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Chen R, Berardelli A, Bhattacharya A, Bologna M, Chen KHS, Fasano A, Helmich RC, Hutchison WD, Kamble N, Kühn AA, Macerollo A, Neumann WJ, Pal PK, Paparella G, Suppa A, Udupa K. Clinical neurophysiology of Parkinson's disease and parkinsonism. Clin Neurophysiol Pract 2022; 7:201-227. [PMID: 35899019 PMCID: PMC9309229 DOI: 10.1016/j.cnp.2022.06.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 06/11/2022] [Accepted: 06/22/2022] [Indexed: 01/01/2023] Open
Abstract
This review is part of the series on the clinical neurophysiology of movement disorders and focuses on Parkinson’s disease and parkinsonism. The pathophysiology of cardinal parkinsonian motor symptoms and myoclonus are reviewed. The recordings from microelectrode and deep brain stimulation electrodes are reported in detail.
This review is part of the series on the clinical neurophysiology of movement disorders. It focuses on Parkinson’s disease and parkinsonism. The topics covered include the pathophysiology of tremor, rigidity and bradykinesia, balance and gait disturbance and myoclonus in Parkinson’s disease. The use of electroencephalography, electromyography, long latency reflexes, cutaneous silent period, studies of cortical excitability with single and paired transcranial magnetic stimulation, studies of plasticity, intraoperative microelectrode recordings and recording of local field potentials from deep brain stimulation, and electrocorticography are also reviewed. In addition to advancing knowledge of pathophysiology, neurophysiological studies can be useful in refining the diagnosis, localization of surgical targets, and help to develop novel therapies for Parkinson’s disease.
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Affiliation(s)
- Robert Chen
- Krembil Research Institute, University Health Network, Toronto, Ontario, Canada.,Division of Neurology, Department of Medicine, University of Toronto, Ontario, Canada.,Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Alfredo Berardelli
- Department of Human Neurosciences, Sapienza University of Rome, Italy.,IRCCS Neuromed Pozzilli (IS), Italy
| | - Amitabh Bhattacharya
- Department of Neurology, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | - Matteo Bologna
- Department of Human Neurosciences, Sapienza University of Rome, Italy.,IRCCS Neuromed Pozzilli (IS), Italy
| | - Kai-Hsiang Stanley Chen
- Department of Neurology, National Taiwan University Hospital Hsinchu Branch, Hsinchu, Taiwan
| | - Alfonso Fasano
- Krembil Research Institute, University Health Network, Toronto, Ontario, Canada.,Division of Neurology, Department of Medicine, University of Toronto, Ontario, Canada.,Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Rick C Helmich
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology and Centre of Expertise for Parkinson & Movement Disorders, Nijmegen, the Netherlands
| | - William D Hutchison
- Krembil Research Institute, University Health Network, Toronto, Ontario, Canada.,Departments of Surgery and Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Nitish Kamble
- Department of Neurology, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | - Andrea A Kühn
- Department of Neurology, Movement Disorder and Neuromodulation Unit, Charité - Universitätsmedizin Berlin, Germany
| | - Antonella Macerollo
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, United Kingdom.,The Walton Centre NHS Foundation Trust for Neurology and Neurosurgery, Liverpool, United Kingdom
| | - Wolf-Julian Neumann
- Department of Neurology, Movement Disorder and Neuromodulation Unit, Charité - Universitätsmedizin Berlin, Germany
| | - Pramod Kumar Pal
- Department of Neurology, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | | | - Antonio Suppa
- Department of Human Neurosciences, Sapienza University of Rome, Italy.,IRCCS Neuromed Pozzilli (IS), Italy
| | - Kaviraja Udupa
- Department of Neurophysiology National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
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2
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Qu A, Xu L, Xu C, Kuang H. Chiral nanomaterials for biosensing, bioimaging, and disease therapies. Chem Commun (Camb) 2022; 58:12782-12802. [DOI: 10.1039/d2cc04420j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Chiral plasmonic nanomaterials for biosensing, bioimaging and disease therapy.
