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Droby A, Thaler A, Mirelman A. Imaging Markers in Genetic Forms of Parkinson's Disease. Brain Sci 2023; 13:1212. [PMID: 37626568 PMCID: PMC10452191 DOI: 10.3390/brainsci13081212] [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: 07/19/2023] [Revised: 08/13/2023] [Accepted: 08/14/2023] [Indexed: 08/27/2023] Open
Abstract
Parkinson's disease (PD) is a complex neurodegenerative disorder characterized by motor symptoms such as bradykinesia, rigidity, and resting tremor. While the majority of PD cases are sporadic, approximately 15-20% of cases have a genetic component. Advances in neuroimaging techniques have provided valuable insights into the pathophysiology of PD, including the different genetic forms of the disease. This literature review aims to summarize the current state of knowledge regarding neuroimaging findings in genetic PD, focusing on the most prevalent known genetic forms: mutations in the GBA1, LRRK2, and Parkin genes. In this review, we will highlight the contributions of various neuroimaging modalities, including positron emission tomography (PET), single-photon emission computed tomography (SPECT), and magnetic resonance imaging (MRI), in elucidating the underlying pathophysiological mechanisms and potentially identifying candidate biomarkers for genetic forms of PD.
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Affiliation(s)
- Amgad Droby
- Laboratory for Early Markers of Neurodegeneration (LEMON), Neurological Institute, Tel Aviv Medical Center, Tel Aviv 6801298, Israel; (A.T.); (A.M.)
- Movement Disorders Unit, Neurological Institute, Tel Aviv Medical Center, Tel Aviv 6423906, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv 39040, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 39040, Israel
| | - Avner Thaler
- Laboratory for Early Markers of Neurodegeneration (LEMON), Neurological Institute, Tel Aviv Medical Center, Tel Aviv 6801298, Israel; (A.T.); (A.M.)
- Movement Disorders Unit, Neurological Institute, Tel Aviv Medical Center, Tel Aviv 6423906, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv 39040, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 39040, Israel
| | - Anat Mirelman
- Laboratory for Early Markers of Neurodegeneration (LEMON), Neurological Institute, Tel Aviv Medical Center, Tel Aviv 6801298, Israel; (A.T.); (A.M.)
- Movement Disorders Unit, Neurological Institute, Tel Aviv Medical Center, Tel Aviv 6423906, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv 39040, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 39040, Israel
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Zhang D, Zhou L, Shi Y, Liu J, Wei H, Tong Q, He H, Wu T. Increased Free Water in the Substantia Nigra in Asymptomatic LRRK2 G2019S Mutation Carriers. Mov Disord 2023; 38:138-142. [PMID: 36253640 DOI: 10.1002/mds.29253] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 09/05/2022] [Accepted: 09/26/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND The alteration of substantia nigra (SN) degeneration in populations at risk of Parkinson's disease (PD) is unclear. OBJECTIVE We investigated free water (FW) values in the posterior SN (pSN) in asymptomatic LRRK2 G2019S mutation carriers. METHODS We analyzed diffusion imaging data from 28 asymptomatic LRRK2 G2019S mutation carriers and 30 healthy controls (HCs), whereas 11 asymptomatic LRRK2 G2019S carriers and 11 HCs were followed up. FW values in the pSN were measured and compared between the groups. The relationship between longitudinal changes in FW in the pSN and dopamine transporter striatal binding ratio (SBR) was analyzed. RESULTS FW values in the pSN were significantly elevated and kept increasing during follow-up in asymptomatic LRRK2 G2019S carriers. There was a negative correlation between FW changes in the left pSN and SBR changes in the left putamen. CONCLUSION FW in the pSN has the potential to be a progression imaging marker of early dopaminergic degeneration in the population at risk of PD. © 2022 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Dongling Zhang
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Parkinson's Disease Center, Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China
| | - Liche Zhou
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuting Shi
- Institute for Medical Imaging Technology, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Jun Liu
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hongjiang Wei
- Institute for Medical Imaging Technology, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Qiqi Tong
- Research Center for Healthcare Data Science, Zhejiang Lab, Hangzhou, Zhejiang, China
| | - Hongjian He
- Center for Brain Imaging Science and Technology, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, Zhejiang, China
| | - Tao Wu
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Parkinson's Disease Center, Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China
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Yu J, Chen L, Cai G, Wang Y, Chen X, Hong W, Ye Q. Evaluating white matter alterations in Parkinson's disease-related parkin S/N167 mutation carriers using tract-based spatial statistics. Quant Imaging Med Surg 2022; 12:4272-4285. [PMID: 35919057 PMCID: PMC9338378 DOI: 10.21037/qims-21-1007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 05/05/2022] [Indexed: 11/30/2022]
Abstract
Background Genetic susceptibility plays an important role in the pathogenesis of Parkinson’s disease (PD). parkin S/N167 mutations may increase the risk of PD and affect white matter fibers in the brain. This cross-sectional study explored the effects of gene polymorphisms on white matter fiber damage in PD. Methods In all, 54 cases were enrolled in the study, including PD patients carrying parkin gene S/N167 mutations (G/A), PD patients without gene S/N167 mutations (G/G), and healthy controls (HC). The whole-brain white matter fiber skeleton was analyzed using the tract-based spatial statistics (TBSS) method. Two-way analysis of variance (ANOVA) and post hoc tests were used for data analyses. Results Two classification methods were used; one was based on disease classification, with 26 patients in the PD group (n=12 G/G, n=14 G/A) and 28 in the HC group (n=15 G/G, n=13 G/A), and the other was based on genetic classification, with 27 patients in the G/G group and 27 in the G/A group. In the G/A group, there was a wide range of significant changes in fractional anisotropy (FA), radial diffusivity (RD), and mean diffusivity (MD) values (P<0.05). There was also a significant decrease in FA in the PD-G/A group compared with the PD-G/G and HC-G/A groups (P<0.05). Conclusions There were more extensive brain white matter fiber damage and changes in PD patients; the G/A polymorphism may cause more extensive brain white matter damage.
