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Chu HY, Smith Y, Lytton WW, Grafton S, Villalba R, Masilamoni G, Wichmann T. Dysfunction of motor cortices in Parkinson's disease. Cereb Cortex 2024; 34:bhae294. [PMID: 39066504 PMCID: PMC11281850 DOI: 10.1093/cercor/bhae294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 06/26/2024] [Accepted: 07/19/2024] [Indexed: 07/28/2024] Open
Abstract
The cerebral cortex has long been thought to be involved in the pathophysiology of motor symptoms of Parkinson's disease. The impaired cortical function is believed to be a direct and immediate effect of pathologically patterned basal ganglia output, mediated to the cerebral cortex by way of the ventral motor thalamus. However, recent studies in humans with Parkinson's disease and in animal models of the disease have provided strong evidence suggesting that the involvement of the cerebral cortex is much broader than merely serving as a passive conduit for subcortical disturbances. In the present review, we discuss Parkinson's disease-related changes in frontal cortical motor regions, focusing on neuropathology, plasticity, changes in neurotransmission, and altered network interactions. We will also examine recent studies exploring the cortical circuits as potential targets for neuromodulation to treat Parkinson's disease.
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Affiliation(s)
- Hong-Yuan Chu
- Aligning Science Across Parkinson’s (ASAP) Collaborative Research Network, Chevy Chase, MD 20815, United States
- Department of Pharmacology and Physiology, Georgetown University Medical Center, 3900 Reservoir Rd N.W., Washington D.C. 20007, United States
| | - Yoland Smith
- Aligning Science Across Parkinson’s (ASAP) Collaborative Research Network, Chevy Chase, MD 20815, United States
- Department of Neurology, School of Medicine, Emory University, 12 Executive Drive N.E., Atlanta, GA 30329, United States
- Emory National Primate Research Center, 954 Gatewood Road N.E., Emory University, Atlanta, GA 30329, United States
| | - William W Lytton
- Aligning Science Across Parkinson’s (ASAP) Collaborative Research Network, Chevy Chase, MD 20815, United States
- Department of Physiology & Pharmacology, SUNY Downstate Medical Center, 450 Clarkson Avenue, Brooklyn, NY 11203, United States
- Department of Neurology, Kings County Hospital, 451 Clarkson Avenue,Brooklyn, NY 11203, United States
| | - Scott Grafton
- Aligning Science Across Parkinson’s (ASAP) Collaborative Research Network, Chevy Chase, MD 20815, United States
- Department of Psychological and Brain Sciences, University of California, 551 UCEN Road, Santa Barbara, CA 93106, United States
| | - Rosa Villalba
- Aligning Science Across Parkinson’s (ASAP) Collaborative Research Network, Chevy Chase, MD 20815, United States
- Emory National Primate Research Center, 954 Gatewood Road N.E., Emory University, Atlanta, GA 30329, United States
| | - Gunasingh Masilamoni
- Aligning Science Across Parkinson’s (ASAP) Collaborative Research Network, Chevy Chase, MD 20815, United States
- Emory National Primate Research Center, 954 Gatewood Road N.E., Emory University, Atlanta, GA 30329, United States
| | - Thomas Wichmann
- Aligning Science Across Parkinson’s (ASAP) Collaborative Research Network, Chevy Chase, MD 20815, United States
- Department of Neurology, School of Medicine, Emory University, 12 Executive Drive N.E., Atlanta, GA 30329, United States
- Emory National Primate Research Center, 954 Gatewood Road N.E., Emory University, Atlanta, GA 30329, United States
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Peng Y, Wang Z. Differential Cortical and Subcortical Activations during Different Stages of Muscle Control: A Functional Magnetic Resonance Imaging Study. Brain Sci 2024; 14:404. [PMID: 38672052 PMCID: PMC11048703 DOI: 10.3390/brainsci14040404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 04/16/2024] [Accepted: 04/19/2024] [Indexed: 04/28/2024] Open
Abstract
Movement and muscle control are crucial for the survival of all free-living organisms. This study aimed to explore differential patterns of cortical and subcortical activation across different stages of muscle control using functional magnetic resonance imaging (fMRI). An event-related design was employed. In each trial, participants (n = 10) were instructed to gently press a button with their right index finger, hold it naturally for several seconds, and then relax the finger. Neural activation in these temporally separated stages was analyzed using a General Linear Model. Our findings revealed that a widely distributed cortical network, including the supplementary motor area and insula, was implicated not only in the pressing stage, but also in the relaxation stage, while only parts of the network were involved in the steady holding stage. Moreover, supporting the direct/indirect pathway model of the subcortical basal ganglia, their substructures played distinct roles in different stages of muscle control. The caudate nucleus exhibited greater involvement in muscle contraction, whereas the putamen demonstrated a stronger association with muscle relaxation; both structures were implicated in the pressing stage. Furthermore, the subthalamic nucleus was exclusively engaged during the muscle relaxation stage. We conclude that even the control of simple muscle movements involves intricate automatic higher sensory-motor integration at a neural level, particularly when coordinating relative muscle movements, including both muscle contraction and muscle relaxation; the cortical and subcortical regions assume distinct yet coordinated roles across different stages of muscle control.
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Affiliation(s)
- Yu Peng
- Key Laboratory of Brain Functional Genomics (MOE & STCSM), Institute of Cognitive Neuroscience, School of Psychology and Cognitive Science, East China Normal University, Shanghai 200062, China;
| | - Zhaoxin Wang
- Key Laboratory of Brain Functional Genomics (MOE & STCSM), Institute of Cognitive Neuroscience, School of Psychology and Cognitive Science, East China Normal University, Shanghai 200062, China;
- Shanghai Changning Mental Health Center, Shanghai 200355, China
- Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai 200062, China
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Chung JW, Bower AE, Malik I, Martello JP, Knight CA, Jeka JJ, Burciu RG. fMRI changes during multi-limb movements in Parkinson's disease. Front Hum Neurosci 2023; 17:1248636. [PMID: 38021235 PMCID: PMC10665733 DOI: 10.3389/fnhum.2023.1248636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 09/29/2023] [Indexed: 12/01/2023] Open
Abstract
BackgroundWhile motor coordination problems are frequently reported among individuals with Parkinson’s disease (PD), the effects of the disease on the performance of multi-limb movements and the brain changes underlying impaired coordination are not well-documented.ObjectiveFunctional magnetic resonance imaging (fMRI) was used to examine differences in brain activity during a task that involved the coordination of non-homologous limbs (i.e., ipsilateral hand and foot) in individuals with and without PD.MethodsParticipants included 20 PD and 20 healthy control participants (HC). They were instructed to generate force in a coordinated manner by simultaneously contracting their ipsilateral hand and foot. PD were tested off their antiparkinsonian medication and on their more affected side, whereas the side in controls was randomized.ResultsAlthough both groups were able to coordinate the two limbs to produce the expected level of force, PD had a slower rate of force production and relaxation compared to HC. Additionally, their globus pallidus and primary motor cortex were underactive, whereas their pre-supplementary motor area (pre-SMA) and lateral cerebellum were overactive relative to HC. Importantly, in PD, the fMRI activity within the pre-SMA correlated with the rate of force decrease.ConclusionMulti-limb force control deficits in PD appear to be related to widespread underactivation within the basal ganglia-cortical loop. An overactivation of higher-level motor regions within the prefrontal cortex and lateral cerebellum may reflect increased cognitive control and performance monitoring that emerges during more complex motor tasks such as those that involve the coordination of multiple limbs.
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Affiliation(s)
- Jae Woo Chung
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States
| | - Abigail E. Bower
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States
| | - Ibrahim Malik
- Center for Biomedical and Brain Imaging, University of Delaware, Newark, DE, United States
| | - Justin P. Martello
- Department of Neurosciences, Christiana Care Health System, Newark, DE, United States
| | - Christopher A. Knight
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States
- Interdisciplinary Neuroscience Graduate Program, University of Delaware, Newark, DE, United States
| | - John J. Jeka
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States
- Interdisciplinary Neuroscience Graduate Program, University of Delaware, Newark, DE, United States
| | - Roxana G. Burciu
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States
- Interdisciplinary Neuroscience Graduate Program, University of Delaware, Newark, DE, United States
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de Albuquerque LL, Pantovic M, Clingo M, Fischer K, Jalene S, Landers M, Mari Z, Poston B. A Single Application of Cerebellar Transcranial Direct Current Stimulation Fails to Enhance Motor Skill Acquisition in Parkinson's Disease: A Pilot Study. Biomedicines 2023; 11:2219. [PMID: 37626716 PMCID: PMC10452618 DOI: 10.3390/biomedicines11082219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 08/01/2023] [Accepted: 08/04/2023] [Indexed: 08/27/2023] Open
Abstract
Parkinson's disease (PD) is a progressive neurodegenerative disorder that leads to numerous impairments in motor function that compromise the ability to perform activities of daily living. Practical and effective adjunct therapies are needed to complement current treatment approaches in PD. Transcranial direct current stimulation applied to the cerebellum (c-tDCS) can increase motor skill in young and older adults. Because the cerebellum is involved in PD pathology, c-tDCS application during motor practice could potentially enhance motor skill in PD. The primary purpose was to examine the influence of c-tDCS on motor skill acquisition in a complex, visuomotor isometric precision grip task (PGT) in PD in the OFF-medication state. The secondary purpose was to determine the influence of c-tDCS on transfer of motor skill in PD. The study utilized a double-blind, SHAM-controlled, within-subjects design. A total of 16 participants completed a c-tDCS condition and a SHAM condition in two experimental sessions separated by a 7-day washout period. Each session involved practice of the PGT concurrent with either c-tDCS or SHAM. Additionally, motor transfer tasks were quantified before and after the practice and stimulation period. The force error in the PGT was not significantly different between the c-tDCS and SHAM conditions. Similarly, transfer task performance was not significantly different between the c-tDCS and SHAM conditions. These findings indicate that a single session of c-tDCS does not elicit acute improvements in motor skill acquisition or transfer in hand and arm tasks in PD while participants are off medications.
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Affiliation(s)
- Lidio Lima de Albuquerque
- School of Health and Applied Human Sciences, University of North Carolina Wilmington, Wilmington, NC 28403, USA;
| | - Milan Pantovic
- Department of Kinesiology and Nutrition Sciences, University of Nevada Las Vegas, Las Vegas, NV 89154, USA; (M.P.); (K.F.); (S.J.)
| | - Mitchell Clingo
- School of Medicine, University of Nevada Las Vegas, Las Vegas, NV 89154, USA;
| | - Katherine Fischer
- Department of Kinesiology and Nutrition Sciences, University of Nevada Las Vegas, Las Vegas, NV 89154, USA; (M.P.); (K.F.); (S.J.)
| | - Sharon Jalene
- Department of Kinesiology and Nutrition Sciences, University of Nevada Las Vegas, Las Vegas, NV 89154, USA; (M.P.); (K.F.); (S.J.)
| | - Merrill Landers
- Department of Physical Therapy, University of Nevada Las Vegas, Las Vegas, NV 89154, USA;
| | - Zoltan Mari
- Movement Disorders Program, Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV 89106, USA;
| | - Brach Poston
- Department of Kinesiology and Nutrition Sciences, University of Nevada Las Vegas, Las Vegas, NV 89154, USA; (M.P.); (K.F.); (S.J.)
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Chung JW, Bower AE, Malik I, Martello JP, Knight CA, Jeka JJ, Burciu RG. Imaging the lower limb network in Parkinson's disease. Neuroimage Clin 2023; 38:103399. [PMID: 37058977 PMCID: PMC10131075 DOI: 10.1016/j.nicl.2023.103399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/27/2023] [Accepted: 04/05/2023] [Indexed: 04/16/2023]
Abstract
BACKGROUND Despite the significant impact of lower limb symptoms on everyday life activities in Parkinson's disease (PD), knowledge of the neural correlates of lower limb deficits is limited. OBJECTIVE We ran an fMRI study to investigate the neural correlates of lower limb movements in individuals with and without PD. METHODS Participants included 24 PD and 21 older adults who were scanned while performing a precisely controlled isometric force generation task by dorsiflexing their ankle. A novel MRI-compatible ankle dorsiflexion device that limits head motion during motor tasks was used. The PD were tested on their more affected side, whereas the side in controls was randomized. Importantly, PD were tested in the off-state, following overnight withdrawal from antiparkinsonian medication. RESULTS The foot task revealed extensive functional brain changes in PD compared to controls, with reduced fMRI signal during ankle dorsiflexion within the contralateral putamen and M1 foot area, and ipsilateral cerebellum. The activity of M1 foot area was negatively correlated with the severity of foot symptoms based on the Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS-III). CONCLUSION Overall, current findings provide new evidence of brain changes underlying motor symptoms in PD. Our results suggest that pathophysiology of lower limb symptoms in PD appears to involve both the cortico-basal ganglia and cortico-cerebellar motor circuits.
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Affiliation(s)
- Jae Woo Chung
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States
| | - Abigail E Bower
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States
| | - Ibrahim Malik
- Center for Biomedical & Brain Imaging, University of Delaware, Newark, DE, United States
| | - Justin P Martello
- Department of Neurosciences, Christiana Care Health System, Newark, DE, United States
| | - Christopher A Knight
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States; Interdisciplinary Neuroscience Graduate Program, University of Delaware, Newark, DE, United States
| | - John J Jeka
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States; Interdisciplinary Neuroscience Graduate Program, University of Delaware, Newark, DE, United States
| | - Roxana G Burciu
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States; Interdisciplinary Neuroscience Graduate Program, University of Delaware, Newark, DE, United States.
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Chung JW, Knight CA, Bower AE, Martello JP, Jeka JJ, Burciu RG. Rate control deficits during pinch grip and ankle dorsiflexion in early-stage Parkinson's disease. PLoS One 2023; 18:e0282203. [PMID: 36867628 PMCID: PMC9983837 DOI: 10.1371/journal.pone.0282203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 02/10/2023] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND Much of our understanding of the deficits in force control in Parkinson's disease (PD) relies on findings in the upper extremity. Currently, there is a paucity of data pertaining to the effect of PD on lower limb force control. OBJECTIVE The purpose of this study was to concurrently evaluate upper- and lower-limb force control in early-stage PD and a group of age- and gender-matched healthy controls. METHODS Twenty individuals with PD and twenty-one healthy older adults participated in this study. Participants performed two visually guided, submaximal (15% of maximum voluntary contractions) isometric force tasks: a pinch grip task and an ankle dorsiflexion task. PD were tested on their more affected side and after overnight withdrawal from antiparkinsonian medication. The tested side in controls was randomized. Differences in force control capacity were assessed by manipulating speed-based and variability-based task parameters. RESULTS Compared with controls, PD demonstrated slower rates of force development and force relaxation during the foot task, and a slower rate of relaxation during the hand task. Force variability was similar across groups but greater in the foot than in the hand in both PD and controls. Lower limb rate control deficits were greater in PD with more severe symptoms based on the Hoehn and Yahr stage. CONCLUSIONS Together, these results provide quantitative evidence of an impaired capacity in PD to produce submaximal and rapid force across multiple effectors. Moreover, results suggest that force control deficits in the lower limb may become more severe with disease progression.