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Affiliation(s)
- Aihua Qu
- International Joint Research Laboratory for Biointerface and Biodetection, State Key Lab of Food Science and Technology, School of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu, 214122, People's Republic of China
| | - Liguang Xu
- International Joint Research Laboratory for Biointerface and Biodetection, State Key Lab of Food Science and Technology, School of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu, 214122, People's Republic of China
| | - Chuanlai Xu
- International Joint Research Laboratory for Biointerface and Biodetection, State Key Lab of Food Science and Technology, School of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu, 214122, People's Republic of China
| | - Hua Kuang
- International Joint Research Laboratory for Biointerface and Biodetection, State Key Lab of Food Science and Technology, School of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu, 214122, People's Republic of China
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3
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Ser MH, Gündüz A, Demirbilek V, Yalçınkaya C, Nalbantoğlu M, Coşkun T, Kızıltan M. Progression of myoclonus subtypes in subacute sclerosing panencephalitis. Neurophysiol Clin 2021; 51:533-540. [PMID: 34772596 DOI: 10.1016/j.neucli.2021.07.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 07/18/2021] [Accepted: 07/18/2021] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES Diagnostic criteria of subacute sclerosing panencephalitis (SSPE) include myoclonus, a well-recognized clinical feature. Here, we studied the electrophysiological features of myoclonus with regards to disease staging in SSPE patients. METHODS We included 10 patients diagnosed with SSPE between 2010 and 2018, along with 21 healthy subjects. All participants had detailed electrophysiological evaluation including polymyographic analysis, blink reflex after trigeminal stimulation, auditory startle response, startle response after somatosensory stimuli, F-waves, and long-loop reflexes. Clinical findings were retrieved from the medical records. RESULTS Patients were categorized into Gascon stage 2B (n = 5, 50%), 2A (n = 2, 20%), 3B (n = 2, 20%) and 4A (n = 1, 10%) at the time of electrophysiological evaluation. Two patients had cortical myoclonus, four had possible cortico-subcortical myoclonus, and four had brainstem myoclonus. Patients were categorized into Gascon stages 2a and 2b had possible cortico-subcortical myoclonus (85.7%). However, none of the patients with stage 3b or 4a had possible cortico-subcortical subtype but all had the brainstem subtype. CONCLUSION Association was seen between subtypes of myoclonus and clinical staging in SSPE. This suggests that myoclonus in SSPE may primarily involve the cortex and cortico-subcortical structures such as the thalamus at earlier stages of disease, and then involve more caudal structures as the disease progresses.
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Affiliation(s)
- Merve Hazal Ser
- Department of Neurology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey.
| | - Ayşegül Gündüz
- Department of Neurology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Veysi Demirbilek
- Department of Neurology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Cengiz Yalçınkaya
- Department of Neurology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Mecbure Nalbantoğlu
- Department of Neurology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Tülin Coşkun
- Department of Neurology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Meral Kızıltan
- Department of Neurology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
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4
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Boutros SW, Raber J, Unni VK. Effects of Alpha-Synuclein Targeted Antisense Oligonucleotides on Lewy Body-Like Pathology and Behavioral Disturbances Induced by Injections of Pre-Formed Fibrils in the Mouse Motor Cortex. JOURNAL OF PARKINSONS DISEASE 2021; 11:1091-1115. [PMID: 34057097 PMCID: PMC8461707 DOI: 10.3233/jpd-212566] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background: Alpha-synuclein (αsyn) characterizes neurodegenerative diseases known as synucleinopathies. The phosphorylated form (psyn) is the primary component of protein aggregates known as Lewy bodies (LBs), which are the hallmark of diseases such as Parkinson’s disease (PD). Synucleinopathies might spread in a prion-like fashion, leading to a progressive emergence of symptoms over time. αsyn pre-formed fibrils (PFFs) induce LB-like pathology in wild-type (WT) mice, but questions remain about their progressive spread and their associated effects on behavioral performance. Objective: To characterize the behavioral, cognitive, and pathological long-term effects of LB-like pathology induced after bilateral motor cortex PFF injection in WT mice and to assess the ability of mouse αsyn-targeted antisense oligonucleotides (ASOs) to ameliorate those effects. Methods: We induced LB-like pathology in the motor cortex and connected brain regions of male WT mice using PFFs. Three months post-PFF injection (mpi), we assessed behavioral and cognitive performance. We then delivered a targeted ASO via the ventricle and assessed behavioral and cognitive performance 5 weeks later, followed by pathological analysis. Results: At 3 and 6 mpi, PFF-injected mice showed mild, progressive behavioral deficits. The ASO reduced total αsyn and psyn protein levels, and LB-like pathology, but was also associated with some deleterious off-target effects not involving lowering of αsyn, such as a decline in body weight and impairments in motor function. Conclusions: These results increase understanding of the progressive nature of the PFF model and support the therapeutic potential of ASOs, though more investigation into effects of ASO-mediated reduction in αsyn on brain function is needed.