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Affiliation(s)
- Jinqiu Yu
- Department of Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China.,Department of Neurology, Affiliated Sanming First Hospital, Fujian Medical University, Sanming, China.,Institute of Neuroscience, Fujian Key Laboratory of Molecular Neurology, Fuzhou, China.,Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China
| | - Lina Chen
- Department of Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China.,Institute of Neuroscience, Fujian Key Laboratory of Molecular Neurology, Fuzhou, China.,Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China
| | - Guoen Cai
- Department of Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China.,Institute of Neuroscience, Fujian Key Laboratory of Molecular Neurology, Fuzhou, China.,Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China
| | - Yingqing Wang
- Department of Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China.,Institute of Neuroscience, Fujian Key Laboratory of Molecular Neurology, Fuzhou, China.,Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China
| | - Xiaochun Chen
- Department of Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China.,Institute of Neuroscience, Fujian Key Laboratory of Molecular Neurology, Fuzhou, China.,Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China
| | - Weimin Hong
- Department of Neurology, Affiliated Sanming First Hospital, Fujian Medical University, Sanming, China
| | - Qinyong Ye
- Department of Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China.,Institute of Neuroscience, Fujian Key Laboratory of Molecular Neurology, Fuzhou, China.,Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China
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Chipika RH, Siah WF, McKenna MC, Li Hi Shing S, Hardiman O, Bede P. The presymptomatic phase of amyotrophic lateral sclerosis: are we merely scratching the surface? J Neurol 2020; 268:4607-4629. [PMID: 33130950 DOI: 10.1007/s00415-020-10289-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 10/18/2020] [Accepted: 10/20/2020] [Indexed: 02/06/2023]
Abstract
Presymptomatic studies in ALS have consistently captured considerable disease burden long before symptom manifestation and contributed important academic insights. With the emergence of genotype-specific therapies, however, there is a pressing need to address practical objectives such as the estimation of age of symptom onset, phenotypic prediction, informing the optimal timing of pharmacological intervention, and identifying a core panel of biomarkers which may detect response to therapy. Existing presymptomatic studies in ALS have adopted striking different study designs, relied on a variety of control groups, used divergent imaging and electrophysiology methods, and focused on different genotypes and demographic groups. We have performed a systematic review of existing presymptomatic studies in ALS to identify common themes, stereotyped shortcomings, and key learning points for future studies. Existing presymptomatic studies in ALS often suffer from sample size limitations, lack of disease controls and rarely follow their cohort until symptom manifestation. As the characterisation of presymptomatic processes in ALS serves a multitude of academic and clinical purposes, the careful review of existing studies offers important lessons for future initiatives.
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Affiliation(s)
- Rangariroyashe H Chipika
- Computational Neuroimaging Group (CNG), Biomedical Sciences Institute, Trinity College Dublin, Pearse Street, Dublin, Ireland
| | - We Fong Siah
- Computational Neuroimaging Group (CNG), Biomedical Sciences Institute, Trinity College Dublin, Pearse Street, Dublin, Ireland
| | - Mary Clare McKenna
- Computational Neuroimaging Group (CNG), Biomedical Sciences Institute, Trinity College Dublin, Pearse Street, Dublin, Ireland
| | - Stacey Li Hi Shing
- Computational Neuroimaging Group (CNG), Biomedical Sciences Institute, Trinity College Dublin, Pearse Street, Dublin, Ireland
| | - Orla Hardiman
- Computational Neuroimaging Group (CNG), Biomedical Sciences Institute, Trinity College Dublin, Pearse Street, Dublin, Ireland
| | - Peter Bede
- Computational Neuroimaging Group (CNG), Biomedical Sciences Institute, Trinity College Dublin, Pearse Street, Dublin, Ireland.
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Altered reward-related neural responses in non-manifesting carriers of the Parkinson disease related LRRK2 mutation. Brain Imaging Behav 2020; 13:1009-1020. [PMID: 29971685 DOI: 10.1007/s11682-018-9920-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Disturbances in reward processing occur in Parkinson's disease (PD) however it is unclear whether these are solely drug-related. We applied an event-related fMRI gambling task to a group of non-manifesting carriers (NMC) of the G2019S mutation in the LRRK2 gene, in order to assess the reward network in an "at risk" population for future development of PD. Sixty-eight non-manifesting participants, 32 of which were non-manifesting non-carriers (NMNC), performed a gambling task which included defined intervals of anticipation and response to both reward and punishment in an fMRI setup. Behavior and cerebral activations were measured using both hypothesis driven and whole brain analysis. NMC demonstrated higher trait anxiety scores (p = 0.04) compared to NMNC. Lower activations were detected among NMC during risky anticipation in the left nucleus accumbens (NAcc) (p = 0.05) and during response to punishment in the right insula (p = 0.02), with higher activations among NMC during safe anticipation in the right insula (p = 0.02). Psycho-Physiological Interaction (PPI) analysis from the NAcc and insula revealed differential connectivity patterns. Whole brain analysis demonstrated divergent between-group activations in distributed cortical regions, bilateral caudate, left midbrain, when participants were required to press the response button upon making their next chosen move. Abnormal neural activity in both the reward and motor networks were detected in NMC indicating involvement of the ventral striatum regardless of medication use in "at risk" individuals for future development of PD.
