1
|
Waldthaler J, Sperlich A, König A, Stüssel C, Bremmer F, Timmermann L, Pedrosa D. High (130 Hz)- and mid (60 Hz)-frequency deep brain stimulation in the subthalamic nucleus differentially modulate response inhibition: A preliminary combined EEG and eye tracking study. Neuroimage Clin 2023; 37:103314. [PMID: 36630863 PMCID: PMC9841351 DOI: 10.1016/j.nicl.2023.103314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/23/2022] [Accepted: 01/02/2023] [Indexed: 01/06/2023]
Abstract
While deep brain stimulation (DBS) in the subthalamic nucleus (STN) improves motor functions in Parkinson's disease (PD), it may also increase impulsivity by interfering with the inhibition of reflexive responses. The aim of this study was to investigate if varying the pulse frequency of STN-DBS has a modulating effect on response inhibition and its neural correlates. For this purpose, 14 persons with PD repeated an antisaccade task in three stimulation settings (DBS off, high-frequency DBS (130 Hz), mid-frequency DBS (60 Hz)) in a randomized order, while eye movements and brain activity via high-density EEG were recorded. On a behavioral level, 130 Hz DBS stimulation had no effect on response inhibition measured as antisaccade error rate, while 60 Hz DBS induced a slight but significant reduction of directional errors compared with the DBS-off state and 130 Hz DBS. Further, stimulation with both frequencies decreased the onset latency of correct antisaccades, while increasing the latency of directional errors. Time-frequency domain analysis of the EEG data revealed that 60 Hz DBS was associated with an increase in preparatory theta power over a midfrontal region of interest compared with the off-DBS state which is generally regarded as a marker of increased cognitive control. While no significant differences in brain activity over mid- and lateral prefrontal regions of interest emerged between the 60 Hz and 130 Hz conditions, both stimulation frequencies were associated with a stronger midfrontal beta desynchronization during the mental preparation for correct antisaccades compared with DBS off-state which is discussed in the context of potentially enhanced proactive recruitment of the oculomotor network. Our preliminary findings suggest that mid-frequency STN-DBS may provide beneficial effects on response inhibition, while both 130 Hz- and 60 Hz STN-DBS may promote voluntary actions at the expense of slower reflexive responses.
Collapse
Affiliation(s)
- Josefine Waldthaler
- Department of Neurology, University Hospital Giessen and Marburg, Marburg, Germany; Department of Neurology, Philipps-University Marburg, Marburg, Germany; Center for Mind, Brain, and Behavior (CMBB), Philipps-University Marburg and Justus-Liebig-University, Giessen, Germany.
| | - Alexander Sperlich
- Department of Neurology, University Hospital Giessen and Marburg, Marburg, Germany; Department of Neurology, Philipps-University Marburg, Marburg, Germany
| | - Aylin König
- Department of Neurophysics, Philipps-University Marburg, Marburg, Germany
| | - Charlotte Stüssel
- Department of Neurology, University Hospital Giessen and Marburg, Marburg, Germany; Department of Neurology, Philipps-University Marburg, Marburg, Germany
| | - Frank Bremmer
- Center for Mind, Brain, and Behavior (CMBB), Philipps-University Marburg and Justus-Liebig-University, Giessen, Germany; Department of Neurophysics, Philipps-University Marburg, Marburg, Germany
| | - Lars Timmermann
- Department of Neurology, University Hospital Giessen and Marburg, Marburg, Germany; Department of Neurology, Philipps-University Marburg, Marburg, Germany; Center for Mind, Brain, and Behavior (CMBB), Philipps-University Marburg and Justus-Liebig-University, Giessen, Germany
| | - David Pedrosa
- Department of Neurology, University Hospital Giessen and Marburg, Marburg, Germany; Department of Neurology, Philipps-University Marburg, Marburg, Germany; Center for Mind, Brain, and Behavior (CMBB), Philipps-University Marburg and Justus-Liebig-University, Giessen, Germany
| |
Collapse
|
2
|
Yu Y, Yan W, Xu X, Zhang K, Si L, Liu X, Wang J, Song J, Sun H, Li X. Response times for reflexive saccades correlate with cognition in parkinson's disease, not disease severity or duration. Front Neurol 2022; 13:945201. [PMID: 36090872 PMCID: PMC9459151 DOI: 10.3389/fneur.2022.945201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 08/03/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveDementia is a common and serious non-motor symptom in Parkinson's disease (PD). We aimed to investigate the reflexive saccade in PD patients and explore its potential role as a biomarker for cognitive decline.MethodsUsing an infrared video-based eye tracker, we investigated reflexive saccades in 94 PD patients and 115 healthy controls (HCs). Saccadic parameters were compared between PD patients and HCs, and also among PD subgroups. The correlation of saccadic performance with disease duration, severity and cognition were further investigated.ResultsCompared with healthy controls, PD patients had prolonged and hypometric reflexive saccades even in early disease stage. Univariate and multivariate analysis showed that there was significant inverse relation between prolonged latency and MMSE in PD patients (P < 0.05); tremor dominant PD patients were more likely to have decreased velocity than non-tremor-dominant PD patients (P < 0.05); saccadic accuracy was found to have no significant relation with disease duration, H&Y staging or MMSE.ConclusionReflexive saccadic performance was abnormal in PD and worsened with cognitive decline. The negative correlation between prolonged latency and MMSE scores may make the reflexive saccade a potential predictor for cognitive decline in Parkinson's disease.
Collapse
Affiliation(s)
- Yaqin Yu
- Department of Neurology, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Weihong Yan
- Department of Neurology, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xin Xu
- Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China
| | - Kaili Zhang
- Department of Neurology, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lihong Si
- Department of Neurology, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaolei Liu
- Department of Neurology, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jinyu Wang
- Department of Neurology, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Junling Song
- Department of Neurology, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huanxin Sun
- Department of Neurology, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xinyi Li
- Department of Neurology, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Xinyi Li
| |
Collapse
|
3
|
Reverse Visually Guided Reaching in Patients with Parkinson’s Disease. PARKINSON'S DISEASE 2022; 2022:8132923. [PMID: 35386952 PMCID: PMC8979744 DOI: 10.1155/2022/8132923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 01/11/2022] [Accepted: 02/22/2022] [Indexed: 11/18/2022]
Abstract
In addition to motor symptoms such as difficulty in movement initiation and bradykinesia, patients with Parkinson’s disease (PD) display nonmotor executive cognitive dysfunction with deficits in inhibitory control. Preoperative psychological assessments are used to screen for impulsivity that may be worsened by deep brain stimulation (DBS) of the subthalamic nucleus (STN). However, it is unclear whether anti-Parkinson’s therapy, such as dopamine replacement therapy (DRT) or DBS, which has beneficial effects on motor function, adversely affects inhibitory control or its domains. The detrimental effects of STN-DBS are more apparent when tasks test the inhibition of habitual prepotent responses or involve complex cognitive loads. Our goal was to use a reverse visually guided reaching (RVGR) task, a hand-based version of the antisaccade task, to simultaneously measure motor performance and response inhibition in subjects with PD. We recruited 55 healthy control subjects, 26 PD subjects receiving treatment with DRTs, and 7 PD subjects receiving treatment with STN-DBS and DRTs. In the RVGR task, a cursor moved opposite to the subject’s hand movement. This was compared to visually guided reaching (VGR) where the cursor moved in the same direction as the subject’s hand movement. Reaction time, mean speed, and direction errors (in RVGR) were assessed. Reaction times were longer, and mean speeds were slower during RVGR compared to VGR in all three groups but worse in untreated subjects with PD. Treatment with DRTs, DBS, or DBS + DRT improved the reaction time and speed on the RVGR task to a greater extent than VGR. Additionally, DBS or DBS + DRT demonstrated an increase in direction errors, which was correlated with decreased reaction time. These results show that the RVGR task quantifies the benefit of STN-DBS on bradykinesia and the concomitant reduction of proactive inhibitory control. The RVGR task has the potential to be used to rapidly screen for preoperative deficits in inhibitory control and to titrate STN-DBS, to maximize the therapeutic benefits on movement, and minimize impaired inhibitory control.
