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Bălăeţ M, Alhajraf F, Zerenner T, Welch J, Razzaque J, Lo C, Giunchiglia V, Trender W, Lerede A, Hellyer PJ, Manohar SG, Malhotra P, Hu M, Hampshire A. Online cognitive monitoring technology for people with Parkinson's disease and REM sleep behavioural disorder. NPJ Digit Med 2024; 7:118. [PMID: 38714742 PMCID: PMC11076465 DOI: 10.1038/s41746-024-01124-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 04/23/2024] [Indexed: 05/10/2024] Open
Abstract
Automated online cognitive assessments are set to revolutionise clinical research and healthcare. However, their applicability for Parkinson's Disease (PD) and REM Sleep Behavioural Disorder (RBD), a strong PD precursor, is underexplored. Here, we developed an online battery to measure early cognitive changes in PD and RBD. Evaluating 19 candidate tasks showed significant global accuracy deficits in PD (0.65 SD, p = 0.003) and RBD (0.45 SD, p = 0.027), driven by memory, language, attention and executive underperformance, and global reaction time deficits in PD (0.61 SD, p = 0.001). We identified a brief 20-min battery that had sensitivity to deficits across these cognitive domains while being robust to the device used. This battery was more sensitive to early-stage and prodromal deficits than the supervised neuropsychological scales. It also diverged from those scales, capturing additional cognitive factors sensitive to PD and RBD. This technology offers an economical and scalable method for assessing these populations that can complement standard supervised practices.
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Affiliation(s)
- Maria Bălăeţ
- Department of Brain Sciences, Imperial College London, London, UK.
| | - Falah Alhajraf
- Oxford Parkinson's Disease Centre, Nuffield Department Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Tanja Zerenner
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Jessica Welch
- Oxford Parkinson's Disease Centre, Nuffield Department Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Jamil Razzaque
- Oxford Parkinson's Disease Centre, Nuffield Department Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Christine Lo
- Oxford Parkinson's Disease Centre, Nuffield Department Clinical Neurosciences, University of Oxford, Oxford, UK
| | | | - William Trender
- Department of Brain Sciences, Imperial College London, London, UK
| | - Annalaura Lerede
- Department of Brain Sciences, Imperial College London, London, UK
| | - Peter J Hellyer
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Sanjay G Manohar
- Oxford Parkinson's Disease Centre, Nuffield Department Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Paresh Malhotra
- Department of Brain Sciences, Imperial College London, London, UK
| | - Michele Hu
- Oxford Parkinson's Disease Centre, Nuffield Department Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Adam Hampshire
- Department of Brain Sciences, Imperial College London, London, UK
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Bhome R, Verdi S, Martin SA, Hannaway N, Dobreva I, Oxtoby NP, Castro Leal G, Rutherford S, Marquand AF, Weil RS, Cole JH. A neuroimaging measure to capture heterogeneous patterns of atrophy in Parkinson's disease and dementia with Lewy bodies. Neuroimage Clin 2024; 42:103596. [PMID: 38554485 PMCID: PMC10995913 DOI: 10.1016/j.nicl.2024.103596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 02/27/2024] [Accepted: 03/19/2024] [Indexed: 04/01/2024]
Abstract
INTRODUCTION Parkinson's disease (PD) and Dementia with Lewy bodies (DLB) show heterogeneous brain atrophy patterns which group-average analyses fail to capture. Neuroanatomical normative modelling overcomes this by comparing individuals to a large reference cohort. Patient-specific atrophy patterns are measured objectively and summarised to index overall neurodegeneration (the 'total outlier count'). We aimed to quantify patterns of neurodegenerative dissimilarity in participants with PD and DLB and evaluate the potential clinical relevance of total outlier count by testing its association with key clinical measures in PD and DLB. MATERIALS AND METHODS We included 108 participants with PD and 61 with DLB. PD participants were subclassified into high and low visual performers as this has previously been shown to stratify those at increased dementia risk. We generated z-scores from T1w-MRI scans for each participant relative to normative regional cortical thickness and subcortical volumes, modelled in a reference cohort (n = 58,836). Outliers (z < -1.96) were aggregated across 169 brain regions per participant. To measure dissimilarity, individuals' Hamming distance scores were calculated. We also examined total outlier counts between high versus low visual performance in PD; and PD versus DLB; and tested associations between these and cognition. RESULTS There was significantly greater inter-individual dissimilarity in brain-outlier patterns in PD poor compared to high visual performers (W = 522.5; p < 0.01) and in DLB compared to PD (W = 5649; p < 0.01). PD poor visual performers had significantly greater total outlier counts compared to high (β = -4.73 (SE = 1.30); t = -3.64; p < 0.01) whereas a conventional group-level GLM failed to identify differences. Higher total outlier counts were associated with poorer MoCA (β = -0.55 (SE = 0.27), t = -2.04, p = 0.05) and composite cognitive scores (β = -2.01 (SE = 0.79); t = -2.54; p = 0.02) in DLB, and visuoperception (β = -0.67 (SE = 0.19); t = -3.59; p < 0.01), in PD. CONCLUSIONS Neuroanatomical normative modelling shows promise as a clinically informative technique in PD and DLB, where patterns of atrophy are variable.
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Affiliation(s)
- R Bhome
- Dementia Research Centre, University College London, 8-11 Queen Square, London WC1N 3AR, United Kingdom; UCL Centre for Medical Image Computing, Department of Computer Science, University College London, 90 High Holborn, London WC1V 6LJ, United Kingdom.
| | - S Verdi
- Dementia Research Centre, University College London, 8-11 Queen Square, London WC1N 3AR, United Kingdom; UCL Centre for Medical Image Computing, Department of Computer Science, University College London, 90 High Holborn, London WC1V 6LJ, United Kingdom
| | - S A Martin
- UCL Centre for Medical Image Computing, Department of Computer Science, University College London, 90 High Holborn, London WC1V 6LJ, United Kingdom
| | - N Hannaway
- Dementia Research Centre, University College London, 8-11 Queen Square, London WC1N 3AR, United Kingdom
| | - I Dobreva
- Dementia Research Centre, University College London, 8-11 Queen Square, London WC1N 3AR, United Kingdom
| | - N P Oxtoby
- UCL Centre for Medical Image Computing, Department of Computer Science, University College London, 90 High Holborn, London WC1V 6LJ, United Kingdom
| | - G Castro Leal
- UCL Centre for Medical Image Computing, Department of Computer Science, University College London, 90 High Holborn, London WC1V 6LJ, United Kingdom
| | - S Rutherford
- Donders Institute for Brain, Cognition, and Behavior, Radboud University, Thomas van Aquinostraat 4, 6525 GD Nijmegen, the Netherlands; Department of Cognitive Neuroscience, Radboud University Medical Center, Kapittelweg 29, 6525 EN Nijmegen, the Netherlands; Department of Psychiatry, University of Michigan, 4250 Plymouth Road, Ann Arbor, MI 48109, USA
| | - A F Marquand
- Donders Institute for Brain, Cognition, and Behavior, Radboud University, Thomas van Aquinostraat 4, 6525 GD Nijmegen, the Netherlands; Department of Cognitive Neuroscience, Radboud University Medical Center, Kapittelweg 29, 6525 EN Nijmegen, the Netherlands
| | - R S Weil
- Dementia Research Centre, University College London, 8-11 Queen Square, London WC1N 3AR, United Kingdom; Wellcome Centre for Human Neuroimaging, University College London, 12 Queen Square, London, WC1N 3AR, United Kingdom; Movement Disorders Consortium, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, United Kingdom
| | - J H Cole
- Dementia Research Centre, University College London, 8-11 Queen Square, London WC1N 3AR, United Kingdom; UCL Centre for Medical Image Computing, Department of Computer Science, University College London, 90 High Holborn, London WC1V 6LJ, United Kingdom
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Albert L, Potheegadoo J, Herbelin B, Bernasconi F, Blanke O. Numerosity estimation of virtual humans as a digital-robotic marker for hallucinations in Parkinson's disease. Nat Commun 2024; 15:1905. [PMID: 38472203 DOI: 10.1038/s41467-024-45912-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 02/07/2024] [Indexed: 03/14/2024] Open
Abstract
Hallucinations are frequent non-motor symptoms in Parkinson's disease (PD) associated with dementia and higher mortality. Despite their high clinical relevance, current assessments of hallucinations are based on verbal self-reports and interviews that are limited by important biases. Here, we used virtual reality (VR), robotics, and digital online technology to quantify presence hallucination (vivid sensations that another person is nearby when no one is actually present and can neither be seen nor heard) in laboratory and home-based settings. We establish that elevated numerosity estimation of virtual human agents in VR is a digital marker for experimentally induced presence hallucinations in healthy participants, as confirmed across several control conditions and analyses. We translated the digital marker (numerosity estimation) to an online procedure that 170 PD patients carried out remotely at their homes, revealing that PD patients with disease-related presence hallucinations (but not control PD patients) showed higher numerosity estimation. Numerosity estimation enables quantitative monitoring of hallucinations, is an easy-to-use unobtrusive online method, reaching people far away from medical centers, translating neuroscientific findings using robotics and VR, to patients' homes without specific equipment or trained staff.