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Jacob Y, Rosenberg-Katz K, Gurevich T, Helmich RC, Bloem BR, Orr-Urtreger A, Giladi N, Mirelman A, Hendler T, Thaler A. Network abnormalities among non-manifesting Parkinson disease related LRRK2 mutation carriers. Hum Brain Mapp 2019; 40:2546-2555. [PMID: 30793410 DOI: 10.1002/hbm.24543] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 01/13/2019] [Accepted: 01/29/2019] [Indexed: 12/25/2022] Open
Abstract
Non-manifesting carriers (NMC) of the G2019S mutation in the LRRK2 gene represent an "at risk" group for future development of Parkinson's disease (PD) and have demonstrated task related fMRI changes. However, resting-state networks have received less research focus, thus this study aimed to assess the integrity of the motor, default mode (DMN), salience (SAL), and dorsal attention (DAN) networks among this unique population by using two different connectivity measures: interregional functional connectivity analysis and Dependency network analysis (DEP NA). Machine learning classification methods were used to distinguish connectivity between the two groups of participants. Forty-four NMC and 41 non-manifesting non-carriers (NMNC) participated in this study; while no behavioral differences on standard questionnaires could be detected, NMC demonstrated lower connectivity measures in the DMN, SAL, and DAN compared to NMNC but not in the motor network. Significant correlations between NMC connectivity measures in the SAL and attention were identified. Machine learning classification separated NMC from NMNC with an accuracy rate above 0.8. Reduced integrity of non-motor networks was detected among NMC of the G2019S mutation in the LRRK2 gene prior to identifiable changes in connectivity of the motor network, indicating significant non-motor cerebral changes among populations "at risk" for future development of PD.
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Affiliation(s)
- Yael Jacob
- Translational and Molecular Imaging Institute, Icahn School of Medicine, Mount Sinai Medical Center, New York, New York.,Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel.,Sagol Brain Institute Tel-Aviv Medical Center, Tel-Aviv, Israel
| | | | - Tanya Gurevich
- Sagol Brain Institute Tel-Aviv Medical Center, Tel-Aviv, Israel.,Movement Disorders Unit, Neurological Institute, Tel-Aviv Medical Center, Tel-Aviv, Israel.,Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Rick C Helmich
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands.,Department of Neurology and Parkinson Centre, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Bastiaan R Bloem
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands.,Department of Neurology and Parkinson Centre, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Avi Orr-Urtreger
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.,Tel-Aviv Medical Center, Genetic Institute, Tel-Aviv, Israel
| | - Nir Giladi
- Sagol Brain Institute Tel-Aviv Medical Center, Tel-Aviv, Israel.,Movement Disorders Unit, Neurological Institute, Tel-Aviv Medical Center, Tel-Aviv, Israel.,Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Anat Mirelman
- Sagol Brain Institute Tel-Aviv Medical Center, Tel-Aviv, Israel.,Movement Disorders Unit, Neurological Institute, Tel-Aviv Medical Center, Tel-Aviv, Israel.,Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.,Laboratory of Early Markers of Neurodegeneration, Neurological Institute, Tel-Aviv Medical Center, Tel-Aviv, Israel
| | - Talma Hendler
- Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel.,Sagol Brain Institute Tel-Aviv Medical Center, Tel-Aviv, Israel
| | - Avner Thaler
- Sagol Brain Institute Tel-Aviv Medical Center, Tel-Aviv, Israel.,Movement Disorders Unit, Neurological Institute, Tel-Aviv Medical Center, Tel-Aviv, Israel.,Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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Thaler A. Structural and Functional MRI in Familial Parkinson's Disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2018; 142:261-287. [PMID: 30409255 DOI: 10.1016/bs.irn.2018.09.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Between 10 and 15% of Parkinson disease (PD) cases can be traced to a genetically identified causative mutation which currently number over 40. This enables the study of both "at risk" populations for future development of PD and a unique sub-group of genetically determined patient population. Structural and functional magnetic imaging has the potential of assisting diagnosis, early detection and disease progression as it is relatively cheap and easy to implement. However, the large variety of imaging options and different analytical approaches hamper the pursuit of a unified imaging biomarker. This chapter details the current imaging options and summarizes the findings among both genetically determined patients with PD and their non-manifesting first degree relatives, speculating on possible compensational mechanisms while mapping future directions in order to better utilize MRI in the research of genetic PD.
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Affiliation(s)
- Avner Thaler
- Movement Disorders Unit, Neurological Institute, Tel Aviv Medical Center, Tel Aviv, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.