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Affiliation(s)
- Jae Woo Chung
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States of America
| | - Christopher A. Knight
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States of America
- Interdisciplinary Neuroscience Graduate Program, University of Delaware, Newark, DE, United States of America
| | - Abigail E. Bower
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States of America
| | - Justin P. Martello
- Department of Neurosciences, Christiana Care Health System, Newark, DE, United States of America
| | - John J. Jeka
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States of America
- Interdisciplinary Neuroscience Graduate Program, University of Delaware, Newark, DE, United States of America
| | - Roxana G. Burciu
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States of America
- Interdisciplinary Neuroscience Graduate Program, University of Delaware, Newark, DE, United States of America
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7
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Sharifi S, Luft F, de Boer L, Buijink AWG, Mugge W, Schouten AC, Heida T, Bour LJ, van Rootselaar AF. Closing the loop: Novel quantitative fMRI approach for manipulation of the sensorimotor loop in tremor. Neuroimage 2022; 262:119554. [PMID: 35963505 DOI: 10.1016/j.neuroimage.2022.119554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 07/29/2022] [Accepted: 08/09/2022] [Indexed: 10/31/2022] Open
Abstract
Tremor is thought to be an effect of oscillatory activity within the sensorimotor network. To date, the underlying pathological brain networks are not fully understood. Disentangling tremor activity from voluntary motor output and sensorimotor feedback systems is challenging. To better understand the intrinsic sensorimotor fingerprint underlying tremor, we aimed to disentangle the sensorimotor system into driving (motor) and feedback/compensatory (sensory) neuronal involvement, and aimed to pinpoint tremor activity in essential tremor (ET) and tremor-dominant Parkinson's disease (PD) with a novel closed-loop approach. Eighteen ET patients, 14 tremor-dominant PD patients, and 18 healthy controls were included. An MR-compatible wrist manipulator was employed during functional MRI (fMRI) while muscle activity during (in)voluntary movements was concurrently recorded using electromyography (EMG). Tremor was quantified based on EMG and correlated to brain activity. Participants performed three tasks: an active wrist motor task, a passive wrist movement task, and rest (no wrist movement). The results in healthy controls proved that our experimental paradigm activated the expected motor and sensory networks separately using the active (motor) and passive (sensory) task. ET patients showed similar patterns of activation within the motor and sensory networks. PD patients had less activity during the active motor task in the cerebellum and basal ganglia compared to ET and healthy controls. EMG showed that in ET, tremor fluctuations correlated positively with activity in the inferior olive region, and that in PD tremor fluctuations correlated positively with cerebellar activity. Our novel approach with an MR-compatible wrist manipulator, allowed to investigate the involvement of the motor and sensory networks separately, and as such to better understand tremor pathophysiology. In ET sensorimotor network function did not differ from healthy controls. PD showed less motor-related activity. Focusing on tremor, our results indicate involvement of the inferior olive in ET tremor modulation, and cerebellar involvement in PD tremor modulation.
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Affiliation(s)
- S Sharifi
- Department of Neurology and Clinical Neurophysiology, Amsterdam UMC, Amsterdam Neuroscience, University of Amsterdam, Meibergdreef 9, D2-113, P.O. Box 22660, Amsterdam 1100 DD, the Netherlands; BIC Brain Imaging Center, Academic Medical Center, Amsterdam, the Netherlands.
| | - F Luft
- Department of Biomedical Signals and Systems, TechMed Centre, University of Twente, Enschede, the Netherlands; BIC Brain Imaging Center, Academic Medical Center, Amsterdam, the Netherlands
| | - L de Boer
- Department of Neurology and Clinical Neurophysiology, Amsterdam UMC, Amsterdam Neuroscience, University of Amsterdam, Meibergdreef 9, D2-113, P.O. Box 22660, Amsterdam 1100 DD, the Netherlands
| | - A W G Buijink
- Department of Neurology and Clinical Neurophysiology, Amsterdam UMC, Amsterdam Neuroscience, University of Amsterdam, Meibergdreef 9, D2-113, P.O. Box 22660, Amsterdam 1100 DD, the Netherlands; BIC Brain Imaging Center, Academic Medical Center, Amsterdam, the Netherlands
| | - W Mugge
- Faculty of Mechanical, Maritime and Materials Engineering, Department of Biomechanical Engineering, Delft University of Technology, Delft, the Netherlands
| | - A C Schouten
- Faculty of Mechanical, Maritime and Materials Engineering, Department of Biomechanical Engineering, Delft University of Technology, Delft, the Netherlands
| | - T Heida
- Department of Biomedical Signals and Systems, TechMed Centre, University of Twente, Enschede, the Netherlands
| | - L J Bour
- Department of Neurology and Clinical Neurophysiology, Amsterdam UMC, Amsterdam Neuroscience, University of Amsterdam, Meibergdreef 9, D2-113, P.O. Box 22660, Amsterdam 1100 DD, the Netherlands
| | - A F van Rootselaar
- Department of Neurology and Clinical Neurophysiology, Amsterdam UMC, Amsterdam Neuroscience, University of Amsterdam, Meibergdreef 9, D2-113, P.O. Box 22660, Amsterdam 1100 DD, the Netherlands; BIC Brain Imaging Center, Academic Medical Center, Amsterdam, the Netherlands
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Oh JY, Lee YS, Hwang TY, Cho SJ, Jang JH, Ryu Y, Park HJ. Acupuncture Regulates Symptoms of Parkinson’s Disease via Brain Neural Activity and Functional Connectivity in Mice. Front Aging Neurosci 2022; 14:885396. [PMID: 35774113 PMCID: PMC9237259 DOI: 10.3389/fnagi.2022.885396] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 05/19/2022] [Indexed: 11/13/2022] Open
Abstract
Parkinson’s disease (PD) is a multilayered progressive brain disease characterized by motor dysfunction and a variety of other symptoms. Although acupuncture has been used to ameliorate various symptoms of neurodegenerative disorders, including PD, the underlying mechanisms are unclear. Here, we investigated the mechanism of acupuncture by revealing the effects of acupuncture treatment on brain neural responses and its functional connectivity in an animal model of PD. We observed that destruction of neuronal network between many brain regions in PD mice were reversed by acupuncture. Using machine learning analysis, we found that the key region associated with the improvement of abnormal behaviors might be related to the neural activity of M1, suggesting that the changes of c-Fos in M1 could predict the improvement of motor function induced by acupuncture treatment. In addition, acupuncture treatment was shown to significantly normalize the brain neural activity not only in M1 but also in other brain regions related to motor behavior (striatum, substantia nigra pars compacta, and globus pallidus) and non-motor symptoms (hippocampus, lateral hypothalamus, and solitary tract) of PD. Taken together, our results demonstrate that acupuncture treatment might improve the PD symptoms by normalizing the brain functional connectivity in PD mice model and provide new insights that enhance our current understanding of acupuncture mechanisms for non-motor symptoms.
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Affiliation(s)
- Ju-Young Oh
- Department of Korean Medical Science, Graduate School of Korean Medicine, Kyung Hee University, Seoul, South Korea
- Studies of Translational Acupuncture Research (STAR), Acupuncture and Meridian Science Research Center (AMSRC), Kyung Hee University, Seoul, South Korea
| | - Ye-Seul Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, South Korea
| | - Tae-Yeon Hwang
- Department of Korean Medical Science, Graduate School of Korean Medicine, Kyung Hee University, Seoul, South Korea
- Studies of Translational Acupuncture Research (STAR), Acupuncture and Meridian Science Research Center (AMSRC), Kyung Hee University, Seoul, South Korea
| | - Seong-Jin Cho
- Korean Medicine Fundamental Research Division, Korea Institute of Oriental Medicine (KIOM), Daejeon, South Korea
| | - Jae-Hwan Jang
- Department of Korean Medical Science, Graduate School of Korean Medicine, Kyung Hee University, Seoul, South Korea
- Studies of Translational Acupuncture Research (STAR), Acupuncture and Meridian Science Research Center (AMSRC), Kyung Hee University, Seoul, South Korea
| | - Yeonhee Ryu
- Korean Medicine Fundamental Research Division, Korea Institute of Oriental Medicine (KIOM), Daejeon, South Korea
| | - Hi-Joon Park
- Department of Korean Medical Science, Graduate School of Korean Medicine, Kyung Hee University, Seoul, South Korea
- Studies of Translational Acupuncture Research (STAR), Acupuncture and Meridian Science Research Center (AMSRC), Kyung Hee University, Seoul, South Korea
- *Correspondence: Hi-Joon Park
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Herz DM, Meder D, Camilleri JA, Eickhoff SB, Siebner HR. Brain Motor Network Changes in Parkinson's Disease: Evidence from Meta-Analytic Modeling. Mov Disord 2021; 36:1180-1190. [PMID: 33427336 PMCID: PMC8127399 DOI: 10.1002/mds.28468] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 12/09/2020] [Accepted: 12/10/2020] [Indexed: 12/30/2022] Open
Abstract
Background Motor‐related brain activity in Parkinson's disease has been investigated in a multitude of functional neuroimaging studies, which often yielded apparently conflicting results. Our previous meta‐analysis did not resolve inconsistencies regarding cortical activation differences in Parkinson's disease, which might be related to the limited number of studies that could be included. Therefore, we conducted a revised meta‐analysis including a larger number of studies. The objectives of this study were to elucidate brain areas that consistently show abnormal motor‐related activation in Parkinson's disease and to reveal their functional connectivity profiles using meta‐analytic approaches. Methods We applied a quantitative meta‐analysis of functional neuroimaging studies testing limb movements in Parkinson's disease comprising data from 39 studies, of which 15 studies (285 of 571 individual patients) were published after the previous meta‐analysis. We also conducted meta‐analytic connectivity modeling to elucidate the connectivity profiles of areas showing abnormal activation. Results We found consistent motor‐related underactivation of bilateral posterior putamen and cerebellum in Parkinson's disease. Primary motor cortex and the supplementary motor area also showed deficient activation, whereas cortical regions localized directly anterior to these areas expressed overactivation. Connectivity modeling revealed that areas showing decreased activation shared a common pathway through the posterior putamen, whereas areas showing increased activation were connected to the anterior putamen. Conclusions Despite conflicting results in individual neuroimaging studies, this revised meta‐analytic approach identified consistent patterns of abnormal motor‐related activation in Parkinson's disease. The distinct patterns of decreased and increased activity might be determined by their connectivity with different subregions of the putamen. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Damian M Herz
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - David Meder
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Julia A Camilleri
- Research Center Juelich, Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Juelich, Germany.,Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Duesseldorf, Duesseldorf, Germany
| | - Simon B Eickhoff
- Research Center Juelich, Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Juelich, Germany.,Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Duesseldorf, Duesseldorf, Germany
| | - Hartwig R Siebner
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.,Department of Neurology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark.,Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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10
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An Acute Application of Cerebellar Transcranial Direct Current Stimulation Does Not Improve Motor Performance in Parkinson's Disease. Brain Sci 2020; 10:brainsci10100735. [PMID: 33066348 PMCID: PMC7602166 DOI: 10.3390/brainsci10100735] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 10/08/2020] [Accepted: 10/12/2020] [Indexed: 12/13/2022] Open
Abstract
Transcranial direct current stimulation of the cerebellum (c-tDCS) improves motor performance in young and old adults. Based on the cerebellar involvement in Parkinson’s disease (PD), c-tDCS could have potential to improve motor function in PD. The purpose was to determine the effects of c-tDCS on motor performance in PD while participants were on medications. The study was a randomized, double-blind, SHAM-controlled, between-subjects design. Twenty-two participants with PD were allocated to either a c-tDCS group or a SHAM group. All participants completed one experimental session and performed two motor tasks with their most affected hand in a Baseline condition (no stimulation) and an Experimental condition. The motor tasks were a visuomotor isometric precision grip task (PGT) and a rapid arm movement task (AMT). The primary dependent variables were force error and endpoint error in the PGT and AMT, respectively. There were no significant differences in force error or endpoint error in the Experimental condition between the c-tDCS and SHAM groups. These results indicate that an acute application of c-tDCS does not enhance motor performance in hand and arm tasks in PD. Longer-term c-tDCS application over multiple days may be needed to enhance motor function in PD.
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Shen Y, Hu J, Chen Y, Liu W, Li Y, Yan L, Xie C, Zhang W, Yu M, Liu W. Levodopa Changes Functional Connectivity Patterns in Subregions of the Primary Motor Cortex in Patients With Parkinson's Disease. Front Neurosci 2020; 14:647. [PMID: 32733186 PMCID: PMC7360730 DOI: 10.3389/fnins.2020.00647] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 05/25/2020] [Indexed: 12/12/2022] Open
Abstract
Background The primary motor cortex (M1) is a critical node in Parkinson’s disease (PD)-related motor circuitry; however, the functional roles of its subregions are poorly understood. In this study, we investigated changes in the functional connectivity patterns of M1 subregions and their relationships to improved clinical symptoms following levodopa administration. Methods Thirty-six PD patients and 37 healthy controls (HCs) were enrolled. A formal levodopa challenge test was conducted in the PD group, and the Unified Parkinson’s Disease Rating Scale motor section (UPDRS-III) was assessed before (off state) and 1 h after administration of levodopa (on state). The PD group underwent resting-state functional magnetic resonance imaging in both off and on states, whereas the HC group was scanned once. We used the Human Brainnetome Atlas template to subdivide M1 into twelve regions of interest (ROIs). Functional connectivity (FC) was compared between PD on and off states [paired t-test, voxel-level p < 0.001, cluster-level p < 0.05, Gaussian random field (GRF) correction] and between patients and HC (two-sample t-test voxel-level p < 0.001, cluster-level p < 0.05). Correlations between ΔFC (differences in FC between PD off and on states) and clinical symptom improvements were examined. Results There was decreased FC between the right caudal dorsolateral area 6 and the anterior cingulate gyrus (ACC), the right upper limb region and the left medial dorsal thalamus (mdTHA), as well as increased FC between the left tongue and larynx region and the left medial frontal gyrus. ΔFC between the right caudal dorsolateral area 6 and ACC was positively correlated with improvements in UPDRS-III total scores as well as the rigidity (item 22) and bradykinesia (items 23–26 and 31) subscores. ΔFC between the right upper limb region and left thalamus was positively correlated with improvements in the left upper limb tremor (items 20c and 21b) and postural tremor (item 21b) subscores. Conclusions Our results reveal novel information regarding the underlying mechanisms in the motor circuits in the M1 and a promising way to explore the internal function of the M1 in PD patients. Notably, M1 is a potential therapeutic target in PD, and the exploration of its subregions provides a basis and a source of new insights for clinical intervention and precise drug treatment.
