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Ocklenburg S, Mundorf A, Gerrits R, Karlsson EM, Papadatou-Pastou M, Vingerhoets G. Clinical implications of brain asymmetries. Nat Rev Neurol 2024; 20:383-394. [PMID: 38783057 DOI: 10.1038/s41582-024-00974-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2024] [Indexed: 05/25/2024]
Abstract
No two human brains are alike, and with the rise of precision medicine in neurology, we are seeing an increased emphasis on understanding the individual variability in brain structure and function that renders every brain unique. Functional and structural brain asymmetries are a fundamental principle of brain organization, and recent research suggests substantial individual variability in these asymmetries that needs to be considered in clinical practice. In this Review, we provide an overview of brain asymmetries, variations in such asymmetries and their relevance in the clinical context. We review recent findings on brain asymmetries in neuropsychiatric and neurodevelopmental disorders, as well as in specific learning disabilities, with an emphasis on large-scale database studies and meta-analyses. We also highlight the relevance of asymmetries for disease symptom onset in neurodegenerative diseases and their implications for lateralized treatments, including brain stimulation. We conclude that alterations in brain asymmetry are not sufficiently specific to act as diagnostic biomarkers but can serve as meaningful symptom or treatment response biomarkers in certain contexts. On the basis of these insights, we provide several recommendations for neurological clinical practice.
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Affiliation(s)
- Sebastian Ocklenburg
- Department of Psychology, MSH Medical School Hamburg, Hamburg, Germany.
- ICAN Institute for Cognitive and Affective Neuroscience, MSH Medical School Hamburg, Hamburg, Germany.
- Biopsychology, Institute of Cognitive Neuroscience, Faculty of Psychology, Ruhr University Bochum, Bochum, Germany.
| | - Annakarina Mundorf
- ISM Institute for Systems Medicine and Department of Human Medicine, MSH Medical School Hamburg, Hamburg, Germany
- Division of Cognitive Neuroscience, Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Robin Gerrits
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
- Ghent Institute for Functional and Metabolic Imaging (GIfMI), Ghent University, Ghent, Belgium
| | - Emma M Karlsson
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
- Ghent Institute for Functional and Metabolic Imaging (GIfMI), Ghent University, Ghent, Belgium
| | - Marietta Papadatou-Pastou
- National and Kapodistrian University of Athens, Athens, Greece
- Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | - Guy Vingerhoets
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
- Ghent Institute for Functional and Metabolic Imaging (GIfMI), Ghent University, Ghent, Belgium
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2
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Del Bene VA, Martin RC, Brinkerhoff SA, Olson JW, Nelson MJ, Marotta D, Gonzalez CL, Mills KA, Kamath V, Cutter G, Hurt CP, Wade M, Robinson FG, Bentley JN, Guthrie BL, Knight RT, Walker HC. Differential Cognitive Effects of Unilateral Subthalamic Nucleus Deep Brain Stimulation for Parkinson's Disease. Ann Neurol 2024; 95:1205-1219. [PMID: 38501317 PMCID: PMC11102318 DOI: 10.1002/ana.26903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 02/21/2024] [Accepted: 02/22/2024] [Indexed: 03/20/2024]
Abstract
OBJECTIVE The aim of this study was to investigate the cognitive effects of unilateral directional versus ring subthalamic nucleus deep brain stimulation (STN DBS) in patients with advanced Parkinson's disease. METHODS We examined 31 participants who underwent unilateral STN DBS (left n = 17; right n = 14) as part of an National Institutes of Health (NIH)-sponsored randomized, double-blind, crossover study contrasting directional versus ring stimulation. All participants received unilateral DBS implants in the hemisphere more severely affected by motor parkinsonism. Measures of cognition included verbal fluency, auditory-verbal memory, and response inhibition. We used mixed linear models to contrast the effects of directional versus ring stimulation and implant hemisphere on longitudinal cognitive function. RESULTS Crossover analyses showed no evidence for group-level changes in cognitive performance related to directional versus ring stimulation. Implant hemisphere, however, impacted cognition in several ways. Left STN participants had lower baseline verbal fluency than patients with right implants (t [20.66 = -2.50, p = 0.02]). Verbal fluency declined after left (p = 0.013) but increased after right STN DBS (p < 0.001), and response inhibition was faster following right STN DBS (p = 0.031). Regardless of hemisphere, delayed recall declined modestly over time versus baseline (p = 0.001), and immediate recall was unchanged. INTERPRETATION Directional versus ring STN DBS did not differentially affect cognition. Similar to prior bilateral DBS studies, unilateral left stimulation worsened verbal fluency performance. In contrast, unilateral right STN surgery increased performance on verbal fluency and response inhibition tasks. Our findings raise the hypothesis that unilateral right STN DBS in selected patients with predominant right brain motor parkinsonism could mitigate declines in verbal fluency associated with the bilateral intervention. ANN NEUROL 2024;95:1205-1219.
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Affiliation(s)
- Victor A Del Bene
- Department of Neurology, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, USA
- The Evelyn F. McKnight Brain Institute, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, USA
| | - Roy C. Martin
- Department of Neurology, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, USA
- The Evelyn F. McKnight Brain Institute, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, USA
| | - Sarah A. Brinkerhoff
- Department of Neurology, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, USA
| | - Joseph W. Olson
- Department of Neurology, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, USA
| | - Matthew J. Nelson
- Department of Neurosurgery, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, USA
| | - Dario Marotta
- Department of Neurology, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, USA
| | - Christopher L. Gonzalez
- Department of Neurology, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, USA
| | - Kelly A. Mills
- Department of Neurology, The Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Vidyulata Kamath
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Gary Cutter
- School of Public Health, University of Alabama at Birmingham, Birmingham, AL
| | - Chris P. Hurt
- Department of Physical Therapy, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL
| | - Melissa Wade
- Department of Neurology, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, USA
| | - Frank G. Robinson
- Department of Neurology, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, USA
| | - J. Nicole Bentley
- Department of Neurosurgery, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, USA
| | - Barton L. Guthrie
- Department of Neurosurgery, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, USA
| | - Robert T. Knight
- Department of Psychology, University of California, Berkeley, CA, USA
- Helen Wills Neuroscience Institute, University of California, Berkeley, CA, USA
| | - Harrison C. Walker
- Department of Neurology, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, USA
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Di Carlo F, Pettorruso M, Santorelli M, Cocciolillo F, d'Andrea G, Di Nicola M, Sensi SS, Martinotti G, Grant JE, Camardese G, Di Giuda D. Linking Striatal Dopaminergic Asymmetry with Personality Traits: Insights from Gambling Disorder. J Gambl Stud 2024:10.1007/s10899-024-10311-9. [PMID: 38755422 DOI: 10.1007/s10899-024-10311-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2024] [Indexed: 05/18/2024]
Abstract
The role of dopamine in the pathophysiology of gambling disorder (GD) remains incompletely understood, with disparate research findings concerning presynaptic and postsynaptic structures and dopaminergic synthesis. The aim of this study was to investigate potential correlations between striatal dopamine transporter (DAT) lateralization and asymmetry index, as assessed by 123I-FP-CIT SPECT, and temperamental traits, as measured by Cloninger's Temperament and Character Inventory (TCI), in GD subjects. Significant associations were found between DAT binding asymmetries in the caudate and putamen and the temperamental dimensions of harm avoidance and novelty seeking. Specifically, high novelty seeking scores correlated with increased DAT binding in the left caudate relative to the right, whereas higher harm avoidance scores corresponded to increased DAT binding in the right putamen relative to the left. These observations potentially imply that the asymmetry in DAT expression in the basal ganglia could be an outcome of hemispheric asymmetry in emotional processing and behavioural guidance. In summary, our study provides evidence supporting the relationship between DAT asymmetries, temperamental dimensions and GD. Future investigations could be directed towards examining postsynaptic receptors to gain a more comprehensive understanding of dopamine's influence within the basal ganglia circuit in disordered gambling. If confirmed in larger cohorts, these findings could have substantial implications for the tailoring of individualized neuromodulation therapies in the treatment of behavioural addictions.