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Cerebral Imaging Markers of GBA and LRRK2 Related Parkinson's Disease and Their First-Degree Unaffected Relatives. Brain Topogr 2018; 31:1029-1036. [PMID: 29846835 DOI: 10.1007/s10548-018-0653-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Accepted: 05/26/2018] [Indexed: 12/12/2022]
Abstract
Cerebral atrophy has been detected in patients with Parkinson's disease (PD) both with and without dementia, however differentiation based on genetic status has thus far not yielded robust findings. We assessed cortical thickness and subcortical volumes in a cohort of PD patients and healthy controls carriers of the G2019S mutation in the LRRK2 gene and the common GBA mutations, in an attempt to determine whether genetic status influences structural indexes. Cortical thickness and subcortical volumes were computed and compared between six groups of participants; idiopathic PD, GBA-PD, LRRK2-PD, non-manifesting non-carriers (NMNC), GBA-non-manifesting carriers (NMC) and LRRK2-NMC utilizing the FreeSurfer software program. All participants were cognitively intact based on a computerized cognitive assessment battery. Fifty-seven idiopathic PD patients, 9 LRRK2-PD, 12 GBA-PD, 49 NMNC, 41 LRRK2-NMC and 14 GBA-NMC participated in this study. Lower volumes among patients with PD compared to unaffected participants were detected in bilateral hippocampus, nucleus accumbens, caudate, thalamus, putamen and amygdala and the right pallidum (p = 0.016). PD patients demonstrated lower cortical thickness indexes in a majority of regions assessed compared with non-manifesting participants. No differences in cortical thickness and subcortical volumes were detected within each of the groups of participants based on genetic status. Mutations in the GBA and LRRK2 genes are not important determinants of cortical thickness and subcortical volumes in both patients with PD and non-manifesting participants. PD is associated with a general reduction in cortical thickness and sub-cortical atrophy even in cognitively intact patients.
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Heldmann M, Heeren J, Klein C, Rauch L, Hagenah J, Münte TF, Kasten M, Brüggemann N. Neuroimaging abnormalities in individuals exhibiting Parkinson's disease risk markers. Mov Disord 2018; 33:1412-1422. [PMID: 29756356 DOI: 10.1002/mds.27313] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 12/23/2017] [Accepted: 12/31/2017] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The concept of prodromal Parkinson's disease (PD) involves variable combinations of nonmotor features and subtle motor abnormalities as a result of ongoing neurodegeneration in the brain stem including substantia nigra (SN) and abnormal findings upon transcranial sonography and nuclear imaging. Except for nuclear imaging, the predictive value of risk markers for the conversion to overt PD is low. OBJECTIVE The objective of this study was to determine whether PD risk markers are associated with changes in brain structure and to what extent cognitive changes are risk markers for PD. METHODS Diffusion-weighted imaging, voxel-based morphometry, and cortical thickness analysis was performed in 29 individuals with hyposmia and/or an increased SN hyperechogenicity (SN+) upon transcranial sonography and 28 controls without these 2 risk markers. Classical parkinsonian signs were an exclusion criterion. All of the participants underwent a neuropsychological test battery addressing executive functions, learning ability, and verbal fluency. RESULTS In the PD risk group, diffusion-weighted imaging mean diffusivity was increased in 4 left hemisphere clusters (posterior thalamus, inferior longitudinal fasciculus, fornix, corticospinal tract). A negative relationship of mean diffusivity and smell function was present for the posterior thalamus and the corticospinal tract. There was a significant correlation of mean diffusivity values and SN+ in all clusters. Neither voxel-based morphometry nor cortical thickness analysis revealed any group differences. No relevant group differences were observed for cognitive tests included. CONCLUSION PD-free individuals with PD risk markers show microstructural changes of the white matter, including areas relevant for motor and limbic processes. In addition, our study provides for the first time a neuroanatomical correlate for SN hyperechogenicity. © 2018 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Marcus Heldmann
- Department of Neurology, University of Lübeck, Lübeck, Germany
| | - Janna Heeren
- Department of Neurology, University of Lübeck, Lübeck, Germany.,Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Christine Klein
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Linus Rauch
- Department of Neurology, University of Lübeck, Lübeck, Germany.,Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Johann Hagenah
- Department of Neurology, Westküstenklinikum Heide, Heide, Germany
| | - Thomas F Münte
- Department of Neurology, University of Lübeck, Lübeck, Germany
| | - Meike Kasten
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.,Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Norbert Brüggemann
- Department of Neurology, University of Lübeck, Lübeck, Germany.,Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
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Fengler S, Liepelt-Scarfone I, Brockmann K, Schäffer E, Berg D, Kalbe E. Cognitive changes in prodromal Parkinson's disease: A review. Mov Disord 2017; 32:1655-1666. [PMID: 28980730 DOI: 10.1002/mds.27135] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Revised: 06/22/2017] [Accepted: 06/26/2017] [Indexed: 12/31/2022] Open
Abstract
Although other nonmotor phenomena representing possible prodromal symptoms of Parkinson's disease have been described in some detail, the occurrence and characteristics of cognitive decline in this early phase of the disease are less well understood. The aim of this review is to summarize the current state of research on cognitive changes in prodromal PD. Only a small number of longitudinal studies have been conducted that examined cognitive function in individuals with a subsequent PD diagnosis. However, when we consider data from at-risk groups, the evidence suggests that cognitive decline may occur in a substantial number of individuals who have the potential for developing PD. In terms of specific cognitive domains, executive function in particular and, less frequently, memory scores are reduced. Prospective longitudinal studies are thus needed to clarify whether cognitive, and specifically executive, decline might be added to the prodromal nonmotor symptom complex that may precede motor manifestations of PD by years and may help to update the risk scores used for early identification of PD. © 2017 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Sophie Fengler
- Department of Medical Psychology ǀ Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), University Hospital Cologne, Cologne, Germany.,Psychological Gerontology, Institute of Gerontology, University of Vechta, Vechta, Germany
| | - Inga Liepelt-Scarfone