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Affiliation(s)
- Sydney Weber Boutros
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR, USA
| | - Jacob Raber
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR, USA.,Department of Neurology, Oregon Health & Science University, Portland, OR, USA.,Departments of Psychiatry and Radiation Medicine, Division of Neuroscience, ONPRC, Oregon Health & Science University, Portland, OR, USA
| | - Vivek K Unni
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA.,Jungers Center for Neurosciences Research and OHSU Parkinson Center, Oregon Health & Science University, Portland, OR, USA
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Sejnoha Minsterova A, Klobusiakova P, Pies A, Galaz Z, Mekyska J, Novakova L, Nemcova Elfmarkova N, Rektorova I. Patterns of diffusion kurtosis changes in Parkinson's disease subtypes. Parkinsonism Relat Disord 2020; 81:96-102. [DOI: 10.1016/j.parkreldis.2020.10.032] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 10/15/2020] [Accepted: 10/17/2020] [Indexed: 01/10/2023]
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Wang N, Garcia J, Freeman R, Gibbons CH. Phosphorylated Alpha-Synuclein Within Cutaneous Autonomic Nerves of Patients With Parkinson's Disease: The Implications of Sample Thickness on Results. J Histochem Cytochem 2020; 68:669-678. [PMID: 32921251 DOI: 10.1369/0022155420960250] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The detection of cutaneous phosphorylated alpha-synuclein (P-syn) in patients with Parkinson's disease (PD) has ranged from 30% to 100% across different studies. We hypothesize that part of the variability in P-syn detection is due to methodological differences using sections of different tissue thickness. Three skin biopsies were obtained from 29 individuals with PD and 21 controls. Tissues were cut into 10-, 20-, and 50-µm-thick sections and double-stained with protein gene product (PGP) 9.5 and P-syn. We quantified the deposition of P-syn with and without PGP 9.5 in sweat glands, pilomotor muscle, and blood vessels using confocal digital images of autonomic structures. Overall, the P-syn-positive rates with PGP 9.5 colocalization in subjects with PD were 100% using 50 µm sections, 90% using 20 µm sections, and 73% using 10 µm sections with 100% specificity. (No P-syn was detected within control subjects.) Without PGP 9.5, colocalization of the P-syn-positive rates was 100% for all samples, but specificity dropped below 70%. In this study, double-immunostained 50 µm skin biopsy tissue sections are superior to 20 and 10 µm tissue sections at detecting P-syn in subjects with PD. The increased sensitivity is likely secondary to a combination of greater volume of tissue analyzed and improved visualization of nerve fiber architecture.
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Affiliation(s)
- Ningshan Wang
- Center for Autonomic and Peripheral Nerve Disorders, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Jennifer Garcia
- Center for Autonomic and Peripheral Nerve Disorders, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Roy Freeman
- Center for Autonomic and Peripheral Nerve Disorders, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Christopher H Gibbons
- Center for Autonomic and Peripheral Nerve Disorders, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
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Sifoglu A, Gunduz A, Kiziltan G, Kiziltan ME. Dopaminergic medication unrelated myoclonus is less related to tremor in idiopathic Parkinson's disease. Neurol Sci 2016; 38:679-682. [PMID: 27990561 DOI: 10.1007/s10072-016-2793-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 12/02/2016] [Indexed: 11/25/2022]
Abstract
Myoclonus in Parkinson's disease (PD) may be related or unrelated to dopaminergic medication and may share some features of cortical myoclonus. The aim of this study was to analyze clinical and electrophysiological correlates of the dopaminergic treatment unrelated myoclonus in PD patients. We included 17 PD patients with the end-of-dose myoclonus and 16 PD patients without myoclonus between January 2010 and June 2011. Surface electromyography of upper extremity muscles and long latency reflexes (LLRs) were performed. Positive or negative myoclonus with a duration of 35-100 ms was observed. Rest tremor was less frequent in the group with myoclonus. Only one PD patient with myoclonus had C reflex. Mean LLR amplitude was significantly high in PD with myoclonus compared to the group without myoclonus (p = 0.024). Dopaminergic treatment unrelated myoclonus is less related to rest tremor in PD, may be positive or negative, and exhibits similar features to cortical myoclonus.