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Affiliation(s)
- Francesco Di Carlo
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti, Chieti, Italy
| | - Mauro Pettorruso
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti, Chieti, Italy.
| | - Mario Santorelli
- School of Medicine and Surgery, University of Milano Bicocca, Milan, Italy
| | - Fabrizio Cocciolillo
- Institute of Nuclear Medicine, Fondazione Policlinico Universitario "A. Gemelli" Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giacomo d'Andrea
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti, Chieti, Italy
| | - Marco Di Nicola
- Institute of Psychiatry and Psychology, Fondazione Policlinico Universitario "A. Gemelli" Università Cattolica del Sacro Cuore, Rome, Italy
| | - Stefano S Sensi
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti, Chieti, Italy
- Center for Advanced Studies and Technology - CAST, University "G. d'Annunzio" of Chieti, Chieti, Italy
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti, Chieti, Italy
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - Jon E Grant
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Giovanni Camardese
- Institute of Psychiatry and Psychology, Fondazione Policlinico Universitario "A. Gemelli" Università Cattolica del Sacro Cuore, Rome, Italy
| | - Daniela Di Giuda
- Institute of Nuclear Medicine, Fondazione Policlinico Universitario "A. Gemelli" Università Cattolica del Sacro Cuore, Rome, Italy
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Marano N, Lindell AK. Does the side of onset influence symptom severity in Parkinson's disease? A systematic review and meta-analysis. APPLIED NEUROPSYCHOLOGY. ADULT 2024:1-11. [PMID: 38640454 DOI: 10.1080/23279095.2024.2338803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/21/2024]
Abstract
Parkinson's disease (PD) is a neurodegenerative movement disorder characterized by motor symptoms that initially manifest unilaterally. Whilst some studies indicate that right-side onset is associated with greater symptom severity, others report no differences between right-side and left-side onset patients. The present meta-analysis was thus designed to reconcile inconsistencies in the literature and determine whether side of onset affects PD symptom severity. Following the PRISMA guidelines 1013 studies were initially identified in database and grey literature searches; following title and abstract, and full text, screening 34 studies met the stringent inclusion criteria (n = 2210). Results of the random-effects meta-analysis indicated no difference in symptom severity between PD patients with left-side (n = 1104) and right-side (n = 1106) onset. As such, the meta-analysis suggests that the side of onset should not be used to predict symptom trajectory or to formulate prognoses for PD patients. The current meta-analysis was the first to focus on the relationship between the side of onset and symptom severity in PD. However, the studies included were limited by the common exclusion of left-handed participants. Future research would benefit from exploring other factors that may influence symptom severity and disease progression in PD, such as asymmetric loss of nigrostriatal dopaminergic neurons.
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Affiliation(s)
- Nancy Marano
- Department of Psychology, Counselling and Therapy, La Trobe University, Melbourne, Victoria, Australia
| | - Annukka K Lindell
- Department of Psychology, Counselling and Therapy, La Trobe University, Melbourne, Victoria, Australia
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Lövdal SS, Carli G, Orso B, Biehl M, Arnaldi D, Mattioli P, Janzen A, Sittig E, Morbelli S, Booij J, Oertel WH, Leenders KL, Meles SK. Investigating the aspect of asymmetry in brain-first versus body-first Parkinson's disease. NPJ Parkinsons Dis 2024; 10:74. [PMID: 38555343 PMCID: PMC10981719 DOI: 10.1038/s41531-024-00685-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 03/13/2024] [Indexed: 04/02/2024] Open
Abstract
Parkinson's disease (PD) is characterized by a progressive loss of dopaminergic neurons in the substantia nigra. Recent literature has proposed two subgroups of PD. The "body-first subtype" is associated with a prodrome of isolated REM-sleep Behavior Disorder (iRBD) and a relatively symmetric brain degeneration. The "brain-first subtype" is suggested to have a more asymmetric degeneration and a prodromal stage without RBD. This study aims to investigate the proposed difference in symmetry of the degeneration pattern in the presumed body and brain-first PD subtypes. We analyzed 123I-FP-CIT (DAT SPECT) and 18F-FDG PET brain imaging in three groups of patients (iRBD, n = 20, de novo PD with prodromal RBD, n = 22, and de novo PD without RBD, n = 16) and evaluated dopaminergic and glucose metabolic symmetry. The RBD status of all patients was confirmed with video-polysomnography. The PD groups did not differ from each other with regard to the relative or absolute asymmetry of DAT uptake in the putamen (p = 1.0 and p = 0.4, respectively). The patient groups also did not differ from each other with regard to the symmetry of expression of the PD-related metabolic pattern (PDRP) in each hemisphere. The PD groups had no difference in symmetry considering mean FDG uptake in left and right regions of interest and generally had the same degree of symmetry as controls, while the iRBD patients had nine regions with abnormal left-right differences (p < 0.001). Our findings do not support the asymmetry aspect of the "body-first" versus "brain-first" hypothesis.
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Affiliation(s)
- S S Lövdal
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, Netherlands.
- Bernoulli Institute for Mathematics, Computer Science and Artificial Intelligence, University of Groningen, Groningen, Netherlands.
| | - G Carli
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, Netherlands
| | - B Orso
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - M Biehl
- Bernoulli Institute for Mathematics, Computer Science and Artificial Intelligence, University of Groningen, Groningen, Netherlands
- SMQB, Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - D Arnaldi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- Neurophysiopathology Unit, IRCCS Ospedale Policlinico S. Martino, Genoa, Italy
| | - P Mattioli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- Neurophysiopathology Unit, IRCCS Ospedale Policlinico S. Martino, Genoa, Italy
| | - A Janzen
- Department of Neurology, Philipps-University Marburg, Marburg, Germany
| | - E Sittig
- Department of Neurology, Philipps-University Marburg, Marburg, Germany
| | - S Morbelli
- Department of Health Sciences, University of Genoa, Genoa, Italy
- Nuclear Medicine Unit, IRCCS Ospedale Policlinico S. Martino, Genoa, Italy
| | - J Booij
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - W H Oertel
- Department of Neurology, Philipps-University Marburg, Marburg, Germany
| | - K L Leenders
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, Netherlands
| | - S K Meles
- Department of Neurology, University Medical Center Groningen, Groningen, Netherlands
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Salvatore MF. Dopamine Signaling in Substantia Nigra and Its Impact on Locomotor Function-Not a New Concept, but Neglected Reality. Int J Mol Sci 2024; 25:1131. [PMID: 38256204 PMCID: PMC10815979 DOI: 10.3390/ijms25021131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/11/2024] [Accepted: 01/13/2024] [Indexed: 01/24/2024] Open
Abstract
The mechanistic influences of dopamine (DA) signaling and impact on motor function are nearly always interpreted from changes in nigrostriatal neuron terminals in striatum. This is a standard practice in studies of human Parkinson's disease (PD) and aging and related animal models of PD and aging-related parkinsonism. However, despite dozens of studies indicating an ambiguous relationship between changes in striatal DA signaling and motor phenotype, this perseverating focus on striatum continues. Although DA release in substantia nigra (SN) was first reported almost 50 years ago, assessment of nigral DA signaling changes in relation to motor function is rarely considered. Whereas DA signaling has been well-characterized in striatum at all five steps of neurotransmission (biosynthesis and turnover, storage, release, reuptake, and post-synaptic binding) in the nigrostriatal pathway, the depth of such interrogations in the SN, outside of cell counts, is sparse. However, there is sufficient evidence that these steps in DA neurotransmission in the SN are operational and regulated autonomously from striatum and are present in human PD and aging and related animal models. To complete our understanding of how nigrostriatal DA signaling affects motor function, it is past time to include interrogation of nigral DA signaling. This brief review highlights evidence that changes in nigral DA signaling at each step in DA neurotransmission are autonomous from those in striatum and changes in the SN alone can influence locomotor function. Accordingly, for full characterization of how nigrostriatal DA signaling affects locomotor activity, interrogation of DA signaling in SN is essential.