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,German Center of Neurodegenerative Diseases (DZNE), University of Tübingen, Tübingen, Germany
| | - Kathrin Brockmann
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,German Center of Neurodegenerative Diseases (DZNE), University of Tübingen, Tübingen, Germany
| | - Eva Schäffer
- Department of Neurology, Christian-Albrechts-University, Kiel, Kiel, Germany
| | - Daniela Berg
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,Department of Neurology, Christian-Albrechts-University, Kiel, Kiel, Germany
| | - Elke Kalbe
- Department of Medical Psychology ǀ Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), University Hospital Cologne, Cologne, Germany.,Psychological Gerontology, Institute of Gerontology, University of Vechta, Vechta, Germany
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Artzi M, Even-Sapir E, Lerman Shacham H, Thaler A, Urterger AO, Bressman S, Marder K, Hendler T, Giladi N, Ben Bashat D, Mirelman A. DaT-SPECT assessment depicts dopamine depletion among asymptomatic G2019S LRRK2 mutation carriers. PLoS One 2017; 12:e0175424. [PMID: 28406934 PMCID: PMC5391020 DOI: 10.1371/journal.pone.0175424] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 03/24/2017] [Indexed: 12/20/2022] Open
Abstract
Identification of early changes in Dopamine-Transporter (DaT) SPECT imaging expected in the prodromal phase of Parkinson’s disease (PD), are usually overlooked. Carriers of the G2019S LRRK2 mutation are known to be at high risk for developing PD, compared to non-carriers. In this work we aimed to study early changes in Dopamine uptake in non-manifesting PD carriers (NMC) of the G2019S LRRK2 mutation using quantitative DaT-SPECT analysis and to examine the potential for early prediction of PD. Eighty Ashkenazi-Jewish subjects were included in this study: eighteen patients with PD; thirty-one NMC and thirty-one non-manifesting non-carriers (NMNC). All subjects underwent a through clinical assessment including evaluation of motor, olfactory, affective and non-motor symptoms and DaT-SPECT imaging. A population based DaT-SPECT template was created based on the NMNC cohort, and data driven volumes-of-interest (VOIs) were defined. Comparisons between groups were performed based on VOIs and voxel-wise analysis. The striatum area of all three cohorts was segmented into four VOIs, corresponding to the right/left dorsal and ventral striatum. Significant differences in clinical measures were found between patients with PD and non-manifesting subjects with no differences between NMC and NMNC. Significantly lower uptake (p<0.001) was detected in the right and left dorsal striatum in the PD group (2.2±0.3, 2.3±0.4) compared to the NMC (4.2±0.6, 4.3±0.5) and NMNC (4.5±0.6, 4.6±0.6), and significantly (p = 0.05) lower uptake in the right dorsal striatum in the NMC group compared to NMNC. Converging results were obtained using voxel-wise analysis. Two NMC participants, who later phenoconverted into PD, demonstrated reduced uptake mainly in the dorsal striatum. No significant correlations were found between the DaT-SPECT uptake in the different VOIs and clinical and behavioral assessments in the non-manifesting groups. This study shows the clinical value of quantitative assessment of DaT-SPECT imaging and the potential for predicting PD by detection of dopamine depletion, already at the pre-symptomatic stage. Clinical registration numbers: NCT01089270 and NCT01089283.
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Affiliation(s)
- Moran Artzi
- Functional Brain Center, The Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Einat Even-Sapir
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Nuclear Medicine, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Hedva Lerman Shacham
- Department of Nuclear Medicine, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Avner Thaler
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Movement Disorders Unit, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Avi Orr Urterger
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Genetics Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Susan Bressman
- Columbia University, Columbia University Medical Center, New-York, New York, United States of America
| | - Karen Marder
- Mount Sinai-Beth Israel Medical Center, New York, New York, United States of America
| | - Talma Hendler
- Functional Brain Center, The Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- Department of Psychology, Tel Aviv University, Tel Aviv, Israel
| | - Nir Giladi
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Movement Disorders Unit, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Dafna Ben Bashat
- Functional Brain Center, The Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- * E-mail:
| | - Anat Mirelman
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Movement Disorders Unit, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Laboratory for Early Markers of Neurodegenertion, Neurology Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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12
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Borgonovo J, Allende-Castro C, Laliena A, Guerrero N, Silva H, Concha ML. Changes in neural circuitry associated with depression at pre-clinical, pre-motor and early motor phases of Parkinson's disease. Parkinsonism Relat Disord 2016; 35:17-24. [PMID: 27889469 DOI: 10.1016/j.parkreldis.2016.11.009] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 11/08/2016] [Accepted: 11/18/2016] [Indexed: 12/17/2022]
Abstract
Although Parkinson's Disease (PD) is mostly considered a motor disorder, it can present at early stages as a non-motor pathology. Among the non-motor clinical manifestations, depression shows a high prevalence and can be one of the first clinical signs to appear, even a decade before the onset of motor symptoms. Here, we review the evidence of early dysfunction in neural circuitry associated with depression in the context of PD, focusing on pre-clinical, pre-motor and early motor phases of the disease. In the pre-clinical phase, structural and functional changes in the substantia nigra, basal ganglia and limbic structures are already observed. Some of these changes are linked to motor compensation mechanisms while others correspond to pathological processes common to PD and depression and thus could underlie the appearance of depressive symptoms during the pre-motor phase. Studies of the early motor phase (less than five years post diagnosis) reveal an association between the extent of damage in different monoaminergic systems and the appearance of emotional disorders. We propose that the limbic loop of the basal ganglia and the lateral habenula play key roles in the early genesis of depression in PD. Alterations in the neural circuitry linked with emotional control might be sensitive markers of the ongoing neurodegenerative process and thus may serve to facilitate an early diagnosis of this disease. To take advantage of this, we need to improve the clinical criteria and develop biomarkers to identify depression, which could be used to determine individuals at risk to develop PD.