Collapse
|
4
|
Bayot M, Gérard M, Derambure P, Dujardin K, Defebvre L, Betrouni N, Delval A. Functional networks underlying freezing of gait: a resting-state electroencephalographic study. Neurophysiol Clin 2022; 52:212-222. [PMID: 35351387 DOI: 10.1016/j.neucli.2022.03.003] [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: 11/12/2021] [Revised: 03/09/2022] [Accepted: 03/09/2022] [Indexed: 10/18/2022] Open
Abstract
INTRODUCTION The pathophysiology of freezing of gait in people with Parkinson's disease (PD) remains unclear, despite its association with motor, cognitive, limbic and sensory-perceptual impairments. Resting-state electroencephalography (EEG) may provide functional information for a better understanding of freezing of gait by studying spectral power and connectivity between brain regions in different frequency bands. METHODS High-resolution EEG was recorded in 36 patients with PD (18 freezers, 18 non-freezers), and 18 healthy controls during a 5-min resting-state protocol with eyes open, followed by a basic spectral analysis in the sensor space and a more advanced analysis of functional connectivity at the source level. RESULTS Freezers showed a diffusely higher theta-band relative spectral power than controls. This increased power was correlated with a deficit in executive control. Concerning resting-state functional connectivity, connectivity strength within a left fronto-parietal network appeared to be higher in freezers than in controls in the theta band, and to be correlated with freezing severity and a history of falls. CONCLUSION We have shown that spectral power and connectivity analyses of resting-state EEG provide useful and complementary information to better understand freezing of gait in PD. The higher connectivity strength seen within the left ventral attention network in freezers is in keeping with an excessive guidance of behavior by external cues, due to executive dysfunction, and spectral analysis also found changes in freezers that was closely correlated with executive control deficits. This exaggerated influence of the external environment might result in behavioral consequences that contribute to freezing of gait episodes. These findings should be further investigated with a longitudinal study.
Collapse
Affiliation(s)
- Madli Bayot
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Department of Clinical Neurophysiology, F-59000 Lille, France
| | - Morgane Gérard
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Department of Clinical Neurophysiology, F-59000 Lille, France
| | - Philippe Derambure
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Department of Clinical Neurophysiology, F-59000 Lille, France
| | - Kathy Dujardin
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Department of Neurology and Movement Disorders, F-59000 Lille, France
| | - Luc Defebvre
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Department of Neurology and Movement Disorders, F-59000 Lille, France
| | - Nacim Betrouni
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Department of Clinical Neurophysiology, F-59000 Lille, France
| | - Arnaud Delval
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Department of Clinical Neurophysiology, F-59000 Lille, France.
| |
Collapse
|
5
|
Waldthaler J, Stock L, Student J, Sommerkorn J, Dowiasch S, Timmermann L. Antisaccades in Parkinson's Disease: A Meta-Analysis. Neuropsychol Rev 2021; 31:628-642. [PMID: 33742354 PMCID: PMC8592977 DOI: 10.1007/s11065-021-09489-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 02/18/2021] [Indexed: 11/29/2022]
Abstract
The usefulness of eye-tracking tasks as potential biomarkers for motor or cognitive disease burden in Parkinson's disease (PD) has been subject of debate for many years. Several studies suggest that the performance in the antisaccade task may be altered in patients with PD and associated with motor disease severity or executive dysfunction. In this meta-analysis, random effects models were used to synthesize the existing evidence on antisaccade error rates and latency in PD. Furthermore, meta-regressions were performed to assess the role of motor and cognitive disease severity, dopaminergic medication and methodological factors. Additionally, the impact of acute levodopa administration and activation of deep brain stimulation was evaluated in two separate sub-analyses.This meta-analysis confirms that antisaccade latency and error rate are significantly increased in PD. Disease duration, Unified Parkinson's disease rating scale score and Hoehn and Yahr stage mediate the effect of PD on antisaccade latency with higher motor burden being associated with increased antisaccade latency.Acute administration of levodopa had no significant effects on antisaccade performance in a small number of eligible studies. Deep brain stimulation in the subthalamic nucleus, on the other hand, may alter the speed accuracy trade-off supporting an increase of impulsivity following deep brain stimulation in PD.According to the results of the meta-analysis, antisaccade latency may provide a potential marker for disease severity and progression in PD which needs further confirmation in longitudinal studies.
Collapse
Affiliation(s)
- Josefine Waldthaler
- Department of Neurology, University Hospital Marburg, 35033, Marburg, Germany.
- CMBB - Center for Mind, Brain and Behavior, Universities Gießen and Marburg, Marburg, Germany.