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Affiliation(s)
- Ayla Sifoglu
- Department of Neurology, Cerrahpaşa School of Medicine, Istanbul University, K.M.Pasa, 34098, Istanbul, Turkey.
| | - Aysegul Gunduz
- Department of Neurology, Cerrahpaşa School of Medicine, Istanbul University, K.M.Pasa, 34098, Istanbul, Turkey
| | - Gunes Kiziltan
- Department of Neurology, Cerrahpaşa School of Medicine, Istanbul University, K.M.Pasa, 34098, Istanbul, Turkey
| | - Meral E Kiziltan
- Department of Neurology, Cerrahpaşa School of Medicine, Istanbul University, K.M.Pasa, 34098, Istanbul, Turkey
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Caviness JN, Lue LF, Hentz JG, Schmitz CT, Adler CH, Shill HA, Sabbagh MN, Beach TG, Walker DG. Cortical phosphorylated α-Synuclein levels correlate with brain wave spectra in Parkinson's disease. Mov Disord 2016; 31:1012-9. [PMID: 27062301 DOI: 10.1002/mds.26621] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 02/23/2016] [Accepted: 02/24/2016] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Quantitative EEG features have been identified as surrogates and predictors of cognitive decline/dementia, a common feature of progressive PD. The biochemical correlates for altered quantitative EEG features are unknown. Our primary objective was to test the hypothesis that quantitative EEG measures correlate with cortical levels of phosphorylated α-synuclein, a modified form of the synaptic protein α-synuclein, in PD cases, in contrast to other pathology-associated proteins. A secondary objective was to explore the same correlations among cellular fractions of these proteins. METHODS We used posterior cingulate cortex autopsy tissue from 44 PD subjects with various degrees of cognitive decline, who had undergone EEG. In this brain region, which is a major hub of the default mode network, biochemical measurements for levels of phosphorylated α-synuclein, unmodified α-synuclein, amyloid beta peptide, phosphorylated tau, and key synaptic proteins were analyzed and data correlated with spectral EEG measures. RESULTS Findings revealed significant correlations between background rhythm peak frequency and all bandpower values (highest in delta bandpower) with total phosphorylated α-synuclein, but not any correlation with total α-synuclein, phosphorylated tau protein, amyloid beta peptide, or synaptic proteins. Certain fractions of synaptosomal-associated protein 25 showed correlation with some quantitative EEG measures. CONCLUSIONS These data show an association between increased phosphorylation of α-synuclein and the abnormal EEG signatures of cognitive decline. Results suggest that quantitative EEG may provide an in vivo approximation of phosphorylated α-synuclein in PD cortex. This adds to previous evidence that quantitative EEG measures can be considered valid biomarkers of PD cognitive decline. © 2016 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- John N Caviness
- Department of Neurology, Mayo Clinic, Scottsdale, Arizona, USA
| | - Lih-Fen Lue
- Laboratories of Neuroregeneration and Neuroinflammation, Banner-Sun Health Research Institute, Sun City, Arizona, USA
| | - Joseph G Hentz
- Department of Biostatistics, Mayo Clinic, Scottsdale, Arizona, USA
| | - Christopher T Schmitz
- Laboratories of Neuroregeneration and Neuroinflammation, Banner-Sun Health Research Institute, Sun City, Arizona, USA
| | - Charles H Adler
- Department of Neurology, Mayo Clinic, Scottsdale, Arizona, USA
| | - Holly A Shill
- Cleo Roberts Center, Banner-Sun Health Research Institute, Sun City, Arizona, USA
| | - Marwan N Sabbagh
