1
|
Fan W, Fong KNK, Wang SM. Effects of training involving patterned sensory enhancement on improving upper-limb movements in patients with Parkinson's disease: protocol of a randomised controlled trial. BMJ Open 2023; 13:e072416. [PMID: 37438071 DOI: 10.1136/bmjopen-2023-072416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/14/2023] Open
Abstract
INTRODUCTION Bradykinesia (ie, slow movements) is one of the most prominent symptoms of Parkinson's disease (PD) and has a negative impact on quality of life. Rhythmic auditory stimulation (RAS), a widely used and promising treatment technique, has been shown to effectively improve gait speed in patients with PD. The upper-limb movements, which also suffer from bradykinesia, are essential for daily life and directly impact quality of life. The term, patterned sensory enhancement (PSE) instead of RAS, is used when movement training targets the human body except lower limbs. Up until now, scarce studies have explored effects of training involving PSE on upper-limb movements. The purpose of this study is to investigate effects of movement training involving PSE on upper-limb movement speed and function in patients with PD. METHODS AND ANALYSIS A total of 138 patients with PD will be randomly assigned into two groups: the PSE group and the no-PSE group. A 21-day upper-limb training involving PSE (for the PSE group) or without PSE (for the no-PSE group) will be provided to the patients. An assessor will administer the box and block test and the Jebsen hand function test before and after training to assess upper-limb movement speed and function. The one-way analysis of covariance will be performed. This randomised controlled trial will provide evidence supporting effectiveness of upper-limb movement training involving PSE on reducing severity of bradykinesia in patients with PD. ETHICS AND DISSEMINATION Ethical approval has been obtained from the Institutional Review Board of the Hong Kong Polytechnic University with the reference number HSEARS20221027005. Informed consent forms will be gathered from all patients before their participation. Study results will be disseminated through conferences and peer-reviewed academic journals. TRIAL REGISTRATION NUMBER NCT05637593.
Collapse
Affiliation(s)
- Wei Fan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
| | - Kenneth N K Fong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
| | - Shu-Mei Wang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
| |
Collapse
|
2
|
Santos AN, Kherif F, Melie-Garcia L, Lutti A, Chiappini A, Rauschenbach L, Dinger TF, Riess C, El Rahal A, Darkwah Oppong M, Sure U, Dammann P, Draganski B. Parkinson's disease may disrupt overlapping subthalamic nucleus and pallidal motor networks. Neuroimage Clin 2023; 38:103432. [PMID: 37210889 PMCID: PMC10213095 DOI: 10.1016/j.nicl.2023.103432] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 04/13/2023] [Accepted: 05/07/2023] [Indexed: 05/23/2023]
Abstract
There is an ongoing debate about differential clinical outcome and associated adverse effects of deep brain stimulation (DBS) in Parkinson's disease (PD) targeting the subthalamic nucleus (STN) or the globus pallidus pars interna (GPi). Given that functional connectivity profiles suggest beneficial DBS effects within a common network, the empirical evidence about the underlying anatomical circuitry is still scarce. Therefore, we investigate the STN and GPi-associated structural covariance brain patterns in PD patients and healthy controls. We estimate GPi's and STN's whole-brain structural covariance from magnetic resonance imaging (MRI) in a normative mid- to old-age community-dwelling cohort (n = 1184) across maps of grey matter volume, magnetization transfer (MT) saturation, longitudinal relaxation rate (R1), effective transversal relaxation rate (R2*) and effective proton density (PD*). We compare these with the structural covariance estimates in patients with idiopathic PD (n = 32) followed by validation using a reduced size controls' cohort (n = 32). In the normative data set, we observed overlapping spatially distributed cortical and subcortical covariance patterns across maps confined to basal ganglia, thalamus, motor, and premotor cortical areas. Only the subcortical and midline motor cortical areas were confirmed in the reduced size cohort. These findings contrasted with the absence of structural covariance with cortical areas in the PD cohort. We interpret with caution the differential covariance maps of overlapping STN and GPi networks in patients with PD and healthy controls as correlates of motor network disruption. Our study provides face validity to the proposed extension of the currently existing structural covariance methods based on morphometry features to multiparameter MRI sensitive to brain tissue microstructure.