| | - Lena Stock
- Department of Neurology, University Hospital Marburg, 35033, Marburg, Germany
| | - Justus Student
- Department of Neurology, University Hospital Marburg, 35033, Marburg, Germany
| | - Johanna Sommerkorn
- Department of Neurology, University Hospital Marburg, 35033, Marburg, Germany
| | - Stefan Dowiasch
- CMBB - Center for Mind, Brain and Behavior, Universities Gießen and Marburg, Marburg, Germany
- Department of Neurophysics, University of Marburg, Marburg, Germany
- Thomas RECORDING GmbH, Giessen, Germany
| | - Lars Timmermann
- Department of Neurology, University Hospital Marburg, 35033, Marburg, Germany
- CMBB - Center for Mind, Brain and Behavior, Universities Gießen and Marburg, Marburg, Germany
| |
Collapse
|
6
|
Cui CK, Lewis SJG. Future Therapeutic Strategies for Freezing of Gait in Parkinson's Disease. Front Hum Neurosci 2021; 15:741918. [PMID: 34795568 PMCID: PMC8592896 DOI: 10.3389/fnhum.2021.741918] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 10/05/2021] [Indexed: 12/28/2022] Open
Abstract
Freezing of gait (FOG) is a common and challenging clinical symptom in Parkinson’s disease. In this review, we summarise the recent insights into freezing of gait and highlight the strategies that should be considered to improve future treatment. There is a need to develop individualised and on-demand therapies, through improved detection and wearable technologies. Whilst there already exist a number of pharmacological (e.g., dopaminergic and beyond dopamine), non-pharmacological (physiotherapy and cueing, cognitive training, and non-invasive brain stimulation) and surgical approaches to freezing (i.e., dual-site deep brain stimulation, closed-loop programming), an integrated collaborative approach to future research in this complex area will be necessary to systematically investigate new therapeutic avenues. A review of the literature suggests standardising how gait freezing is measured, enriching patient cohorts for preventative studies, and harnessing the power of existing data, could help lead to more effective treatments for freezing of gait and offer relief to many patients.
Collapse
Affiliation(s)
- Cathy K Cui
- ForeFront Parkinson's Disease Research Clinic, Brain and Mind Centre, School of Medical Sciences, The University of Sydney, Camperdown, NSW, Australia
| | - Simon J G Lewis
- ForeFront Parkinson's Disease Research Clinic, Brain and Mind Centre, School of Medical Sciences, The University of Sydney, Camperdown, NSW, Australia
| |
Collapse
|
7
|
Jin C, Qi S, Teng Y, Li C, Yao Y, Ruan X, Wei X. Altered Degree Centrality of Brain Networks in Parkinson's Disease With Freezing of Gait: A Resting-State Functional MRI Study. Front Neurol 2021; 12:743135. [PMID: 34707559 PMCID: PMC8542685 DOI: 10.3389/fneur.2021.743135] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 09/06/2021] [Indexed: 12/12/2022] Open
Abstract
Freezing of gait (FOG) in Parkinson's disease (PD) leads to devastating consequences; however, little is known about its functional brain network. We explored the differences in degree centrality (DC) of functional networks among PD with FOG (PD FOG+), PD without FOG (PD FOG–), and healthy control (HC) groups. In all, 24 PD FOG+, 37 PD FOG–, and 22 HCs were recruited and their resting-state functional magnetic imaging images were acquired. The whole brain network was analyzed using graph theory analysis. DC was compared among groups using the two-sample t-test. The DC values of disrupted brain regions were correlated with the FOG Questionnaire (FOGQ) scores. Receiver operating characteristic curve analysis was performed. We found significant differences in DC among groups. Compared with HCs, PD FOG+ patients showed decreased DC in the middle frontal gyrus (MFG), superior temporal gyrus (STG), parahippocampal gyrus (PhG), inferior temporal gyrus (ITG), and middle temporal gyrus (MTG). Compared with HC, PD FOG– presented with decreased DC in the MFG, STG, PhG, and ITG. Compared with PD FOG–, PD FOG+ showed decreased DC in the MFG and ITG. A negative correlation existed between the DC of ITG and FOGQ scores; the DC in ITG could distinguish PD FOG+ from PD FOG– and HC. The calculated AUCs were 81.3, 89.5, and 77.7% for PD FOG+ vs. HC, PD FOG– vs. HC, and PD FOG+ vs. PD FOG–, respectively. In conclusion, decreased DC of ITG in PD FOG+ patients compared to PD FOG– patients and HCs may be a unique feature for PD FOG+ and can likely distinguish PD FOG+ from PD FOG– and HC groups.
Collapse
Affiliation(s)
- Chaoyang Jin
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China
| | - Shouliang Qi
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China.,Key Laboratory of Intelligent Computing in Medical Image, Ministry of Education, Northeastern University, Shenyang, China
| | - Yueyang Teng
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China
| | - Chen Li
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China
| | - Yudong Yao
- Department of Electrical and Computer Engineering, Stevens Institute of Technology, Hoboken, NJ, United States
| | - Xiuhang Ruan
- Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Xinhua Wei
- Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| |
Collapse
|
8
|
Sousa NMF, Macedo RC, Brucki SMD. Cross-sectional associations between cognition and mobility in Parkinson's disease. Dement Neuropsychol 2021; 15:105-111. [PMID: 33907603 PMCID: PMC8049584 DOI: 10.1590/1980-57642021dn15-010011] [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] [Indexed: 12/04/2022] Open
Abstract
Cross-sectional studies show an association of decline in mental flexibility and
inhibitory control with reduced gait speed and falls, as well as divided
attention deficit and difficulty in initiating gait.
Collapse
Affiliation(s)
- Nariana Mattos Figueiredo Sousa
- Neurorehabilitation Program, Rede SARAH de Hospitais de Reabilitação - Salvador, BA, Brazil.,Department of Neurology, Faculdade de Medicina, Universidade de São Paulo - São Paulo, SP, Brazil
| | - Roberta Correa Macedo
- Neurorehabilitation Program, Rede SARAH de Hospitais de Reabilitação - Salvador, BA, Brazil
| | - Sonia Maria Dozzi Brucki
- Department of Neurology, Faculdade de Medicina, Universidade de São Paulo - São Paulo, SP, Brazil
| |
Collapse
|
9
|
Okada KI, Takahira M, Mano T, Uga T, Konaka K, Hosomi K, Saitoh Y. Concomitant improvement in anti-saccade success rate and postural instability gait difficulty after rTMS treatment for Parkinson's disease. Sci Rep 2021; 11:2472. [PMID: 33510266 PMCID: PMC7844238 DOI: 10.1038/s41598-021-81795-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 01/05/2021] [Indexed: 12/13/2022] Open
Abstract
Parkinson’s disease (PD) is a progressive neurological disorder characterised by motor and non-motor deficits. Repetitive transcranial magnetic stimulation (rTMS) over the bilateral primary motor cortex at a high frequency (5 Hz or higher) is reported to be a potential treatment of PD. We aimed to assess the effect of rTMS on eye movement control in patients with PD in their ‘on’ state. We enrolled 14 patients with PD and assessed motor symptoms (Movement Disorder Society-Sponsored Unified Parkinson’s Disease Rating Scale; MDS-UPDRS) and eye movement performances (visually guided saccades, volitional anti-saccades, and small involuntary saccades during fixation) at baseline and after administering bilateral 10 Hz rTMS on leg region of the motor cortex. We confirmed that rTMS improved the MDS-UPDRS motor scores and found that rTMS improved the anti-saccade success rate, which requires adequate inhibition of the reflexive response. The improvement in anti-saccade success rate was correlated with that of the postural instability gait difficulty (PIGD) sub-scores of MDS-UPDRS and lower baseline Japanese version of the Montreal Cognitive Assessment scores. This result is consistent with previous findings that PIGD and inhibitory control deficits share common brain dysfunctions in PD. rTMS may alleviate dysfunctions of that circuit and have a clinical effect.