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Affiliation(s)
- Michael F Salvatore
- Department of Pharmacology & Neuroscience, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
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Woo KA, Kim HJ, Shin JH, Cho K, Choi H, Jeon B. Symmetric and Profound Monoaminergic Degeneration in Parkinson's Disease with Premotor REM Sleep Behavior Disorder. JOURNAL OF PARKINSON'S DISEASE 2024; 14:823-831. [PMID: 38640171 PMCID: PMC11191437 DOI: 10.3233/jpd-230459] [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: 03/18/2024] [Indexed: 04/21/2024]
Abstract
Background Rapid eye movement sleep behavior disorder (RBD) may precede or follow motor symptoms in Parkinson's disease (PD). While over 70% of idiopathic RBD cases phenoconvert within a decade, a small subset develops PD after a more extended period or remains nonconverted. These heterogeneous manifestations of RBD in PD prompt subtype investigations. Premotor RBD may signify "body-first" PD with bottom-up, symmetric synucleinopathy propagation. Objective Explore brainstem and nigrostriatal monoaminergic degeneration pattern differences based on premotor RBD presence and duration in de novo PD patients. Methods In a cross-sectional analysis of de novo PD patients (n = 150) undergoing FP-CIT PET and RBD Single-Question Screen, the cohort was categorized into groups with and without premotor RBD (PDRBD +/-), with further classification of PDRBD + based on a 10-year duration of premotor RBD. Analysis of FP-CIT binding in the striatum and pons, striatal asymmetry, and striatum-to-pons ratios compared patterns of nigrostriatal and brainstem monoaminergic degeneration. Results PDRBD + exhibited more severe and symmetrical striatal dopaminergic denervation compared to PDRBD-, with the difference in severity accentuated in the least-affected hemisphere. The PDRBD +<10Y subgroup displayed the most prominent striatal symmetry, supporting a more homogeneous "body-first" subtype. Pontine uptakes remained lower in PDRBD + even after adjusting for striatal uptake, suggesting early degeneration of pontine monoaminergic nuclei. Conclusions Premotor RBD in PD is associated with severe, symmetrical nigrostriatal and brainstem monoaminergic degeneration, especially in cases with PD onset within 10 years of RBD. This supports the concept of a "widespread, bottom-up" pathophysiological mechanism associated with premotor RBD in PD.
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Affiliation(s)
- Kyung Ah Woo
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Han-Joon Kim
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jung Hwan Shin
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Kangyoung Cho
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Hongyoon Choi
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Beomseok Jeon
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
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Hattori N, Kabata D, Asada S, Kanda T, Nomura T, Shintani A, Mori A. Real-world evidence on levodopa dose escalation in patients with Parkinson's disease treated with istradefylline. PLoS One 2023; 18:e0269969. [PMID: 38134023 PMCID: PMC10745149 DOI: 10.1371/journal.pone.0269969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 12/04/2023] [Indexed: 12/24/2023] Open
Abstract
OBJECTIVE Istradefylline, a selective adenosine A2A receptor antagonist, is indicated in the US and Japan as adjunctive treatment to levodopa/decarboxylase inhibitors in adults with Parkinson's disease (PD) experiencing OFF time. This study aimed to observe patterns of dose escalation of levodopa over time in patients initiated on istradefylline. METHODS Using Japanese electronic health record data, interrupted time series analyses were used to compare levodopa daily dose (LDD, mg/day) gradients in patients before and after initiation of istradefylline. Data were analyzed by period relative to istradefylline initiation (Month 1): pre-istradefylline (Months -72 to 0), early istradefylline (Months 1 to 24), and late istradefylline (Months 25 to 72). Subgroup analyses included LDD before istradefylline initiation (<400, ≥400 to <600, ≥600 mg/day) and treatment with or without monoamine oxidase-B (MAO-B) inhibitors, catechol-O-methyltransferase (COMT) inhibitors, or dopamine agonists before istradefylline initiation. RESULTS The analysis included 4026 patients; mean (SD) baseline LDD was 419.27 mg (174.19). Patients receiving ≥600 mg/day levodopa or not receiving MAO-B inhibitors or COMT inhibitors demonstrated a significant reduction in LDD increase gradient for pre-istradefylline vs late-phase istradefylline (≥600 mg/day levodopa, -6.259 mg/day each month, p<0.001; no MAO-B inhibitors, -1.819 mg/day each month, p = 0.004; no COMT inhibitors, -1.412 mg/day each month, p = 0.027). CONCLUSIONS This real-world analysis of Japanese prescription data indicated that slowing of LDD escalation was observed in patients initiated on istradefylline, particularly in those receiving ≥600 mg/day levodopa, suggesting istradefylline may slow progressive LDD increases. These findings suggest that initiating istradefylline before other levodopa-adjunctive therapies may mitigate LDD increases, potentially reducing occurrence or severity of levodopa-induced complications in long-term istradefylline treatment.
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Affiliation(s)
- Nobutaka Hattori
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | - Daijiro Kabata
- Department of Medical Statistics, Osaka City University Graduate School of Medicine, Osaka, Japan
| | | | | | | | - Ayumi Shintani
- Department of Medical Statistics, Osaka City University Graduate School of Medicine, Osaka, Japan
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Shaikh A, Ahmad F, Teoh SL, Kumar J, Yahaya MF. Targeting dopamine transporter to ameliorate cognitive deficits in Alzheimer's disease. Front Cell Neurosci 2023; 17:1292858. [PMID: 38026688 PMCID: PMC10679733 DOI: 10.3389/fncel.2023.1292858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 10/27/2023] [Indexed: 12/01/2023] Open
Abstract
Alzheimer's disease (AD) is characterized by the pathologic deposition of amyloid and neurofibrillary tangles in the brain, leading to neuronal damage and defective synapses. These changes manifest as abnormalities in cognition and behavior. The functional deficits are also attributed to abnormalities in multiple neurotransmitter systems contributing to neuronal dysfunction. One such important system is the dopaminergic system. It plays a crucial role in modulating movement, cognition, and behavior while connecting various brain areas and influencing other neurotransmitter systems, making it relevant in neurodegenerative disorders like AD and Parkinson's disease (PD). Considering its significance, the dopaminergic system has emerged as a promising target for alleviating movement and cognitive deficits in PD and AD, respectively. Extensive research has been conducted on dopaminergic neurons, receptors, and dopamine levels as critical factors in cognition and memory in AD. However, the exact nature of movement abnormalities and other features of extrapyramidal symptoms are not fully understood yet in AD. Recently, a previously overlooked element of the dopaminergic system, the dopamine transporter, has shown significant promise as a more effective target for enhancing cognition while addressing dopaminergic system dysfunction in AD.
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Affiliation(s)
- Ammara Shaikh
- Department of Anatomy, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Fairus Ahmad
- Department of Anatomy, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Seong Lin Teoh
- Department of Anatomy, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Jaya Kumar
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Mohamad Fairuz Yahaya
- Department of Anatomy, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
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Campagnolo M, Emmi A, Biundo R, Fiorenzato E, Batzu L, Chaudhuri KR, Antonini A. The pharmacological management of the behavioral aspects of Parkinson's disease: an update. Expert Opin Pharmacother 2023; 24:1693-1701. [PMID: 37493445 DOI: 10.1080/14656566.2023.2240228] [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: 05/28/2023] [Accepted: 07/20/2023] [Indexed: 07/27/2023]
Abstract
INTRODUCTION Behavioural symptoms are common manifestations of Parkinson's disease and include depression, anxiety, impulse control disorders, hallucinations, psychosis, and cognitive dysfunction. They remain inadequately addressed in many patients despite their relevance for quality of life and disability. This applies also to impulse control disorders where the most common approach in recent literature is to refrain from using dopamine agonists without consideration about their potential benefit on motor complications. AREAS COVERED We conducted a narrative review searching for articles on behavioral symptoms in Parkinson disease and selected those which included involved neurotransmitters such as dopamine, noradrenaline, serotonin, acetylcholine. We specifically focused our search on open-label and randomized double-blind studies and biomarkers which could best characterize these clinical manifestations. EXPERT OPINION Management of Parkinson disease behavioural manifestations lacks clear guidelines and standardized protocols beside general suggestions of dose adjustments in dopamine replacement therapy and use of antidepressants or antipsychotic drugs with little consideration of patients' age, sex, comorbidities, and motor status. We suggest a pragmatic approach which includes education of affected patients and caring people, dealing with complex cases by experienced multidisciplinary teams, use of cognitive behavioural therapy, and psychological counselling to complement drug treatment.