Collapse
Affiliation(s)
- Alejandro N Santos
- Laboratory of Research in Neuroimaging (LREN) -Department of Clinical Neuroscience, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Department of Neurosurgery, University Hospital Essen, Essen, Germany; Center for Translational Neuroscience and Behavioral Science (C-TNBS), University of Duisburg, Essen, Germany
| | - Ferath Kherif
- Laboratory of Research in Neuroimaging (LREN) -Department of Clinical Neuroscience, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Lester Melie-Garcia
- Laboratory of Research in Neuroimaging (LREN) -Department of Clinical Neuroscience, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Antoine Lutti
- Laboratory of Research in Neuroimaging (LREN) -Department of Clinical Neuroscience, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Alessio Chiappini
- Department of Neurosurgery, University Hospital Basel, Basel, Switzerland
| | - Laurèl Rauschenbach
- Department of Neurosurgery, University Hospital Essen, Essen, Germany; Center for Translational Neuroscience and Behavioral Science (C-TNBS), University of Duisburg, Essen, Germany
| | - Thiemo F Dinger
- Department of Neurosurgery, University Hospital Essen, Essen, Germany; Center for Translational Neuroscience and Behavioral Science (C-TNBS), University of Duisburg, Essen, Germany
| | - Christoph Riess
- Department of Neurosurgery, University Hospital Essen, Essen, Germany; Center for Translational Neuroscience and Behavioral Science (C-TNBS), University of Duisburg, Essen, Germany
| | - Amir El Rahal
- Department of Neurosurgery, University Hospital Freiburg, Freiburg im Breisgau, Germany
| | - Marvin Darkwah Oppong
- Department of Neurosurgery, University Hospital Essen, Essen, Germany; Center for Translational Neuroscience and Behavioral Science (C-TNBS), University of Duisburg, Essen, Germany
| | - Ulrich Sure
- Department of Neurosurgery, University Hospital Essen, Essen, Germany; Center for Translational Neuroscience and Behavioral Science (C-TNBS), University of Duisburg, Essen, Germany
| | - Philipp Dammann
- Department of Neurosurgery, University Hospital Essen, Essen, Germany; Center for Translational Neuroscience and Behavioral Science (C-TNBS), University of Duisburg, Essen, Germany
| | - Bogdan Draganski
- Laboratory of Research in Neuroimaging (LREN) -Department of Clinical Neuroscience, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
| |
Collapse
|
3
|
Snyder AD, Ma L, Steinberg JL, Woisard K, Moeller FG. Dynamic Causal Modeling Self-Connectivity Findings in the Functional Magnetic Resonance Imaging Neuropsychiatric Literature. Front Neurosci 2021; 15:636273. [PMID: 34456665 PMCID: PMC8385130 DOI: 10.3389/fnins.2021.636273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 06/07/2021] [Indexed: 11/15/2022] Open
Abstract
Dynamic causal modeling (DCM) is a method for analyzing functional magnetic resonance imaging (fMRI) and other functional neuroimaging data that provides information about directionality of connectivity between brain regions. A review of the neuropsychiatric fMRI DCM literature suggests that there may be a historical trend to under-report self-connectivity (within brain regions) compared to between brain region connectivity findings. These findings are an integral part of the neurologic model represented by DCM and serve an important neurobiological function in regulating excitatory and inhibitory activity between regions. We reviewed the literature on the topic as well as the past 13 years of available neuropsychiatric DCM literature to find an increasing (but still, perhaps, and inadequate) trend in reporting these results. The focus of this review is fMRI as the majority of published DCM studies utilized fMRI and the interpretation of the self-connectivity findings may vary across imaging methodologies. About 25% of articles published between 2007 and 2019 made any mention of self-connectivity findings. We recommend increased attention toward the inclusion and interpretation of self-connectivity findings in DCM analyses in the neuropsychiatric literature, particularly in forthcoming effective connectivity studies of substance use disorders.