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Affiliation(s)
- Janina Borgonovo
- Anatomy and Developmental Biology, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, PO Box 70031, Santiago, Chile; Biomedical Neuroscience Institute, Independencia 1027, Santiago, Chile; Center for Geroscience, Brain Health and Metabolism, Santiago, Chile
| | - Camilo Allende-Castro
- Anatomy and Developmental Biology, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, PO Box 70031, Santiago, Chile; Biomedical Neuroscience Institute, Independencia 1027, Santiago, Chile; Center for Geroscience, Brain Health and Metabolism, Santiago, Chile
| | - Almudena Laliena
- Anatomy and Developmental Biology, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, PO Box 70031, Santiago, Chile; Biomedical Neuroscience Institute, Independencia 1027, Santiago, Chile
| | - Néstor Guerrero
- Anatomy and Developmental Biology, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, PO Box 70031, Santiago, Chile; Biomedical Neuroscience Institute, Independencia 1027, Santiago, Chile
| | - Hernán Silva
- Department of Psychiatry and Mental Health, Clinical Hospital, Universidad de Chile, Santiago, Chile
| | - Miguel L Concha
- Anatomy and Developmental Biology, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, PO Box 70031, Santiago, Chile; Biomedical Neuroscience Institute, Independencia 1027, Santiago, Chile; Center for Geroscience, Brain Health and Metabolism, Santiago, Chile.
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13
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Vilas D, Segura B, Baggio HC, Pont-Sunyer C, Compta Y, Valldeoriola F, José Martí M, Quintana M, Bayés A, Hernández-Vara J, Calopa M, Aguilar M, Junqué C, Tolosa E. Nigral and striatal connectivity alterations in asymptomatic LRRK2 mutation carriers: A magnetic resonance imaging study. Mov Disord 2016; 31:1820-1828. [PMID: 27653520 DOI: 10.1002/mds.26799] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Revised: 08/03/2016] [Accepted: 08/05/2016] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND The study of functional connectivity by means of magnetic resonance imaging (MRI) in asymptomatic LRRK2 mutation carriers could contribute to the characterization of the prediagnostic phase of LRRK2-associated Parkinson's disease (PD). The objective of this study was to characterize MRI functional patterns during the resting state in asymptomatic LRRK2 mutation carriers. METHODS We acquired structural and functional MRI data of 18 asymptomatic LRRK2 mutation carriers and 18 asymptomatic LRRK2 mutation noncarriers, all first-degree relatives of LRRK2-PD patients. Starting from resting-state data, we analyzed the functional connectivity of the striatocortical and the nigrocortical circuitry. Structural brain data were analyzed by voxel-based morphometry, cortical thickness, and volumetric measures. RESULTS Asymptomatic LRRK2 mutation carriers had functional connectivity reductions between the caudal motor part of the left striatum and the ipsilateral precuneus and superior parietal lobe. Connectivity in these regions correlated with subcortical gray-matter volumes in mutation carriers. Asymptomatic carriers also showed increased connectivity between the right substantia nigra and bilateral occipital cortical regions (occipital pole and cuneus bilaterally and right lateral occipital cortex). No intergroup differences in structural MRI measures were found. In LRRK2 mutation carriers, age and functional connectivity correlated negatively with striatal volumes. Additional analyses including only subjects with the G2019S mutation revealed similar findings. CONCLUSIONS Asymptomatic LRRK2 mutation carriers showed functional connectivity changes in striatocortical and nigrocortical circuits compared with noncarriers. These findings support the concept that altered brain connectivity precedes the onset of classical motor features in a genetic form of PD. © 2016 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Dolores Vilas
- Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Barcelona, Catalonia, Spain
| | - Bàrbara Segura
- Psychiatry and Clinical Psychobiology Department, Universitat de Barcelona. Barcelona, Catalonia, Spain
| | - Hugo C Baggio
- Psychiatry and Clinical Psychobiology Department, Universitat de Barcelona. Barcelona, Catalonia, Spain
| | - Claustre Pont-Sunyer
- Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Barcelona, Catalonia, Spain
| | - Yaroslau Compta
- Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Barcelona, Catalonia, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain.,Centro en Red para la Investigacion de Enfermedades Neurodegenerativas CIBERNED, Barcelona, Catalonia, Spain
| | - Francesc Valldeoriola
- Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Barcelona, Catalonia, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain.,Centro en Red para la Investigacion de Enfermedades Neurodegenerativas CIBERNED, Barcelona, Catalonia, Spain
| | - María José Martí
- Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Barcelona, Catalonia, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain.,Centro en Red para la Investigacion de Enfermedades Neurodegenerativas CIBERNED, Barcelona, Catalonia, Spain
| | - María Quintana
- Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Barcelona, Catalonia, Spain
| | - Angels Bayés
- Parkinson's Unit, Clínica Teknon, Barcelona, Spain
| | - Jorge Hernández-Vara
- Neurology Service, Hospital Universitari Vall D'Hebron, Barcelona, Catalonia, Spain
| | - Matilde Calopa
- Neurology Service, Hospital Universitari de Bellvitge, Barcelona, Catalonia, Spain
| | - Miquel Aguilar
- Neurology Service, Hospital Universitari Mutua de Terrasa, Barcelona, Catalonia, Spain
| | - Carme Junqué
- Psychiatry and Clinical Psychobiology Department, Universitat de Barcelona. Barcelona, Catalonia, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain.,Centro en Red para la Investigacion de Enfermedades Neurodegenerativas CIBERNED, Barcelona, Catalonia, Spain