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Affiliation(s)
- Marta Campagnolo
- Parkinson's Disease and Movement Disorders Unit, Centre for Rare Neurological Diseases (ERN-RND), Department of Neuroscience, University of Padova, Padova, Italy
- Center for Neurodegenerative Disease Research (CESNE), Department of Neuroscience, University of Padova, Padova, Italy
| | - Aron Emmi
- Center for Neurodegenerative Disease Research (CESNE), Department of Neuroscience, University of Padova, Padova, Italy
- Institute of Human Anatomy, Department of Neuroscience, University of Padova, Padova, Italy
| | - Roberta Biundo
- Parkinson's Disease and Movement Disorders Unit, Centre for Rare Neurological Diseases (ERN-RND), Department of Neuroscience, University of Padova, Padova, Italy
- Center for Neurodegenerative Disease Research (CESNE), Department of Neuroscience, University of Padova, Padova, Italy
- Department of General Psychology, University of Padova, Padova, Italy
| | - Eleonora Fiorenzato
- Parkinson's Disease and Movement Disorders Unit, Centre for Rare Neurological Diseases (ERN-RND), Department of Neuroscience, University of Padova, Padova, Italy
| | - Lucia Batzu
- Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Parkinson's Foundation Centre of Excellence, King's College Hospital, London, UK
| | - K Ray Chaudhuri
- Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Parkinson's Foundation Centre of Excellence, King's College Hospital, London, UK
| | - Angelo Antonini
- Parkinson's Disease and Movement Disorders Unit, Centre for Rare Neurological Diseases (ERN-RND), Department of Neuroscience, University of Padova, Padova, Italy
- Center for Neurodegenerative Disease Research (CESNE), Department of Neuroscience, University of Padova, Padova, Italy
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11
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Constantin IM, Voruz P, Péron JA. Moderating effects of uric acid and sex on cognition and psychiatric symptoms in asymmetric Parkinson's disease. Biol Sex Differ 2023; 14:26. [PMID: 37143121 PMCID: PMC10157998 DOI: 10.1186/s13293-023-00510-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 04/17/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND Non-motor symptoms are an important early feature of Parkinson's disease (PD), encompassing a variety of cognitive and psychiatric symptoms that seem to manifest differently depending on motor symptom asymmetry. Different factors, such as uric acid (UA) and sex, seem to influence cognitive and psychiatric expression in PD, however their interplay remains to be better understood. METHODS Participants taking part in the Parkinson's Progression Marker Initiative were studied based on the side of motor symptom asymmetry and sex. Three-way interaction modeling was used to examine the moderating effects of sex and UA on cognitive functions and psychiatric symptoms. RESULTS Significant three-way interactions were highlighted at 1-year follow-up between motor symptom asymmetry, UA and sex for immediate and long-term memory in female patients exhibiting predominantly left-sided motor symptoms, and for processing speed and sleepiness in female patients exhibiting predominantly right-sided motor symptoms. No significant interactions were observed for male patients. Moreover, female patients exhibiting predominantly right-sided motor symptoms demonstrated lower serum UA concentrations and had overall better outcomes, while male patients with predominantly right-sided motor symptoms demonstrated particularly poor outcomes. CONCLUSIONS These findings suggest that in the earliest stages of the disease, UA and sex moderate cognitive functions and psychiatric symptoms differently depending on motor asymmetry, holding important clinical implications for symptom management in patients.
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Affiliation(s)
- Ioana Medeleine Constantin
- Clinical and Experimental Neuropsychology Laboratory, Faculty of Psychology and Educational Sciences, University of Geneva, 40 Bd du Pont d'Arve, 1205, Geneva, Switzerland
| | - Philippe Voruz
- Clinical and Experimental Neuropsychology Laboratory, Faculty of Psychology and Educational Sciences, University of Geneva, 40 Bd du Pont d'Arve, 1205, Geneva, Switzerland
- Neurology Department, Geneva University Hospitals, 4 Rue Gabrielle-Perret-Gentil, 1205, Geneva, Switzerland
| | - Julie Anne Péron
- Clinical and Experimental Neuropsychology Laboratory, Faculty of Psychology and Educational Sciences, University of Geneva, 40 Bd du Pont d'Arve, 1205, Geneva, Switzerland.
- Neurology Department, Geneva University Hospitals, 4 Rue Gabrielle-Perret-Gentil, 1205, Geneva, Switzerland.
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12
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Jeong SH, Park CW, Lee HS, Kim YJ, Yun M, Lee PH, Sohn YH, Chung SJ. Patterns of striatal dopamine depletion and motor deficits in de novo Parkinson's disease. J Neural Transm (Vienna) 2023; 130:19-28. [PMID: 36462096 DOI: 10.1007/s00702-022-02571-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 11/24/2022] [Indexed: 12/07/2022]
Abstract
The background of this study is to investigate whether striatal dopamine depletion patterns (selective involvement in the sensorimotor striatum or asymmetry) are associated with motor deficits in Parkinson's disease (PD). We enrolled 404 drug-naïve patients with early stage PD who underwent dopamine transporter (DAT) imaging. After quantifying DAT availability in each striatal sub-region, principal component (PC) analysis was conducted to yield PCs representing the spatial patterns of striatal dopamine depletion. Subsequently, multivariate linear regression analysis was conducted to investigate the relationship between striatal dopamine depletion patterns and motor deficits assessed using the Unified PD Rating Scale Part III (UPDRS-III). Mediation analyses were used to evaluate whether dopamine deficiency in the posterior putamen mediated the association between striatal dopamine depletion patterns and parkinsonian motor deficits. Three PCs indicated patterns of striatal dopamine depletion: PC1 (overall striatal dopamine deficiency), PC2 (selective dopamine loss in the sensorimotor striatum), and PC3 (symmetric dopamine loss in the striatum). Multivariate linear regression analysis revealed that PC1 (β = - 1.605, p < 0.001) and PC2 (β = 3.201, p < 0.001) were associated with motor deficits (i.e., higher UPDRS-III scores in subjects with severe dopamine depletion throughout the whole striatum or more selective dopamine loss in the sensorimotor striatum), whereas PC3 was not (β = - 0.016, p = 0.992). Mediation analyses demonstrated that the effects of PC1 and PC2 on UPDRS-III scores were indirectly mediated by DAT availability in the posterior putamen, with a non-significant direct effect. Dopamine deficiency in the posterior putamen was most relevant to the severity of motor deficits in patients with PD, while the spatial patterns of striatal dopamine depletion were not a key determinant.
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Affiliation(s)
- Seong Ho Jeong
- Department of Neurology, Inje University Sanggye Paik Hospital, Seoul, South Korea.,Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Chan Wook Park
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea.,Department of Physiology, Yonsei University College of Medicine, Seoul, South Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, South Korea
| | - Yun Joong Kim
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea.,Department of Neurology, Yongin Severance Hospital, Yonsei University Health System, 363 Dongbaekjukjeon-daero Giheung-gu, Yongin-si, Gyeonggi-do, 16995, South Korea.,YONSEI BEYOND LAB, Yongin, South Korea
| | - Mijin Yun
- Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Young H Sohn
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Seok Jong Chung
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea. .,Department of Neurology, Yongin Severance Hospital, Yonsei University Health System, 363 Dongbaekjukjeon-daero Giheung-gu, Yongin-si, Gyeonggi-do, 16995, South Korea. .,YONSEI BEYOND LAB, Yongin, South Korea.