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Affiliation(s)
- Louis Albert
- Laboratory of Cognitive Neuroscience, Neuro-X Institute, Faculty of Life Sciences, Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland
| | - Jevita Potheegadoo
- Laboratory of Cognitive Neuroscience, Neuro-X Institute, Faculty of Life Sciences, Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland
| | - Bruno Herbelin
- Laboratory of Cognitive Neuroscience, Neuro-X Institute, Faculty of Life Sciences, Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland
| | - Fosco Bernasconi
- Laboratory of Cognitive Neuroscience, Neuro-X Institute, Faculty of Life Sciences, Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland
| | - Olaf Blanke
- Laboratory of Cognitive Neuroscience, Neuro-X Institute, Faculty of Life Sciences, Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland.
- Department of Clinical Neurosciences, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
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Tran KK, Lee PY, Finkelstein DI, McKendrick AM, Nguyen BN, Bui BV, Nguyen CT. Altered Outer Retinal Structure, Electrophysiology and Visual Perception in Parkinson's Disease. JOURNAL OF PARKINSON'S DISEASE 2024; 14:167-180. [PMID: 38189711 PMCID: PMC10836541 DOI: 10.3233/jpd-230293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/19/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND Visual biomarkers of Parkinson's disease (PD) are attractive as the retina is an outpouching of the brain. Although inner retinal neurodegeneration in PD is well-established this has overlap with other neurodegenerative diseases and thus outer retinal (photoreceptor) measures warrant further investigation. OBJECTIVE To examine in a cross-sectional study whether clinically implementable measures targeting outer retinal function and structure can differentiate PD from healthy ageing and whether these are sensitive to intraday levodopa (L-DOPA) dosing. METHODS Centre-surround perceptual contrast suppression, macular visual field sensitivity, colour discrimination, light-adapted electroretinography and optical coherence tomography (OCT) were tested in PD participants (n = 16) and controls (n = 21). Electroretinography and OCT were conducted before and after midday L-DOPA in PD participants, or repeated after ∼2 hours in controls. RESULTS PD participants had decreased center-surround contrast suppression (p < 0.01), reduced macular visual field sensitivity (p < 0.05), color vision impairment (p < 0.01) photoreceptor dysfunction (a-wave, p < 0.01) and photoreceptor neurodegeneration (outer nuclear layer thinning, p < 0.05), relative to controls. Effect size comparison between inner and outer retinal parameters showed that photoreceptor metrics were similarly robust in differentiating the PD group from age-matched controls as inner retinal changes. Electroretinography and OCT were unaffected by L-DOPA treatment or time. CONCLUSIONS We show that outer retinal outcomes of photoreceptoral dysfunction (decreased cone function and impaired color vision) and degeneration (i.e., outer nuclear layer thinning) were equivalent to inner retinal metrics at differentiating PD from healthy age-matched adults. These findings suggest outer retinal metrics may serve as useful biomarkers for PD.
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Affiliation(s)
- Katie K.N. Tran
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, VIC, Australia
| | - Pei Ying Lee
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, VIC, Australia
| | - David I. Finkelstein
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Allison M. McKendrick
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, VIC, Australia
- Division of Optometry, School of Allied Health, The University of Western Australia, Crawley, WA, Australia
- Lions Eye Institute, Nedlands, WA, Australia
| | - Bao N. Nguyen
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, VIC, Australia
| | - Bang V. Bui
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, VIC, Australia
| | - Christine T.O. Nguyen
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, VIC, Australia
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Mezzarobba S, Grassi M, Galliussi J, Murena L, Bernardis P. Perception of biological motion. No sensitivity differences between patients with Parkinson's disease and healthy observers. APPLIED NEUROPSYCHOLOGY. ADULT 2023; 30:63-70. [PMID: 33886377 DOI: 10.1080/23279095.2021.1910511] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The use of biological motion (BM) stimuli (point-light walkers PLW) may be a novel alternative to improve the clinical impact of Action Observation treatments in Parkinson's Disease, by directing the patient's attentional focus on gait kinematics. However, the recognition of biological motion in Parkinson's patients has thus far been controversial. To evaluate the clinical feasibility of using BM stimuli in Action Observation treatments, we aimed at investigating whether Parkinson's patients in the ON-state condition can identify and use gender-specific cues conveyed by the body structure and by the kinematics of gait of a PLW. 30 Parkinson's patients and 30 healthy elderly observers were tested in a gender identification task with PLW. Parkinson's patients were able to correctly identify the gender of PLW; no differences were found between the two groups of observers. While for both groups, the gender identification task was easier when it required a judgment on a healthy PLW. Lastly, we found that females were more sensitive than males in our identification task. Our study shows that Parkinson's patients in the ON-state condition are able to extract subtle structural and kinematic characteristics from biological motion stimuli, which is favorable to the use of BM in Action Observation treatments.
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Affiliation(s)
- Susanna Mezzarobba
- Department of Life Sciences, University of Trieste, Trieste, Italy.,Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy.,Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Michele Grassi
- Department of Life Sciences, University of Trieste, Trieste, Italy
| | | | - Luigi Murena
- Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy.,Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Paolo Bernardis
- Department of Life Sciences, University of Trieste, Trieste, Italy
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Del Pino R, Acera M, Murueta-Goyena A, Lucas-Jiménez O, Ojeda N, Ibarretxe-Bilbao N, Peña J, Reyero P, Cortés J, Tijero B, Galdós M, Gómez-Esteban JC, Gabilondo I. Visual dysfunction is associated with cognitive impairment in Parkinson's disease. Parkinsonism Relat Disord 2021; 92:22-25. [PMID: 34662807 DOI: 10.1016/j.parkreldis.2021.10.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 09/02/2021] [Accepted: 10/03/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Visual dysfunction and cognitive impairment are common in Parkinson's disease (PD) but the precise contribution of lower-level visual impairment to visual-input based cognitive performance has not been extensively characterized in PD. METHODS We included 49 PD patients and 22 healthy controls (HC). Lower-level visual function tests [high and low contrast visual acuity (HCVA and LCVA) and contrast sensitivity (CS)] and a neuropsychological battery (involving visual cognition) were performed. Pairwise correlations between lower-level visual functions and visual cognition were computed and stepwise linear regressions were fitted introducing age, Geriatric Depression Scale, and lower-level visual functions in the model to calculate their predicted effect on visual cognition. RESULTS Compared to controls, patients presented a significant impairment in all cognitive domains (visual attention, visual processing speed and visual perception, visuospatial abilities, visuoconstructive abilities, and visual memory), and lower-level visual functions. HCVA and LCVA were significantly associated with visual cognition in PD. HCVA explained up to 49.3% and 34.2% of the variability in visual perception and visuospatial abilities, respectively, whereas LCVA was mainly associated with short- and long-term visual memory and visuospatial abilities. CONCLUSION Lower-level visual dysfunction is highly associated with cognitive performance in PD, when cognitive tests are based on visual input. Our results support that lower-level visual functions should be considered when assessing cognitive status of PD patients and might be useful for predicting cognitive deterioration.