- Cleo Roberts Center, Banner-Sun Health Research Institute, Sun City, Arizona, USA
| | - Thomas G Beach
- Department of Neuropathology, Banner-Sun Health Research Institute, Sun City, Arizona, USA
| | - Douglas G Walker
- Laboratories of Neuroregeneration and Neuroinflammation, Banner-Sun Health Research Institute, Sun City, Arizona, USA
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9
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Morris M, Sanchez PE, Verret L, Beagle AJ, Guo W, Dubal D, Ranasinghe KG, Koyama A, Ho K, Yu GQ, Vossel KA, Mucke L. Network dysfunction in α-synuclein transgenic mice and human Lewy body dementia. Ann Clin Transl Neurol 2015; 2:1012-28. [PMID: 26732627 PMCID: PMC4693622 DOI: 10.1002/acn3.257] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 07/14/2015] [Accepted: 08/25/2015] [Indexed: 12/20/2022] Open
Abstract
Objective Dementia with Lewy bodies (DLB) is associated with the accumulation of wild‐type human α‐synuclein (SYN) in neurons and with prominent slowing of brain oscillations on electroencephalography (EEG). However, it remains uncertain whether the EEG abnormalities are actually caused by SYN. Methods To determine whether SYN can cause neural network abnormalities, we performed EEG recordings and analyzed the expression of neuronal activity‐dependent gene products in SYN transgenic mice. We also carried out comparative analyses in humans with DLB. Results We demonstrate that neuronal expression of SYN in transgenic mice causes a left shift in spectral power that closely resembles the EEG slowing observed in DLB patients. Surprisingly, SYN mice also had seizures and showed molecular hippocampal alterations indicative of aberrant network excitability, including calbindin depletion in the dentate gyrus. In postmortem brain tissues from DLB patients, we found reduced levels of calbindin mRNA in the dentate gyrus. Furthermore, nearly one quarter of DLB patients showed myoclonus, a clinical sign of aberrant network excitability that was associated with an earlier age of onset of cognitive impairments. In SYN mice, partial suppression of epileptiform activity did not alter their shift in spectral power. Furthermore, epileptiform activity in human amyloid precursor protein transgenic mice was not associated with a left shift in spectral power. Interpretation We conclude that neuronal accumulation of SYN slows brain oscillations and, in parallel, causes aberrant network excitability that can escalate into seizure activity. The potential role of aberrant network excitability in DLB merits further investigation.
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Affiliation(s)
- Meaghan Morris
- Gladstone Institute of Neurological Disease San Francisco California 94158; Biochemistry, Cellular and Molecular Biology Graduate Program Department of Biological Chemistry The Johns Hopkins University School of Medicine Baltimore Maryland 21205
| | - Pascal E Sanchez
- Gladstone Institute of Neurological Disease San Francisco California 94158
| | - Laure Verret
- Gladstone Institute of Neurological Disease San Francisco California 94158; Department of Neurology University of California, San Francisco San Francisco California 94158
| | - Alexander J Beagle
- Department of Neurology University of California, San Francisco San Francisco California 94158
| | - Weikun Guo
- Gladstone Institute of Neurological Disease San Francisco California 94158
| | - Dena Dubal
- Department of Neurology University of California, San Francisco San Francisco California 94158
| | - Kamalini G Ranasinghe