Collapse
Affiliation(s)
- Andrew D Snyder
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University School of Medicine, Richmond, VA, United States.,Department of Psychiatry, Virginia Commonwealth University School of Medicine, Richmond, VA, United States
| | - Liangsuo Ma
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University School of Medicine, Richmond, VA, United States.,Department of Radiology, Virginia Commonwealth University School of Medicine, Richmond, VA, United States
| | - Joel L Steinberg
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University School of Medicine, Richmond, VA, United States.,Department of Psychiatry, Virginia Commonwealth University School of Medicine, Richmond, VA, United States
| | - Kyle Woisard
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University School of Medicine, Richmond, VA, United States.,Virginia Commonwealth University School of Medicine, Richmond, VA, United States
| | - Frederick G Moeller
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University School of Medicine, Richmond, VA, United States.,Department of Psychiatry, Virginia Commonwealth University School of Medicine, Richmond, VA, United States.,Department of Pharmacology and Toxicology, Virginia Commonwealth University School of Medicine, Richmond, VA, United States.,Department of Neurology, Virginia Commonwealth University School of Medicine, Richmond, VA, United States
| |
Collapse
|
4
|
Jastrzębowska MA, Marquis R, Melie-García L, Lutti A, Kherif F, Herzog MH, Draganski B. Dopaminergic modulation of motor network compensatory mechanisms in Parkinson's disease. Hum Brain Mapp 2019; 40:4397-4416. [PMID: 31291039 DOI: 10.1002/hbm.24710] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 05/28/2019] [Accepted: 06/27/2019] [Indexed: 12/29/2022] Open
Abstract
The dopaminergic system has a unique gating function in the initiation and execution of movements. When the interhemispheric imbalance of dopamine inherent to the healthy brain is disrupted, as in Parkinson's disease (PD), compensatory mechanisms act to stave off behavioral changes. It has been proposed that two such compensatory mechanisms may be (a) a decrease in motor lateralization, observed in drug-naïve PD patients and (b) reduced inhibition - increased facilitation. Seeking to investigate the differential effect of dopamine depletion and subsequent substitution on compensatory mechanisms in non-drug-naïve PD, we studied 10 PD patients and 16 healthy controls, with patients undergoing two test sessions - "ON" and "OFF" medication. Using a simple visually-cued motor response task and fMRI, we investigated cortical motor activation - in terms of laterality, contra- and ipsilateral percent BOLD signal change and effective connectivity in the parametric empirical Bayes framework. We found that decreased motor lateralization persists in non-drug-naïve PD and is concurrent with decreased contralateral activation in the cortical motor network. Normal lateralization is not reinstated by dopamine substitution. In terms of effective connectivity, disease-related changes primarily affect ipsilaterally-lateralized homotopic cortical motor connections, while medication-related changes affect contralaterally-lateralized homotopic connections. Our findings suggest that, in non-drug-naïve PD, decreased lateralization is no longer an adaptive cortical mechanism, but rather the result of maladaptive changes, related to disease progression and long-term dopamine replacement. These findings highlight the need for the development of noninvasive therapies, which would promote the adaptive mechanisms of the PD brain.
Collapse
Affiliation(s)
- Maya A Jastrzębowska
- Laboratory of Psychophysics, Brain Mind Institute, School of Life Sciences, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
- Laboratory for Research in Neuroimaging (LREN), Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Renaud Marquis
- Laboratory for Research in Neuroimaging (LREN), Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- EEG and Epilepsy Unit, University Hospital of Geneva and Faculty of Medicine, Geneva, Switzerland
| | - Lester Melie-García
- Laboratory for Research in Neuroimaging (LREN), Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Antoine Lutti
- Laboratory for Research in Neuroimaging (LREN), Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Ferath Kherif
- Laboratory for Research in Neuroimaging (LREN), Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Michael H Herzog
- Laboratory of Psychophysics, Brain Mind Institute, School of Life Sciences, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Bogdan Draganski
- Laboratory for Research in Neuroimaging (LREN), Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| |
Collapse
|