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Affiliation(s)
- Yang Shen
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Jun Hu
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yong Chen
- Department of Laboratory Medicine, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Wan Liu
- Department of Rehabilitation, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yuqian Li
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Lei Yan
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Chunming Xie
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Wenbin Zhang
- Department of Functional Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Miao Yu
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Weiguo Liu
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
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Bergamino M, Keeling EG, Mishra VR, Stokes AM, Walsh RR. Assessing White Matter Pathology in Early-Stage Parkinson Disease Using Diffusion MRI: A Systematic Review. Front Neurol 2020; 11:314. [PMID: 32477235 PMCID: PMC7240075 DOI: 10.3389/fneur.2020.00314] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 03/31/2020] [Indexed: 12/15/2022] Open
Abstract
Structural brain white matter (WM) changes such as axonal caliber, density, myelination, and orientation, along with WM-dependent structural connectivity, may be impacted early in Parkinson disease (PD). Diffusion magnetic resonance imaging (dMRI) has been used extensively to understand such pathological WM changes, and the focus of this systematic review is to understand both the methods utilized and their corresponding results in the context of early-stage PD. Diffusion tensor imaging (DTI) is the most commonly utilized method to probe WM pathological changes. Previous studies have suggested that DTI metrics are sensitive in capturing early disease-associated WM changes in preclinical symptomatic regions such as olfactory regions and the substantia nigra, which is considered to be a hallmark of PD pathology and progression. Postprocessing analytic approaches include region of interest-based analysis, voxel-based analysis, skeletonized approaches, and connectome analysis, each with unique advantages and challenges. While DTI has been used extensively to study WM disorganization in early-stage PD, it has several limitations, including an inability to resolve multiple fiber orientations within each voxel and sensitivity to partial volume effects. Given the subtle changes associated with early-stage PD, these limitations result in inaccuracies that severely impact the reliability of DTI-based metrics as potential biomarkers. To overcome these limitations, advanced dMRI acquisition and analysis methods have been employed, including diffusion kurtosis imaging and q-space diffeomorphic reconstruction. The combination of improved acquisition and analysis in DTI may yield novel and accurate information related to WM-associated changes in early-stage PD. In the current article, we present a systematic and critical review of dMRI studies in early-stage PD, with a focus on recent advances in DTI methodology. Yielding novel metrics, these advanced methods have been shown to detect diffuse WM changes in early-stage PD. These findings support the notion of early axonal damage in PD and suggest that WM pathology may go unrecognized until symptoms appear. Finally, the advantages and disadvantages of different dMRI techniques, analysis methods, and software employed are discussed in the context of PD-related pathology.
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Affiliation(s)
- Maurizio Bergamino
- Division of Neuroimaging Research, Barrow Neurological Institute, Phoenix, AZ, United States
| | - Elizabeth G. Keeling
- Division of Neuroimaging Research, Barrow Neurological Institute, Phoenix, AZ, United States
- School of Life Sciences, Arizona State University, Tempe, AZ, United States
| | - Virendra R. Mishra
- Imaging Research, Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, United States
| | - Ashley M. Stokes
- Division of Neuroimaging Research, Barrow Neurological Institute, Phoenix, AZ, United States
| | - Ryan R. Walsh
- Muhammad Ali Parkinson Center, Barrow Neurological Institute, Phoenix, AZ, United States
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Solstrand Dahlberg L, Lungu O, Doyon J. Cerebellar Contribution to Motor and Non-motor Functions in Parkinson's Disease: A Meta-Analysis of fMRI Findings. Front Neurol 2020; 11:127. [PMID: 32174883 PMCID: PMC7056869 DOI: 10.3389/fneur.2020.00127] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 02/04/2020] [Indexed: 01/19/2023] Open
Abstract
Background: Parkinson's disease (PD) results in both motor and non-motor symptoms. Traditionally, the underlying mechanism of PD has been linked to neurodegeneration of the basal ganglia. Yet it does not adequately account for the non-motor symptoms of the disease, suggesting that other brain regions may be involved. One such region is the cerebellum, which is known to be involved, together with the basal ganglia, in both motor and non-motor functions. Many studies have found the cerebellum to be hyperactive in PD patients, a finding that is seldom discussed in detail, and warrants further examination. The current study thus aims to examine quantitively the current literature on the cerebellar involvement in both motor and non-motor functioning in PD. Methods: A meta-analysis of functional neuroimaging literature was conducted with Seed-based D mapping. Only the studies testing functional activation in response to motor and non-motor paradigms in PD and healthy controls (HC) were included in the meta-analysis. Separate analyses were conducted by including only studies with non-motor paradigms, as well as meta-regressions with UPDRS III scores and disease duration. Results: A total of 57 studies with both motor and non-motor paradigms fulfilled our inclusion criteria and were included in the meta-analysis, which revealed hyperactivity in Crus I-II and vermal III in PD patients compared to HC. An analysis including only studies with cognitive paradigms revealed a cluster of increased activity in PD patients encompassing lobule VIIB and VIII. Another meta-analysis including the only 20 studies that employed motor paradigms did not reveal any significant group differences. However, a descriptive analysis of these studies revealed that 60% of them reported cerebellar hyperactivations in PD and included motor paradigm with significant cognitive task demands, as opposed to 40% presenting the opposite pattern and using mainly force grip tasks. The meta-regression with UPDRS III scores found a negative association between motor scores and activation in lobule VI and vermal VII-VIII. No correlation was found with disease duration. Discussion: The present findings suggest that one of the main cerebellar implications in PD is linked to cognitive functioning. The negative association between UPDRS scores and activation in regions implicated in motor functioning indicate that there is less involvement of these areas as the disease severity increases. In contrast, the lack of correlation with disease duration seems to indicate that the cerebellar activity may be a compensatory mechanism to the dysfunctional basal ganglia, where certain sub-regions of the cerebellum are employed to cope with motor demands. Yet future longitudinal studies are needed to fully address this possibility.
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Affiliation(s)
- Linda Solstrand Dahlberg
- Department of Neurology & Neurosurgery, McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Ovidiu Lungu
- Department of Neurology & Neurosurgery, McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
- Department of Psychiatry, University of Montreal, Montreal, QC, Canada
| | - Julien Doyon
- Department of Neurology & Neurosurgery, McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
- Functional Neuroimaging Unit, Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada
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Abstract
Parkinson's disease (PD) is an aging-related neurodegenerative disorder characterized by progressive motor impairment.The etiology of PD is poorly understood but likely involves both genetic and environmental factors; the management of the disease is still with symptomatic therapy without any interference on the progression of neurodegeneration. In the past two decades, the results of a series of prospective cohort studies suggested that lifestyle factors likely modify the risk of developing PD. Among these, physical activity is known to reduce the risk of a wide range of diseases and conditions, including cardiovascular disease, stroke, and diabetes.Recently, a growing body of evidence has suggested that increased physical activity may also reduce the risk of PD and partly improve motor and non-motor symptoms during the disease course.Here we report the main findings on the effect of physical activity on both mobility and cognition either in animal models of PD or in people with PD. We also highlighted the structural and functional links between gait and cognition by reporting evidence from neuroimaging studies.
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Affiliation(s)
- Simona Bonavita
- II Clinic of Neurology, Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.
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15
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Meder D, Herz DM, Rowe JB, Lehéricy S, Siebner HR. The role of dopamine in the brain - lessons learned from Parkinson's disease. Neuroimage 2019; 190:79-93. [DOI: 10.1016/j.neuroimage.2018.11.021] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 10/25/2018] [Accepted: 11/16/2018] [Indexed: 11/30/2022] Open
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Martin JA, Zimmermann N, Scheef L, Jankowski J, Paus S, Schild HH, Klockgether T, Boecker H. Disentangling motor planning and motor execution in unmedicated de novo Parkinson's disease patients: An fMRI study. NEUROIMAGE-CLINICAL 2019; 22:101784. [PMID: 30925383 PMCID: PMC6438987 DOI: 10.1016/j.nicl.2019.101784] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Revised: 02/27/2019] [Accepted: 03/16/2019] [Indexed: 11/28/2022]
Abstract
Many studies have used functional magnetic resonance imaging to unravel the neuronal underpinnings of motor system abnormalities in Parkinson's disease, indicating functional inhibition at the level of basal ganglia-thalamo-cortical motor networks. The study aim was to extend the characterization of functional motor changes in Parkinson's Disease by dissociating between two phases of action (i.e. motor planning and motor execution) during an automated unilateral finger movement sequence with the left and right hand, separately. In essence, we wished to identify neuronal dysfunction and potential neuronal compensation before (planning) and during (execution) automated sequential motor behavior in unmedicated early stage Parkinson's Disease patients. Twenty-two Parkinson's Disease patients (14 males; 53 ± 11 years; Hoehn and Yahr score 1.4 ± 0.6; UPDRS (part 3) motor score 16 ± 6) and 22 healthy controls (14 males; 49 ± 12 years) performed a pre-learnt four finger sequence (index, ring, middle and little finger, in order), either self-initiated (FREE) or externally triggered (REACT), within an 8-second time window. Findings were most pronounced during FREE with the clinically most affected side, where motor execution revealed significant underactivity of contralateral primary motor cortex, contralateral posterior putamen (sensorimotor territory), ipsilateral anterior cerebellum / cerebellar vermis, along with underactivity in supplementary motor area (based on ROI analyses only), corroborating previous findings in Parkinson's Disease. During motor planning, Parkinson's Disease patients showed a significant relative overactivity in dorsolateral prefrontal cortex (DLPFC), suggesting a compensatory overactivity. To a variable extent this relative overactivity in the DLPFC went along with a relative overactivity in the precuneus and the ipsilateral anterior cerebellum/cerebellar vermis Our study illustrates that a refined view of disturbances in motor function and compensatory processes can be gained from experimental designs that try to dissociate motor planning from motor execution, emphasizing that compensatory mechanisms are triggered in Parkinson's Disease when voluntary movements are conceptualized for action. Dissociated activations in early stage PD for motor planning and motor execution PD patients show frontal-parietal network compensation during self-initiated movement. Compensation for an impaired basal ganglia-premotor circuit occurs during planning.
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Affiliation(s)
- Jason A Martin
- Functional Neuroimaging Group, Department of Radiology, University Hospital Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany; Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), University Hospital Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany.
| | - Nadine Zimmermann
- Functional Neuroimaging Group, Department of Radiology, University Hospital Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany; Department of Neurology, University Hospital Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
| | - Lukas Scheef
- Functional Neuroimaging Group, Department of Radiology, University Hospital Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany; Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), University Hospital Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
| | - Jakob Jankowski
- Functional Neuroimaging Group, Department of Radiology, University Hospital Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
| | - Sebastian Paus
- Department of Neurology, University Hospital Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
| | - Hans H Schild
- Department of Radiology, University Hospital Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
| | - Thomas Klockgether
- Department of Neurology, University Hospital Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany; Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), University Hospital Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
| | - Henning Boecker
- Functional Neuroimaging Group, Department of Radiology, University Hospital Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany; Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), University Hospital Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
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Intzandt B, Beck EN, Silveira CR. The effects of exercise on cognition and gait in Parkinson’s disease: A scoping review. Neurosci Biobehav Rev 2018; 95:136-169. [DOI: 10.1016/j.neubiorev.2018.09.018] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 09/23/2018] [Accepted: 09/24/2018] [Indexed: 10/28/2022]
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Strafella AP, Bohnen NI, Pavese N, Vaillancourt DE, van Eimeren T, Politis M, Tessitore A, Ghadery C, Lewis S. Imaging Markers of Progression in Parkinson's Disease. Mov Disord Clin Pract 2018; 5:586-596. [PMID: 30637278 DOI: 10.1002/mdc3.12673] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 07/22/2018] [Accepted: 07/30/2018] [Indexed: 12/12/2022] Open
Abstract
Background Parkinson's disease (PD) is the second-most common neurodegenerative disorder after Alzheimer's disease; however, to date, there is no approved treatment that stops or slows down disease progression. Over the past decades, neuroimaging studies, including molecular imaging and MRI are trying to provide insights into the mechanisms underlying PD. Methods This work utilized a literature review. Results It is now becoming clear that these imaging modalities can provide biomarkers that can objectively detect brain changes related to PD and monitor these changes as the disease progresses, and these biomarkers are required to establish a breakthrough in neuroprotective or disease-modifying therapeutics. Conclusions Here, we provide a review of recent observations deriving from PET, single-positron emission tomography, and MRI studies exploring PD and other parkinsonian disorders.
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Affiliation(s)
- Antonio P Strafella
- Morton and Gloria Shulman Movement Disorder Unit & E.J. Safra Parkinson Disease Program, Neurology Division, Department of Medicine, Toronto Western Hospital, UHN University of Toronto Toronto Ontario Canada.,Division of Brain, Imaging and Behaviour-Systems Neuroscience, Krembil Research Institute, UHN University of Toronto Toronto Ontario Canada.,Research Imaging Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health University of Toronto Toronto Ontario Canada
| | - Nico I Bohnen
- Department of Radiology & Neurology University of Michigan Ann Arbor Michigan USA.,Veterans Administration Ann Arbor Healthcare System Ann Arbor Michigan USA.,Morris K. Udall Center of Excellence for Parkinson's Disease Research University of Michigan Ann Arbor Michigan USA
| | - Nicola Pavese
- Newcastle Magnetic Resonance Centre & Positron Emission Tomography Centre Newcastle University, Campus for Ageing & Vitality Newcastle upon Tyne United Kingdom
| | - David E Vaillancourt
- Applied Physiology and Kinesiology, Biomedical Engineering, and Neurology University of Florida Gainesville Florida USA
| | - Thilo van Eimeren
- Department of Nuclear Medicine and Department of Neurology University of Cologne Cologne Germany.,Institute for Cognitive Neuroscience, Jülich Research Centre Jülich Germany.,German Center for Neurodegenerative Diseases (DZNE) Bonn-Cologne Bonn Germany
| | - Marios Politis
- Neurodegeneration Imaging Group (NIG), Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London London United Kingdom
| | - Alessandro Tessitore
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences-MRI Research Center SUN-FISM University of Campania "Luigi Vanvitelli" Naples Italy
| | - Christine Ghadery
- Morton and Gloria Shulman Movement Disorder Unit & E.J. Safra Parkinson Disease Program, Neurology Division, Department of Medicine, Toronto Western Hospital, UHN University of Toronto Toronto Ontario Canada.,Division of Brain, Imaging and Behaviour-Systems Neuroscience, Krembil Research Institute, UHN University of Toronto Toronto Ontario Canada.,Research Imaging Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health University of Toronto Toronto Ontario Canada
| | - Simon Lewis
- Parkinson's Disease Research Clinic, Brain and Mind Centre University of Sydney Sydney NSW Australia
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Burciu RG, Vaillancourt DE. Imaging of Motor Cortex Physiology in Parkinson's Disease. Mov Disord 2018; 33:1688-1699. [PMID: 30280416 PMCID: PMC6261674 DOI: 10.1002/mds.102] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 06/26/2018] [Accepted: 06/29/2018] [Indexed: 12/13/2022] Open
Abstract
There is abundant evidence that the pathophysiology of Parkinson's disease (PD) is not confined to the nigrostriatal dopaminergic pathway but propagates along the cortico‐basal ganglia‐thalamo‐cortical neural network. A critical node in this functional circuit impacted by PD is the primary motor cortex (M1), which plays a key role in generating neural impulses that regulate movements. The past several decades have lay witness to numerous in vivo neuroimaging techniques that provide a window into the function and structure of M1. A consistent observation from numerous studies is that during voluntary movement, but also at rest, the functional activity of M1 is altered in PD relative to healthy individuals, and it relates to many of the motor signs. Although this abnormal functional activity can be partially restored with acute dopaminergic medication, it continues to deteriorate with disease progression and may predate structural degeneration of M1. The current review discusses the evidence that M1 is fundamental to the pathophysiology of PD, as measured by neuroimaging techniques such as positron emission tomography, single‐photon emission computed tomography, electroencephalography, magnetoencephalography, and functional and structural MRI. Although novel treatments that target the cortex will not cure PD, they could significantly slow down and alter the progressive course of the disease and thus improve clinical care for this degenerative disease. © 2018 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society
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Affiliation(s)
- Roxana G Burciu
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware, USA
| | - David E Vaillancourt
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida, USA.,Department of Neurology, University of Florida, Gainesville, Florida, USA.,Department of Biomedical Engineering, University of Florida, Gainesville, Florida, USA
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Chung JW, Burciu RG, Ofori E, Coombes SA, Christou EA, Okun MS, Hess CW, Vaillancourt DE. Beta-band oscillations in the supplementary motor cortex are modulated by levodopa and associated with functional activity in the basal ganglia. NEUROIMAGE-CLINICAL 2018; 19:559-571. [PMID: 29984164 PMCID: PMC6029579 DOI: 10.1016/j.nicl.2018.05.021] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 05/14/2018] [Accepted: 05/16/2018] [Indexed: 12/15/2022]
Abstract
We investigated the effect of acute levodopa administration on movement-related cortical oscillations and movement velocity in Parkinson's disease (PD). Patients with PD on and off medication and age- and sex-matched healthy controls performed a ballistic upper limb flexion movement as fast and accurately as possible while cortical oscillations were recorded with high-density electroencephalography. Patients off medication were also studied using task-based functional magnetic resonance imaging (fMRI) using a force control paradigm. Percent signal change of functional activity during the force control task was calculated for the putamen and subthalamic nucleus (STN) contralateral to the hand tested. We found that patients with PD off medication had an exaggerated movement-related beta-band (13–30 Hz) desynchronization in the supplementary motor area (SMA) compared to controls. In PD, spectral power in the beta-band was correlated with movement velocity. Following an acute dose of levodopa, we observed that the beta-band desynchronization in the SMA was reduced in PD, and was associated with increased movement velocity and increased voltage of agonist muscle activity. Further, using fMRI we found that the functional activity in the putamen and STN in the off medication state, was related to how responsive that cortical oscillations in the SMA of PD were to levodopa. Collectively, these findings provide the first direct evaluation of how movement-related cortical oscillations relate to movement velocity during the ballistic phase of movement in PD and demonstrate that functional brain activity in the basal ganglia pathways relate to the effects of dopaminergic medication on cortical neuronal oscillations during movement. Acute levodopa decreased beta-band desynchronization in the SMA, while improving movement velocity and muscle activity. Beta-band cortical activity during movement is positively correlated with upper limb movement velocity. fMRI in basal ganglia predicted the response of beta-band cortical activity to levodopa.