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13
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Biomarkers and non-motor symptoms as a function of motor symptom asymmetry in early Parkinson's disease. Neuropsychologia 2022; 177:108419. [PMID: 36375651 DOI: 10.1016/j.neuropsychologia.2022.108419] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 10/19/2022] [Accepted: 11/06/2022] [Indexed: 11/13/2022]
Abstract
INTRODUCTION The longitudinal trajectories of cognitive-neuropsychiatric symptoms from the early stages of Parkinson's disease, as a function of motor symptom asymmetry at the onset of the disease, remain to be fully explored. Moreover, the relationship to biomarkers warrants further investigation. METHODOLOGY Non-motor and biospecimen data from 413 patients with Parkinson's disease, dissociating predominantly left-sided motor symptoms patients (n = 179), predominantly right-sided motor symptoms patients (n = 234), and matched healthy controls (n = 196), were extracted from the Parkinson's Progression Marker Initiative database during a 3-Year follow-up. Non-parametric and conservative corrections for multivariate comparisons were carried out on neuropsychiatric and biomarker data. RESULTS A decline for global cognitive efficiency scores in predominantly right-sided motor symptoms patients was observed, whereas depressive and anxiety symptoms were greater overtime for predominantly left-sided motor symptoms patients. Biomarker analysis revealed that predominantly right-sided patients expressed decreased levels of total-tau and phospho-tau over time, while left-sided patients didn't differ from healthy controls. CONCLUSION From the early course of the disease, the existence of different clinical phenotypes is proposed, associated to emerging evidences of distinct pathological pathways and a left-hemispheric vulnerability for cognitive decline.
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14
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Sun X, Li X, Zhang L, Zhang Y, Qi X, Wang S, Qin C. Longitudinal assessment of motor function following the unilateral intrastriatal 6-hydroxydopamine lesion model in mice. Front Behav Neurosci 2022; 16:982218. [PMID: 36505729 PMCID: PMC9730519 DOI: 10.3389/fnbeh.2022.982218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 11/04/2022] [Indexed: 11/27/2022] Open
Abstract
Introduction Despite the widespread use of the unilateral striatal 6-hydroxydopamine (6-OHDA) lesion model in mice in recent years, the stability of behavioral deficits in the 6-OHDA striatal mouse model over time is not yet clear, raising concerns about using this model to evaluate a compound's long-term therapeutic effects. Materials and methods In the current study, mice were tested at regular intervals in the cylinder test and gait analysis beginning 3 days after 6-OHDA injection of 4 and 8 μg and lasting until 56 days post-lesion. Apomorphine-induced rotational test and rotarod test were also performed on Day 23 and 43 post-lesion, respectively. Immunohistochemistry for dopaminergic neurons stained by tyrosine hydroxylase (TH) was also performed. Results Our results showed that both the 4 and 8 μg 6-OHDA lesion groups exhibited forelimb use asymmetry with a preference for the ipsilateral (injection) side on Day 3 and until Day 21 post-lesion, but did not show forelimb asymmetry on Day 28 to 56 post-lesion. The 8 μg 6-OHDA lesion group still exhibited forelimb asymmetry on Day 28 and 42 post-lesion, but not on Day 56. The gait analysis showed that the contralateral front and hind step cycles increased from Day 3 to 42 post-lesion and recovered on Day 56 post-lesion. In addition, our results displayed a dose-dependent reduction in TH+ cells and TH+ fibers, as well as dose-dependent apomorphine-induced rotations. In the rotarod test, the 8 μg 6-OHDA lesion group, but not the 4 μg group, decreased the latency to fall on the rotarod on Day 43 post-lesion. Conclusion In summary, unilateral striatal 6-OHDA injections of 4 and 8 μg induced spontaneous motor impairment in mice, which partially recovered starting on Day 28 post-lesion. Forced motor deficits were observed in the 8 g 6-OHDA lesion group, which remained stable on Day 43 post-lesion. In addition, the rotarod test and apomorphine-induced rotational test can distinguish between lesions of different extents and are useful tools for the assessment of functional recovery in studies screening novel potential therapies.
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Affiliation(s)
- Xiuping Sun
- National Health Commission Key Laboratory of Human Disease Comparative Medicine, Beijing Engineering Research Center for Experimental Animal Models of Human Critical Diseases, National Center of Technology Innovation for Animal Model, Institute of Laboratory Animal Sciences, Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College (PUMC), Beijing, China
| | - Xianglei Li
- National Health Commission Key Laboratory of Human Disease Comparative Medicine, Beijing Engineering Research Center for Experimental Animal Models of Human Critical Diseases, National Center of Technology Innovation for Animal Model, Institute of Laboratory Animal Sciences, Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College (PUMC), Beijing, China
| | - Ling Zhang
- National Health Commission Key Laboratory of Human Disease Comparative Medicine, Beijing Engineering Research Center for Experimental Animal Models of Human Critical Diseases, National Center of Technology Innovation for Animal Model, Institute of Laboratory Animal Sciences, Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College (PUMC), Beijing, China
| | - Yu Zhang
- National Health Commission Key Laboratory of Human Disease Comparative Medicine, Beijing Engineering Research Center for Experimental Animal Models of Human Critical Diseases, National Center of Technology Innovation for Animal Model, Institute of Laboratory Animal Sciences, Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College (PUMC), Beijing, China
| | - Xiaolong Qi
- National Health Commission Key Laboratory of Human Disease Comparative Medicine, Beijing Engineering Research Center for Experimental Animal Models of Human Critical Diseases, National Center of Technology Innovation for Animal Model, Institute of Laboratory Animal Sciences, Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College (PUMC), Beijing, China
| | - Siyuan Wang
- National Health Commission Key Laboratory of Human Disease Comparative Medicine, Beijing Engineering Research Center for Experimental Animal Models of Human Critical Diseases, National Center of Technology Innovation for Animal Model, Institute of Laboratory Animal Sciences, Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College (PUMC), Beijing, China
| | - Chuan Qin
- National Health Commission Key Laboratory of Human Disease Comparative Medicine, Beijing Engineering Research Center for Experimental Animal Models of Human Critical Diseases, National Center of Technology Innovation for Animal Model, Institute of Laboratory Animal Sciences, Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College (PUMC), Beijing, China,Changping National Laboratory (CPNL), Beijing, China,*Correspondence: Chuan Qin,
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15
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Jeong EH, Sunwoo MK, Lee JY, Han SK, Hyung SW, Song YS. Serial changes of I-123 FP-CIT SPECT binding asymmetry in Parkinson's disease: Analysis of the PPMI data. Front Neurol 2022; 13:976101. [PMID: 36119683 PMCID: PMC9474999 DOI: 10.3389/fneur.2022.976101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 08/03/2022] [Indexed: 11/18/2022] Open
Abstract
Background Dopaminergic denervation and motor symptoms are usually asymmetric at the onset of Parkinson's disease (PD). In this study, we estimated the asymmetry of specific binding ratio (SBR) of I-123 FP-CIT SPECT images during 4-years of follow up, to demonstrate the pattern of serial changes of asymmetry. Methods Clinical and I-123 FP-CIT SPECT image data of 301 PD patients and 141 normal controls were reviewed from the Parkinson's Progression Markers Initiative cohort. I-123 FP-CIT SPECT images were taken at baseline, 1-, 2-, and 4-year follow up periods for PD patients, and at baseline for normal controls. Asymmetry index were calculated by two methods. Method 1, by using the ratio of absolute difference of right and left SBRs to the average SBR. Method 2, by using the ratio of absolute difference of right and left SBRs to the SBR values of age-matched normal controls. Results Asymmetry index by method 2 revealed a more significant decrease during the 4-year follow up period, compared with method 1. The baseline asymmetry index of the putamen by method 2 showed significant correlation with the non-dominant putamen SBRs. However, there were no significant correlation with the baseline asymmetry index by method 2 and motor symptoms, cognition, nor autonomic symptoms. Conclusion We suggest a novel asymmetry index in association to age-matched normal SBR values. This novel index could be adopted in predicting and evaluating the natural course of PD.