| | - Eduardo Tolosa
- Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Barcelona, Catalonia, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain.,Centro en Red para la Investigacion de Enfermedades Neurodegenerativas CIBERNED, Barcelona, Catalonia, Spain
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14
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Bregman N, Thaler A, Mirelman A, Helmich RC, Gurevich T, Orr-Urtreger A, Marder K, Bressman S, Bloem BR, Giladi N. A cognitive fMRI study in non-manifesting LRRK2 and GBA carriers. Brain Struct Funct 2016; 222:1207-1218. [PMID: 27401793 DOI: 10.1007/s00429-016-1271-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 07/05/2016] [Indexed: 10/21/2022]
Abstract
Mutations in the GBA and LRRK2 genes account for one-third of the prevalence of Parkinson's disease (PD) in Ashkenazi Jews. Non-manifesting carriers (NMC) of these mutations represent a population at risk for future development of PD. PD patient who carry mutations in the GBA gene demonstrates more significant cognitive decline compared to idiopathic PD patients. We assessed cognitive domains using fMRI among NMC of both LRRK2 and GBA mutations to better understand pre-motor cognitive functions in these populations. Twenty-one LRRK2-NMC, 10 GBA-NMC, and 22 non-manifesting non-carriers (NMNC) who participated in this study were evaluated using the standard questionnaires and scanned while performing two separate cognitive tasks; a Stroop interference task and an N-Back working memory task. Cerebral activation patterns were assessed using both whole brain and predefined region of interest (ROI) analysis. Subjects were well matched in all demographic and clinical characteristics. On the Stroop task, in spite of similar behavior, GBA-NMC demonstrated increased task-related activity in the right medial frontal gyrus and reduced task-related activity in the left lingual gyrus compared to both LRRK2-NMC and NMNC. In addition, GBA-NMC had higher activation patterns in the incongruent task compared to NMNC in the left medial frontal gyrus and bilateral precentral gyrus. No whole-brain differences were noted between groups on the N-Back task. Paired cognitive and task-related performance between GBA-NMC, LRRK2-NMC, and NMNC could indicate that the higher activation patterns in the incongruent Stroop condition among GBA-NMC compared to LRRK2-NMC and NMNC may represent a compensatory mechanism that enables adequate cognitive performance.
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Affiliation(s)
- Noa Bregman
- Department of Neurology, Memory and Attention Disorders Center, Tel-Aviv Medical Center, Tel-Aviv, Israel.,Sackler School of Medicine, Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
| | - Avner Thaler
- Movement Disorders Unit, Department of Neurology, Tel-Aviv Medical Center, 6 Weizman Street, 64239, Tel-Aviv, Israel. .,Sackler School of Medicine, Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel. .,Functional Brain Center, Wohl Institute for Advanced Imaging, Tel-Aviv Medical Center, Tel-Aviv, Israel.
| | - Anat Mirelman
- Movement Disorders Unit, Department of Neurology, Tel-Aviv Medical Center, 6 Weizman Street, 64239, Tel-Aviv, Israel.,Sackler School of Medicine, Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
| | - Rick C Helmich
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Tanya Gurevich
- Movement Disorders Unit, Department of Neurology, Tel-Aviv Medical Center, 6 Weizman Street, 64239, Tel-Aviv, Israel.,Sackler School of Medicine, Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
| | - Avi Orr-Urtreger
- Sackler School of Medicine, Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel.,Genetic Institute, Tel-Aviv Medical Center, Tel-Aviv, Israel
| | - Karen Marder
- Columbia University Medical Center, Columbia University, New York, NY, USA
| | | | - Bastiaan R Bloem
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Nir Giladi
- Movement Disorders Unit, Department of Neurology, Tel-Aviv Medical Center, 6 Weizman Street, 64239, Tel-Aviv, Israel.,Sackler School of Medicine, Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
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15
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Weingarten CP, Sundman MH, Hickey P, Chen NK. Neuroimaging of Parkinson's disease: Expanding views. Neurosci Biobehav Rev 2015; 59:16-52. [PMID: 26409344 PMCID: PMC4763948 DOI: 10.1016/j.neubiorev.2015.09.007] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 09/07/2015] [Accepted: 09/15/2015] [Indexed: 12/14/2022]
Abstract
Advances in molecular and structural and functional neuroimaging are rapidly expanding the complexity of neurobiological understanding of Parkinson's disease (PD). This review article begins with an introduction to PD neurobiology as a foundation for interpreting neuroimaging findings that may further lead to more integrated and comprehensive understanding of PD. Diverse areas of PD neuroimaging are then reviewed and summarized, including positron emission tomography, single photon emission computed tomography, magnetic resonance spectroscopy and imaging, transcranial sonography, magnetoencephalography, and multimodal imaging, with focus on human studies published over the last five years. These included studies on differential diagnosis, co-morbidity, genetic and prodromal PD, and treatments from L-DOPA to brain stimulation approaches, transplantation and gene therapies. Overall, neuroimaging has shown that PD is a neurodegenerative disorder involving many neurotransmitters, brain regions, structural and functional connections, and neurocognitive systems. A broad neurobiological understanding of PD will be essential for translational efforts to develop better treatments and preventive strategies. Many questions remain and we conclude with some suggestions for future directions of neuroimaging of PD.