- Department of Neurology University of California, San Francisco San Francisco California 94158
| | - Akihiko Koyama
- Gladstone Institute of Neurological Disease San Francisco California 94158
| | - Kaitlyn Ho
- Gladstone Institute of Neurological Disease San Francisco California 94158
| | - Gui-Qiu Yu
- Gladstone Institute of Neurological Disease San Francisco California 94158
| | - Keith A Vossel
- Gladstone Institute of Neurological Disease San Francisco California 94158; Department of Neurology University of California, San Francisco San Francisco California 94158
| | - Lennart Mucke
- Gladstone Institute of Neurological Disease San Francisco California 94158; Department of Neurology University of California, San Francisco San Francisco California 94158
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McCann H, Fung VSC, Klein C, Halliday GM. Unusual α-synuclein and cerebellar pathologies in a case of hereditary myoclonus-dystonia without SGCE mutation. Neuropathol Appl Neurobiol 2015; 41:837-42. [PMID: 25582306 DOI: 10.1111/nan.12216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2014] [Accepted: 01/07/2015] [Indexed: 01/10/2023]
Affiliation(s)
- Heather McCann
- Sydney Brain Bank, Neuroscience Research Australia, Sydney, Australia
| | - Victor S C Fung
- Sydney Medical School, University of Sydney, Sydney, Australia.,Movement Disorders Unit, Department of Neurology, Westmead Hospital, Sydney, Australia
| | - Christine Klein
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Glenda M Halliday
- Sydney Brain Bank, Neuroscience Research Australia, Sydney, Australia.,School of Medical Sciences, UNSW Medicine, Sydney, Australia
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Yavuz D, Gündüz A, Ertan S, Apaydın H, Şifoğlu A, Kiziltan G, Kiziltan ME. Specific brainstem and cortico-spinal reflex abnormalities in coexisting essential tremor and Parkinson's disease (ET-PD). Neurophysiol Clin 2015; 45:143-9. [PMID: 25892331 DOI: 10.1016/j.neucli.2015.01.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 10/15/2014] [Accepted: 01/04/2015] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE We aimed to analyze functional changes at brainstem and spinal levels in essential tremor (ET), Parkinson's disease (PD) and coexisting essential tremor and Parkinson's disease (ET-PD). PATIENTS AND METHOD Age- and gender-matched patients with tremor (15 ET, 7 ET with resting tremor, 25 ET-PD and 10 PD) and 12 healthy subjects were enrolled in the study. Diagnosis was established according to standardized clinical criteria. Electrophysiological studies included blink reflex (BR), auditory startle reaction (ASR) and long latency reflex (LLR). RESULTS Blink reflex was normal and similar in all groups. Probability of ASR was significantly lower in ET-PD group whereas it was similar to healthy subjects in ET and PD (P<0.001). LLR was recorded during voluntary activity in all three groups. LLR II was more common in ET, PD and ET-PD groups. LLR III was far more common in the PD group (n=3, 13.6% in ET; n=4, 16.0% in ET-PD and n=7, 46.7% in PD; p=0.037). CONCLUSIONS Despite the integrity of BR pathways, ASR and LLR show distinctive abnormalities in ET-PD. In our opinion, our electrophysiological findings support the hypothesis that ET-PD is a distinct entity.
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Affiliation(s)
- D Yavuz
- Istanbul University, Cerrahpasa School of Medicine, Department of Neurology, 34098 K.M.Pasa, Istanbul, Turkey
| | - A Gündüz
- Istanbul University, Cerrahpasa School of Medicine, Department of Neurology, 34098 K.M.Pasa, Istanbul, Turkey.