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Affiliation(s)
- Eun Hye Jeong
- Department of Neurology, Bundang Jesaeng General Hospital, Seongnam-si, South Korea
| | - Mun Kyung Sunwoo
- Department of Neurology, Bundang Jesaeng General Hospital, Seongnam-si, South Korea
| | - Jae Yong Lee
- Department of Neurology, Bundang Jesaeng General Hospital, Seongnam-si, South Korea
| | - Sun-Ku Han
- Department of Neurology, Bundang Jesaeng General Hospital, Seongnam-si, South Korea
| | - Sung Wook Hyung
- Department of Neurology, Bundang Jesaeng General Hospital, Seongnam-si, South Korea
| | - Yoo Sung Song
- Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seongnam-si, South Korea
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, South Korea
- *Correspondence: Yoo Sung Song
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16
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Bove F, Cavallieri F, Castrioto A, Meoni S, Schmitt E, Bichon A, Lhommée E, Pélissier P, Kistner A, Chevrier E, Seigneuret E, Chabardès S, Valzania F, Fraix V, Moro E. Does Motor Symptoms Asymmetry Predict Motor Outcome of Subthalamic Deep Brain Stimulation in Parkinson's Disease Patients? Front Hum Neurosci 2022; 16:931858. [PMID: 35799771 PMCID: PMC9253299 DOI: 10.3389/fnhum.2022.931858] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 05/23/2022] [Indexed: 12/02/2022] Open
Abstract
Background In Parkinson's disease (PD), the side of motor symptoms onset may influence disease progression, with a faster motor symptom progression in patients with left side lateralization. Moreover, worse neuropsychological outcomes after subthalamic nucleus deep brain stimulation (STN-DBS) have been described in patients with predominantly left-sided motor symptoms. The objective of this study was to evaluate if the body side of motor symptoms onset may predict motor outcome of bilateral STN-DBS. Methods This retrospective study included all consecutive PD patients treated with bilateral STN-DBS at Grenoble University Hospital from 1993 to 2015. Demographic, clinical and neuroimaging data were collected before (baseline condition) and 1 year after surgery (follow-up condition). The predictive factors of motor outcome at one-year follow-up, measured by the percentage change in the MDS-UPDRS-III score, were evaluated through univariate and multivariate linear regression analysis. Results A total of 233 patients were included with one-year follow-up after surgery [143 males (61.40%); 121 (51.90 %) right body onset; 112 (48.10%) left body onset; mean age at surgery, 55.31 ± 8.44 years; mean disease duration, 11.61 ± 3.87]. Multivariate linear regression analysis showed that the left side of motor symptoms onset did not predict motor outcome (β = 0.093, 95% CI = −1.967 to 11.497, p = 0.164). Conclusions In this retrospective study, the body side of motor symptoms onset did not significantly influence the one-year motor outcome in a large cohort of PD patients treated with bilateral STN-DBS.
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Affiliation(s)
- Francesco Bove
- Neurology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Francesco Cavallieri
- Neurology Unit, Department of Neuromotor and Rehabilitation, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
- *Correspondence: Francesco Cavallieri
| | - Anna Castrioto
- Division of Neurology, Grenoble Institute of Neurosciences, Inserm U1216, CHU of Grenoble, Grenoble Alpes University, Grenoble, France
| | - Sara Meoni
- Division of Neurology, Grenoble Institute of Neurosciences, Inserm U1216, CHU of Grenoble, Grenoble Alpes University, Grenoble, France
| | - Emmanuelle Schmitt
- Division of Neurology, Grenoble Institute of Neurosciences, Inserm U1216, CHU of Grenoble, Grenoble Alpes University, Grenoble, France
| | - Amélie Bichon
- Division of Neurology, Grenoble Institute of Neurosciences, Inserm U1216, CHU of Grenoble, Grenoble Alpes University, Grenoble, France
| | - Eugénie Lhommée
- Division of Neurology, Grenoble Institute of Neurosciences, Inserm U1216, CHU of Grenoble, Grenoble Alpes University, Grenoble, France
| | - Pierre Pélissier
- Division of Neurology, Grenoble Institute of Neurosciences, Inserm U1216, CHU of Grenoble, Grenoble Alpes University, Grenoble, France
| | - Andrea Kistner
- Division of Neurology, Grenoble Institute of Neurosciences, Inserm U1216, CHU of Grenoble, Grenoble Alpes University, Grenoble, France
| | - Eric Chevrier
- Division of Neurology, Grenoble Institute of Neurosciences, Inserm U1216, CHU of Grenoble, Grenoble Alpes University, Grenoble, France
| | - Eric Seigneuret
- Division of Neurosurgery, CHU of Grenoble, Grenoble Alpes University, Grenoble, France
| | - Stephan Chabardès
- Division of Neurosurgery, CHU of Grenoble, Grenoble Alpes University, Grenoble, France
| | - Franco Valzania
- Neurology Unit, Department of Neuromotor and Rehabilitation, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Valerie Fraix
- Division of Neurology, Grenoble Institute of Neurosciences, Inserm U1216, CHU of Grenoble, Grenoble Alpes University, Grenoble, France
| | - Elena Moro
- Division of Neurology, Grenoble Institute of Neurosciences, Inserm U1216, CHU of Grenoble, Grenoble Alpes University, Grenoble, France
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17
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Chen J, Jiang X, Wu J, Wu H, Zhou C, Guo T, Bai X, Liu X, Wen J, Cao Z, Gu L, Yang W, Pu J, Guan X, Xu X, Zhang B, Zhang M. Gray and white matter alterations in different predominant side and type of motor symptom in Parkinson's disease. CNS Neurosci Ther 2022; 28:1372-1379. [PMID: 35673762 PMCID: PMC9344082 DOI: 10.1111/cns.13877] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 05/12/2022] [Accepted: 05/20/2022] [Indexed: 11/29/2022] Open
Abstract
Background Parkinson's disease (PD) is highly heterogeneous reflected by different affected side of body and type of motor symptom. We aim to explore clinical characteristics and underlying brain structure alterations in PD with different predominant sides and motor types. Methods We recruited 161 PD patients and 50 healthy controls (HC). Patients were classified into four subtypes according to their predominant side and motor type: left akinetic/rigid‐dominant (LAR), left tremor‐dominant (LTD), right akinetic/rigid‐dominant (RAR), and right tremor‐dominant (RTD). All participants assessed motor and cognitive performances, then underwent T1‐weighted and diffusion tensor imaging scanning. A general linear model was used to compare neuroimaging parameters among five groups. Results Among four PD subtypes, patients of LAR subtype experienced the worst motor impairment, and only this subtype showed worse cognitive performance compared with HC. Compared with HC and other subtypes, LAR subtype showed a significant reduction in cortical thickness of the right caudal‐anterior‐cingulate gyrus and fractional anisotropy of the right cingulum bundle. Conclusions We demonstrated that LAR subtype had the worst clinical performance, which the severer damage in the right cingulate region might be the underlying mechanism. This study underscores the importance of classifying PD subtypes based on both the side and type of motor symptom for clinical intervention and research to optimize behavioral outcomes in the future.