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Affiliation(s)
- Rocío Del Pino
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Bizkaia, Spain.
| | - Marian Acera
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Bizkaia, Spain
| | - Ane Murueta-Goyena
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Bizkaia, Spain
| | - Olaia Lucas-Jiménez
- Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Spain
| | - Natalia Ojeda
- Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Spain
| | - Naroa Ibarretxe-Bilbao
- Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Spain
| | - Javier Peña
- Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Spain
| | - Paula Reyero
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Bizkaia, Spain
| | - Jesús Cortés
- Computational Neuroimaging Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain; Department of Cell Biology, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Beatriz Tijero
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Bizkaia, Spain; Neurology Department, Cruces University Hospital, Barakaldo, Bizkaia, Spain
| | - Marta Galdós
- Ophthalmology Department, Cruces University Hospital, Barakaldo, Bizkaia, Spain
| | - Juan Carlos Gómez-Esteban
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Bizkaia, Spain; Neurology Department, Cruces University Hospital, Barakaldo, Bizkaia, Spain; Department of Neuroscience, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Iñigo Gabilondo
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Bizkaia, Spain; Neurology Department, Cruces University Hospital, Barakaldo, Bizkaia, Spain; Ikerbasque: the Basque Foundation for Science, Bilbao, Spain
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Zarkali A, McColgan P, Leyland L, Lees AJ, Weil RS. Visual Dysfunction Predicts Cognitive Impairment and White Matter Degeneration in Parkinson's Disease. Mov Disord 2021; 36:1191-1202. [PMID: 33421201 PMCID: PMC8248368 DOI: 10.1002/mds.28477] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/23/2020] [Accepted: 12/14/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Visual dysfunction predicts dementia in Parkinson's disease (PD), but whether this translates to structural change is not known. The objectives of this study were to identify longitudinal white matter changes in patients with Parkinson's disease and low visual function and also in those who developed mild cognitive impairment. METHODS We used fixel-based analysis to examine longitudinal white matter change in PD. Diffusion MRI and clinical assessments were performed in 77 patients at baseline (22 low visual function/55 intact vision and 13 PD-mild cognitive impairment/51 normal cognition) and 25 controls and again after 18 months. We compared microstructural changes in fiber density, macrostructural changes in fiber bundle cross-section and combined fiber density and cross-section, across white matter, adjusting for age, sex, and intracranial volume. RESULTS Patients with PD and visual dysfunction showed worse cognitive performance at follow-up and were more likely to develop mild cognitive impairment compared with those with normal vision (P = 0.008). Parkinson's with poor visual function showed diffuse microstructural and macrostructural changes at baseline, whereas those with mild cognitive impairment showed fewer baseline changes. At follow-up, Parkinson's with low visual function showed widespread macrostructural changes, involving the fronto-occipital fasciculi, external capsules, and middle cerebellar peduncles bilaterally. No longitudinal change was seen in those with mild cognitive impairment at baseline or converters, even when the 2 groups were combined. CONCLUSION Parkinson's patients with poor visual function show increased white matter damage over time, providing further evidence for visual function as a marker of imminent cognitive decline. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Angeliki Zarkali
- Dementia Research CentreUniversity College LondonLondonUnited Kingdom
| | - Peter McColgan
- Huntington's Disease CentreUniversity College LondonLondonUnited Kingdom
| | | | - Andrew J. Lees
- Reta Lila Weston Institute of Neurological StudiesLondonUnited Kingdom
| | - Rimona S. Weil
- Dementia Research CentreUniversity College LondonLondonUnited Kingdom,Wellcome Centre for Human NeuroimagingUniversity College LondonLondonUnited Kingdom,Movement Disorders ConsortiumNational Hospital for Neurology and NeurosurgeryLondonUnited Kingdom
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Zarkali A, McColgan P, Leyland LA, Lees AJ, Rees G, Weil RS. Organisational and neuromodulatory underpinnings of structural-functional connectivity decoupling in patients with Parkinson's disease. Commun Biol 2021; 4:86. [PMID: 33469150 PMCID: PMC7815846 DOI: 10.1038/s42003-020-01622-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 12/18/2020] [Indexed: 01/01/2023] Open
Abstract
Parkinson's dementia is characterised by changes in perception and thought, and preceded by visual dysfunction, making this a useful surrogate for dementia risk. Structural and functional connectivity changes are seen in humans with Parkinson's disease, but the organisational principles are not known. We used resting-state fMRI and diffusion-weighted imaging to examine changes in structural-functional connectivity coupling in patients with Parkinson's disease, and those at risk of dementia. We identified two organisational gradients to structural-functional connectivity decoupling: anterior-to-posterior and unimodal-to-transmodal, with stronger structural-functional connectivity coupling in anterior, unimodal areas and weakened towards posterior, transmodal regions. Next, we related spatial patterns of decoupling to expression of neurotransmitter receptors. We found that dopaminergic and serotonergic transmission relates to decoupling in Parkinson's overall, but instead, serotonergic, cholinergic and noradrenergic transmission relates to decoupling in patients with visual dysfunction. Our findings provide a framework to explain the specific disorders of consciousness in Parkinson's dementia, and the neurotransmitter systems that underlie these.
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Affiliation(s)
- Angeliki Zarkali
- Dementia Research Centre, University College London, 8-11 Queen Square, London, WC1N 3AR, UK.
| | - Peter McColgan
- Huntington's Disease Centre, University College London, Russell Square House, London, WC1B 5EH, UK
| | - Louise-Ann Leyland
- Dementia Research Centre, University College London, 8-11 Queen Square, London, WC1N 3AR, UK
| | - Andrew J Lees
- Reta Lila Weston Institute of Neurological Studies, 1 Wakefield Street, London, WC1N 1PJ, UK
| | - Geraint Rees
- Institute of Cognitive Neuroscience, University College London, 17-19 Queen Square, London, WC1N 3AR, UK
- Wellcome Centre for Human Neuroimaging, University College London, 12 Queen Square, London, WC1N 3AR, UK
| | - Rimona S Weil
- Dementia Research Centre, University College London, 8-11 Queen Square, London, WC1N 3AR, UK
- Wellcome Centre for Human Neuroimaging, University College London, 12 Queen Square, London, WC1N 3AR, UK
- Movement Disorders Consortium, University College London, London, WC1N 3BG, UK
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Zarkali A, McColgan P, Ryten M, Reynolds RH, Leyland LA, Lees AJ, Rees G, Weil RS. Dementia risk in Parkinson's disease is associated with interhemispheric connectivity loss and determined by regional gene expression. Neuroimage Clin 2020; 28:102470. [PMID: 33395965 PMCID: PMC7581968 DOI: 10.1016/j.nicl.2020.102470] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 09/08/2020] [Accepted: 10/11/2020] [Indexed: 12/11/2022]
Abstract
Parkinson's dementia is a common and devastating part of Parkinson's disease. Whilst timing and severity vary, dementia in Parkinson's is often preceded by visual dysfunction. White matter changes, representing axonal loss, occur early in the disease process. Clarifying which white matter connections are affected in Parkinson's with visual dysfunction and why specific connections are vulnerable will provide important mechanistic insights. Here, we use diffusion tractography in 100 Parkinson's patients (33 low visual performers) and 34 controls to identify patterns of connectivity loss in Parkinson's with visual dysfunction. We examine the relationship between regional transcription and connectivity loss, using the Allen Institute for Brain Science transcriptome atlas. We show that interhemispheric connections are preferentially affected in Parkinson's low visual performers. Interhemispheric connection loss was associated with downweighted genes related to the smoothened signalling pathway (enriched in glutamatergic neurons) and upweighted metabolic genes. Risk genes for Parkinson's but not Alzheimer's or Dementia with Lewy bodies were over-represented in upweighted genes associated with interhemispheric connection loss. Our findings suggest selective vulnerability in Parkinson's patients at highest risk of dementia (those with visual dysfunction), where differences in gene expression and metabolic dysfunction, affecting longer connections with higher metabolic burden, drive connectivity loss.