Collapse
Affiliation(s)
- Ken-Ichi Okada
- Graduate School of Frontier Biosciences, Osaka University, 1-3 Yamadaoka, Suita, 565-0871, Japan.,Center for Information and Neural Networks (CiNet), National Institute of Information and Communications Technology, and Osaka University, 1-4 Yamadaoka, Suita, 565-0871, Japan.,Department of Physiology, Hokkaido University School of Medicine, Sapporo, 060-8638, Japan
| | - Mizuki Takahira
- Graduate School of Frontier Biosciences, Osaka University, 1-3 Yamadaoka, Suita, 565-0871, Japan
| | - Tomoo Mano
- Department of Neuromodulation and Neurosurgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan.,Department of Neurology, Nara Medical University, 840 Shijo-Cho, Kashihara, 634-8521, Japan
| | - Taichi Uga
- Graduate School of Frontier Biosciences, Osaka University, 1-3 Yamadaoka, Suita, 565-0871, Japan
| | - Kuni Konaka
- Department of Physical Therapy, Faculty of Health Science, Osaka Yukioka College of Health Science, 1-1-41 Soujiji, Ibaraki, 567-0801, Japan
| | - Koichi Hosomi
- Department of Neuromodulation and Neurosurgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan.,Department of Neurosurgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
| | - Youichi Saitoh
- Department of Neuromodulation and Neurosurgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan. .,Department of Neurosurgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan.
| |
Collapse
|
10
|
Moser C, Schmitt L, Schmidt J, Fairchild A, Klusek J. Response Inhibition Deficits in Women with the FMR1 Premutation are Associated with Age and Fall Risk. Brain Cogn 2020; 148:105675. [PMID: 33387817 DOI: 10.1016/j.bandc.2020.105675] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 12/04/2020] [Accepted: 12/19/2020] [Indexed: 12/12/2022]
Abstract
One in 113-178 females worldwide carry a premutation allele on the FMR1 gene. The FMR1 premutation is linked to neurocognitive and neuromotor impairments, although the phenotype is not fully understood, particularly with respect to age effects. This study sought to define oculomotor response inhibition skills in women with the FMR1 premutation and their association with age and fall risk. We employed an antisaccade eye-tracking paradigm to index oculomotor inhibition skills in 35 women with the FMR1 premutation and 28 control women. The FMR1 premutation group exhibited longer antisaccade latency and reduced accuracy relative to controls, indicating deficient response inhibition skills. Longer response latency was associated with older age in the FMR1 premutation and was also predictive of fall risk. Findings highlight the utility of the antisaccade paradigm for detecting early signs of age-related executive decline in the FMR1 premutation, which is related to fall risk. Findings support the need for clinical prevention efforts to decrease and delay the trajectory of age-related executive decline in women with the FMR1 premutation during midlife.
Collapse
Affiliation(s)
- Carly Moser
- Communication Sciences and Disorders, University of South Carolina, 1705 College Street, Columbia, South Carolina, 29208, USA
| | - Lyndsay Schmitt
- Communication Sciences and Disorders, University of South Carolina, 1705 College Street, Columbia, South Carolina, 29208, USA
| | - Joseph Schmidt
- Department of Psychology, University of Central Florida, 4111 Pictor Lane, Orlando, FL 32816, Orlando, Florida 32816, USA
| | - Amanda Fairchild
- Department of Psychology, University of South Carolina, 1512 Pendleton Street, Columbia, South Carolina, 29208, USA
| | - Jessica Klusek
- Communication Sciences and Disorders, University of South Carolina, 1705 College Street, Columbia, South Carolina, 29208, USA.
| |
Collapse
|
11
|
Ehgoetz Martens KA, Peterson DS, Almeida QJ, Lewis SJG, Hausdorff JM, Nieuwboer A. Behavioural manifestations and associated non-motor features of freezing of gait: A narrative review and theoretical framework. Neurosci Biobehav Rev 2020; 116:350-364. [PMID: 32603716 DOI: 10.1016/j.neubiorev.2020.06.026] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 06/19/2020] [Accepted: 06/22/2020] [Indexed: 12/30/2022]
Abstract
Over the past decade, non-motor related symptoms and provocative contexts have offered unique opportunities to gain insight into the potential mechanisms that may underpin freezing of gait (FOG) in Parkinson's disease (PD). While this large body of work has informed several theoretical models, to date, few are capable of explaining behavioural findings across multiple domains (i.e. cognitive, sensory-perceptual and affective) and in different behavorial contexts. As such, the exact nature of these interrelationships and their neural basis remain quite enigmatic. Here, the non-motor, behavioural evidence for cognitive, sensory-perceptual and affective contributors to FOG are reviewed and synthesized by systematically examining (i) studies that manipulated contextual environments that provoke freezing of gait, (ii) studies that uncovered factors that have been proposed to contribute to freezing, and (iii) studies that longitudinally tracked factors that predict the future development of freezing of gait. After consolidating the evidence, we offer a novel perspective for integrating these multi-faceted behavioural patterns and identify key challenges that warrant consideration in future work.
Collapse
Affiliation(s)
| | - Daniel S Peterson
- College of Health Solutions, Arizona State University, Arizona, USA; Phoenix Veterans Affairs Medical Centre, Arizona, USA
| | - Quincy J Almeida
- Movement Disorders Research & Rehabilitation Centre, Laurier University, Waterloo, ON, Canada
| | - Simon J G Lewis
- ForeFront Parkinson's Disease Research Clinic, Brain and Mind Centre, School of Medical Sciences, University of Sydney, Camperdown, New South Wales, Australia
| | - Jeffrey M Hausdorff
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; Dept of Physical Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Rush Alzheimer's Disease Center and Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Alice Nieuwboer
- Department of Rehabilitation Science, University of Leuven, Leuven, Belgium
| |
Collapse
|
12
|
Sousa NMF, Macedo RC. Relationship between cognitive performance and mobility in patients with Parkinson's disease: A cross-sectional study. Dement Neuropsychol 2019; 13:403-409. [PMID: 31844493 PMCID: PMC6907702 DOI: 10.1590/1980-57642018dn13-040006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Gait disorders may be associated with cognitive impairment, and slow speed
predicts cognitive impairment and dementia. Objective: To investigate the
relationships between cognitive function and gait performance in patients with
Parkinson’s disease (PD) who attended a hospital neurorehabilitation program.