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Key Words
- BOLD, blood oxygen level dependent
- Ballistic movements
- DBS, deep brain stimulation
- ECoG, electrocorticography
- EEG
- EEG, electroencephalography
- EMG, electromyography
- ERSP, event-related power spectral perturbation
- FDR, false discovery rate
- HC, healthy control
- ICA, independent component analysis
- LFP, local field potential
- Levodopa
- M1, primary motor cortex
- MDS-UPDRS, Movement Disorder Society Unified Parkinson's Disease Rating Scale
- MEG, magnetoencephalography
- MPA, measure projection analysis
- MVC, maximum voluntary contraction
- MoCA, Montreal Cognitive Assessment
- PD, Parkinson's disease
- PD-OFF, off medication (levodopa) day
- PD-ON, on medication (levodopa) day
- PET, positron emission tomography
- Parkinson's disease
- ROI, regions of interest
- S1, primary somatosensory cortex
- SMA, supplementary motor area
- SNc, substantia nigra pars compacta
- STN, subthalamic nucleus
- Supplementary motor area
- fMRI
- fMRI, functional magnetic resonance imaging
- iEMG, integrated electromyography
- rCBF, regional cerebral blood flow
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Affiliation(s)
- Jae Woo Chung
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA
| | - Roxana G Burciu
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, USA
| | - Edward Ofori
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | - Stephen A Coombes
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA
| | - Evangelos A Christou
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA; Department of Physical Therapy, University of Florida, Gainesville, FL, USA
| | - Michael S Okun
- Department of Neurology and Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, USA
| | - Christopher W Hess
- Department of Neurology and Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, USA
| | - David E Vaillancourt
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA; Department of Neurology and Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, USA; Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA.
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Basal ganglia involvement in ARX patients: The reason for ARX patients very specific grasping? NEUROIMAGE-CLINICAL 2018; 19:454-465. [PMID: 29984154 PMCID: PMC6029499 DOI: 10.1016/j.nicl.2018.04.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 03/05/2018] [Accepted: 04/01/2018] [Indexed: 01/15/2023]
Abstract
The ARX (Aristaless Related homeoboX) gene was identified in 2002 as responsible for XLAG syndrome, a lissencephaly characterized by an almost complete absence of cortical GABAergic interneurons, and for milder forms of X-linked Intellectual Disability (ID) without apparent brain abnormalities. The most frequent mutation found in the ARX gene, a duplication of 24 base pairs (c.429_452dup24) in exon 2, results in a recognizable syndrome in which patients present ID without primary motor impairment, but with a very specific upper limb distal motor apraxia associated with a pathognomonic hand-grip, described as developmental Limb Kinetic Apraxia (LKA). In this study, we first present ARX expression during human fetal brain development showing that it is strongly expressed in GABAergic neuronal progenitors during the second and third trimester of pregnancy. We show that although ARX expression strongly decreases towards the end of gestation, it is still present after birth in some neurons of the basal ganglia, thalamus and cerebral cortex, suggesting that ARX also plays a role in more mature neuron functioning. Then, using morphometric brain MRI in 13 ARX patients carrying c.429_452dup24 mutation and in 13 sex- and age-matched healthy controls, we show that ARX patients have a significantly decreased volume of several brain structures including the striatum (and more specifically the caudate nucleus), hippocampus and thalamus as well as decreased precentral gyrus cortical thickness. We observe a significant correlation between caudate nucleus volume reduction and motor impairment severity quantified by kinematic parameter of precision grip. As basal ganglia are known to regulate sensorimotor processing and are involved in the control of precision gripping, the combined decrease in cortical thickness of primary motor cortex and basal ganglia volume in ARX dup24 patients is very likely the anatomical substrate of this developmental form of LKA. c.429_452dup24 in ARX is responsible for ID with Limb Kinetic Apraxia. During human brain development, ARX is expressed in GABAergic neuronal progenitors. ARX patients have a significantly decreased caudate nucleus volume by MRI. This caudate nucleus volume reduction is correlated with motor impairment severity. These anatomic findings may explain this developmental form of Limb Kinetic Apraxia.
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Key Words
- ARX
- ARX, Aristaless-Related homeoboX gene (according to the genetic convention, ARX was written in italics when it refers to the gene, in plain-text characters when it refers to the protein, in capital letters when it refers to the human gene, and in lowercase when it refers to the mouse gene)
- CGE, caudal ganglionic eminence
- CP, cortical plate
- DS, down syndrome
- GE, ganglionic eminences
- Human brain development
- ICV, intracranial volume
- ID, Intellectual Disability
- IQ, intelligence quotient
- IZ, intermediate zone
- Intellectual disability
- Kinematic
- LGE, lateral ganglionic eminence
- LKA, Limb Kinetic Apraxia
- Limb Kinetic Apraxia
- MGE, medial ganglionic eminence
- MRI, magnetic resonance imaging
- MZ, marginal zone
- Morphometric MRI
- ROI, region of interest
- SGL, subpial granular layer
- SVZ, subventricular zone
- VZ, ventricular zone
- WG, weeks of gestation
- XLAG, X-linked lissencephaly with abnormal genitalia
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Burciu RG, Seidler RD, Shukla P, Nalls MA, Singleton AB, Okun MS, Vaillancourt DE. Multimodal neuroimaging and behavioral assessment of α-synuclein polymorphism rs356219 in older adults. Neurobiol Aging 2018; 66:32-39. [PMID: 29505953 DOI: 10.1016/j.neurobiolaging.2018.02.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 01/26/2018] [Accepted: 02/02/2018] [Indexed: 11/24/2022]
Abstract
The single-nucleotide polymorphism rs356219 in the α-synuclein (SNCA) gene has been shown to significantly contribute to an earlier age at onset of Parkinson's disease (PD), and regulates SNCA expression in PD brain regions, blood, and plasma. Here, we used multimodal magnetic resonance imaging (MRI) to study healthy adults with and without the rs356219 risk genotype. Motor and cognitive tests were administered, and all participants underwent functional and structural MRI. Imaging analyses included (1) task-based functional MRI; (2) task-based functional connectivity; (3) free-water diffusion MRI of the substantia nigra; (4) voxel-based morphometry; and (5) surface-based morphometry. There were no differences between the 2 groups in motor and cognitive performance, or brain structure. However, carrying a PD risk variant was associated with reduced functional activity in the posterior putamen and primary motor cortex. Moreover, the posterior putamen had reduced functional connectivity with the motor cortex during motor control in those with a risk genotype compared to those without. These findings point to functional abnormalities in the striatocortical circuit of rs356219 risk genotype carriers.
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Affiliation(s)
- Roxana G Burciu
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA
| | - Rachael D Seidler
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA
| | - Priyank Shukla
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA
| | - Mike A Nalls
- Data Tecnica International, Glen Echo, MD, USA; Laboratory of Neurogenetics, National Institute of Aging, Bethesda, MD, USA
| | | | - Michael S Okun
- Department of Neurology, University of Florida, Gainesville, FL, USA; Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, USA
| | - David E Vaillancourt
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA; Department of Neurology, University of Florida, Gainesville, FL, USA; Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA.
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Burciu RG, Hess CW, Coombes SA, Ofori E, Shukla P, Chung JW, McFarland NR, Wagle Shukla A, Okun MS, Vaillancourt DE. Functional activity of the sensorimotor cortex and cerebellum relates to cervical dystonia symptoms. Hum Brain Mapp 2017; 38:4563-4573. [PMID: 28594097 PMCID: PMC5547035 DOI: 10.1002/hbm.23684] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 05/26/2017] [Accepted: 05/30/2017] [Indexed: 12/31/2022] Open
Abstract
Cervical dystonia (CD) is the most common type of focal dystonia, causing abnormal movements of the neck and head. In this study, we used noninvasive imaging to investigate the motor system of patients with CD and uncover the neural correlates of dystonic symptoms. Furthermore, we examined whether a commonly prescribed anticholinergic medication in CD has an effect on the dystonia-related brain abnormalities. Participants included 16 patients with CD and 16 healthy age-matched controls. We collected functional MRI scans during a force task previously shown to extensively engage the motor system, and diffusion and T1-weighted MRI scans from which we calculated free-water and brain tissue densities. The dystonia group was also scanned ca. 2 h after a 2-mg dose of trihexyphenidyl. Severity of dystonia was assessed pre- and post-drug using the Burke-Fahn-Marsden Dystonia Rating Scale. Motor-related activity in CD was altered relative to controls in the primary somatosensory cortex, cerebellum, dorsal premotor and posterior parietal cortices, and occipital cortex. Most importantly, a regression model showed that increased severity of symptoms was associated with decreased functional activity of the somatosensory cortex and increased activity of the cerebellum. Structural imaging measures did not differ between CD and controls. The single dose of trihexyphenidyl altered the fMRI signal in the somatosensory cortex but not in the cerebellum. Symptom severity was not significantly reduced post-treatment. Findings show widespread changes in functional brain activity in CD and most importantly that dystonic symptoms relate to disrupted activity in the somatosensory cortex and cerebellum. Hum Brain Mapp 38:4563-4573, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Roxana G. Burciu
- Department of Applied Physiology and KinesiologyUniversity of FloridaGainesvilleFlorida
| | - Christopher W. Hess
- Department of NeurologyUniversity of FloridaGainesvilleFlorida
- Center for Movement Disorders and Neurorestoration, University of FloridaGainesvilleFlorida
| | - Stephen A. Coombes
- Department of Applied Physiology and KinesiologyUniversity of FloridaGainesvilleFlorida
| | - Edward Ofori
- Department of Applied Physiology and KinesiologyUniversity of FloridaGainesvilleFlorida
| | - Priyank Shukla
- Department of Applied Physiology and KinesiologyUniversity of FloridaGainesvilleFlorida
| | - Jae Woo Chung
- Department of Applied Physiology and KinesiologyUniversity of FloridaGainesvilleFlorida
| | - Nikolaus R. McFarland
- Department of NeurologyUniversity of FloridaGainesvilleFlorida
- Center for Movement Disorders and Neurorestoration, University of FloridaGainesvilleFlorida
| | - Aparna Wagle Shukla
- Department of NeurologyUniversity of FloridaGainesvilleFlorida
- Center for Movement Disorders and Neurorestoration, University of FloridaGainesvilleFlorida
| | - Michael S. Okun
- Department of NeurologyUniversity of FloridaGainesvilleFlorida
- Center for Movement Disorders and Neurorestoration, University of FloridaGainesvilleFlorida
- Department of NeurosurgeryUniversity of FloridaGainesvilleFlorida
| | - David E. Vaillancourt
- Department of Applied Physiology and KinesiologyUniversity of FloridaGainesvilleFlorida
- Department of NeurologyUniversity of FloridaGainesvilleFlorida
- Department of Biomedical EngineeringUniversity of FloridaGainesvilleFlorida
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Wei P, Zhang Z, Lv Z, Jing B. Strong Functional Connectivity among Homotopic Brain Areas Is Vital for Motor Control in Unilateral Limb Movement. Front Hum Neurosci 2017; 11:366. [PMID: 28747880 PMCID: PMC5506200 DOI: 10.3389/fnhum.2017.00366] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 06/27/2017] [Indexed: 11/13/2022] Open
Abstract
The mechanism underlying brain region organization for motor control in humans remains poorly understood. In this functional magnetic resonance imaging (fMRI) study, right-handed volunteers were tasked to maintain unilateral foot movements on the right and left sides as consistently as possible. We aimed to identify the similarities and differences between brain motor networks of the two conditions. We recruited 18 right-handed healthy volunteers aged 25 ± 2.3 years and used a whole-body 3T system for magnetic resonance (MR) scanning. Image analysis was performed using SPM8, Conn toolbox and Brain Connectivity Toolbox. We determined a craniocaudally distributed, mirror-symmetrical modular structure. The functional connectivity between homotopic brain areas was generally stronger than the intrahemispheric connections, and such strong connectivity led to the abovementioned modular structure. Our findings indicated that the interhemispheric functional interaction between homotopic brain areas is more intensive than the interaction along the conventional top-down and bottom-up pathways within the brain during unilateral limb movement. The detected strong interhemispheric horizontal functional interaction is an important aspect of motor control but often neglected or underestimated. The strong interhemispheric connectivity may explain the physiological phenomena and effects of promising therapeutic approaches. Further accurate and effective therapeutic methods may be developed on the basis of our findings.