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Affiliation(s)
- Angeliki Zarkali
- Dementia Research Centre, University College London, 8-11 Queen Square, London WC1N 3AR, UK.
| | - Peter McColgan
- Huntington's Disease Centre, University College London, Russell Square House, London WC1B 5EH, UK
| | - Mina Ryten
- NIHR Great Ormond Street Hospital Biomedical Research Centre, University College London, London, UK; Great Ormond Street Institute of Child Health, Genetics and Genomic Medicine, University College London, London, UK; Department of Neurodegenerative Disease, UCL Institute of Neurology, 10-12 Russell Square House, London WC1B 5EH, UK
| | - Regina H Reynolds
- NIHR Great Ormond Street Hospital Biomedical Research Centre, University College London, London, UK; Great Ormond Street Institute of Child Health, Genetics and Genomic Medicine, University College London, London, UK; Department of Neurodegenerative Disease, UCL Institute of Neurology, 10-12 Russell Square House, London WC1B 5EH, UK
| | - Louise-Ann Leyland
- Dementia Research Centre, University College London, 8-11 Queen Square, London WC1N 3AR, UK
| | - Andrew J Lees
- Reta Lila Weston Institute of Neurological Studies, 1 Wakefield Street, London WC1N 1PJ, UK
| | - Geraint Rees
- Institute of Cognitive Neuroscience, University College London, 17-19 Queen Square, London WC1N 3AR, UK; Wellcome Centre for Human Neuroimaging, University College London, 12 Queen Square, London WC1N 3AR, UK
| | - Rimona S Weil
- Dementia Research Centre, University College London, 8-11 Queen Square, London WC1N 3AR, UK; Wellcome Centre for Human Neuroimaging, University College London, 12 Queen Square, London WC1N 3AR, UK; Movement Disorders Consortium, University College London, London WC1N 3BG, UK
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Salmi J, Ritakallio L, Fellman D, Ellfolk U, Rinne JO, Laine M. Disentangling the Role of Working Memory in Parkinson's Disease. Front Aging Neurosci 2020; 12:572037. [PMID: 33088273 PMCID: PMC7544957 DOI: 10.3389/fnagi.2020.572037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 08/18/2020] [Indexed: 11/13/2022] Open
Abstract
Working memory (WM) represents a core cognitive function with a major striatal contribution, and thus WM deficits, commonly observed in Parkinson’s disease (PD), could also relate to many other problems in PD patients. Our online study aimed to determine the subdomains of WM that are particularly affected in PD and to clarify the links between WM and everyday cognitive deficits, other executive functions, psychiatric and PD symptoms, as well as early cognitive impairment. Fifty-two mild-to-moderate PD patients and 54 healthy controls performed seven WM tasks tapping selective updating, continuous monitoring, or maintenance of currently active information. Self-ratings of everyday cognition, depression, and apathy symptoms, as well as screenings of global cognitive impairment, were also collected. The data were analyzed using structural equation modeling. Of the three WM domains, only selective updating was directly predictive of PD group membership. More widespread WM deficits were observed only in relation to global cognitive impairment in PD patients. Self-rated everyday cognition or psychiatric symptoms were not linked to WM performance but correlated with each other. Our findings suggest that WM has a rather limited role in the clinical manifestation of PD. Nevertheless, due to its elementary link to striatal function, the updating component of WM could be a candidate for a cognitive marker of PD also in patients who are otherwise cognitively well-preserved.
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Affiliation(s)
- Juha Salmi
- Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland.,Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland.,Turku Institute for Advanced Studies, University of Turku, Turku, Finland.,Department of Psychology, Åbo Akademi University, Turku, Finland
| | - Liisa Ritakallio
- Department of Psychology, Åbo Akademi University, Turku, Finland
| | - Daniel Fellman
- Department of Psychology, Åbo Akademi University, Turku, Finland.,Department of Applied Educational Science, Umeå University, Umeå, Sweden
| | - Ulla Ellfolk
- Department of Psychology, Åbo Akademi University, Turku, Finland.,Department of Psychiatry, Visby County Hospital, Visby, Sweden
| | - Juha O Rinne
- Division of Clinical Neurosciences, Turku University Hospital, Turku, Finland.,Turku PET Centre, University of Turku, Turku, Finland
| | - Matti Laine
- Department of Psychology, Åbo Akademi University, Turku, Finland.,Turku Brain and Mind Center, University of Turku, Turku, Finland
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11
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Zarkali A, McColgan P, Leyland LA, Lees AJ, Rees G, Weil RS. Fiber-specific white matter reductions in Parkinson hallucinations and visual dysfunction. Neurology 2020; 94:e1525-e1538. [PMID: 32094242 PMCID: PMC7251523 DOI: 10.1212/wnl.0000000000009014] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 10/11/2019] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To investigate the microstructural and macrostructural white matter changes that accompany visual hallucinations and low visual performance in Parkinson disease, a risk factor for Parkinson dementia. METHODS We performed fixel-based analysis, a novel technique that provides metrics of specific fiber-bundle populations within a voxel (or fixel). Diffusion MRI data were acquired from patients with Parkinson disease (n = 105, of whom 34 were low visual performers and 19 were hallucinators) and age-matched controls (n = 35). We used whole-brain fixel-based analysis to compare microstructural differences in fiber density (FD), macrostructural differences in fiber bundle cross section (FC), and the combined FD and FC (FDC) metric across all white matter fixels. We then performed a tract-of-interest analysis comparing the most sensitive FDC metric across 11 tracts within the visual system. RESULTS Patients with Parkinson disease hallucinations exhibited macrostructural changes (reduced FC) within the splenium of the corpus callosum and the left posterior thalamic radiation compared to patients without hallucinations. While there were no significant changes in FD, we found large reductions in the combined FDC metric in Parkinson hallucinators within the splenium (>50% reduction compared to nonhallucinators). Patients with Parkinson disease and low visual performance showed widespread microstructural and macrostructural changes within the genu and splenium of the corpus callosum, bilateral posterior thalamic radiations, and left inferior fronto-occipital fasciculus. CONCLUSIONS We demonstrate specific white matter tract degeneration affecting posterior thalamic tracts in patients with Parkinson disease with hallucinations and low visual performance, providing direct mechanistic support for attentional models of visual hallucinations.
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Affiliation(s)
- Angeliki Zarkali
- From the Dementia Research Centre (A.Z., L.-A.L., R.S.W.), Huntington's Disease Centre (P.M.), Institute of Cognitive Neuroscience (G.R.), and Wellcome Centre for Human Neuroimaging (G.R., R.S.W.), University College London; and Reta Lila Weston Institute of Neurological Studies (A.J.L.), London, UK.
| | - Peter McColgan
- From the Dementia Research Centre (A.Z., L.-A.L., R.S.W.), Huntington's Disease Centre (P.M.), Institute of Cognitive Neuroscience (G.R.), and Wellcome Centre for Human Neuroimaging (G.R., R.S.W.), University College London; and Reta Lila Weston Institute of Neurological Studies (A.J.L.), London, UK
| | - Louise-Ann Leyland
- From the Dementia Research Centre (A.Z., L.-A.L., R.S.W.), Huntington's Disease Centre (P.M.), Institute of Cognitive Neuroscience (G.R.), and Wellcome Centre for Human Neuroimaging (G.R., R.S.W.), University College London; and Reta Lila Weston Institute of Neurological Studies (A.J.L.), London, UK
| | - Andrew J Lees
- From the Dementia Research Centre (A.Z., L.-A.L., R.S.W.), Huntington's Disease Centre (P.M.), Institute of Cognitive Neuroscience (G.R.), and Wellcome Centre for Human Neuroimaging (G.R., R.S.W.), University College London; and Reta Lila Weston Institute of Neurological Studies (A.J.L.), London, UK
| | - Geraint Rees
- From the Dementia Research Centre (A.Z., L.-A.L., R.S.W.), Huntington's Disease Centre (P.M.), Institute of Cognitive Neuroscience (G.R.), and Wellcome Centre for Human Neuroimaging (G.R., R.S.W.), University College London; and Reta Lila Weston Institute of Neurological Studies (A.J.L.), London, UK
| | - Rimona S Weil
- From the Dementia Research Centre (A.Z., L.-A.L., R.S.W.), Huntington's Disease Centre (P.M.), Institute of Cognitive Neuroscience (G.R.), and Wellcome Centre for Human Neuroimaging (G.R., R.S.W.), University College London; and Reta Lila Weston Institute of Neurological Studies (A.J.L.), London, UK
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12
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Yakubovich S, Israeli-Korn S, Halperin O, Yahalom G, Hassin-Baer S, Zaidel A. Visual self-motion cues are impaired yet overweighted during visual-vestibular integration in Parkinson's disease. Brain Commun 2020; 2:fcaa035. [PMID: 32954293 PMCID: PMC7425426 DOI: 10.1093/braincomms/fcaa035] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 02/17/2020] [Accepted: 03/11/2020] [Indexed: 11/25/2022] Open
Abstract
Parkinson's disease is prototypically a movement disorder. Although perceptual and motor functions are highly interdependent, much less is known about perceptual deficits in Parkinson's disease, which are less observable by nature, and might go unnoticed if not tested directly. It is therefore imperative to seek and identify these, to fully understand the challenges facing patients with Parkinson's disease. Also, perceptual deficits may be related to motor symptoms. Posture, gait and balance, affected in Parkinson's disease, rely on veridical perception of one's own motion (self-motion) in space. Yet it is not known whether self-motion perception is impaired in Parkinson's disease. Using a well-established multisensory paradigm of heading discrimination (that has not been previously applied to Parkinson's disease), we tested unisensory visual and vestibular self-motion perception, as well as multisensory integration of visual and vestibular cues, in 19 Parkinson's disease, 23 healthy age-matched and 20 healthy young-adult participants. After experiencing vestibular (on a motion platform), visual (optic flow) or multisensory (combined visual-vestibular) self-motion stimuli at various headings, participants reported whether their perceived heading was to the right or left of straight ahead. Parkinson's disease participants and age-matched controls were tested twice (Parkinson's disease participants on and off medication). Parkinson's disease participants demonstrated significantly impaired visual self-motion perception compared with age-matched controls on both visits, irrespective of medication status. Young controls performed slightly (but not significantly) better than age-matched controls and significantly better than the Parkinson's disease group. The visual self-motion perception impairment in Parkinson's disease correlated significantly with clinical disease severity. By contrast, vestibular performance was unimpaired in Parkinson's disease. Remarkably, despite impaired visual self-motion perception, Parkinson's disease participants significantly overweighted the visual cues during multisensory (visual-vestibular ) integration (compared with Bayesian predictions of optimal integration) and significantly more than controls. These findings indicate that self-motion perception in Parkinson's disease is affected by impaired visual cues and by suboptimal visual-vestibular integration (overweighting of visual cues). Notably, vestibular self-motion perception was unimpaired. Thus, visual self-motion perception is specifically impaired in early-stage Parkinson's disease. This can impact Parkinson's disease diagnosis and subtyping. Overweighting of visual cues could reflect a general multisensory integration deficit in Parkinson's disease, or specific overestimation of visual cue reliability. Finally, impaired self-motion perception in Parkinson's disease may contribute to impaired balance and gait control. Future investigation into this connection might open up new avenues of alternative therapies to better treat these difficult symptoms.