Methods: Descriptive and inferential statistics (Pearson’s correlation) were
used for data analysis. The cognitive functions were evaluated through Digit
Span, Mental Control, Trail Making Test, Phonemic Verbal Fluency Task, and
Addenbrooke’s Cognitive Examination III. The motor function was assessed through
10-meter walk test, Mini BESTest and Timed Up and Go Test. Results: A total of
65 patients were included in this study. Of these, 66.15% were males, mean age
was 61.14 (8.39) years, mean educational was 12 (8) years, disease progression
time was 5.45 (4.37) years. 64.61% were in stages I and II of the Hoehn and Yahr
stage. The correlation analyses showed that balance skills are significantly
correlated with the ability to switch attention between two tasks and
visuospatial function. The function mobility showed a significant correlation
with cognitive tests. Conclusion: Data suggest the importance of the aspects of
switch attention and mental flexibility in gait, evidencing the greater
difficulty for double tasks.
Collapse
Affiliation(s)
| | - Roberta Correa Macedo
- Rede SARAH de Hospitais de Reabilitação Ringgold standard institution - Reabilitação Neurológica, Salvador, BA, Brazil
| |
Collapse
|
13
|
|
14
|
Lal V, Truong D. Eye movement abnormalities in movement disorders. Clin Park Relat Disord 2019; 1:54-63. [PMID: 34316601 PMCID: PMC8288550 DOI: 10.1016/j.prdoa.2019.08.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 08/26/2019] [Accepted: 08/27/2019] [Indexed: 11/12/2022] Open
Abstract
The visual system represents the most well-developed sensory system in humans, who are highly dependent on vision for organized response to their environment. The region of eye that is responsible for sharp central vision is the fovea. Thus, to see the world, images of objects of interest should fall on fovea. This is achieved through various sets of eye movements, all of which work together to keep the image of the target object on the fovea. It is therefore not surprising that a large part of the human brain is devoted to eye movements (e.g., several cortical and subcortical areas, including the brainstem, cerebellum and basal ganglia). Given that a large area of brain is devoted to eye movements, it is not surprising to find eye movement abnormalities in various brain disorders, including movement disorders. In fact, many of the movement disorders commonly encountered in clinical practice are associated with characteristic eye movement abnormalities that not only help in specific diagnosis, but also contribute to morbidity associated with these disorders. In this article, we review the pathophysiology, clinical characteristics, and significance of various eye movement abnormalities in patients with various movement disorders.
Collapse
Affiliation(s)
- Vivek Lal
- Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Daniel Truong
- The Truong Neuroscience Institute, Orange Coast Memorial Medical Center, Fountain Valley, CA 92708, USA
- Department of Psychiatry and Neuroscience, University of California Riverside, Riverside, CA, USA
| |
Collapse
|
15
|
Stuart S, Lawson RA, Yarnall AJ, Nell J, Alcock L, Duncan GW, Khoo TK, Barker RA, Rochester L, Burn DJ. Pro-Saccades Predict Cognitive Decline in Parkinson's Disease: ICICLE-PD. Mov Disord 2019; 34:1690-1698. [PMID: 31442355 DOI: 10.1002/mds.27813] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 07/10/2019] [Accepted: 07/12/2019] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Cumulative dementia incidence in Parkinson's disease (PD) is significant, with major personal and socioeconomic impacts on individuals with PD and their carers. Early identification of dementia risk is vital to ensuring optimal intervention. Saccadic deficits often distinguish neurodegenerative disorders and cognitive impairment, but their ability to predict cognitive decline in PD has yet to be determined. The aims of this study were to (1) evaluate baseline (6.4 ± 6.1 months since PD diagnosis) differences in pro-saccadic metrics between those with early PD and healthy age-matched adults; and (2) assess the ability of baseline pro-saccades to predict subsequent cognitive decline over 4.5 years. METHODS One hundred and forty-one PD and 90 age-matched participants recruited at diagnosis underwent saccadometric assessment of pro-saccades at baseline and had cognition assessed at baseline, 18, 36, and 54 months. Pro-saccadic characteristics included latency, duration, amplitude, peak, and average velocity. Cognitive assessment included executive function, attention, fluctuating attention, and memory. Linear mixed-effects models examined pro-saccadic metrics as predictors of cognitive decline over 54 months. RESULTS Pro-saccades were significantly impaired at baseline in PD compared with controls. Pro-saccadic characteristics of latency, duration, peak, and average velocity predicted decline in global cognition, executive function, attention, and memory over 54 months in PD. In addition, only reduction in global cognition and attention were predicted by pro-saccadic metrics in age-matched adults, indicating that PD findings were not purely age related. CONCLUSIONS Saccadic characteristics are impaired in early PD and are predictive of cognitive decline in several domains. Assessment of saccades may provide a useful non-invasive biomarker for long-term PD cognitive decline in early disease. © 2019 International Parkinson and Movement Disorder Society.
Collapse
Affiliation(s)
- Samuel Stuart
- Institute of Neuroscience/Newcastle University Institute for Ageing, Clinical Ageing Research Unit, Newcastle University, Newcastle Upon Tyne, UK.,Department of Neurology, Balance Disorders Laboratory, Oregon Health & Science University, Portland, Oregon, USA
| | - Rachael A Lawson
- Institute of Neuroscience/Newcastle University Institute for Ageing, Clinical Ageing Research Unit, Newcastle University, Newcastle Upon Tyne, UK
| | - Alison J Yarnall
- Institute of Neuroscience/Newcastle University Institute for Ageing, Clinical Ageing Research Unit, Newcastle University, Newcastle Upon Tyne, UK
| | - Jeremy Nell
- Institute of Neuroscience/Newcastle University Institute for Ageing, Clinical Ageing Research Unit, Newcastle University, Newcastle Upon Tyne, UK.,Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Lisa Alcock
- Institute of Neuroscience/Newcastle University Institute for Ageing, Clinical Ageing Research Unit, Newcastle University, Newcastle Upon Tyne, UK
| | - Gordon W Duncan
- Institute of Neuroscience/Newcastle University Institute for Ageing, Clinical Ageing Research Unit, Newcastle University, Newcastle Upon Tyne, UK.,Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Tien K Khoo
- School of Medicine & Menzies Health Institute Queensland, Griffith University, Australia.,School of Medicine, University of Wollongong, Wallongong, New South Wales, Australia
| | - Roger A Barker
- Cambridge University, John van Geest Centre for Brain Repair and Department of Neurology, E.D. Adrian Building, Cambridge, UK
| | - Lynn Rochester
- Institute of Neuroscience/Newcastle University Institute for Ageing, Clinical Ageing Research Unit, Newcastle University, Newcastle Upon Tyne, UK.,Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - David J Burn
- Faculty of Medical Science, Newcastle University, Newcastle Upon Tyne, UK
| | | |
Collapse
|
16
|
Jung I, Kim JS. Abnormal Eye Movements in Parkinsonism and Movement Disorders. J Mov Disord 2019; 12:1-13. [PMID: 30732429 PMCID: PMC6369379 DOI: 10.14802/jmd.18034] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 11/07/2018] [Accepted: 12/12/2018] [Indexed: 01/10/2023] Open
Abstract
Abnormal eye movements are commonly observed in movement disorders. Ocular motility examination should include bedside evaluation and laboratory recording of ocular misalignment, involuntary eye movements, including nystagmus and saccadic intrusions/oscillations, triggered nystagmus, saccades, smooth pursuit (SP), and the vestibulo-ocular reflex. Patients with Parkinson's disease (PD) mostly show hypometric saccades, especially for the selfpaced saccades, and impaired SP. Early vertical saccadic palsy is characteristic of progressive supranuclear palsy-Richardson's syndrome. Patients with cortico-basal syndrome typically show a delayed onset of saccades. Downbeat and gaze-evoked nystagmus and hypermetric saccades are characteristic ocular motor findings in ataxic disorders due to cerebellar dysfunction. In this review, we discuss various ocular motor findings in movement disorders, including PD and related disorders, ataxic syndromes, and hyperkinetic movement disorders. Systemic evaluation of the ocular motor functions may provide valuable information for early detection and monitoring of movement disorders, despite an overlap in the abnormal eye movements among different movement disorders.