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Affiliation(s)
- Pengxu Wei
- Beijing Key Laboratory of Rehabilitation Technical Aids for Old-age Disability, Key Laboratory of Neuro-functional Information and Rehabilitation Engineering of the Ministry of Civil Affairs, National Research Center for Rehabilitation Technical AidsBeijing, China
| | - Zuting Zhang
- Beijing Key Laboratory of Rehabilitation Technical Aids for Old-age Disability, Key Laboratory of Neuro-functional Information and Rehabilitation Engineering of the Ministry of Civil Affairs, National Research Center for Rehabilitation Technical AidsBeijing, China
| | - Zeping Lv
- Beijing Key Laboratory of Rehabilitation Technical Aids for Old-age Disability, Key Laboratory of Neuro-functional Information and Rehabilitation Engineering of the Ministry of Civil Affairs, National Research Center for Rehabilitation Technical AidsBeijing, China
| | - Bin Jing
- School of Biomedical Engineering, Capital Medical UniversityBeijing, China
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Kang N, Christou EA, Burciu RG, Chung JW, DeSimone JC, Ofori E, Ashizawa T, Subramony SH, Vaillancourt DE. Sensory and motor cortex function contributes to symptom severity in spinocerebellar ataxia type 6. Brain Struct Funct 2017; 222:1039-1052. [PMID: 27352359 PMCID: PMC6276122 DOI: 10.1007/s00429-016-1263-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 06/22/2016] [Indexed: 11/29/2022]
Abstract
Spinocerebellar ataxia type 6 (SCA6) is a genetic disease that causes degeneration of Purkinje cells, and recent evidence points to degeneration of Betz cells in the motor cortex. The relation between functional activity of motor cortex and symptom severity during a hand-grip motor control in vivo has not yet been investigated. This study explored both functional changes in the sensorimotor cortex and cerebellar regions and structural alterations in the cerebellum for SCA6 patients as compared to age-matched healthy controls using a multimodal imaging approach (task-based fMRI, task-based functional connectivity, and free-water diffusion MRI). Further, we tested their relation with the severity of ataxia symptoms. SCA6 patients had reduced functional activity in the sensorimotor cortex, supplementary motor area (SMA), cerebellar vermis, and cerebellar lobules I-VI (corrected P < 0.05). Reduced task-based functional connectivity between cortical motor regions (i.e., primary motor cortex and SMA) and cerebellar regions (i.e., vermis and lobules I-VI) was found in SCA6 (corrected P < 0.05). SCA6 had elevated free-water values throughout the cerebellum as compared with controls (corrected P < 0.05). Importantly, reduced functional activity in the sensorimotor cortex and SMA and increased free-water in the superior cerebellar peduncle and cerebellar lobule V were related to more severe symptoms in SCA6 (all pairs: R 2 ≥ 0.4 and corrected P < 0.05). Current results demonstrate that impaired functional activity in sensorimotor cortex and SMA and elevated free-water of lobule V and superior cerebellar peduncle are both related to symptom severity, and may provide candidate biomarkers for SCA6.
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Affiliation(s)
- Nyeonju Kang
- Department of Applied Physiology and Kinesiology, University of Florida, P.O. Box 118205, Gainesville, FL, 32611-8205, USA
| | - Evangelos A Christou
- Department of Applied Physiology and Kinesiology, University of Florida, P.O. Box 118205, Gainesville, FL, 32611-8205, USA
| | - Roxana G Burciu
- Department of Applied Physiology and Kinesiology, University of Florida, P.O. Box 118205, Gainesville, FL, 32611-8205, USA
| | - Jae Woo Chung
- Department of Applied Physiology and Kinesiology, University of Florida, P.O. Box 118205, Gainesville, FL, 32611-8205, USA
| | - Jesse C DeSimone
- Department of Applied Physiology and Kinesiology, University of Florida, P.O. Box 118205, Gainesville, FL, 32611-8205, USA
| | - Edward Ofori
- Department of Applied Physiology and Kinesiology, University of Florida, P.O. Box 118205, Gainesville, FL, 32611-8205, USA
| | - Tetsuo Ashizawa
- Department of Neurology, University of Florida, Gainesville, USA
| | | | - David E Vaillancourt
- Department of Applied Physiology and Kinesiology, University of Florida, P.O. Box 118205, Gainesville, FL, 32611-8205, USA.
- Department of Neurology, University of Florida, Gainesville, USA.
- Department of Biomedical Engineering, University of Florida, Gainesville, USA.
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26
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David FJ, Robichaud JA, Vaillancourt DE, Poon C, Kohrt WM, Comella CL, Corcos DM. Progressive resistance exercise restores some properties of the triphasic EMG pattern and improves bradykinesia: the PRET-PD randomized clinical trial. J Neurophysiol 2016; 116:2298-2311. [PMID: 27582297 DOI: 10.1152/jn.01067.2015] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 08/31/2016] [Indexed: 01/05/2023] Open
Abstract
In Parkinson's disease (PD), the characteristic triphasic agonist and antagonist muscle activation pattern during ballistic movement is impaired: the number of agonist muscle bursts is increased, and the amplitudes of the agonist and antagonist bursts are reduced. The breakdown of the triphasic electromyographic (EMG) pattern has been hypothesized to underlie bradykinesia in PD. Progressive resistance exercise has been shown to improve clinical measures of bradykinesia, but it is not clear whether the benefits for bradykinesia are accompanied by changes in agonist and antagonist muscle activity. This study examined the spatiotemporal changes in agonist and antagonist muscle activity following 24 mo of progressive resistance exercise and the combined relationship between spatiotemporal muscle activity and strength measures and upper limb bradykinesia. We compared the effects of progressive resistance exercise training (PRET) with a nonprogressive exercise intervention, modified Fitness Counts (mFC), in patients with PD. We randomized 48 participants with mild-to-moderate PD to mFC or PRET. At the study endpoint of 24 mo, participants randomized to PRET compared with mFC had significantly faster movement velocity, accompanied by significant increases in the duration, magnitude, and magnitude normalized to duration of the 1st agonist burst and fewer number of agonist bursts before peak velocity. The antagonist muscle activity was increased relative to baseline but did not differ between groups. Spatiotemporal EMG muscle activity and muscle strength were significantly associated with upper limb bradykinesia. These findings demonstrate that progressive resistance exercise improves upper limb movement velocity and restores some aspects of the triphasic EMG pattern.
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Affiliation(s)
- Fabian J David
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, Illinois;
| | - Julie A Robichaud
- Physical Therapy Department, University of Illinois at Chicago, Chicago, Illinois
| | - David E Vaillancourt
- Departments of Applied Physiology and Kinesiology, Biomedical Engineering, and Neurology, University of Florida, Gainesville, Florida
| | - Cynthia Poon
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, Illinois
| | - Wendy M Kohrt
- Division of Geriatric Medicine, University of Colorado School of Medicine, Aurora, Colorado; and
| | - Cynthia L Comella
- Department of Neurological Sciences, Section of Parkinson Disease and Movement Disorders, Rush University Medical Center, Chicago, Illinois
| | - Daniel M Corcos
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, Illinois.,Department of Neurological Sciences, Section of Parkinson Disease and Movement Disorders, Rush University Medical Center, Chicago, Illinois
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27
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Burciu RG, Chung JW, Shukla P, Ofori E, Li H, McFarland NR, Okun MS, Vaillancourt DE. Functional MRI of disease progression in Parkinson disease and atypical parkinsonian syndromes. Neurology 2016; 87:709-17. [PMID: 27421545 DOI: 10.1212/wnl.0000000000002985] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 05/09/2016] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To explore longitudinal changes in brain activity in patients with Parkinson disease (PD), multiple system atrophy (MSA), and progressive supranuclear palsy (PSP) using task-based functional MRI (fMRI). METHODS A total of 112 individuals were scanned 1 year apart while performing a unimanual grip force task: 46 PD, 13 MSA, 19 PSP, and 34 healthy controls. The outcome measure was percent signal change in prespecified regions of interest: putamen, primary motor cortex (M1), supplementary motor area (SMA), and superior motor regions of the cerebellum (lobules V-VI). RESULTS Patients with PD showed a decline in functional activity over the course of 1 year in the putamen and M1 compared to controls. Changes after 1 year in MSA were exclusively extrastriatal, and included a reduction in functional activity in M1, SMA, and superior cerebellum. In PSP, all regions of interest were less active at 1 year compared to baseline. The functional activity of these regions did not change in the control group. CONCLUSIONS We provide evidence using task-based fMRI for cortical and striatal functional deterioration in PD over a 1-year period of time. Results also describe more widespread and unique patterns of functional changes in MSA and PSP compared to PD, suggesting distinct rates of disease progression in parkinsonian disorders that may assist in future clinical studies testing the potential efficacy of disease-modifying therapies.
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Affiliation(s)
- Roxana G Burciu
- From the Department of Applied Physiology and Kinesiology (R.G.B., J.W.C., P.S., E.O., D.E.V.) and the Departments of Neurology (N.R.M., M.S.O., D.E.V.) and Neurosurgery (M.S.O.), Center for Movement Disorders and Neurorestoration, and Department of Biomedical Engineering (D.E.V.), University of Florida, Gainesville; and Department of Public Health Sciences (H.L.), Medical University of South Carolina, Charleston
| | - Jae Woo Chung
- From the Department of Applied Physiology and Kinesiology (R.G.B., J.W.C., P.S., E.O., D.E.V.) and the Departments of Neurology (N.R.M., M.S.O., D.E.V.) and Neurosurgery (M.S.O.), Center for Movement Disorders and Neurorestoration, and Department of Biomedical Engineering (D.E.V.), University of Florida, Gainesville; and Department of Public Health Sciences (H.L.), Medical University of South Carolina, Charleston
| | - Priyank Shukla
- From the Department of Applied Physiology and Kinesiology (R.G.B., J.W.C., P.S., E.O., D.E.V.) and the Departments of Neurology (N.R.M., M.S.O., D.E.V.) and Neurosurgery (M.S.O.), Center for Movement Disorders and Neurorestoration, and Department of Biomedical Engineering (D.E.V.), University of Florida, Gainesville; and Department of Public Health Sciences (H.L.), Medical University of South Carolina, Charleston
| | - Edward Ofori
- From the Department of Applied Physiology and Kinesiology (R.G.B., J.W.C., P.S., E.O., D.E.V.) and the Departments of Neurology (N.R.M., M.S.O., D.E.V.) and Neurosurgery (M.S.O.), Center for Movement Disorders and Neurorestoration, and Department of Biomedical Engineering (D.E.V.), University of Florida, Gainesville; and Department of Public Health Sciences (H.L.), Medical University of South Carolina, Charleston
| | - Hong Li
- From the Department of Applied Physiology and Kinesiology (R.G.B., J.W.C., P.S., E.O., D.E.V.) and the Departments of Neurology (N.R.M., M.S.O., D.E.V.) and Neurosurgery (M.S.O.), Center for Movement Disorders and Neurorestoration, and Department of Biomedical Engineering (D.E.V.), University of Florida, Gainesville; and Department of Public Health Sciences (H.L.), Medical University of South Carolina, Charleston
| | - Nikolaus R McFarland
- From the Department of Applied Physiology and Kinesiology (R.G.B., J.W.C., P.S., E.O., D.E.V.) and the Departments of Neurology (N.R.M., M.S.O., D.E.V.) and Neurosurgery (M.S.O.), Center for Movement Disorders and Neurorestoration, and Department of Biomedical Engineering (D.E.V.), University of Florida, Gainesville; and Department of Public Health Sciences (H.L.), Medical University of South Carolina, Charleston
| | - Michael S Okun
- From the Department of Applied Physiology and Kinesiology (R.G.B., J.W.C., P.S., E.O., D.E.V.) and the Departments of Neurology (N.R.M., M.S.O., D.E.V.) and Neurosurgery (M.S.O.), Center for Movement Disorders and Neurorestoration, and Department of Biomedical Engineering (D.E.V.), University of Florida, Gainesville; and Department of Public Health Sciences (H.L.), Medical University of South Carolina, Charleston
| | - David E Vaillancourt
- From the Department of Applied Physiology and Kinesiology (R.G.B., J.W.C., P.S., E.O., D.E.V.) and the Departments of Neurology (N.R.M., M.S.O., D.E.V.) and Neurosurgery (M.S.O.), Center for Movement Disorders and Neurorestoration, and Department of Biomedical Engineering (D.E.V.), University of Florida, Gainesville; and Department of Public Health Sciences (H.L.), Medical University of South Carolina, Charleston.