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Affiliation(s)
- Sol Yakubovich
- Gonda Multidisciplinary Brain Research Center, Bar Ilan University, Ramat Gan 5290002, Israel
| | - Simon Israeli-Korn
- Department of Neurology, Movement Disorders Institute, Sheba Medical Center, Tel Hashomer, Ramat Gan 5266202, Israel
- The Neurology and Neurosurgery Department, The Sackler School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Orly Halperin
- Gonda Multidisciplinary Brain Research Center, Bar Ilan University, Ramat Gan 5290002, Israel
| | - Gilad Yahalom
- Department of Neurology, Movement Disorders Institute, Sheba Medical Center, Tel Hashomer, Ramat Gan 5266202, Israel
- Department of Neurology, Movement Disorders Clinic, Shaare Zedek Medical Center, Jerusalem 9103102, Israel
| | - Sharon Hassin-Baer
- Department of Neurology, Movement Disorders Institute, Sheba Medical Center, Tel Hashomer, Ramat Gan 5266202, Israel
- The Neurology and Neurosurgery Department, The Sackler School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Adam Zaidel
- Gonda Multidisciplinary Brain Research Center, Bar Ilan University, Ramat Gan 5290002, Israel
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13
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Ionov ID, Pushinskaya II, Gorev NP, Frenkel DD. Cyclosomatostatin-induced catalepsy in aged rats: Specific change of brain c-Fos protein expression in the lateral entorhinal cortex. Brain Res Bull 2020; 159:79-86. [PMID: 32224159 DOI: 10.1016/j.brainresbull.2020.03.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 02/19/2020] [Accepted: 03/21/2020] [Indexed: 11/16/2022]
Abstract
Aging represents the largest risk factor for developing Parkinson's disease (PD); another salient feature of this disorder is a decreased brain levels of somatostatin. Recently, in aged Wistar rats, we simulated the central somatostatinergic deficiency by intracerebroventricular injections of a somatostatin antagonist, cyclosomatostatin (cSST). The treated animals displayed catalepsy, a state that resembles the extrapyramidal signs of Parkinson's disease; young animals were insensitive to cSST. The neuroanatomical substrates responsible for the increased cataleptogenic activity of cSST in aged animals, are currently unknown. To study this issue, we assessed the cSST effect on brain c-Fos-protein expression in aged and young rats; thirty three brain regions were examined. cSST was employed at the dose cataleptogenic for aged animals and non-cataleptogenic for young ones. c-Fos expression patterns in the 'cataleptic' and 'non-cataleptic' animals were very similar, with the only distinction being a decrease in the c-Fos expression in the aged lateral entorhinal cortex (LEntCx). This decrease was not observed when the cSST-induced cataleptic response was inhibited by administration of diphenhydramine and nicotine. Thus, the development of catalepsy in the aged Wistar rats appeared to be associated with a hypoactivation of the LEntCx; possibly, there exists a mechanistic link between the LEntCx hypoactivation and increased susceptibility of aged rats to catalepsy. Apparently, these findings may provide novel insight into the link between mechanisms of parkinsonian motor disorders and aging.
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Affiliation(s)
- Ilya D Ionov
- Centre on Theoretical Problems in Physical and Chemical Pharmacology, Russian Academy of Sciences, Moscow, Russia.
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14
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Leyland LA, Bremner FD, Mahmood R, Hewitt S, Durteste M, Cartlidge MRE, Lai MMM, Miller LE, Saygin AP, Keane PA, Schrag AE, Weil RS. Visual tests predict dementia risk in Parkinson disease. Neurol Clin Pract 2020; 10:29-39. [PMID: 32190418 PMCID: PMC7057066 DOI: 10.1212/cpj.0000000000000719] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess the role of visual measures and retinal volume to predict the risk of Parkinson disease (PD) dementia. METHODS In this cohort study, we collected visual, cognitive, and motor data in people with PD. Participants underwent ophthalmic examination, retinal imaging using optical coherence tomography, and visual assessment including acuity and contrast sensitivity and high-level visuoperception measures of skew tolerance and biological motion. We assessed the risk of PD dementia using a recently described algorithm that combines age at onset, sex, depression, motor scores, and baseline cognition. RESULTS One hundred forty-six people were included in the study (112 with PD and 34 age-matched controls). The mean disease duration was 4.1 (±2·5) years. None of these participants had dementia. Higher risk of dementia was associated with poorer performance in visual measures (acuity: ρ = 0.29, p = 0.0024; contrast sensitivity: ρ = -0.37, p < 0.0001; skew tolerance: ρ = -0.25, p = 0.0073; and biological motion: ρ = -0.26, p = 0.0054). In addition, higher risk of PD dementia was associated with thinner retinal structure in layers containing dopaminergic cells, measured as ganglion cell layer (GCL) and inner plexiform layer (IPL) thinning (ρ = -0.29, p = 0.0021; ρ = -0.33, p = 0.00044). These relationships were not seen for the retinal nerve fiber layer that does not contain dopaminergic cells and were not seen in unaffected controls. CONCLUSION Visual measures and retinal structure in dopaminergic layers were related to risk of PD dementia. Our findings suggest that visual measures and retinal GCL and IPL volumes may be useful to predict the risk of dementia in PD.
