and superior temporal gyrus. Patients with aMCI also showed significantly lower amplitudes of low-frequency fluctuations (ALFF) in the posterior cingulate cortex, precuneus, temporal gyrus and inferior parietal lobule when compared with the control group. However, in several other brain regions including the occipital lobe and cerebellum, the ALFF in patients with aMCI was significantly increased. The variation in ALFF between the two groups remained significant after adjustment for structural differences. Our results obtained in this pilot study are consistent with our previous finding and collectively show that patients with aMCI have abnormal MRI imaging findings. The pathological basis of these imaging features in patients with aMCI needs to be further explored.
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O'Callaghan C, Moustafa AA, de Wit S, Shine JM, Robbins TW, Lewis SJG, Hornberger M. Fronto-striatal gray matter contributions to discrimination learning in Parkinson's disease. Front Comput Neurosci 2013; 7:180. [PMID: 24376416 PMCID: PMC3859902 DOI: 10.3389/fncom.2013.00180] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Accepted: 11/25/2013] [Indexed: 11/13/2022] Open
Abstract
Discrimination learning deficits in Parkinson's disease (PD) have been well-established. Using both behavioral patient studies and computational approaches, these deficits have typically been attributed to dopamine imbalance across the basal ganglia. However, this explanation of impaired learning in PD does not account for the possible contribution of other pathological changes that occur in the disease process, importantly including gray matter loss. To address this gap in the literature, the current study explored the relationship between fronto-striatal gray matter atrophy and learning in PD. We employed a discrimination learning task and computational modeling in order to assess learning rates in non-demented PD patients. Behaviorally, we confirmed that learning rates were reduced in patients relative to controls. Furthermore, voxel-based morphometry imaging analysis demonstrated that this learning impairment was directly related to gray matter loss in discrete fronto-striatal regions (specifically, the ventromedial prefrontal cortex, inferior frontal gyrus and nucleus accumbens). These findings suggest that dopaminergic imbalance may not be the sole determinant of discrimination learning deficits in PD, and highlight the importance of factoring in the broader pathological changes when constructing models of learning in PD.
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Affiliation(s)
- Claire O'Callaghan
- Neuroscience Research AustraliaSydney, NSW, Australia
- Faculty of Medicine, School of Medical Sciences, University of New South WalesSydney, NSW, Australia
| | - Ahmed A. Moustafa
- School of Social Sciences and Psychology and the Marcs Institute for Brain and Behaviour, University of Western SydneySydney, NSW, Australia
| | - Sanne de Wit
- Cognitive Science Center Amsterdam and Department of Clinical Psychology, University of AmsterdamAmsterdam, Netherlands
| | - James M. Shine
- Parkinson's Disease Clinic, Brain and Mind Research Institute, University of SydneySydney, NSW, Australia
| | - Trevor W. Robbins
- Department of Psychology, Behavioural and Clinical Neuroscience Institute, University of CambridgeCambridge, UK
| | - Simon J. G. Lewis
- Parkinson's Disease Clinic, Brain and Mind Research Institute, University of SydneySydney, NSW, Australia
| | - Michael Hornberger
- Neuroscience Research AustraliaSydney, NSW, Australia
- Faculty of Medicine, School of Medical Sciences, University of New South WalesSydney, NSW, Australia
- ARC Centre of Excellence in Cognition and its DisordersSydney, NSW, Australia
- Department of Clinical Neurosciences, University of CambridgeCambridge, UK
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Ellfolk U, Joutsa J, Rinne JO, Parkkola R, Jokinen P, Karrasch M. Striatal volume is related to phonemic verbal fluency but not to semantic or alternating verbal fluency in early Parkinson's disease. J Neural Transm (Vienna) 2013; 121:33-40. [PMID: 23913130 PMCID: PMC3889690 DOI: 10.1007/s00702-013-1073-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Accepted: 07/22/2013] [Indexed: 12/13/2022]
Abstract
Verbal fluency impairments are frequent in Parkinson’s disease (PD) and they may be present already at early stages. Semantic fluency impairment is associated with Parkinson’s disease dementia and temporal, frontal and cerebellar cortical changes. Few studies have addressed cerebral structural correlates of different verbal fluency tasks in early stage PD. We therefore studied gray matter volumes of T1-weighted MRI images using voxel-based morphometry in relation to semantic, phonemic, and alternating verbal fluency in younger (mean age <65 years), early stage (mean disease duration <3 years), non-demented PD patients (n = 28) and healthy controls (n = 27). We found a significant association between worse phonemic fluency and smaller striatal, namely right caudate gray matter volume in the PD group only (family-wise error corrected p = 0.007). Reduced semantic fluency was associated with smaller gray matter volumes in left parietal cortex (p = 0.037) and at trend level with smaller bilateral cerebellum gray matter volume across groups (p = 0.062), but not in the separate PD or control groups. There were no significant relationships between alternating fluency and gray matter volumes in the whole sample or in the groups separately. The fact that phonemic fluency, but not semantic or alternating fluency, was associated with caudate gray matter volume at early stage PD suggests that different fluency tasks rely on different neural substrates, and that language networks supporting semantic search and verbal-semantic switching are unrelated to brain gray matter volume at early disease stages in PD.