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Rosenthal LS, Drake D, Alcalay RN, Babcock D, Bowman FD, Chen-Plotkin A, Dawson TM, Dewey RB, German D, Huang X, Landin B, McAuliffe M, Petyuk VA, Scherzer CR, St Hillaire-Clarke C, Sieber BA, Sutherland M, Tarn C, West A, Vaillancourt D, Zhang J, Gwinn K. The NINDS Parkinson's disease biomarkers program. Mov Disord 2016; 31:915-23. [PMID: 26442452 PMCID: PMC4824671 DOI: 10.1002/mds.26438] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2015] [Revised: 08/11/2015] [Accepted: 08/16/2015] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Neuroprotection for Parkinson's disease (PD) remains elusive. Biomarkers hold the promise of removing roadblocks to therapy development. The National Institute of Neurological Disorders and Stroke has therefore established the Parkinson's Disease Biomarkers Program to promote discovery of PD biomarkers for use in phase II and III clinical trials. METHODS Using a novel consortium design, the Parkinson's Disease Biomarker Program is focused on the development of clinical and laboratory-based biomarkers for PD diagnosis, progression, and prognosis. Standardized operating procedures and pooled reference samples were created to allow cross-project comparisons and assessment of batch effects. A web-based Data Management Resource facilitates rapid sharing of data and biosamples across the research community for additional biomarker projects. RESULTS Eleven consortium projects are ongoing, seven of which recruit participants and obtain biosamples. As of October 2014, 1,082 participants have enrolled (620 PD, 101 with other causes of parkinsonism, 23 essential tremor, and 338 controls), 1,040 of whom have at least one biosample. Six thousand eight hundred ninety-eight total biosamples are available from baseline, 6-, 12-, and 18-month visits: 1,006 DNA, 1,661 RNA, 1,419 whole blood, 1,382 plasma, 1,200 serum, and 230 cerebrospinal fluid (CSF). Quality control analysis of plasma, serum, and CSF samples indicates that almost all samples are high quality (24 of 2,812 samples exceed acceptable hemoglobin levels). CONCLUSIONS By making samples and data widely available, using stringent operating procedures based on existing standards, hypothesis testing for biomarker discovery, and providing a resource that complements existing programs, the Parkinson's Disease Biomarker Program will accelerate the pace of PD biomarker research. © 2015 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Liana S. Rosenthal
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore MD
| | - Daniel Drake
- Department of Biostatistics, Columbia University, New York, New York
| | - Roy N. Alcalay
- Department of Neurology, Columbia University, New York, New York
| | - Debra Babcock
- National Institute of Neurological Diseases and Stroke, National Institutes of Health, Bethesda, MD
| | - F. DuBois Bowman
- Department of Biostatistics, Columbia University, New York, New York
| | | | - Ted M. Dawson
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore MD
- Neuroregeneration and Stem Cell Programs, Institute for Cell Engineering, Solomon H. Snyder Department of Neuroscience, Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Richard B. Dewey
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas TX
| | - Dwight German
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas TX
| | - Xuemei Huang
- Department of Neurology, Penn State Hershey Medical Center, Hershey, PA
| | - Barry Landin
- Center for Information Technology, National Institutes of Health, Bethesda, MD
| | - Matthew McAuliffe
- Center for Information Technology, National Institutes of Health, Bethesda, MD
| | - Vladislav A. Petyuk
- Biological Sciences Division, Pacific Northwest National Laboratory, Richland, WA
| | - Clemens R. Scherzer
- Department of Neurology, Brigham & Women’s Hospital, Harvard Medical School, Cambridge, MA
| | | | - Beth-Anne Sieber
- National Institute of Neurological Diseases and Stroke, National Institutes of Health, Bethesda, MD
| | - Margaret Sutherland
- National Institute of Neurological Diseases and Stroke, National Institutes of Health, Bethesda, MD
| | - Chi Tarn
- Coriell Institute for Medical Research, Camden, NJ
| | - Andrew West
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL
| | - David Vaillancourt
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL
| | - Jing Zhang
- Department of Pathology, University of Washington, Seattle, WA
| | - Katrina Gwinn
- National Institute of Neurological Diseases and Stroke, National Institutes of Health, Bethesda, MD
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Burciu RG, Ofori E, Shukla P, Pasternak O, Chung JW, McFarland NR, Okun MS, Vaillancourt DE. Free-water and BOLD imaging changes in Parkinson's disease patients chronically treated with a MAO-B inhibitor. Hum Brain Mapp 2016; 37:2894-903. [PMID: 27089850 DOI: 10.1002/hbm.23213] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 03/14/2016] [Accepted: 04/04/2016] [Indexed: 12/25/2022] Open
Abstract
Rasagiline is a monoamine oxidase type B inhibitor that possesses no amphetamine-like properties, and provides symptomatic relief in early and late stages of Parkinson's disease (PD). Data in animal models of PD suggest that chronic administration of rasagiline is associated with structural changes in the substantia nigra, and raise the question whether the structure and function of the basal ganglia could be different in PD patients treated chronically with rasagiline as compared with PD patients not treated with rasagiline. Here, we performed a retrospective cross-sectional magnetic resonance imaging (MRI) study at 3 T that investigated nigrostriatal function and structure in PD patients who had taken rasagiline before testing (∼8 months), PD who had not taken rasagiline before testing, and age-matched controls. The two PD groups were selected a priori to not differ significantly in age, sex, disease duration, severity of symptoms, cognitive status, and total levodopa equivalent daily dose of medication. We evaluated percent signal change in the posterior putamen during force production using functional MRI, free-water in the posterior substantia nigra using diffusion MRI, and performance on a bimanual coordination task using a pegboard test. All patients were tested after overnight withdrawal from antiparkinsonian medication. The rasagiline group had greater percent signal change in the posterior putamen, less free-water in the posterior substantia nigra, and better performance on the coordination task than the group not taking rasagiline. These findings point to a possible chronic effect of rasagiline on the structure and function of the basal ganglia in PD. Hum Brain Mapp 37:2894-2903, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Roxana G Burciu
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida
| | - Edward Ofori
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida
| | - Priyank Shukla
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida
| | - Ofer Pasternak
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.,Department of and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jae Woo Chung
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida
| | - Nikolaus R McFarland
- Department of Neurology, University of Florida, Gainesville, Florida.,Center for Movement Disorders and Neurorestoration, College of Medicine, University of Florida, University of Florida, Gainesville, Florida
| | - Michael S Okun
- Department of Neurology, University of Florida, Gainesville, Florida.,Center for Movement Disorders and Neurorestoration, College of Medicine, University of Florida, University of Florida, Gainesville, Florida.,Department of Neurosurgery, University of Florida, Gainesville, Florida
| | - David E Vaillancourt
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida.,Department of Neurology, University of Florida, Gainesville, Florida.,Department of Biomedical Engineering, University of Florida, Gainesville, Florida
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Vigaru B, Sulzer J, Gassert R. Design and Evaluation of a Cable-Driven fMRI-Compatible Haptic Interface to Investigate Precision Grip Control. IEEE TRANSACTIONS ON HAPTICS 2016; 9:20-32. [PMID: 26441454 PMCID: PMC4829477 DOI: 10.1109/toh.2015.2485201] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Our hands and fingers are involved in almost all activities of daily living and, as such, have a disproportionately large neural representation. Functional magnetic resonance imaging investigations into the neural control of the hand have revealed great advances, but the harsh MRI environment has proven to be a challenge to devices capable of delivering a large variety of stimuli necessary for well-controlled studies. This paper presents a fMRI-compatible haptic interface to investigate the neural mechanisms underlying precision grasp control. The interface, located at the scanner bore, is controlled remotely through a shielded electromagnetic actuation system positioned at the end of the scanner bed and then through a high stiffness, low inertia cable transmission. We present the system design, taking into account requirements defined by the biomechanics and dynamics of the human hand, as well as the fMRI environment. Performance evaluation revealed a structural stiffness of 3.3 N/mm, renderable forces up to 94 N, and a position control bandwidth of at least 19 Hz. MRI-compatibility tests showed no degradation in the operation of the haptic interface or the image quality. A preliminary fMRI experiment during a pilot study validated the usability of the haptic interface, illustrating the possibilities offered by this device.
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Bagga P, Chugani AN, Patel AB. Neuroprotective effects of caffeine in MPTP model of Parkinson's disease: A 13 C NMR study. Neurochem Int 2016; 92:25-34. [DOI: 10.1016/j.neuint.2015.11.006] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 11/18/2015] [Accepted: 11/20/2015] [Indexed: 11/17/2022]
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Hackney ME, Lee HL, Battisto J, Crosson B, McGregor KM. Context-Dependent Neural Activation: Internally and Externally Guided Rhythmic Lower Limb Movement in Individuals With and Without Neurodegenerative Disease. Front Neurol 2015; 6:251. [PMID: 26696952 PMCID: PMC4667008 DOI: 10.3389/fneur.2015.00251] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 11/16/2015] [Indexed: 12/24/2022] Open
Abstract
Parkinson’s disease is a neurodegenerative disorder that has received considerable attention in allopathic medicine over the past decades. However, it is clear that, to date, pharmacological and surgical interventions do not fully address symptoms of PD and patients’ quality of life. As both an alternative therapy and as an adjuvant to conventional approaches, several types of rhythmic movement (e.g., movement strategies, dance, tandem biking, and Tai Chi) have shown improvements to motor symptoms, lower limb control, and postural stability in people with PD (1–6). However, while these programs are increasing in number, still little is known about the neural mechanisms underlying motor improvements attained with such interventions. Studying limb motor control under task-specific contexts can help determine the mechanisms of rehabilitation effectiveness. Both internally guided (IG) and externally guided (EG) movement strategies have evidence to support their use in rehabilitative programs. However, there appears to be a degree of differentiation in the neural substrates involved in IG vs. EG designs. Because of the potential task-specific benefits of rhythmic training within a rehabilitative context, this report will consider the use of IG and EG movement strategies, and observations produced by functional magnetic resonance imaging and other imaging techniques. This review will present findings from lower limb imaging studies, under IG and EG conditions for populations with and without movement disorders. We will discuss how these studies might inform movement disorders rehabilitation (in the form of rhythmic, music-based movement training) and highlight research gaps. We believe better understanding of lower limb neural activity with respect to PD impairment during rhythmic IG and EG movement will facilitate the development of novel and effective therapeutic approaches to mobility limitations and postural instability.
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Affiliation(s)
- Madeleine E Hackney
- Atlanta VA Center for Visual and Neurocognitive Rehabilitation , Decatur, GA , USA ; Division of General Medicine and Geriatrics, Department of Medicine, Emory School of Medicine , Atlanta, GA , USA
| | - Ho Lim Lee
- Emory College of Arts and Sciences, Emory University , Atlanta, GA , USA
| | - Jessica Battisto
- Emory College of Arts and Sciences, Emory University , Atlanta, GA , USA
| | - Bruce Crosson
- Atlanta VA Center for Visual and Neurocognitive Rehabilitation , Decatur, GA , USA ; Department of Neurology, Emory School of Medicine , Atlanta, GA , USA
| | - Keith M McGregor
- Atlanta VA Center for Visual and Neurocognitive Rehabilitation , Decatur, GA , USA ; Department of Neurology, Emory School of Medicine , Atlanta, GA , USA
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Burciu RG, Ofori E, Shukla P, Planetta PJ, Snyder AF, Li H, Hass CJ, Okun MS, McFarland NR, Vaillancourt DE. Distinct patterns of brain activity in progressive supranuclear palsy and Parkinson's disease. Mov Disord 2015; 30:1248-58. [PMID: 26148135 PMCID: PMC4578977 DOI: 10.1002/mds.26294] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 04/28/2015] [Accepted: 05/11/2015] [Indexed: 11/05/2022] Open
Abstract
The basal ganglia-thalamo-cortical and cerebello-thalamo-cortical circuits are important for motor control. Whether their functioning is affected in a similar or different way by progressive supranuclear palsy (PSP) and Parkinson's disease (PD) is not clear. A functional magnetic resonance imaging (fMRI) force production paradigm and voxel-based morphometry were used to assess differences in brain activity and macrostructural volumes between PSP, PD, and healthy age-matched controls. We found that PSP and PD share reduced functional activity of the basal ganglia and cortical motor areas, but this is more pronounced in PSP than in PD. In PSP the frontal regions are underactive, whereas the posterior parietal and occipital regions are overactive as compared with controls and PD. Furthermore, lobules I through IV, V, and VI of the cerebellum are hypoactive in PSP and PD, whereas Crus I and lobule IX are hyperactive in PSP only. Reductions in gray and white matter volume are specific to PSP. Finally, the functional status of the caudate as well as the volume of the superior frontal gyrus predict clinical gait and posture measures in PSP. PSP and PD share hypoactivity of the basal ganglia, motor cortex, and anterior cerebellum. These patients also display a unique pattern, such that anterior regions of the cortex are hypoactive and posterior regions of the cortex and cerebellum are hyperactive. Together, these findings suggest that specific structures within the basal ganglia, cortex, and cerebellum are affected differently in PSP relative to PD.
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Affiliation(s)
- Roxana G. Burciu
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, 32611, USA
| | - Edward Ofori
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, 32611, USA
| | - Priyank Shukla
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, 32611, USA
| | - Peggy J. Planetta
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, 32611, USA
| | - Amy F. Snyder
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, 32611, USA
| | - Hong Li
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, 60612
| | - Chris J. Hass
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, 32611, USA
- Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, 32607, USA
| | - Michael S. Okun
- Department of Neurology, University of Florida, Gainesville, FL, 32610, USA
- Department of Neurosurgery, University of Florida, Gainesville, FL, 32610, USA
- Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, 32607, USA
| | - Nikolaus R. McFarland
- Department of Neurology, University of Florida, Gainesville, FL, 32610, USA
- Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, 32607, USA
| | - David E. Vaillancourt
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, 32611, USA
- Department of Biomedical Engineering, University of Florida, Gainesville, FL, 32611, USA
- Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, 32607, USA
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Qing Z, Dong Z, Li S, Zang Y, Liu D. Global signal regression has complex effects on regional homogeneity of resting state fMRI signal. Magn Reson Imaging 2015; 33:1306-1313. [PMID: 26234499 DOI: 10.1016/j.mri.2015.07.011] [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] [Received: 05/24/2013] [Revised: 05/11/2015] [Accepted: 07/27/2015] [Indexed: 01/28/2023]
Abstract
Regional homogeneity (ReHo) quantifies spatially local synchronization of resting state fMRI signal and has been applied to lots of clinic studies. Accumulating evidences demonstrated that the synchronization between spatially distinct brain regions, i.e. functional connectivity, can be remarkably influenced if the global mean time course is regressed out, namely global signal regression (GSR). Very recently, it was reported GSR reduces the test-retest reliability of ReHo, and reduces the positive correlation between ReHo and head motion. In this study, we were interested in two questions: 1) how GSR affects the raw ReHo values and its spatial distribution over the brain; 2) how GSR affects the differences of ReHo between two resting states, eyes open (EO) and eyes closed (EC), in healthy individuals. We found that the ReHo values were reduced by GSR but the spatial distribution of ReHo was not changed remarkably. In addition, split-half reproducibility analysis showed reproducible ReHo difference between EO and EC in some areas (e.g., thalamus and caudate) only with GSR, but showed reproducible ReHo difference in some other area (right temporal pole) only without GSR. The effects of GSR were almost independent of regression of other nuisance covariates. Our results suggest that the influences of GSR on ReHo are remarkable, reliable and complex. For the between-condition comparison, the GSR effects are region specific. We suggest that, for application studies using ReHo approach, it would be helpful to report results both with and without GSR.
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Affiliation(s)
- Zhao Qing
- National Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Zhangye Dong
- National Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Sufang Li
- Neuroimage Research Branch, National Institute of Drug Abuse, National Institute of Health, Baltimore, MD, USA
| | - Yufeng Zang
- Center for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou, China; Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China
| | - Dongqiang Liu
- Center for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou, China; Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China.
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35
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Ofori E, Du G, Babcock D, Huang X, Vaillancourt DE. Parkinson's disease biomarkers program brain imaging repository. Neuroimage 2015; 124:1120-1124. [PMID: 25976927 DOI: 10.1016/j.neuroimage.2015.05.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 04/13/2015] [Accepted: 05/02/2015] [Indexed: 12/17/2022] Open
Abstract
The Parkinson's Disease Biomarkers Program (PDBP) is a multi-site study designed to identify Parkinson's disease (PD) biomarkers that can be used to improve the understanding of PD pathophysiology and to develop tools that provide novel measures to evaluate PD clinical trials. The PDBP consortium comprises numerous individual projects of which two are specifically geared to the development of brain imaging markers for diagnosis, progression, and prognosis of PD or related disorders. All study data from PD patients, atypical Parkinsonian patients, patients with essential tremor, and healthy controls collected from the sites are integrated in the PDBP database and will be publically available. All subjects are asked to submit blood samples, and undergo a battery of clinical evaluations that cover motor, cognitive, and other background information. In addition, a subset of subjects contributed cerebrospinal fluid samples. A restricted access, web-based Data Management Resource facilitates rapid sharing of data and biosamples across the entire PD research community. The PDBP consortium is a useful resource for research and collaboration aimed at the discovery of biomarkers and their use in understanding the pathophysiology of PD.