| | - S Ertan
- Istanbul University, Cerrahpasa School of Medicine, Department of Neurology, 34098 K.M.Pasa, Istanbul, Turkey
| | - H Apaydın
- Istanbul University, Cerrahpasa School of Medicine, Department of Neurology, 34098 K.M.Pasa, Istanbul, Turkey
| | - A Şifoğlu
- Istanbul University, Cerrahpasa School of Medicine, Department of Neurology, 34098 K.M.Pasa, Istanbul, Turkey
| | - G Kiziltan
- Istanbul University, Cerrahpasa School of Medicine, Department of Neurology, 34098 K.M.Pasa, Istanbul, Turkey
| | - M E Kiziltan
- Istanbul University, Cerrahpasa School of Medicine, Department of Neurology, 34098 K.M.Pasa, Istanbul, Turkey
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12
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Beach TG, Adler CH, Sue LI, Serrano G, Shill HA, Walker DG, Lue L, Roher AE, Dugger BN, Maarouf C, Birdsill AC, Intorcia A, Saxon-Labelle M, Pullen J, Scroggins A, Filon J, Scott S, Hoffman B, Garcia A, Caviness JN, Hentz JG, Driver-Dunckley E, Jacobson SA, Davis KJ, Belden CM, Long KE, Malek-Ahmadi M, Powell JJ, Gale LD, Nicholson LR, Caselli RJ, Woodruff BK, Rapscak SZ, Ahern GL, Shi J, Burke AD, Reiman EM, Sabbagh MN. Arizona Study of Aging and Neurodegenerative Disorders and Brain and Body Donation Program. Neuropathology 2015; 35:354-89. [PMID: 25619230 DOI: 10.1111/neup.12189] [Citation(s) in RCA: 303] [Impact Index Per Article: 33.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Accepted: 11/11/2014] [Indexed: 12/13/2022]
Abstract
The Brain and Body Donation Program (BBDP) at Banner Sun Health Research Institute (http://www.brainandbodydonationprogram.org) started in 1987 with brain-only donations and currently has banked more than 1600 brains. More than 430 whole-body donations have been received since this service was commenced in 2005. The collective academic output of the BBDP is now described as the Arizona Study of Aging and Neurodegenerative Disorders (AZSAND). Most BBDP subjects are enrolled as cognitively normal volunteers residing in the retirement communities of metropolitan Phoenix, Arizona. Specific recruitment efforts are also directed at subjects with Alzheimer's disease, Parkinson's disease and cancer. The median age at death is 82. Subjects receive standardized general medical, neurological, neuropsychological and movement disorders assessments during life and more than 90% receive full pathological examinations by medically licensed pathologists after death. The Program has been funded through a combination of internal, federal and state of Arizona grants as well as user fees and pharmaceutical industry collaborations. Subsets of the Program are utilized by the US National Institute on Aging Arizona Alzheimer's Disease Core Center and the US National Institute of Neurological Disorders and Stroke National Brain and Tissue Resource for Parkinson's Disease and Related Disorders. Substantial funding has also been received from the Michael J. Fox Foundation for Parkinson's Research. The Program has made rapid autopsy a priority, with a 3.0-hour median post-mortem interval for the entire collection. The median RNA Integrity Number (RIN) for frozen brain and body tissue is 8.9 and 7.4, respectively. More than 2500 tissue requests have been served and currently about 200 are served annually. These requests have been made by more than 400 investigators located in 32 US states and 15 countries. Tissue from the BBDP has contributed to more than 350 publications and more than 200 grant-funded projects.
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Affiliation(s)
- Thomas G Beach
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | | | - Lucia I Sue
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Geidy Serrano
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Holly A Shill
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | | | - LihFen Lue
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Alex E Roher
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | | | - Chera Maarouf
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Alex C Birdsill
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | | | | | - Joel Pullen
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | | | - Jessica Filon
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Sarah Scott
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | | | - Angelica Garcia
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | | | | | | | | | - Kathryn J Davis
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | | | - Kathy E Long
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | | | | | - Lisa D Gale
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | | | | | | | | | | | - Jiong Shi
- Barrow Neurological Institute, Phoenix, Arizona, USA
| | - Anna D Burke
- Banner Alzheimer Institute, Phoenix, Arizona, USA
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13
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Caviness JN. Pathophysiology of Parkinson's disease behavior--a view from the network. Parkinsonism Relat Disord 2014; 20 Suppl 1:S39-43. [PMID: 24262185 DOI: 10.1016/s1353-8020(13)70012-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Advancements in neuroscience have uncovered an amazing complexity of connectivity between nuclei sites and circuits within the brain. Moreover, clinical and neuropathological study has revealed diffuse involvement of the nervous system in Parkinson's disease associated with early and/or significant clinical symptoms. Behavior manifestations in Parkinson's disease include cognitive decline and unwanted positive behaviors such as hallucinations and impulse-control disorders. The pathophysiology of Parkinson's disease can be conceptualized at multiple levels that include: (1) Molecular pathogenesis, (2) Cellular/Tissue abnormalities, (3) Neurochemical changes, (4) Site and circuit dysfunction, and (5) Network dysfunction. Currently, there is only a vague correlation with genetic abnormalities that manifest worse Parkinson's disease behavior problems, but abnormalities in misfolded proteins such as α-synuclein and Aβ peptide that are increased in cortical and subcortical areas do correlate with worse behavior signs and symptoms. Both Lewy-type synucleinopathy and Alzheimer's disease pathologies, along with loss of synaptic integrity, seem to correlate with Parkinson's disease cognitive decline. Neurochemical changes of dopamine, acetylcholine, and other monoamines are associated. The frontostriate circuit is most commonly implicated in Parkinson's disease behavior. However, there is now beginning to be evidence that diffuse global network dysfunction is possibly the unifying pathophysiology from all of these level abnormalities.