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Affiliation(s)
- Ulla Ellfolk
- Department of Psychology and Logopedics, Abo Akademi University, 20500, Turku, Finland,
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Melzer TR. The evolution of diffusion tensor imaging in Parkinson's disease research. Mov Disord 2013; 28:1316. [DOI: 10.1002/mds.25566] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Accepted: 05/16/2013] [Indexed: 11/10/2022] Open
Affiliation(s)
- Tracy R. Melzer
- New Zealand Brain Research Institute; Christchurch New Zealand
- Department of Medicine; University of Otago; Christchurch New Zealand
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Biomarkers in Parkinson's disease (recent update). Neurochem Int 2013; 63:201-29. [PMID: 23791710 DOI: 10.1016/j.neuint.2013.06.005] [Citation(s) in RCA: 141] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Revised: 05/31/2013] [Accepted: 06/06/2013] [Indexed: 12/22/2022]
Abstract
Parkinson's disease (PD) is the second most common neurodegenerative disorder mostly affecting the aging population over sixty. Cardinal symptoms including, tremors, muscle rigidity, drooping posture, drooling, walking difficulty, and autonomic symptoms appear when a significant number of nigrostriatal dopaminergic neurons are already destroyed. Hence we need early, sensitive, specific, and economical peripheral and/or central biomarker(s) for the differential diagnosis, prognosis, and treatment of PD. These can be classified as clinical, biochemical, genetic, proteomic, and neuroimaging biomarkers. Novel discoveries of genetic as well as nongenetic biomarkers may be utilized for the personalized treatment of PD during preclinical (premotor) and clinical (motor) stages. Premotor biomarkers including hyper-echogenicity of substantia nigra, olfactory and autonomic dysfunction, depression, hyposmia, deafness, REM sleep disorder, and impulsive behavior may be noticed during preclinical stage. Neuroimaging biomarkers (PET, SPECT, MRI), and neuropsychological deficits can facilitate differential diagnosis. Single-cell profiling of dopaminergic neurons has identified pyridoxal kinase and lysosomal ATPase as biomarker genes for PD prognosis. Promising biomarkers include: fluid biomarkers, neuromelanin antibodies, pathological forms of α-Syn, DJ-1, amyloid β and tau in the CSF, patterns of gene expression, metabolomics, urate, as well as protein profiling in the blood and CSF samples. Reduced brain regional N-acetyl-aspartate is a biomarker for the in vivo assessment of neuronal loss using magnetic resonance spectroscopy and T2 relaxation time with MRI. To confirm PD diagnosis, the PET biomarkers include [(18)F]-DOPA for estimating dopaminergic neurotransmission, [(18)F]dG for mitochondrial bioenergetics, [(18)F]BMS for mitochondrial complex-1, [(11)C](R)-PK11195 for microglial activation, SPECT imaging with (123)Iflupane and βCIT for dopamine transporter, and urinary salsolinol and 8-hydroxy, 2-deoxyguanosine for neuronal loss. This brief review describes the merits and limitations of recently discovered biomarkers and proposes coenzyme Q10, mitochondrial ubiquinone-NADH oxidoreductase, melatonin, α-synculein index, Charnoly body, and metallothioneins as novel biomarkers to confirm PD diagnosis for early and effective treatment of PD.
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