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Affiliation(s)
- Carol P Weingarten
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, United States.
| | - Mark H Sundman
- Brain Imaging and Analysis Center, Duke University Medical Center, United States
| | - Patrick Hickey
- Department of Neurology, Duke University School of Medicine, United States
| | - Nan-kuei Chen
- Brain Imaging and Analysis Center, Duke University Medical Center, United States; Department of Radiology, Duke University School of Medicine, United States
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16
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Mirelman A, Alcalay RN, Saunders-Pullman R, Yasinovsky K, Thaler A, Gurevich T, Mejia-Santana H, Raymond D, Gana-Weisz M, Bar-Shira A, Ozelius L, Clark L, Orr-Urtreger A, Bressman S, Marder K, Giladi N. Nonmotor symptoms in healthy Ashkenazi Jewish carriers of the G2019S mutation in the LRRK2 gene. Mov Disord 2015; 30:981-6. [PMID: 25809001 DOI: 10.1002/mds.26213] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2014] [Revised: 02/18/2015] [Accepted: 02/19/2015] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The asymptomatic carriers of the Leucine rich repeat kinase 2 (LRRK2) G2019S mutation represent a population at risk for developing PD. The aim of this study was to assess differences in nonmotor symptoms between nonmanifesting carriers and noncarriers of the G2019S mutation. METHODS Two hundred fifty-three subjects participated in this observational cross-sectional multicenter study. Standard questionnaires assessing anxiety, depression, cognition, smell, nonmotor symptoms, and rapid eye movement (REM) sleep behavior were administered. Analyses were adjusted for age, sex, family relations, education, and site. RESULTS One hundred thirty-four carriers were identified. Carriers had higher nonmotor symptoms score on the Nonmotor symptoms (NMS) questionnaire (P = 0.02). These findings were amplified in carriers older than age 50 y, with higher nonmotor symptoms scores and trait anxiety scores (P < 0.03). CONCLUSIONS In this cross-section study, carriers of the G2019S LRRK2 mutation endorsed subtle nonmotor symptoms. Whether these are early features of PD will require a longitudinal study. © 2015 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Anat Mirelman
- Movement Disorders Unit, Department of Neurology, Tel-Aviv Medical Center, Department of Neurology, Israel
| | - Roy N Alcalay
- College of Physicians and Surgeons, Columbia University, New York, NY, USA.,Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA
| | - Rachel Saunders-Pullman
- The Alan and Barbara Mirken Department of Neurology, Mount Sinai-Beth Israel Medical Center, New York, New York, USA.,Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kira Yasinovsky
- Movement Disorders Unit, Department of Neurology, Tel-Aviv Medical Center, Department of Neurology, Israel
| | - Avner Thaler
- Movement Disorders Unit, Department of Neurology, Tel-Aviv Medical Center, Department of Neurology, Israel
| | - Tanya Gurevich
- Movement Disorders Unit, Department of Neurology, Tel-Aviv Medical Center, Department of Neurology, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Deborah Raymond
- The Alan and Barbara Mirken Department of Neurology, Mount Sinai-Beth Israel Medical Center, New York, New York, USA
| | - Mali Gana-Weisz
- Genetics Institute, Tel Aviv Sourasky Medical Center, Israel
| | - Anat Bar-Shira
- Genetics Institute, Tel Aviv Sourasky Medical Center, Israel
| | - Laurie Ozelius
- Departments of Genetics and Genomic Sciences and Neurology, Mount Sinai School of Medicine, New York, NY, USA
| | - Lorraine Clark
- Department of Pathology and Cell Biology, College of Physicians and Surgeons, Columbia University, New York, NY, USA.,Center for Human Genetics, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Avi Orr-Urtreger
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Genetics Institute, Tel Aviv Sourasky Medical Center, Israel
| | - Susan Bressman
- The Alan and Barbara Mirken Department of Neurology, Mount Sinai-Beth Israel Medical Center, New York, New York, USA.,Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Karen Marder
- College of Physicians and Surgeons, Columbia University, New York, NY, USA.,Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA
| | - Nir Giladi
- Movement Disorders Unit, Department of Neurology, Tel-Aviv Medical Center, Department of Neurology, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sieratzki Chair in Neurology, Tel-Aviv University, New York, NY, USA
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17
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Youn J, Lee JM, Kwon H, Kim JS, Son TO, Cho JW. Alterations of mean diffusivity of pedunculopontine nucleus pathway in Parkinson's disease patients with freezing of gait. Parkinsonism Relat Disord 2015; 21:12-7. [DOI: 10.1016/j.parkreldis.2014.10.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 09/29/2014] [Accepted: 10/01/2014] [Indexed: 11/29/2022]
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