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Affiliation(s)
- John N Caviness
- Mayo Clinic School of Medicine, Mayo Clinic Movement Disorders Division, Scottsdale, AZ, USA
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14
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Gibbons C, Cheshire W, Barboi A, Levine B, Olshansky B, Kinsella L, Claydon VE, Crandall C, Fink G, Joyner M, Macefield V, Norcliffe-Kaufmann L, Freeman R, Raj S, Stewart J, Sandroni P, Kaufmann H, Chelimsky T. Endovascular procedures for the treatment of autonomic dysfunction. Clin Auton Res 2013; 24:1-2. [PMID: 24178965 DOI: 10.1007/s10286-013-0217-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Accepted: 10/15/2013] [Indexed: 11/24/2022]
Affiliation(s)
- Christopher Gibbons
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA,
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15
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Lindenbach D, Bishop C. Critical involvement of the motor cortex in the pathophysiology and treatment of Parkinson's disease. Neurosci Biobehav Rev 2013; 37:2737-50. [PMID: 24113323 DOI: 10.1016/j.neubiorev.2013.09.008] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Revised: 06/20/2013] [Accepted: 09/13/2013] [Indexed: 12/16/2022]
Abstract
This review examines the involvement of the motor cortex in Parkinson's disease (PD), a debilitating movement disorder typified by degeneration of dopamine cells of the substantia nigra. While much of PD research has focused on the caudate/putamen, many aspects of motor cortex function are abnormal in PD patients and in animal models of PD, implicating motor cortex involvement in disease symptoms and their treatment. Herein, we discuss several lines of evidence to support this hypothesis. Dopamine depletion alters regional metabolism in the motor cortex and also reduces interneuron activity, causing a breakdown in intracortical inhibition. This leads to functional reorganization of motor maps and excessive corticostriatal synchrony when movement is initiated. Recent work suggests that electrical stimulation of the motor cortex provides a clinical benefit for PD patients. Based on extant research, we identify a number of unanswered questions regarding the motor cortex in PD and argue that a better understanding of the contribution of the motor cortex to PD symptoms will facilitate the development of novel therapeutic approaches.
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Affiliation(s)
- David Lindenbach
- Behavioral Neuroscience Program, Department of Psychology, Binghamton University - State University of New York, PO Box 6000, Binghamton, NY 13902-6000, USA.
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16
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Abstract
Accumulation of alpha-synuclein is a pathological feature in several neurological diseases. Its characterization has allowed for a re-grouping of diseases according to the expected pathology. The clinical syndrome of PD can now be classified into forms with and without alpha-synuclein pathology. DLB and PDD are synucleinopathies, and MSA shows alpha-synuclein pathology with glial inclusions. ADHD symptoms commonly occur in persons that will subsequently develop DLB. A similar phenomenon may be the early personality changes and frontotemporal atrophy in patients with SNCA multiplication. RLS is not known to have alpha-synuclein pathology, but as PD and ADHD, involves a hypodopaminergic state. Furthermore, PD and RLS co-occur in families in a way that suggests common inheritance. A proportion of patients with ET have brainstem Lewy body pathology. Gaucher disease and other lysosomal storage disorders also have alpha-synuclein pathology. Alpha-synuclein is a naturally unfolded protein. Non-fibrillar oligomeres may be the toxic species, and Lewy body formation may in fact be protective. Inhibiting alpha-synuclein toxicity seems to be an attractive novel treatment strategy and several approaches are being developed. When such treatments become available, clinicians will need to be familiar with the clinical features that distinguish the synucleinopathies from their look-alikes.
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