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Affiliation(s)
- Jingwen Chen
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University of Medicine, Hangzhou, China
| | - Xianchen Jiang
- Quzhou Center for Disease Control and Prevention, Quzhou, China
| | - Jingjing Wu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University of Medicine, Hangzhou, China
| | - Haoting Wu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University of Medicine, Hangzhou, China
| | - Cheng Zhou
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University of Medicine, Hangzhou, China
| | - Tao Guo
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University of Medicine, Hangzhou, China
| | - Xueqin Bai
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University of Medicine, Hangzhou, China
| | - Xiaocao Liu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University of Medicine, Hangzhou, China
| | - Jiaqi Wen
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University of Medicine, Hangzhou, China
| | - Zhengye Cao
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University of Medicine, Hangzhou, China
| | - Luyan Gu
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University of Medicine, Hangzhou, China
| | - Wenyi Yang
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University of Medicine, Hangzhou, China
| | - Jiali Pu
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University of Medicine, Hangzhou, China
| | - Xiaojun Guan
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University of Medicine, Hangzhou, China
| | - Xiaojun Xu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University of Medicine, Hangzhou, China
| | - Baorong Zhang
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University of Medicine, Hangzhou, China
| | - Minming Zhang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University of Medicine, Hangzhou, China
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18
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Yassine S, Gschwandtner U, Auffret M, Achard S, Verin M, Fuhr P, Hassan M. Functional Brain Dysconnectivity in Parkinson's Disease: A 5-Year Longitudinal Study. Mov Disord 2022; 37:1444-1453. [PMID: 35420713 PMCID: PMC9543227 DOI: 10.1002/mds.29026] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/19/2022] [Accepted: 03/24/2022] [Indexed: 11/29/2022] Open
Abstract
Background Tracking longitudinal functional brain dysconnectivity in Parkinson's disease (PD) is a key element to decoding the underlying physiopathology and understanding PD progression. Objectives The objectives of this follow‐up study were to explore, for the first time, the longitudinal changes in the functional brain networks of PD patients over 5 years and to associate them with their cognitive performance and the lateralization of motor symptoms. Methods We used a 5‐year longitudinal cohort of PD patients (n = 35) who completed motor and non‐motor assessments and sequent resting state (RS) high‐density electroencephalography (HD‐EEG) recordings at three timepoints: baseline (BL), 3 years follow‐up (3YFU) and 5 years follow‐up (5YFU). We assessed disruptions in frequency‐dependent functional networks over the course of the disease and explored their relation to clinical symptomatology. Results In contrast with HC (n = 32), PD patients showed a gradual connectivity impairment in α2 (10‐13 Hz) and β (13–30 Hz) frequency bands. The deterioration in the global cognitive assessment was strongly correlated with the disconnected networks. These disconnected networks were also associated with the lateralization of motor symptoms, revealing a dominance of the right hemisphere in terms of impaired connections in the left‐affected PD patients in contrast to dominance of the left hemisphere in the right‐affected PD patients. Conclusions Taken together, our findings suggest that with disease progression, dysconnectivity in the brain networks in PD can reflect the deterioration of global cognitive deficits and the lateralization of motor symptoms. RS HD‐EEG may be an early biomarker of PD motor and non‐motor progression. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society
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Affiliation(s)
- Sahar Yassine
- Univ Rennes, Inserm, LTSI - U1099, Rennes, F-35000, France.,NeuroKyma, Rennes, F-35000, France
| | - Ute Gschwandtner
- Department of Neurology, Hospitals of the University of Basel, Basel, Switzerland
| | - Manon Auffret
- Comportement et noyaux gris centraux, EA 4712, CHU Rennes, Rennes, France
| | - Sophie Achard
- CNRS, Grenoble INP, GIPSA-Lab, University of Grenoble Alpes, Grenoble, France
| | - Marc Verin
- Univ Rennes, Inserm, LTSI - U1099, Rennes, F-35000, France.,Comportement et noyaux gris centraux, EA 4712, CHU Rennes, Rennes, France.,Movement Disorders Unit, Neurology Department, Pontchaillou University Hospital, Rennes, France.,Institut des Neurosciences Cliniques de Rennes (INCR), Rennes, France
| | - Peter Fuhr
- Department of Neurology, Hospitals of the University of Basel, Basel, Switzerland
| | - Mahmoud Hassan
- MINDig, Rennes, F-35000, France.,School of Science and Engineering, Reykjavik University, Reykjavik, Iceland
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Garon M, Weis L, Fiorenzato E, Pistonesi F, Cagnin A, Bertoldo A, Anglani M, Cecchin D, Antonini A, Biundo R. Quantification of Brain β-Amyloid Load in Parkinson's Disease With Mild Cognitive Impairment: A PET/MRI Study. Front Neurol 2022; 12:760518. [PMID: 35300351 PMCID: PMC8921107 DOI: 10.3389/fneur.2021.760518] [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: 08/18/2021] [Accepted: 12/24/2021] [Indexed: 11/13/2022] Open
Abstract
Background Mild cognitive impairment in Parkinson's disease (PD-MCI) is associated with faster cognitive decline and conversion to dementia. There is uncertainty about the role of β-amyloid (Aβ) co-pathology and its contribution to the variability in PD-MCI profile and cognitive progression. Objective To study how presence of Aβ affects clinical and cognitive manifestations as well as regional brain volumes in PD-MCI. Methods Twenty-five PD-MCI patients underwent simultaneous PET/3T-MRI with [18F]flutemetamol and a clinical and neuropsychological examination allowing level II diagnosis. We tested pairwise differences in motor, clinical, and cognitive features with Mann–Whitney U test. We calculated [18F]flutemetamol (FMM) standardized uptake value ratios (SUVR) in striatal and cortical ROIs, and we performed a univariate linear regression analysis between the affected cognitive domains and the mean SUVR. Finally, we investigated differences in cortical and subcortical brain regional volumes with magnetic resonance imaging (MRI). Results There were 8 Aβ+ and 17 Aβ- PD-MCI. They did not differ for age, disease duration, clinical, motor, behavioral, and global cognition scores. PD-MCI-Aβ+ showed worse performance in the overall executive domain (p = 0.037). Subcortical ROIs analysis showed significant Aβ deposition in PD-MCI-Aβ+ patients in the right caudal and rostral middle frontal cortex, in precuneus, in left paracentral and pars triangularis (p < 0.0001), and bilaterally in the putamen (p = 0.038). Cortical regions with higher amyloid load correlated with worse executive performances (p < 0.05). Voxel-based morphometry (VBM) analyses showed no between groups differences. Conclusions Presence of cerebral Aβ worsens executive functions, but not motor and global cognitive abilities in PD-MCI, and it is not associated with middle-temporal cortex atrophy. These findings, together with the observation of significant proportion of PD-MCI-Aβ-, suggest that Aβ may not be the main pathogenetic determinant of cognitive deterioration in PD-MCI, but it would rather aggravate deficits in domains vulnerable to Parkinson primary pathology.