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Affiliation(s)
- Edward Ofori
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32611, USA
| | - Guangwei Du
- Department of Neurology, Penn State-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Debra Babcock
- National Institute of Neurological Diseases and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Xuemei Huang
- Department of Neurology, Penn State-Milton S. Hershey Medical Center, Hershey, PA, USA; Departments of Neurosurgery, Radiology, Pharmacology and Kinesiology, Penn State-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - David E Vaillancourt
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32611, USA; Department of Biomedical Engineering, University of Florida, Gainesville, FL 32611, USA; Department of Neurology, University of Florida, Gainesville, FL 32611, USA.
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36
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Planetta PJ, Kurani AS, Shukla P, Prodoehl J, Corcos DM, Comella CL, McFarland NR, Okun MS, Vaillancourt DE. Distinct functional and macrostructural brain changes in Parkinson's disease and multiple system atrophy. Hum Brain Mapp 2014; 36:1165-79. [PMID: 25413603 DOI: 10.1002/hbm.22694] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Revised: 09/16/2014] [Accepted: 11/10/2014] [Indexed: 01/11/2023] Open
Abstract
Parkinson's disease (PD) and the parkinsonian variant of multiple system atrophy (MSAp) are neurodegenerative disorders that can be difficult to differentiate clinically. This study provides the first characterization of the patterns of task-related functional magnetic resonance imaging (fMRI) changes across the whole brain in MSAp. We used fMRI during a precision grip force task and also performed voxel-based morphometry (VBM) on T1 -weighted images in MSAp patients, PD patients, and healthy controls. All groups were matched on age, and the patient groups had comparable motor symptom durations and severities. There were three main findings. First, MSAp and PD had reduced fMRI activation in motor control areas, including the basal ganglia, thalamus, insula, primary sensorimotor and prefrontal cortices, and cerebellum compared with controls. Second, there were no activation differences among the disease groups in the basal ganglia, thalamus, insula, or primary sensorimotor cortices, but PD had more extensive activation deficits throughout the cerebrum compared with MSAp and controls. Third, VBM revealed reduced volume in the basal ganglia, middle and inferior cerebellar peduncles, pons, and throughout the cerebrum in MSAp compared with controls and PD, and additionally throughout the cerebellar cortex and vermis in MSAp compared with controls. Collectively, these results provide the first evidence that fMRI activation is abnormal in the basal ganglia, cerebellum, and cerebrum in MSAp, and that a key distinguishing feature between MSAp and PD is the extensive and widespread volume loss throughout the brain in MSAp.
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Affiliation(s)
- Peggy J Planetta
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida
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Planetta PJ, McFarland NR, Okun MS, Vaillancourt DE. MRI reveals brain abnormalities in drug-naive Parkinson's disease. Exerc Sport Sci Rev 2014; 42:12-22. [PMID: 24188978 DOI: 10.1249/jes.0000000000000003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Most brain studies of Parkinson's disease (PD) focus on patients who are already taking antiparkinsonian medication. This makes it difficult to isolate the effects of disease from those of treatment. We review magnetic resonance imaging evidence supporting the hypothesis that early-stage untreated PD patients have structural and functional abnormalities in the brain, some of which are related to motor symptoms.
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Affiliation(s)
- Peggy J Planetta
- Departments of 1Applied Physiology and Kinesiology, and 2Neurology, 3Center for Movement Disorders and Neurorestoration, and Departments of 4Neurosurgery, and 5Biomedical Engineering, University of Florida, Gainesville, FL
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Kurani AS, Seidler RD, Burciu RG, Comella CL, Corcos DM, Okun MS, MacKinnon CD, Vaillancourt DE. Subthalamic nucleus--sensorimotor cortex functional connectivity in de novo and moderate Parkinson's disease. Neurobiol Aging 2014; 36:462-9. [PMID: 25095723 DOI: 10.1016/j.neurobiolaging.2014.07.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 06/24/2014] [Accepted: 07/08/2014] [Indexed: 11/17/2022]
Abstract
Previous research has indicated increased functional connectivity between subthalamic nucleus (STN) and sensorimotor cortex in off-medication Parkinson's disease (PD) compared with control subjects. It is not clear if the increase in functional connectivity between STN and sensorimotor cortex occurs in de novo PD, which is before patients begin dopamine therapy. Resting-state functional magnetic resonance imaging was carried out in 20 de novo (drug naïve) patients with PD (Hoehn and Yahr stage: I-II), 19 patients with moderate PD (Hoehn and Yahr stage: II-III), and 19 healthy controls. The functional connectivity analysis in de novo and moderate PD patients focused on the connectivity of the more affected STN and the sensorimotor cortex. Using resting-state functional connectivity analysis, we provide new evidence that people with de novo PD and off-medicated moderate PD have increased functional connectivity between the more affected STN and different regions within the sensorimotor cortex. The overlapping sensorimotor cortex found in both de novo and moderate PD had functional connectivity values that correlated positively with the Unified Parkinson's Disease Rating Scale part III. This key finding suggests that changes in functional connectivity between STN and sensorimotor cortex occur early in the disease following diagnosis and before dopamine therapy.
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Affiliation(s)
- Ajay S Kurani
- Department of Bioengineering, University of Illinois, Chicago, IL, USA
| | - Rachael D Seidler
- Department of Psychology, School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
| | - Roxana G Burciu
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA
| | - Cynthia L Comella
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Daniel M Corcos
- Department of Bioengineering, University of Illinois, Chicago, IL, USA; Department of Kinesiology and Nutrition, University of Illinois, Chicago, IL, USA
| | - Michael S Okun
- Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, USA; Department of Neurology, University of Florida, Gainesville, FL, USA; Department of Neurosurgery, University of Florida, Gainesville, FL, USA
| | - Colum D MacKinnon
- Department of Neurology, University of Minnesota, Minneapolis, MN, USA
| | - David E Vaillancourt
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA; Department of Neurology, University of Florida, Gainesville, FL, USA; Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA.
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Neely KA, Kurani AS, Shukla P, Planetta PJ, Wagle Shukla A, Goldman JG, Corcos DM, Okun MS, Vaillancourt DE. Functional Brain Activity Relates to 0-3 and 3-8 Hz Force Oscillations in Essential Tremor. Cereb Cortex 2014; 25:4191-202. [PMID: 24962992 DOI: 10.1093/cercor/bhu142] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
It is well-established that during goal-directed motor tasks, patients with essential tremor have increased oscillations in the 0-3 and 3-8 Hz bands. It remains unclear if these increased oscillations relate to activity in specific brain regions. This study used task-based functional magnetic resonance imaging to compare the brain activity associated with oscillations in grip force output between patients with essential tremor, patients with Parkinson's disease who had clinically evident tremor, and healthy controls. The findings demonstrate that patients with essential tremor have increased brain activity in the motor cortex and supplementary motor area compared with controls, and this activity correlated positively with 3-8 Hz force oscillations. Brain activity in cerebellar lobules I-V was reduced in essential tremor compared with controls and correlated negatively with 0-3 Hz force oscillations. Widespread differences in brain activity were observed between essential tremor and Parkinson's disease. Using functional connectivity analyses during the task evidenced reduced cerebellar-cortical functional connectivity in patients with essential tremor compared with controls and Parkinson's disease. This study provides new evidence that in essential tremor 3-8 Hz force oscillations relate to hyperactivity in motor cortex, 0-3 Hz force oscillations relate to the hypoactivity in the cerebellum, and cerebellar-cortical functional connectivity is impaired.
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Affiliation(s)
- Kristina A Neely
- Department of Kinesiology, The Pennsylvania State University, State College, PA, USA
| | - Ajay S Kurani
- Department of Bioengineering, University of Illinois at Chicago, Chicago, IL, USA
| | - Priyank Shukla
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA
| | - Peggy J Planetta
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA
| | - Aparna Wagle Shukla
- Department of Neurology and Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, USA
| | - Jennifer G Goldman
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Daniel M Corcos
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA Department of Physical Therapy and Human Movement Sciences, Northwestern University, Evanston, IL, USA
| | - Michael S Okun
- Department of Neurology and Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, USA
| | - David E Vaillancourt
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA Department of Neurology and Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, USA Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
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The handyman's brain: a neuroimaging meta-analysis describing the similarities and differences between grip type and pattern in humans. Neuroimage 2014; 102 Pt 2:923-37. [PMID: 24927986 DOI: 10.1016/j.neuroimage.2014.05.064] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2014] [Revised: 05/13/2014] [Accepted: 05/22/2014] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Handgrip is a ubiquitous human movement that was critical in our evolution. However, the differences in brain activity between grip type (i.e. power or precision) and pattern (i.e. dynamic or static) are not fully understood. In order to address this, we performed Activation Likelihood Estimation (ALE) analysis between grip type and grip pattern using functional magnetic resonance imaging (fMRI) data. ALE provides a probabilistic summary of the BOLD response in hundreds of subjects, which is often beyond the scope of a single fMRI experiment. METHODS We collected data from 28 functional magnetic resonance data sets, which included a total of 398 male and female subjects. Using ALE, we analyzed the BOLD response during power, precision, static and dynamic grip in a range of forces and age in right handed healthy individuals without physical impairment, cardiovascular or neurological dysfunction using a variety of grip tools, feedback and experimental training. RESULTS Power grip generates unique activation in the postcentral gyrus (areas 1 and 3b) and precision grip generates unique activation in the supplementary motor area (SMA, area 6) and precentral gyrus (area 4a). Dynamic handgrip generates unique activation in the precentral gyrus (area 4p) and SMA (area 6) and of particular interest, both dynamic and static grip share activation in the area 2 of the postcentral gyrus, an area implicated in the evolution of handgrip. According to effect size analysis, precision and dynamic grip generates stronger activity than power and static, respectively. CONCLUSION Our study demonstrates specific differences between grip type and pattern. However, there was a large degree of overlap in the pre and postcentral gyrus, SMA and areas of the frontal-parietal-cerebellar network, which indicates that other mechanisms are potentially involved in regulating handgrip. Further, our study provides empirically based regions of interest, which can be downloaded here within, that can be used to more effectively study power grip in a range of populations and conditions.
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Aarts E, Nusselein AAM, Smittenaar P, Helmich RC, Bloem BR, Cools R. Greater striatal responses to medication in Parkinson׳s disease are associated with better task-switching but worse reward performance. Neuropsychologia 2014; 62:390-7. [PMID: 24912070 DOI: 10.1016/j.neuropsychologia.2014.05.023] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Revised: 05/24/2014] [Accepted: 05/27/2014] [Indexed: 01/19/2023]
Abstract
Dopaminergic medication in Parkinson's disease has been proposed to improve cognitive processing by modulating the severely depleted dorsal striatum, while impairing reward processing by modulating the relatively intact ventral striatum. However, there is no direct (neural) evidence for this hypothesis. Here we fill this gap by scanning Parkinson's disease patients (n=15) ON and relatively OFF their dopaminergic medication using functional magnetic resonance imaging. During scanning, patients performed a task that enabled the simultaneous measurement of task-switching and reward-related processing. Brain-behavior correlations revealed that medication-related increases (ON-OFF) in switch-related BOLD signal (switch-repeat) in the dorsomedial striatum were associated, on an individual basis, with improvements in task-switching (i.e. a decreased switch cost). Conversely, medication-related increases (ON-OFF) in reward-related BOLD signal (high-low) in the ventromedial striatum were associated, on an individual basis, with impairments in performance in anticipation of reward (i.e. an increased reward cost). Linear regression analyses demonstrated that the positive relationship between medication-related changes in BOLD and the reward cost was unique to the ventromedial striatum, whereas the negative relationship between medication-related changes in BOLD and the switch cost was not unique to the dorsomedial striatum. These findings extend the dopamine overdose hypothesis, according to which dopamine-induced changes in dorsal and ventral striatal processing lead to cognitive improvement and impairment respectively.
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Affiliation(s)
- Esther Aarts
- Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
| | - Abraham A M Nusselein
- Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Peter Smittenaar
- Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Rick C Helmich
- Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands; Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Parkinson Centre Nijmegen (ParC), P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Bastiaan R Bloem
- Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Parkinson Centre Nijmegen (ParC), P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Roshan Cools
- Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands; Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Psychiatry, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
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Peterson DS, Pickett KA, Duncan RP, Perlmutter JS, Earhart GM. Brain activity during complex imagined gait tasks in Parkinson disease. Clin Neurophysiol 2014; 125:995-1005. [PMID: 24210997 PMCID: PMC3981914 DOI: 10.1016/j.clinph.2013.10.008] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2013] [Revised: 09/24/2013] [Accepted: 10/01/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Motor imagery during functional magnetic resonance imaging (fMRI) allows assessment of brain activity during tasks, like walking, that cannot be completed in an MRI scanner. We used gait imagery to assess the neural pathophysiology of locomotion in Parkinson disease (PD). METHODS Brain activity was measured in five locomotor regions (supplementary motor area (SMA), globus pallidus (GP), putamen, mesencephalic locomotor region, cerebellar locomotor region) during simple (forward) and complex (backward, turning) gait imagery. Brain activity was correlated to overground walking velocity. RESULTS Across tasks, PD exhibited reduced activity in the globus pallidus compared to controls. People with PD, but not controls, exhibited more activity in the SMA during imagined turning compared to forward or backward walking. In PD, walking speed was correlated to brain activity in several regions. CONCLUSIONS Altered SMA activity in PD during imagined turning may represent compensatory neural adaptations during complex gait. The lowered activity and positive correlation to locomotor function in GP suggests reduced activity in this region may relate to locomotor dysfunction. SIGNIFICANCE This study elucidates changes in neural activity during gait in PD, underscoring the importance of testing simple and complex tasks. Results support a positive relationship between activity in locomotor regions and walking ability.
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Affiliation(s)
- Daniel S Peterson
- Program in Physical Therapy, Washington University in St. Louis, 660 S. Euclid, St. Louis, MO 63110, United States.
| | - Kristen A Pickett
- Program in Physical Therapy, Washington University in St. Louis, 660 S. Euclid, St. Louis, MO 63110, United States; Department of Neurology, Washington University in St. Louis, 660 S. Euclid, St. Louis, MO 63110, United States.
| | - Ryan P Duncan
- Program in Physical Therapy, Washington University in St. Louis, 660 S. Euclid, St. Louis, MO 63110, United States.
| | - Joel S Perlmutter
- Program in Physical Therapy, Washington University in St. Louis, 660 S. Euclid, St. Louis, MO 63110, United States; Department of Neurology, Washington University in St. Louis, 660 S. Euclid, St. Louis, MO 63110, United States; Department of Neurobiology, Washington University in St. Louis, 660 S. Euclid, St. Louis, MO 63110, United States; Department of Radiology, Washington University in St. Louis, 660 S. Euclid, St. Louis, MO 63110, United States; Program in Occupational Therapy, Washington University in St. Louis, 660 S. Euclid, St. Louis, MO 63110, United States.
| | - Gammon M Earhart
- Program in Physical Therapy, Washington University in St. Louis, 660 S. Euclid, St. Louis, MO 63110, United States; Department of Neurology, Washington University in St. Louis, 660 S. Euclid, St. Louis, MO 63110, United States; Department of Neurobiology, Washington University in St. Louis, 660 S. Euclid, St. Louis, MO 63110, United States.