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Affiliation(s)
- Louise-Ann Leyland
- Dementia Research Centre (L-AL, RM, RSW), Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology (FDB, MM-ML), National Hospital for Neurology and Neurosurgery, University College London Hospitals, London, United Kingdom; Institute of Neurology (SH, MD, MREC), University College London, UCL, United Kingdom; School of Biomedical Sciences (MREC), Biological Sciences, Leeds University, United Kingdom; ImpAct (LEM), Lyon Neuroscience Research Center, France; Department of Cognitive Science (APS), University of California, San Diego; Kavli Institute for Brain and Mind (APS), University of California, San Diego; Institute of Ophthalmology (PAK), UCL, United Kingdom; Moorfields Eye Hospital (PAK), London, United Kingdom; Department of Clinical Neuroscience (AES), Institute of Neurology, UCL Hampstead Campus, London, United Kingdom; Movement Disorders Consortium (AES, RSW), UCL, United Kingdom; and The Wellcome Centre for Human Neuroimaging (RSW), Institute of Neurology, University College London, United Kingdom
| | - Fion D Bremner
- Dementia Research Centre (L-AL, RM, RSW), Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology (FDB, MM-ML), National Hospital for Neurology and Neurosurgery, University College London Hospitals, London, United Kingdom; Institute of Neurology (SH, MD, MREC), University College London, UCL, United Kingdom; School of Biomedical Sciences (MREC), Biological Sciences, Leeds University, United Kingdom; ImpAct (LEM), Lyon Neuroscience Research Center, France; Department of Cognitive Science (APS), University of California, San Diego; Kavli Institute for Brain and Mind (APS), University of California, San Diego; Institute of Ophthalmology (PAK), UCL, United Kingdom; Moorfields Eye Hospital (PAK), London, United Kingdom; Department of Clinical Neuroscience (AES), Institute of Neurology, UCL Hampstead Campus, London, United Kingdom; Movement Disorders Consortium (AES, RSW), UCL, United Kingdom; and The Wellcome Centre for Human Neuroimaging (RSW), Institute of Neurology, University College London, United Kingdom
| | - Ribeya Mahmood
- Dementia Research Centre (L-AL, RM, RSW), Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology (FDB, MM-ML), National Hospital for Neurology and Neurosurgery, University College London Hospitals, London, United Kingdom; Institute of Neurology (SH, MD, MREC), University College London, UCL, United Kingdom; School of Biomedical Sciences (MREC), Biological Sciences, Leeds University, United Kingdom; ImpAct (LEM), Lyon Neuroscience Research Center, France; Department of Cognitive Science (APS), University of California, San Diego; Kavli Institute for Brain and Mind (APS), University of California, San Diego; Institute of Ophthalmology (PAK), UCL, United Kingdom; Moorfields Eye Hospital (PAK), London, United Kingdom; Department of Clinical Neuroscience (AES), Institute of Neurology, UCL Hampstead Campus, London, United Kingdom; Movement Disorders Consortium (AES, RSW), UCL, United Kingdom; and The Wellcome Centre for Human Neuroimaging (RSW), Institute of Neurology, University College London, United Kingdom
| | - Sam Hewitt
- Dementia Research Centre (L-AL, RM, RSW), Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology (FDB, MM-ML), National Hospital for Neurology and Neurosurgery, University College London Hospitals, London, United Kingdom; Institute of Neurology (SH, MD, MREC), University College London, UCL, United Kingdom; School of Biomedical Sciences (MREC), Biological Sciences, Leeds University, United Kingdom; ImpAct (LEM), Lyon Neuroscience Research Center, France; Department of Cognitive Science (APS), University of California, San Diego; Kavli Institute for Brain and Mind (APS), University of California, San Diego; Institute of Ophthalmology (PAK), UCL, United Kingdom; Moorfields Eye Hospital (PAK), London, United Kingdom; Department of Clinical Neuroscience (AES), Institute of Neurology, UCL Hampstead Campus, London, United Kingdom; Movement Disorders Consortium (AES, RSW), UCL, United Kingdom; and The Wellcome Centre for Human Neuroimaging (RSW), Institute of Neurology, University College London, United Kingdom
| | - Marion Durteste
- Dementia Research Centre (L-AL, RM, RSW), Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology (FDB, MM-ML), National Hospital for Neurology and Neurosurgery, University College London Hospitals, London, United Kingdom; Institute of Neurology (SH, MD, MREC), University College London, UCL, United Kingdom; School of Biomedical Sciences (MREC), Biological Sciences, Leeds University, United Kingdom; ImpAct (LEM), Lyon Neuroscience Research Center, France; Department of Cognitive Science (APS), University of California, San Diego; Kavli Institute for Brain and Mind (APS), University of California, San Diego; Institute of Ophthalmology (PAK), UCL, United Kingdom; Moorfields Eye Hospital (PAK), London, United Kingdom; Department of Clinical Neuroscience (AES), Institute of Neurology, UCL Hampstead Campus, London, United Kingdom; Movement Disorders Consortium (AES, RSW), UCL, United Kingdom; and The Wellcome Centre for Human Neuroimaging (RSW), Institute of Neurology, University College London, United Kingdom
| | - Molly R E Cartlidge
- Dementia Research Centre (L-AL, RM, RSW), Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology (FDB, MM-ML), National Hospital for Neurology and Neurosurgery, University College London Hospitals, London, United Kingdom; Institute of Neurology (SH, MD, MREC), University College London, UCL, United Kingdom; School of Biomedical Sciences (MREC), Biological Sciences, Leeds University, United Kingdom; ImpAct (LEM), Lyon Neuroscience Research Center, France; Department of Cognitive Science (APS), University of California, San Diego; Kavli Institute for Brain and Mind (APS), University of California, San Diego; Institute of Ophthalmology (PAK), UCL, United Kingdom; Moorfields Eye Hospital (PAK), London, United Kingdom; Department of Clinical Neuroscience (AES), Institute of Neurology, UCL Hampstead Campus, London, United Kingdom; Movement Disorders Consortium (AES, RSW), UCL, United Kingdom; and The Wellcome Centre for Human Neuroimaging (RSW), Institute of Neurology, University College London, United Kingdom
| | - Michelle M-M Lai
- Dementia Research Centre (L-AL, RM, RSW), Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology (FDB, MM-ML), National Hospital for Neurology and Neurosurgery, University College London Hospitals, London, United Kingdom; Institute of Neurology (SH, MD, MREC), University College London, UCL, United Kingdom; School of Biomedical Sciences (MREC), Biological Sciences, Leeds University, United Kingdom; ImpAct (LEM), Lyon Neuroscience Research Center, France; Department of Cognitive Science (APS), University of California, San Diego; Kavli Institute for Brain and Mind (APS), University of California, San Diego; Institute of Ophthalmology (PAK), UCL, United Kingdom; Moorfields Eye Hospital (PAK), London, United Kingdom; Department of Clinical Neuroscience (AES), Institute of Neurology, UCL Hampstead Campus, London, United Kingdom; Movement Disorders Consortium (AES, RSW), UCL, United Kingdom; and The Wellcome Centre for Human Neuroimaging (RSW), Institute of Neurology, University College London, United Kingdom
| | - Luke E Miller
- Dementia Research Centre (L-AL, RM, RSW), Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology (FDB, MM-ML), National Hospital for Neurology and Neurosurgery, University College London Hospitals, London, United Kingdom; Institute of Neurology (SH, MD, MREC), University College London, UCL, United Kingdom; School of Biomedical Sciences (MREC), Biological Sciences, Leeds University, United Kingdom; ImpAct (LEM), Lyon Neuroscience Research Center, France; Department of Cognitive Science (APS), University of California, San Diego; Kavli Institute for Brain and Mind (APS), University of California, San Diego; Institute of Ophthalmology (PAK), UCL, United Kingdom; Moorfields Eye Hospital (PAK), London, United Kingdom; Department of Clinical Neuroscience (AES), Institute of Neurology, UCL Hampstead Campus, London, United Kingdom; Movement Disorders Consortium (AES, RSW), UCL, United Kingdom; and The Wellcome Centre for Human Neuroimaging (RSW), Institute of Neurology, University College London, United Kingdom
| | - Ayse P Saygin
- Dementia Research Centre (L-AL, RM, RSW), Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology (FDB, MM-ML), National Hospital for Neurology and Neurosurgery, University College London Hospitals, London, United Kingdom; Institute of Neurology (SH, MD, MREC), University College London, UCL, United Kingdom; School of Biomedical Sciences (MREC), Biological Sciences, Leeds University, United Kingdom; ImpAct (LEM), Lyon Neuroscience Research Center, France; Department of Cognitive Science (APS), University of California, San Diego; Kavli Institute for Brain and Mind (APS), University of California, San Diego; Institute of Ophthalmology (PAK), UCL, United Kingdom; Moorfields Eye Hospital (PAK), London, United Kingdom; Department of Clinical Neuroscience (AES), Institute of Neurology, UCL Hampstead Campus, London, United Kingdom; Movement Disorders Consortium (AES, RSW), UCL, United Kingdom; and The Wellcome Centre for Human Neuroimaging (RSW), Institute of Neurology, University College London, United Kingdom
| | - Pearse A Keane