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Affiliation(s)
- Michela Garon
- Parkinson and Movement Disorders Unit, Department of Neuroscience, University of Padua, Padua, Italy
| | - Luca Weis
- Parkinson and Movement Disorders Unit, Department of Neuroscience, University of Padua, Padua, Italy
| | | | - Francesca Pistonesi
- Parkinson and Movement Disorders Unit, Department of Neuroscience, University of Padua, Padua, Italy
| | - Annachiara Cagnin
- Department of Neuroscience, University of Padua, Padua, Italy.,Padova Neuroscience Center, University of Padua, Padua, Italy
| | - Alessandra Bertoldo
- Padova Neuroscience Center, University of Padua, Padua, Italy.,Department of Information Engineering, University of Padua, Padua, Italy
| | | | - Diego Cecchin
- Padova Neuroscience Center, University of Padua, Padua, Italy.,Nuclear Medicine Unit, Department of Medicine - DIMED, Padua University Hospital, Padua, Italy
| | - Angelo Antonini
- Parkinson and Movement Disorders Unit, Department of Neuroscience, University of Padua, Padua, Italy.,Padova Neuroscience Center, University of Padua, Padua, Italy.,Study Center for Neurodegeneration, University of Padua, Padua, Italy
| | - Roberta Biundo
- Department of General Psychology, University of Padua, Padua, Italy.,Study Center for Neurodegeneration, University of Padua, Padua, Italy
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20
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Murtomäki K, Mertsalmi T, Jaakkola E, Mäkinen E, Levo R, Nojonen T, Eklund M, Nuuttila S, Lindholm K, Pekkonen E, Joutsa J, Noponen T, Ihalainen T, Kaasinen V, Scheperjans F. Gastrointestinal Symptoms and Dopamine Transporter Asymmetry in Early Parkinson's Disease. Mov Disord 2022; 37:1284-1289. [PMID: 35274368 PMCID: PMC9314058 DOI: 10.1002/mds.28986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 02/01/2022] [Accepted: 02/13/2022] [Indexed: 11/09/2022] Open
Abstract
Background The neurophysiological correlates of gastrointestinal symptoms (GISs) in Parkinson's disease (PD) are not well understood. It has been proposed that in patients with a gastrointestinal origin of PD dopaminergic neurodegeneration would be more symmetric. Objectives The aim is to assess the associations between GISs and asymmetry of nigrostriatal dopaminergic neurodegeneration in PD. Methods Ninety PD patients were assessed using motor and GIS scales and 123I‐FP‐CIT SPECT. We calculated the asymmetry index and the predominant side of motor symptoms and dopamine transporter (DAT) imaging defect and assessed their association with GISs. Results There were no significant differences in GISs between symmetric and asymmetric dopaminergic defect. Left predominant defect was related to more GIS and higher constipation scores. Conclusions GISs were associated with left predominant reduction in putaminal DAT binding but not asymmetry per se. It remains open whether left‐sided DAT deficit is related to more pronounced GI involvement or symptom perception in PD. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson Movement Disorder Society.
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Affiliation(s)
- Kirsi Murtomäki
- Department of Neurology, Helsinki University Hospital, and Clinicum, University of Helsinki, Helsinki, Finland
| | - Tuomas Mertsalmi
- Department of Neurology, Helsinki University Hospital, and Clinicum, University of Helsinki, Helsinki, Finland
| | - Elina Jaakkola
- Clinical Neurosciences, University of Turku, and Neurocenter, Turku University Hospital, Turku, Finland
| | - Elina Mäkinen
- Department of Neurology, Helsinki University Hospital, and Clinicum, University of Helsinki, Helsinki, Finland.,Clinical Neurosciences, University of Turku, and Neurocenter, Turku University Hospital, Turku, Finland
| | - Reeta Levo
- Department of Neurology, Helsinki University Hospital, and Clinicum, University of Helsinki, Helsinki, Finland
| | - Tanja Nojonen
- Department of Neurology, Helsinki University Hospital, and Clinicum, University of Helsinki, Helsinki, Finland
| | - Mikael Eklund
- Clinical Neurosciences, University of Turku, and Neurocenter, Turku University Hospital, Turku, Finland.,Turku PET Centre, Turku University Hospital, Turku, Finland.,Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Simo Nuuttila
- Clinical Neurosciences, University of Turku, and Neurocenter, Turku University Hospital, Turku, Finland
| | - Kari Lindholm
- Clinical Neurosciences, University of Turku, and Neurocenter, Turku University Hospital, Turku, Finland
| | - Eero Pekkonen
- Department of Neurology, Helsinki University Hospital, and Clinicum, University of Helsinki, Helsinki, Finland
| | - Juho Joutsa
- Clinical Neurosciences, University of Turku, and Neurocenter, Turku University Hospital, Turku, Finland.,Turku PET Centre, Turku University Hospital, Turku, Finland.,Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Tommi Noponen
- Department of Clinical Physiology and Nuclear Medicine, Department of Medical Physics, Turku University Hospital, Turku, Finland
| | - Toni Ihalainen
- HUS Medical Imaging Center, Clinical Physiology and Nuclear Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Valtteri Kaasinen
- Clinical Neurosciences, University of Turku, and Neurocenter, Turku University Hospital, Turku, Finland
| | - Filip Scheperjans
- Department of Neurology, Helsinki University Hospital, and Clinicum, University of Helsinki, Helsinki, Finland
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21
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Zhang L, Shen Q, Liao H, Li J, Wang T, Zi Y, Zhou F, Song C, Mao Z, Wang M, Cai S, Tan C. Aberrant Changes in Cortical Complexity in Right-Onset Versus Left-Onset Parkinson's Disease in Early-Stage. Front Aging Neurosci 2021; 13:749606. [PMID: 34819848 PMCID: PMC8606890 DOI: 10.3389/fnagi.2021.749606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 10/05/2021] [Indexed: 11/17/2022] Open
Abstract
There is increasing evidence to show that motor symptom lateralization in Parkinson’s disease (PD) is linked to non-motor features, progression, and prognosis of the disease. However, few studies have reported the difference in cortical complexity between patients with left-onset of PD (LPD) and right-onset of PD (RPD). This study aimed to investigate the differences in the cortical complexity between early-stage LPD and RPD. High-resolution T1-weighted magnetic resonance images of the brain were acquired in 24 patients with LPD, 34 patients with RPD, and 37 age- and sex-matched healthy controls (HCs). Cortical complexity including gyrification index, fractal dimension (FD), and sulcal depth was analyzed using surface-based morphometry via CAT12/SPM12. Familywise error (FWE) peak-level correction at p < 0.05 was performed for significance testing. In patients with RPD, we found decreased mean FD and mean sulcal depth in the banks of the left superior temporal sulcus (STS) compared with LPD and HCs. The mean FD in the left superior temporal gyrus (STG) was decreased in RPD compared with HCs. However, in patients with LPD, we did not identify significantly abnormal cortical complex change compared with HCs. Moreover, we observed that the mean FD in STG was negatively correlated with the 17-item Hamilton Depression Scale (HAMD) among the three groups. Our findings support the specific influence of asymmetrical motor symptoms in cortical complexity in early-stage PD and reveal that the banks of left STS and left STG might play a crucial role in RPD.
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Affiliation(s)
- Lin Zhang
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Qin Shen
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Haiyan Liao
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Junli Li
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Tianyu Wang
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, China.,Department of Radiology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yuheng Zi
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Fan Zhou
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Chendie Song
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Zhenni Mao
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Min Wang
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Sainan Cai
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Changlian Tan
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, China
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22
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Palermo G, Giannoni S, Bellini G, Siciliano G, Ceravolo R. Dopamine Transporter Imaging, Current Status of a Potential Biomarker: A Comprehensive Review. Int J Mol Sci 2021; 22:11234. [PMID: 34681899 PMCID: PMC8538800 DOI: 10.3390/ijms222011234] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 11/16/2022] Open
Abstract
A major goal of current clinical research in Parkinson's disease (PD) is the validation and standardization of biomarkers enabling early diagnosis, predicting outcomes, understanding PD pathophysiology, and demonstrating target engagement in clinical trials. Molecular imaging with specific dopamine-related tracers offers a practical indirect imaging biomarker of PD, serving as a powerful tool to assess the status of presynaptic nigrostriatal terminals. In this review we provide an update on the dopamine transporter (DAT) imaging in PD and translate recent findings to potentially valuable clinical practice applications. The role of DAT imaging as diagnostic, preclinical and predictive biomarker is discussed, especially in view of recent evidence questioning the incontrovertible correlation between striatal DAT binding and nigral cell or axon counts.
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Affiliation(s)
- Giovanni Palermo
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (G.P.); (S.G.); (G.B.); (G.S.)
| | - Sara Giannoni
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (G.P.); (S.G.); (G.B.); (G.S.)
- Unit of Neurology, San Giuseppe Hospital, 50053 Empoli, Italy
| | - Gabriele Bellini
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (G.P.); (S.G.); (G.B.); (G.S.)
| | - Gabriele Siciliano
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (G.P.); (S.G.); (G.B.); (G.S.)
| | - Roberto Ceravolo
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (G.P.); (S.G.); (G.B.); (G.S.)
- Center for Neurodegenerative Diseases, Unit of Neurology, Parkinson’s Disease and Movement Disorders, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
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