Collapse
Affiliation(s)
- Ileok Jung
- Department of Neurology, Korea University College of Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Ji-Soo Kim
- Department of Neurology, Seoul National University College of Medicine, Seoul, Korea
- Dizziness Center, Clinical Neuroscience Center, and Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Korea
| |
Collapse
|
17
|
Srivastava A, Ahmad OF, Pacia CP, Hallett M, Lungu C. The Relationship between Saccades and Locomotion. J Mov Disord 2018; 11:93-106. [PMID: 30086615 PMCID: PMC6182301 DOI: 10.14802/jmd.18018] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 04/26/2018] [Indexed: 12/11/2022] Open
Abstract
Human locomotion involves a complex interplay among multiple brain regions and depends on constant feedback from the visual system. We summarize here the current understanding of the relationship among fixations, saccades, and gait as observed in studies sampling eye movements during locomotion, through a review of the literature and a synthesis of the relevant knowledge on the topic. A significant overlap in locomotor and saccadic neural circuitry exists that may support this relationship. Several animal studies have identified potential integration nodes between these overlapping circuitries. Behavioral studies that explored the relationship of saccadic and gait-related impairments in normal conditions and in various disease states are also discussed. Eye movements and locomotion share many underlying neural circuits, and further studies can leverage this interplay for diagnostic and therapeutic purposes.
Collapse
Affiliation(s)
- Anshul Srivastava
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Omar F Ahmad
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Christopher Pham Pacia
- Department of Biomedical Engineering, Washington University in St. Louis, Saint Louis, MO, USA
| | - Mark Hallett
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Codrin Lungu
- Division of Clinical Research, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| |
Collapse
|
18
|
Gorges M, Müller HP, Kassubek J. Structural and Functional Brain Mapping Correlates of Impaired Eye Movement Control in Parkinsonian Syndromes: A Systems-Based Concept. Front Neurol 2018; 9:319. [PMID: 29867729 PMCID: PMC5949537 DOI: 10.3389/fneur.2018.00319] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 04/23/2018] [Indexed: 01/18/2023] Open
Abstract
The investigation of the human oculomotor system by eye movement recordings provides an approach to behavior and its alterations in disease. The neurodegenerative process underlying parkinsonian syndromes, including Parkinson’s disease (PD), progressive supranuclear palsy (PSP), and multisystem atrophy (MSA) changes structural and functional brain organization, and thus affects eye movement control in a characteristic manner. Video-oculography has been established as a non-invasive recording device for eye movements, and systematic investigations of eye movement control in a clinical framework have emerged as a functional diagnostic tool in neurodegenerative parkinsonism. Disease-specific brain atrophy in parkinsonian syndromes has been reported for decades, these findings were refined by studies utilizing diffusion tensor imaging (DTI) and task-based/task-free functional MRI—both MRI techniques revealed disease-specific patterns of altered structural and functional brain organization. Here, characteristic disturbances of eye movement control in parkinsonian syndromes and their correlations with the structural and functional brain network alterations are reviewed. On this basis, we discuss the growing field of graph-based network analysis of the structural and functional connectome as a promising candidate for explaining abnormal phenotypes of eye movement control at the network level, both in health and in disease.
Collapse
Affiliation(s)
- Martin Gorges
- Department of Neurology, University of Ulm, Ulm, Germany
| | | | - Jan Kassubek
- Department of Neurology, University of Ulm, Ulm, Germany
| |
Collapse
|
19
|
Hall JM, Shine JM, Ehgoetz Martens KA, Gilat M, Broadhouse KM, Szeto JYY, Walton CC, Moustafa AA, Lewis SJG. Alterations in white matter network topology contribute to freezing of gait in Parkinson's disease. J Neurol 2018; 265:1353-1364. [PMID: 29616302 DOI: 10.1007/s00415-018-8846-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 03/16/2018] [Accepted: 03/21/2018] [Indexed: 12/31/2022]
Abstract
Freezing of gait (FOG) is a common symptom in advanced Parkinson's disease (PD). Despite current advances, the neural mechanisms underpinning this disturbance remain poorly understood. To this end, we investigated the structural organisation of the white matter connectome in PD freezers and PD non-freezers. We hypothesized that freezers would show an altered network architecture, which could hinder the effective information processing that characterizes the disorder. Twenty-six freezers and twenty-four well-matched non-freezers were included in this study. Using diffusion tensor imaging, we investigated the modularity and integration of the regional connectome by calculating the module degree z score and the participation coefficient, respectively. Compared to non-freezers, freezers demonstrated lower participation coefficients in the right caudate, thalamus, and hippocampus, as well as within superior frontal and parietal cortical regions. Importantly, several of these nodes were found within the brain's 'rich club'. Furthermore, group differences in module degree z scores within cortical frontal and sensory processing areas were found. Together, our results suggest that changes in the structural network topology contribute to the manifestation of FOG in PD, specifically due to a lack of structural integration between key information processing hubs of the brain.