- Dementia Research Centre (L-AL, RM, RSW), Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology (FDB, MM-ML), National Hospital for Neurology and Neurosurgery, University College London Hospitals, London, United Kingdom; Institute of Neurology (SH, MD, MREC), University College London, UCL, United Kingdom; School of Biomedical Sciences (MREC), Biological Sciences, Leeds University, United Kingdom; ImpAct (LEM), Lyon Neuroscience Research Center, France; Department of Cognitive Science (APS), University of California, San Diego; Kavli Institute for Brain and Mind (APS), University of California, San Diego; Institute of Ophthalmology (PAK), UCL, United Kingdom; Moorfields Eye Hospital (PAK), London, United Kingdom; Department of Clinical Neuroscience (AES), Institute of Neurology, UCL Hampstead Campus, London, United Kingdom; Movement Disorders Consortium (AES, RSW), UCL, United Kingdom; and The Wellcome Centre for Human Neuroimaging (RSW), Institute of Neurology, University College London, United Kingdom
| | - Anette E Schrag
- Dementia Research Centre (L-AL, RM, RSW), Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology (FDB, MM-ML), National Hospital for Neurology and Neurosurgery, University College London Hospitals, London, United Kingdom; Institute of Neurology (SH, MD, MREC), University College London, UCL, United Kingdom; School of Biomedical Sciences (MREC), Biological Sciences, Leeds University, United Kingdom; ImpAct (LEM), Lyon Neuroscience Research Center, France; Department of Cognitive Science (APS), University of California, San Diego; Kavli Institute for Brain and Mind (APS), University of California, San Diego; Institute of Ophthalmology (PAK), UCL, United Kingdom; Moorfields Eye Hospital (PAK), London, United Kingdom; Department of Clinical Neuroscience (AES), Institute of Neurology, UCL Hampstead Campus, London, United Kingdom; Movement Disorders Consortium (AES, RSW), UCL, United Kingdom; and The Wellcome Centre for Human Neuroimaging (RSW), Institute of Neurology, University College London, United Kingdom
| | - Rimona S Weil
- Dementia Research Centre (L-AL, RM, RSW), Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology (FDB, MM-ML), National Hospital for Neurology and Neurosurgery, University College London Hospitals, London, United Kingdom; Institute of Neurology (SH, MD, MREC), University College London, UCL, United Kingdom; School of Biomedical Sciences (MREC), Biological Sciences, Leeds University, United Kingdom; ImpAct (LEM), Lyon Neuroscience Research Center, France; Department of Cognitive Science (APS), University of California, San Diego; Kavli Institute for Brain and Mind (APS), University of California, San Diego; Institute of Ophthalmology (PAK), UCL, United Kingdom; Moorfields Eye Hospital (PAK), London, United Kingdom; Department of Clinical Neuroscience (AES), Institute of Neurology, UCL Hampstead Campus, London, United Kingdom; Movement Disorders Consortium (AES, RSW), UCL, United Kingdom; and The Wellcome Centre for Human Neuroimaging (RSW), Institute of Neurology, University College London, United Kingdom
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15
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Salazar RD, Moon KLM, Neargarder S, Cronin-Golomb A. Spatial judgment in Parkinson's disease: Contributions of attentional and executive dysfunction. Behav Neurosci 2020; 133:350-360. [PMID: 31294590 DOI: 10.1037/bne0000329] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Spatial judgment is impaired in Parkinson's disease (PD), with previous research suggesting that disruptions in attention and executive function are likely contributors. If judgment of center places demands on frontal systems, performance on tests of attention/executive function may correlate with extent of bias in PD, and attentional disturbance may predict inconsistency in spatial judgment. The relation of spatial judgment to attention/executive function may differ for those with left-side versus right-side motor onset (LPD, RPD), reflecting effects of attentional lateralization. We assessed 42 RPD, 37 LPD, and 67 healthy control participants with a Landmark task (LM) in which a cursor moved horizontally from the right (right-LM) or left (left-LM). The task was to judge the center of the line. Participants also performed neuropsychological tests of attention and executive function. LM group differences were found on left-LM only, with both PD subgroups biased leftward of the control group (RPD p < .05; LPD p < .01; no RPD-LPD difference). For left-LM trials, extent of bias significantly correlated with performance on the cognitive tasks for PD but not for the control group. PD showed greater variability in perceived center than the control group; this variability correlated with performance on the cognitive tasks. The correlations between performance on the test of spatial judgment and the tests of attention/executive function suggest that frontal-based attentional dysfunction affects dynamic spatial judgment, both in extent of spatial bias and in consistency of response as indexed by intertrial variability. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Robert D Salazar
- Department of Psychological and Brain Sciences, Boston University
| | - Kathryn L M Moon
- Department of Psychological and Brain Sciences, Boston University
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16
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Miloserdov K, Schmidt-Samoa C, Williams K, Weinrich CA, Kagan I, Bürk K, Trenkwalder C, Bähr M, Wilke M. Aberrant functional connectivity of resting state networks related to misperceptions and intra-individual variability in Parkinson's disease. Neuroimage Clin 2019; 25:102076. [PMID: 31794926 PMCID: PMC6906716 DOI: 10.1016/j.nicl.2019.102076] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 08/31/2019] [Accepted: 11/04/2019] [Indexed: 12/12/2022]
Abstract
Patients with Parkinson's disease (PD) frequently suffer from visual misperceptions and hallucinations, which are difficult to objectify and quantify. We aimed to develop an image recognition task to objectify misperceptions and to assess performance fluctuations in PD patients with and without self-reported hallucinations. Thirty-two non-demented patients with Parkinson's disease (16 with and 16 without self-reported visual hallucinations) and 25 age-matched healthy controls (HC) were tested. Participants performed a dynamic image recognition task with real and scrambled images. We assessed misperception scores and intra-individual variability in recognition times. To gain insight into possible neural mechanisms related to misperceptions and performance fluctuations we correlated resting state network connectivity to the behavioral outcomes in a subsample of Parkinson's disease patients (N = 16). We found that PD patients with self-reported hallucinations (PD-VH) exhibited higher perceptual error rates, due to decreased perceptual sensitivity and not due to changed decision criteria. In addition, PD-VH patients exhibited higher intra-individual variability in recognition times than HC or PD-nonVH patients. Both, misperceptions and intra-individual variability were negatively correlated with resting state functional connectivity involving frontal and parietal brain regions, albeit in partly different subregions. Consistent with previous research suggesting that hallucinations arise from dysfunction in attentional networks, misperception scores correlated with reduced functional connectivity between the dorsal attention and salience network. Intra-individual variability correlated with decreased connectivity between somatomotor and right fronto-parietal networks. We conclude that our task can detect visual misperceptions that are more prevalent in PD-VH patients. In addition, fluctuating visual performance appear to be a signature of PD-VH patients, which might assist further studies of the underlying pathophysiological mechanisms and cognitive processes.
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Affiliation(s)
- Kristina Miloserdov
- Department of Cognitive Neurology, University Medical Center Goettingen, Robert-Koch-Str. 40, Goettingen 37075, Germany; German Primate Center, Leibniz Institute for Primate Research, Kellnerweg 4, Goettingen 37077, Germany; Leibniz Science Campus Primate Cognition, German Primate Center, Kellnerweg 4, Goettingen 37077, Germany
| | - Carsten Schmidt-Samoa
- Department of Cognitive Neurology, University Medical Center Goettingen, Robert-Koch-Str. 40, Goettingen 37075, Germany
| | - Kathleen Williams
- Department of Cognitive Neurology, University Medical Center Goettingen, Robert-Koch-Str. 40, Goettingen 37075, Germany
| | - Christiane Anne Weinrich
- Department of Cognitive Neurology, University Medical Center Goettingen, Robert-Koch-Str. 40, Goettingen 37075, Germany; Department of Neurology, University Medical Center Goettingen, Robert-Koch-Str. 40, Goettingen 37075, Germany
| | - Igor Kagan
- Department of Cognitive Neurology, University Medical Center Goettingen, Robert-Koch-Str. 40, Goettingen 37075, Germany; German Primate Center, Leibniz Institute for Primate Research, Kellnerweg 4, Goettingen 37077, Germany; Leibniz Science Campus Primate Cognition, German Primate Center, Kellnerweg 4, Goettingen 37077, Germany
| | - Katrin Bürk
- Kliniken Schmieder Stuttgart-Gerlingen, Solitudestraße 20, Gerlingen 70839, Germany
| | - Claudia Trenkwalder
- Paracelsus-Elena Klinik, Klinikstraße 16, Kassel 34128, Germany; Department of Neurosurgery, University Medical Center Goettingen, Robert-Koch-Str. 40, Goettingen 37075, Germany
| | - Mathias Bähr
- Department of Neurology, University Medical Center Goettingen, Robert-Koch-Str. 40, Goettingen 37075, Germany
| | - Melanie Wilke
- Department of Cognitive Neurology, University Medical Center Goettingen, Robert-Koch-Str. 40, Goettingen 37075, Germany; German Primate Center, Leibniz Institute for Primate Research, Kellnerweg 4, Goettingen 37077, Germany; Leibniz Science Campus Primate Cognition, German Primate Center, Kellnerweg 4, Goettingen 37077, Germany.