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Peterson DS, Pickett KA, Duncan R, Perlmutter J, Earhart GM. Gait-related brain activity in people with Parkinson disease with freezing of gait. PLoS One 2014; 9:e90634. [PMID: 24595265 PMCID: PMC3940915 DOI: 10.1371/journal.pone.0090634] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Accepted: 02/05/2014] [Indexed: 11/18/2022] Open
Abstract
Approximately 50% of people with Parkinson disease experience freezing of gait, described as a transient inability to produce effective stepping. Complex gait tasks such as turning typically elicit freezing more commonly than simple gait tasks, such as forward walking. Despite the frequency of this debilitating and dangerous symptom, the brain mechanisms underlying freezing remain unclear. Gait imagery during functional magnetic resonance imaging permits investigation of brain activity associated with locomotion. We used this approach to better understand neural function during gait-like tasks in people with Parkinson disease who experience freezing--"FoG+" and people who do not experience freezing--"FoG-". Nine FoG+ and nine FoG- imagined complex gait tasks (turning, backward walking), simple gait tasks (forward walking), and quiet standing during measurements of blood oxygen level dependent (BOLD) signal. Changes in BOLD signal (i.e. beta weights) during imagined walking and imagined standing were analyzed across FoG+ and FoG- groups in locomotor brain regions including supplementary motor area, globus pallidus, putamen, mesencephalic locomotor region, and cerebellar locomotor region. Beta weights in locomotor regions did not differ for complex tasks compared to simple tasks in either group. Across imagined gait tasks, FoG+ demonstrated significantly lower beta weights in the right globus pallidus with respect to FoG-. FoG+ also showed trends toward lower beta weights in other right-hemisphere locomotor regions (supplementary motor area, mesencephalic locomotor region). Finally, during imagined stand, FoG+ exhibited lower beta weights in the cerebellar locomotor region with respect to FoG-. These data support previous results suggesting FoG+ exhibit dysfunction in a number of cortical and subcortical regions, possibly with asymmetric dysfunction towards the right hemisphere.
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Affiliation(s)
- Daniel S. Peterson
- Program in Physical Therapy, Washington University in St. Louis, St. Louis, Missouri, United States of America
| | - Kristen A. Pickett
- Program in Physical Therapy, Washington University in St. Louis, St. Louis, Missouri, United States of America
- Department of Neurology, Washington University in St. Louis, St. Louis, Missouri, United States of America
| | - Ryan Duncan
- Program in Physical Therapy, Washington University in St. Louis, St. Louis, Missouri, United States of America
| | - Joel Perlmutter
- Program in Physical Therapy, Washington University in St. Louis, St. Louis, Missouri, United States of America
- Department of Neurology, Washington University in St. Louis, St. Louis, Missouri, United States of America
- Anatomy and Neurobiology, Washington University in St. Louis, St. Louis, Missouri, United States of America
- Radiology, Washington University in St. Louis, St. Louis, Missouri, United States of America
| | - Gammon M. Earhart
- Program in Physical Therapy, Washington University in St. Louis, St. Louis, Missouri, United States of America
- Department of Neurology, Washington University in St. Louis, St. Louis, Missouri, United States of America
- Anatomy and Neurobiology, Washington University in St. Louis, St. Louis, Missouri, United States of America
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Danion F. Superposition of automatic and voluntary aspects of grip force control in humans during object manipulation. PLoS One 2013; 8:e79341. [PMID: 24244483 PMCID: PMC3823659 DOI: 10.1371/journal.pone.0079341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Accepted: 09/28/2013] [Indexed: 11/19/2022] Open
Abstract
When moving grasped objects, people automatically modulate grip force (GF) with movement-dependent load force (LF) in order to prevent object slip. However, GF can also be modulated voluntarily as when squeezing an object. Here we investigated possible interactions between automatic and voluntary GF control. Participants were asked to generate horizontal cyclic movements (between 0.6 and 2.0 Hz) of a hand-held object that was restrained by an elastic band such that the load force (LF) reached a peak once per movement cycle, and to simultaneously squeeze the object at each movement reversal (i.e., twice per cycle). Participants also performed two control tasks in which they either only moved (between 0.6 and 2.0 Hz) or squeezed (between 1.2 and 4.0 Hz) the object. The extent to which GF modulation in the simultaneous task could be predicted from the two control tasks was assessed using power spectral analyses. At all frequencies, the GF power spectra from the simultaneous task exhibited two prominent components that occurred at the cycle frequency (ƒ) and at twice this frequency (2ƒ), whereas the spectra from the movement and squeeze control task exhibited only single peaks at ƒ and 2ƒ, respectively. At lower frequencies, the magnitudes of both frequency components in the simultaneous task were similar to the magnitudes of the corresponding components in the control tasks. However, as frequency increased, the magnitudes of both components in the simultaneous task were greater than the magnitudes of the corresponding control task components. Moreover, the phase relationship between the ƒ components of GF and LF began to drift from the value observed in the movement control task. Overall these results suggest that, at lower movement frequencies, voluntary and automatic GF control processes operate at different hierarchical levels. Several mechanisms are discussed to account for interaction effects observed at higher movement frequencies.
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Affiliation(s)
- Frederic Danion
- Institut de Neurosciences de la Timone, CNRS & Aix-Marseille University, Marseille, France
- * E-mail:
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45
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Herz DM, Eickhoff SB, Løkkegaard A, Siebner HR. Functional neuroimaging of motor control in Parkinson's disease: a meta-analysis. Hum Brain Mapp 2013; 35:3227-37. [PMID: 24123553 DOI: 10.1002/hbm.22397] [Citation(s) in RCA: 131] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Revised: 08/07/2013] [Accepted: 08/13/2013] [Indexed: 12/13/2022] Open
Abstract
Functional neuroimaging has been widely used to study the activation patterns of the motor network in patients with Parkinson's disease (PD), but these studies have yielded conflicting results. This meta-analysis of previous neuroimaging studies was performed to identify patterns of abnormal movement-related activation in PD that were consistent across studies. We applied activation likelihood estimation (ALE) of functional neuroimaging studies probing motor function in patients with PD. The meta-analysis encompassed data from 283 patients with PD reported in 24 functional neuroimaging studies and yielded consistent alterations in neural activity in patients with PD. Differences in cortical activation between PD patients and healthy controls converged in a left-lateralized fronto-parietal network comprising the presupplementary motor area, primary motor cortex, inferior parietal cortex, and superior parietal lobule. Both, increases as well as decreases in motor cortical activity, which were related to differences in movement timing and selection in the applied motor tasks, were reported in these cortical areas. In the basal ganglia, PD patients expressed a decrease of motor activation in the posterior motor putamen, which improved with dopaminergic medication. The likelihood of detecting a decrease in putaminal activity increased with motor impairment. This reduced motor activation of the posterior putamen across previous neuroimaging studies indicates that nigrostriatal dopaminergic denervation affects neural processing in the denervated striatal motor territory. In contrast, fronto-parietal motor areas display both increases as well as decreases in movement related activation. This points to a more complex relationship between altered cortical physiology and nigrostriatal dopaminergic denervation in PD.
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Affiliation(s)
- Damian M Herz
- Danish Research Center for Magnetic Resonance, Center for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
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Corcos DM, Robichaud JA, David FJ, Leurgans SE, Vaillancourt DE, Poon C, Rafferty MR, Kohrt WM, Comella CL. A two-year randomized controlled trial of progressive resistance exercise for Parkinson's disease. Mov Disord 2013; 28:1230-40. [PMID: 23536417 DOI: 10.1002/mds.25380] [Citation(s) in RCA: 195] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Revised: 12/22/2012] [Accepted: 01/03/2013] [Indexed: 11/08/2022] Open
Abstract
The effects of progressive resistance exercise (PRE) on the motor signs of Parkinson's disease have not been studied in controlled trials. The objective of the current trial was to compare 6-, 12-, 18-, and 24-month outcomes of patients with Parkinson's disease who received PRE with a stretching, balance, and strengthening exercise program. The authors conducted a randomized controlled trial between September 2007 and July 2011. Pairs of patients matched by sex and off-medication scores on the Unified Parkinson's Disease Rating Scale, motor subscale (UPDRS-III), were randomly assigned to the interventions with a 1:1 allocation ratio. The PRE group performed a weight-lifting program. The modified fitness counts (mFC) group performed a stretching, balance, and strengthening exercise program. Patients exercised 2 days per week for 24 months at a gym. A personal trainer directed both weekly sessions for the first 6 months and 1 weekly session after 6 months. The primary outcome was the off-medication UPDRS-III score. Patients were followed for 24 months at 6-month intervals. Of 51 patients, 20 in the PRE group and 18 in the mFC group completed the trial. At 24 months, the mean off-medication UPDRS-III score decreased more with PRE than with mFC (mean difference, -7.3 points; 95% confidence interval, -11.3 to -3.6; P<0.001). The PRE group had 10 adverse events, and the mFC group had 7 adverse events. PRE demonstrated a statistically and clinically significant reduction in UPDRS-III scores compared with mFC and is recommended as a useful adjunct therapy to improve Parkinsonian motor signs. © 2013 Movement Disorder Society.
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Affiliation(s)
- Daniel M Corcos
- Department of Kinesiology and Nutrition, University of Illinois, Chicago, IL, USA.
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47
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Prodoehl J, Planetta PJ, Kurani AS, Comella CL, Corcos DM, Vaillancourt DE. Differences in brain activation between tremor- and nontremor-dominant Parkinson disease. JAMA Neurol 2013; 70:100-6. [PMID: 23318516 DOI: 10.1001/jamaneurol.2013.582] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To compare differences in functional brain activity between tremor- and nontremor-dominant subtypes of Parkinson disease (PD) using functional magnetic resonance imaging. DESIGN In our study, patients with tremor-dominant PD and those with nontremor-dominant PD performed a grip task, and the results obtained were compared using voxelwise analysis. Areas of the brain that were significantly different were then examined using a region-of-interest analysis to compare these patients with healthy controls. Voxel-based morphometry was used to determine macroscopic differences in gray and white matter volume between patient groups. SETTING University-affiliated research institution. PARTICIPANTS A total of 20 drug-naive patients with PD (10 with tremor-dominant PD and 10 with nontremor-dominant PD) and a total of 20 healthy controls. MAIN OUTCOME MEASURES Blood oxygenation level-dependent activation and percent signal change. RESULTS Robust findings across both voxelwise and region-of-interest analyses showed that, compared with patients with tremor-dominant PD, patients with nontremor-dominant PD had reduced activation in the ipsilateral dorsolateral prefrontal cortex, the globus pallidus interna, and the globus pallidus externa. Region-of-interest analyses confirmed that patients with nontremor-dominant PD had reduced activity in the ipsilateral dorsolateral prefrontal cortex, the globus pallidus interna, and the globus pallidus externa compared with patients with tremor-dominant PD and healthy controls. Patients with tremor-dominant PD had increased activity in the contralateral dorsolateral prefrontal cortex compared with patients with nontremor-dominant PD and healthy controls. These results could not be explained by differences in gray or white matter volume. CONCLUSIONS Reduced brain activity occurs in the prefrontal cortex and globus pallidus of patients with nontremor-dominant PD compared with both patients with tremor-dominant PD and healthy controls, which suggests that functional magnetic resonance imaging is a promising technique to understand differences in brain activation between subtypes of PD.
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Affiliation(s)
- Janey Prodoehl
- Department of Kinesiology, University of Illinois, Chicago, USA
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Holiga Š, Mueller K, Möller HE, Sieger T, Schroeter ML, Vymazal J, Růžička E, Jech R. Motor matters: tackling heterogeneity of Parkinson's disease in functional MRI studies. PLoS One 2013; 8:e56133. [PMID: 23418522 PMCID: PMC3572025 DOI: 10.1371/journal.pone.0056133] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Accepted: 01/05/2013] [Indexed: 12/22/2022] Open
Abstract
To tackle the heterogeneity of Parkinson’s disease symptoms, most functional imaging studies tend to select a uniform group of subjects. We hypothesize that more profound considerations are needed to account for intra/inter-subject clinical variability and possibly for differing pathophysiological processes. Twelve patients were investigated using functional magnetic resonance imaging during visually-guided finger tapping. To account for disease heterogeneity, the motor score and individual symptom scores from the Unified Parkinson’s Disease Rating Scale (UPDRS-III) were utilized in the group-level model using two approaches either as the explanatory variable or as the effect of interest. Employment of the UPDRS-III score and symptom scores was systematically tested on the resulting group response to the levodopa challenge, which further accentuated the diversity of the diseased state of participants. Statistics revealed a bilateral group response to levodopa in the basal ganglia. Interestingly, systematic incorporation of individual motor aspects of the disease in the modelling amended the resulting activity patterns conspicuously, evidencing a manifold amount of explained variability by the particular score. In conclusion, the severity of clinical symptoms expressed in the UPDRS-III scores should be considered in the analysis to attain unbiased statistics, draw reliable conclusions and allow for comparisons between research groups studying Parkinson’s disease using functional magnetic resonance imaging.
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Affiliation(s)
- Štefan Holiga
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Karsten Mueller
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Harald E. Möller
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Tomáš Sieger
- Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, Prague, Czech Republic
- Department of Cybernetics, Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czech Republic
| | - Matthias L. Schroeter
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Clinic for Cognitive Neurology & Leipzig Research Center for Civilization Diseases, University of Leipzig and FTLD Consortium, Leipzig, Germany
| | - Josef Vymazal
- Department of Radiology, Na Homolce Hospital, Prague, Czech Republic
| | - Evžen Růžička
- Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, Prague, Czech Republic
| | - Robert Jech
- Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, Prague, Czech Republic
- * E-mail:
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Rizzo G, Tonon C, Lodi R. Looking into the brain: How can conventional, morphometric and functional MRI help in diagnosing and understanding PD? ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.baga.2012.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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50
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Planetta PJ, Schulze ET, Geary EK, Corcos DM, Goldman JG, Little DM, Vaillancourt DE. Thalamic projection fiber integrity in de novo Parkinson disease. AJNR Am J Neuroradiol 2012; 34:74-9. [PMID: 22766668 DOI: 10.3174/ajnr.a3178] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Postmortem studies of advanced PD have revealed disease-related pathology in the thalamus with an apparent predilection for specific thalamic nuclei. In the present study, we used DTI to investigate in vivo the microstructural integrity of 6 thalamic regions in de novo patients with PD relative to healthy controls. MATERIALS AND METHODS Forty subjects (20 with early stage untreated PD and 20 age- and sex-matched controls) were studied with a high-resolution DTI protocol at 3T to investigate the integrity of thalamic nuclei projection fibers. Two blinded, independent raters drew ROIs in the following 6 thalamic regions: AN, VA, VL, DM, VPL/VPM, and PU. FA values were then calculated from the projection fibers in each region. RESULTS FA values were reduced significantly in the fibers projecting from the AN, VA, and DM, but not the VPL/VPM and PU, in the PD group compared with the control group. In addition, there was a reduction in FA values that approached significance in the VL of patients with PD. These findings were consistent across both raters. CONCLUSIONS The present study provides preliminary in vivo evidence of thalamic projection fiber degeneration in de novo PD and sheds light on the extent of disrupted thalamic circuitry as a result of the disease itself.
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Affiliation(s)
- P J Planetta
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida 32611, USA
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