Collapse
Affiliation(s)
- Julie M Hall
- School of Social Sciences and Psychology, Western Sydney University, Milperra, NSW, 2214, Australia
- Brain and Mind Centre, University of Sydney, 100 Mallett Street, Camperdown, NSW, 2050, Australia
| | - James M Shine
- Brain and Mind Centre, University of Sydney, 100 Mallett Street, Camperdown, NSW, 2050, Australia
| | | | - Moran Gilat
- Brain and Mind Centre, University of Sydney, 100 Mallett Street, Camperdown, NSW, 2050, Australia
| | - Kathryn M Broadhouse
- Brain and Mind Centre, University of Sydney, 100 Mallett Street, Camperdown, NSW, 2050, Australia
| | - Jennifer Y Y Szeto
- Brain and Mind Centre, University of Sydney, 100 Mallett Street, Camperdown, NSW, 2050, Australia
| | - Courtney C Walton
- Brain and Mind Centre, University of Sydney, 100 Mallett Street, Camperdown, NSW, 2050, Australia
| | - Ahmed A Moustafa
- School of Social Sciences and Psychology, Western Sydney University, Milperra, NSW, 2214, Australia
- MARCS Institute, Western Sydney University, Milperra, NSW, 2214, Australia
| | - Simon J G Lewis
- Brain and Mind Centre, University of Sydney, 100 Mallett Street, Camperdown, NSW, 2050, Australia.
| |
Collapse
|
20
|
|
21
|
Gilat M, Ehgoetz Martens KA, Miranda-Domínguez O, Arpan I, Shine JM, Mancini M, Fair DA, Lewis SJG, Horak FB. Dysfunctional Limbic Circuitry Underlying Freezing of Gait in Parkinson's Disease. Neuroscience 2018; 374:119-132. [PMID: 29408498 DOI: 10.1016/j.neuroscience.2018.01.044] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 01/18/2018] [Accepted: 01/20/2018] [Indexed: 11/18/2022]
Abstract
Freezing of gait (FOG) is a poorly understood symptom affecting many patients with Parkinson's disease (PD). Despite growing evidence of a behavioral link between anxiety, attention and FOG in PD, no research to date has investigated the neural mechanisms that might explain this relationship. The present study therefore examined resting-state MRI functional connectivity between the amygdala, striatum and frontoparietal attentional control network in PD patients with (freezers: n = 19) and without FOG (non-freezers: n = 21) in the dopaminergic 'off' state. Functional connectivity was subsequently correlated with an objective measure of FOG severity and a subjective scale of affective disorder within each group. Connectivity between the right amygdala and right putamen was significantly increased in freezers compared to non-freezers (p < 0.01). Furthermore, freezers showed increased anti-coupling between the frontoparietal network and left amygdala (p = 0.011), but reduced anti-coupling between this network and the right putamen (p = 0.027) as compared to non-freezers. Key functional connections between the amygdala, putamen and frontoparietal network were significantly associated with FOG severity and a fear of falling. This study provides the first evidence that dysfunctional fronto-striato-limbic processes may underpin the link between anxiety and FOG in PD. It is proposed that freezers have heightened striato-limbic load and reduced top-down attentional control at rest, which when further challenged by the parallel processing demands of walking may precipitate FOG.
Collapse
Affiliation(s)
- Moran Gilat
- Parkinson's Disease Research Clinic, Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia.
| | - Kaylena A Ehgoetz Martens
- Parkinson's Disease Research Clinic, Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
| | - Oscar Miranda-Domínguez
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR, USA
| | - Ishu Arpan
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA
| | - James M Shine
- Parkinson's Disease Research Clinic, Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
| | - Martina Mancini
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA
| | - Damien A Fair
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR, USA; Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA; Advanced Imaging Research Center, Oregon Health & Science University, Portland, OR, USA
| | - Simon J G Lewis
- Parkinson's Disease Research Clinic, Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
| | - Fay B Horak
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA; Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR, USA; Medical Veterans Affairs Portland Health Care System (VAPORHCS), Portland, OR, USA
| |
Collapse
|
22
|
The development of inhibitory saccadic trajectory deviations correlates with measures of antisaccadic inhibition. Neuroreport 2018; 27:1196-201. [PMID: 27607229 DOI: 10.1097/wnr.0000000000000672] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Chronological age is related positively to a participant's ability to inhibit distracting information. Inhibition can be measured using the trajectory deviation of a saccade. Saccadic curvature away from distracting visual information is controlled through top-down inhibition mediated by the frontal eye fields. In the present study, we aimed to further test the saccadic trajectory deviation paradigm's sensitivity to the development of frontal inhibitory procuresses by comparing its measure of saccadic inhibition with that of a widely used paradigm, namely, the antisaccade task. We show that the later 'inhibition' phase of the trajectory deviation function correlated strongly with the measure of antisaccadic inhibition obtained in the same individuals. As expected, the earlier 'capture' phase of the trajectory deviation function, which does not represent the involvement of frontal structures, did not correlate with antisaccadic inhibition. Further, both measures of frontal inhibition increased with chronological age.
Collapse
|
23
|
Ehgoetz Martens KA, Lukasik EL, Georgiades MJ, Gilat M, Hall JM, Walton CC, Lewis SJG. Predicting the onset of freezing of gait: A longitudinal study. Mov Disord 2017; 33:128-135. [PMID: 29150872 DOI: 10.1002/mds.27208] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 09/29/2017] [Accepted: 10/06/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Freezing of gait is a disabling symptom of Parkinson's disease that ultimately affects approximately 80% of patients, yet very little research has focused on predicting the onset of freezing of gait and tracking the longitudinal progression of symptoms prior to its onset. The objective of the current study was to examine longitudinal data spanning the transition period when patients with PD developed freezing of gait to identify symptoms that may precede freezing and create a prediction model that identifies those "at risk" for developing freezing of gait in the year to follow. METHODS Two hundred and twenty-one patients with PD were divided into 3 groups (88 nonfreezers, 41 transitional freezers, and 92 continuing freezers) based on their responses to the validated Freezing of Gait-Questionnaire item 3 at baseline and follow-up. Critical measures across motor, cognitive, mood, and sleep domains were assessed at 2 times approximately 1 year apart. RESULTS A logistic regression model that included age, disease duration, gait symptoms, motor phenotype, attentional set-shifting, and mood measures could predict with 70% and 90% accuracy those patients who would and would not develop, respectively, freezing of gait over the next year. Notably, the Freezing of Gait-Questionnaire total and the anxiety section of the Hospital Anxiety and Depression Scale were the strongest predictors and alone could significantly predict if one might develop freezing of gait in the next 15 months with 82% accuracy. CONCLUSIONS Our results suggest that it is possible to identify the majority of patients who will develop freezing of gait in the following year, potentially allowing targeted interventions to delay or possibly even prevent the onset of freezing. © 2017 International Parkinson and Movement Disorder Society.