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Pretegiani E, Vanegas-Arroyave N, FitzGibbon EJ, Hallett M, Optican LM. Evidence From Parkinson's Disease That the Superior Colliculus Couples Action and Perception. Mov Disord 2019; 34:1680-1689. [PMID: 31633242 DOI: 10.1002/mds.27861] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 07/12/2019] [Accepted: 08/12/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Action and perception should be coordinated for good visual-motor performance. The mechanism coupling action and perception may be a prominence map in the intermediate layer of the superior colliculus that modulates motor and attentional/perceptual processes. This coordination comes with a cost: the misperception that briefly overlapping stimuli are separated in time. Our model predicts that abnormal intermediate layer of the superior colliculus inhibition, such as that arising from increased basal ganglia output, would affect the action and perception coupling, and it would worsen the misperception. OBJECTIVE To test the prominence map model by measuring reaction times and perceptions in human intermediate layer of the superior colliculus dysfunction. METHODS We measured the saccadic and perceptual reaction time changes and the percept for different temporal asynchronies between fixation point offset and peripheral target onset in Parkinson's disease (PD). RESULTS We found that increased basal ganglia inhibitory output to the intermediate layer of the superior colliculus prominence map disrupted the normal coupling of action and perception. With increasing temporal asynchronies, the PD perceptual reaction times increased approximately 3 times more than the increase of the saccadic reaction times. Also, PD subjects misperceive small overlaps as gaps for temporal asynchronies up to 3 times longer than controls. The results can be reproduced by an intermediate layer of the superior colliculus rostral-caudal gradient of inhibition. CONCLUSION These findings support the hypothesis that a prominence map in the intermediate layer of the superior colliculus couples action and perception through modulation of attention. A dysfunction of this network quantifies abnormal basal ganglia output and could underlie visual deficits, including common, yet poorly understood, misperceptions and visual-motor deficits of PD. © 2019 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Elena Pretegiani
- Laboratory of Sensorimotor Research, National Eye Institute, NIH, Bethesda, Maryland, USA
| | - Nora Vanegas-Arroyave
- Department of Neurology, Columbia University College of Physicians and Surgeons, New York, New York, USA
| | - Edmond J FitzGibbon
- Laboratory of Sensorimotor Research, National Eye Institute, NIH, Bethesda, Maryland, USA
| | - Mark Hallett
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, NIH, Bethesda, Maryland, USA
| | - Lance M Optican
- Laboratory of Sensorimotor Research, National Eye Institute, NIH, Bethesda, Maryland, USA
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Weil RS, Winston JS, Leyland L, Pappa K, Mahmood RB, Morris HR, Rees G. Neural correlates of early cognitive dysfunction in Parkinson's disease. Ann Clin Transl Neurol 2019; 6:902-912. [PMID: 31139688 PMCID: PMC6529983 DOI: 10.1002/acn3.767] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 03/05/2019] [Accepted: 03/06/2019] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE Dementia is a common and feared aspect of Parkinson's disease but there are no robust predictors of cognitive outcome. Visuoperceptual deficits are linked to risk of dementia in Parkinson's disease but whether they predict cognitive change is not known, and the neural substrates of visuoperceptual dysfunction in Parkinson's have not yet been identified. METHODS We compared patients with Parkinson's disease and unaffected controls who underwent BOLD fMRI while performing our previously validated visuoperceptual task and tested how functional connectivity between task-specific regions and the rest of the brain differed between patients who performed well and poorly in the task. RESULTS We show that task performance at baseline predicts change in cognition in Parkinson's disease after 1 year. Our task-based fMRI study showed that the performance in this task is associated with activity in the posterior cingulate cortex/precuneus. We found that functional connectivity between this region and dorsomedial prefrontal cortex was reduced in poor performers compared with good performers of this task. INTERPRETATION Our findings suggest that functional connectivity is reduced between posterior and anterior hubs of the default mode network in Parkinson's patients who are likely to progress to worsening cognitive dysfunction. Our work implicates posterior default mode nodes and their connections as key brain regions in early stages of dementia in Parkinson's disease.
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Affiliation(s)
- Rimona S. Weil
- Dementia Research CentreUCLLondonUnited Kingdom,Wellcome Centre for Human NeuroimagingUCLLondonUnited Kingdom
| | - Joel S. Winston
- Wellcome Centre for Human NeuroimagingUCLLondonUnited Kingdom,National Hospital for Neurology and NeurosurgeryLondonUnited Kingdom
| | | | - Katerina Pappa
- Institute of Cognitive NeuroscienceUCLLondonUnited Kingdom
| | | | - Huw R. Morris
- Department of Clinical and Motor NeuroscienceUCL Queen Square Institute of NeurologyLondonUnited Kingdom,Movement Disorders CentreUCL Queen Square Institute of NeurologyLondonUnited Kingdom
| | - Geraint Rees
- Wellcome Centre for Human NeuroimagingUCLLondonUnited Kingdom,Institute of Cognitive NeuroscienceUCLLondonUnited Kingdom
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Cortical Visual Performance Test Setup for Parkinson's Disease Based on Motion Blur Orientation. PARKINSONS DISEASE 2019; 2019:3247608. [PMID: 30854187 PMCID: PMC6377996 DOI: 10.1155/2019/3247608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 12/14/2018] [Accepted: 12/25/2018] [Indexed: 11/18/2022]
Abstract
Studies on Parkinson's disease (PD) are becoming very popular on multidisciplinary platforms. The development of predictable telemonitored early detection models has become closely related to many different research areas. The aim of this article is to develop a visual performance test that can examine the effects of Parkinson's disease on the visual cortex, which can be a subtitle scoring test in UPDRS. However, instead of showing random images and asking for discrepancies between them, it is expected that the questions to be asked to patients should be provable in the existing cortex models, should be deduced between the images, and produce a reference threshold value to compare with the practical results. In a developed test, horizontal and vertical motion blur orientation was applied to natural image samples, and then neural outputs were produced by representing three (original-horizontal-vertical) image groups with the Layer 4 (L4) cortex model. This image representation is then compared with a filtering model which is very similar to thalamus' functionality. Thus, the linear problem-solving performance of the L4 cortex model is also addressed in the study. According to the obtained classification results, the L4 model produces high-performance success rates compared to the thalamic model, which shows the adaptation power of the visual cortex on the image pattern differences. In future studies, developed motion-based visual tests are planned to be applied to PD patient groups/controls, and their performances with mathematical threshold values will be examined.
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Litvinenko IV, Dynin PS, Trufanov AG, Gimadutdinov RF, Maltsev DS. [Eye as an object of investigation of cognitive impairment in Parkinson's disease]. Zh Nevrol Psikhiatr Im S S Korsakova 2018; 118:105-114. [PMID: 30346443 DOI: 10.17116/jnevro2018118062105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM To study visual and spatial disorders in Parkinson's disease (PD). MATERIAL AND METHODS One hundred and eighteen patients with PD and 30 healthy people (the control group) were studied. All participants underwent neurological and ophthalmological examinations. PD progression was assessed using The Hoehn and Yahr scale. MMSE, FAB and other psychological tests were administered. Optical coherence tomography (OCT) and MRI of the brain were performed. RESULTS AND CONCLUSION The relationship of the variation in the thickness of various parts of the retina and brain cortex with cognitive deficit that manifests itself as visual-spatial disturbances is shown. The complex diagnostic technique, including neuropsychological and instrumental method (OCT of the retina, MRI of the brain with MRI-morphometry), should be used.
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Affiliation(s)
- I V Litvinenko
- S.M. Kirov Saint-Petersburg Military Medical Academy, St-Petersburg, Russia
| | - P S Dynin
- S.M. Kirov Saint-Petersburg Military Medical Academy, St-Petersburg, Russia
| | - A G Trufanov
- S.M. Kirov Saint-Petersburg Military Medical Academy, St-Petersburg, Russia
| | - R F Gimadutdinov
- S.M. Kirov Saint-Petersburg Military Medical Academy, St-Petersburg, Russia
| | - D S Maltsev
- S.M. Kirov Saint-Petersburg Military Medical Academy, St-Petersburg, Russia
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