Collapse
Affiliation(s)
| | - Emily L Lukasik
- Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, Sydney, Australia
| | - Matthew J Georgiades
- Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, Sydney, Australia
| | - Moran Gilat
- Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, Sydney, Australia
| | - Julie M Hall
- Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, Sydney, Australia.,School of Social Sciences and Psychology, Western Sydney University, Sydney, Australia
| | - Courtney C Walton
- Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, Sydney, Australia
| | - Simon J G Lewis
- Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, Sydney, Australia
| |
Collapse
|
24
|
Pretegiani E, Optican LM. Eye Movements in Parkinson's Disease and Inherited Parkinsonian Syndromes. Front Neurol 2017; 8:592. [PMID: 29170650 PMCID: PMC5684125 DOI: 10.3389/fneur.2017.00592] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 10/23/2017] [Indexed: 12/02/2022] Open
Abstract
Despite extensive research, the functions of the basal ganglia (BG) in movement control have not been fully understood. Eye movements, particularly saccades, are convenient indicators of BG function. Here, we review the main oculomotor findings reported in Parkinson’s disease (PD) and genetic parkinsonian syndromes. PD is a progressive, neurodegenerative disorder caused by dopaminergic cell loss within the substantia nigra pars compacta, resulting in depletion of striatal dopamine and subsequent increased inhibitory BG output from the internal globus pallidus and the substantia nigra pars reticulata. Eye movement abnormalities are common in PD: anomalies are more evident in voluntary than reflexive saccades in the initial stages, but visually guided saccades may also be involved at later stages. Saccadic hypometria (including abnormally fragmented saccades), reduced accuracy, and increased latency are among the most prominent deficits. PD patients show also unusually frequent and large square wave jerks and impaired inhibition of reflexive saccades when voluntary mirror saccades are required. Poor convergence ability and altered pursuit are common. Inherited parkinsonisms are a heterogeneous group of rare syndromes due to gene mutations causing symptoms resembling those of PD. Eye movement characteristics of some parkinsonisms have been studied. While sharing some PD features, each syndrome has a distinctive profile that could contribute to better define the clinical phenotype of parkinsonian disorders. Moreover, because the pathogenesis and the underlying neural circuit failure of inherited parkinsonisms are often well defined, they might offer a better prospect than idiopathic PD to understand the BG function.
Collapse
Affiliation(s)
- Elena Pretegiani
- Laboratory of Sensorimotor Research, National Eye Institute, NIH, Bethesda, MD, United States
| | - Lance M Optican
- Laboratory of Sensorimotor Research, National Eye Institute, NIH, Bethesda, MD, United States
| |
Collapse
|
25
|
Manza P, Amandola M, Tatineni V, Li CSR, Leung HC. Response inhibition in Parkinson's disease: a meta-analysis of dopaminergic medication and disease duration effects. NPJ Parkinsons Dis 2017; 3:23. [PMID: 28702504 PMCID: PMC5501877 DOI: 10.1038/s41531-017-0024-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 06/07/2017] [Accepted: 06/16/2017] [Indexed: 12/24/2022] Open
Abstract
Parkinson's disease is a neurodegenerative disorder involving the basal ganglia that results in a host of motor and cognitive deficits. Dopamine-replacement therapy ameliorates some of the hallmark motor symptoms of Parkinson's disease, but whether these medications improve deficits in response inhibition, a critical executive function for behavioral control, has been questioned. Several studies of Parkinson's disease patients "on" and "off" (12-h withdrawal) dopaminergic medications suggested that dopamine-replacement therapy did not provide significant response inhibition benefits. However, these studies tended to include patients with moderate-to-advanced Parkinson's disease, when the efficacy of dopaminergic drugs is reduced compared to early-stage Parkinson's disease. In contrast, a few recent studies in early-stage Parkinson's disease report that dopaminergic drugs do improve response inhibition deficits. Based on these findings, we hypothesized that Parkinson's disease duration interacts with medication status to produce changes in cognitive function. To investigate this issue, we conducted a meta-analysis of studies comparing patients with Parkinson's disease and healthy controls on tests of response inhibition (50 comparisons from 42 studies). The findings supported the hypothesis; medication benefited response inhibition in patients with shorter disease duration, whereas "off" medication, moderate deficits were present that were relatively unaffected by disease duration. These findings support the role of dopamine in response inhibition and suggest the need to consider disease duration in research of the efficacy of dopamine-replacement therapy on cognitive function in Parkinson's disease.
Collapse
Affiliation(s)
- Peter Manza
- Department of Psychology, Stony Brook University, Stony Brook, NY 11790 USA
| | - Matthew Amandola
- Department of Psychology, Stony Brook University, Stony Brook, NY 11790 USA
| | | | - Chiang-shan R. Li
- Department of Psychiatry, Yale University, New Haven, CT 06519 USA
- Department of Neuroscience, Yale University, New Haven, CT 06520 USA
- Interdepartmental Neuroscience Program, Yale University, New Haven, CT 06520 USA
- Beijing Huilongguan Hospital, Beijing, China
| | - Hoi-Chung Leung
- Department of Psychology, Stony Brook University, Stony Brook, NY 11790 USA
| |
Collapse
|
26
|
Okada KI, Kobayashi Y. Reward and Behavioral Factors Contributing to the Tonic Activity of Monkey Pedunculopontine Tegmental Nucleus Neurons during Saccade Tasks. Front Syst Neurosci 2016; 10:94. [PMID: 27891082 PMCID: PMC5104745 DOI: 10.3389/fnsys.2016.00094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 11/03/2016] [Indexed: 01/24/2023] Open
Abstract
The pedunculopontine tegmental nucleus (PPTg) in the brainstem plays a role in controlling reinforcement learning and executing conditioned behavior. We previously examined the activity of PPTg neurons in monkeys during a reward-conditioned, visually guided saccade task, and reported that a population of these neurons exhibited tonic responses throughout the task period. These tonic responses might depend on prediction of the upcoming reward, successful execution of the task, or both. Here, we sought to further distinguish these factors and to investigate how each contributes to the tonic neuronal activity of the PPTg. In our normal visually guided saccade task, the monkey initially fixated on the central fixation target (FT), then made saccades to the peripheral saccade target and received a juice reward after the saccade target disappeared. Most of the tonic activity terminated shortly after the reward delivery, when the monkey broke fixation. To distinguish between reward and behavioral epochs, we then changed the task sequence for a block of trials, such that the saccade target remained visible after the reward delivery. Under these visible conditions, the monkeys tended to continue fixating on the saccade target even after the reward delivery. Therefore, the prediction of the upcoming reward and the end of an individual trial were separated in time. Regardless of the task conditions, half of the tonically active PPTg neurons terminated their activity around the time of the reward delivery, consistent with the view that PPTg neurons might send reward prediction signals until the time of reward delivery, which is essential for computing reward prediction error in reinforcement learning. On the other hand, the other half of the tonically active PPTg neurons changed their activity dependent on the task condition. In the normal condition, the tonic responses terminated around the time of the reward delivery, while in the visible condition, the activity continued until the disappearance of the saccade target (ST) after reward delivery. Thus, for these neurons, the tonic activity might be related to maintaining attention to complete fixation behavior. These results suggest that, in addition to the reward value information, some PPTg neurons might contribute to the execution of conditioned task behavior.
Collapse
Affiliation(s)
- Ken-Ichi Okada
- Laboratories for Neuroscience, Visual Neuroscience Group, Graduate School of Frontier Biosciences, Osaka UniversityOsaka, Japan; Center for Information and Neural Networks, National Institute of Information and Communications Technology, Osaka UniversityOsaka, Japan
| | - Yasushi Kobayashi
- Laboratories for Neuroscience, Visual Neuroscience Group, Graduate School of Frontier Biosciences, Osaka UniversityOsaka, Japan; Center for Information and Neural Networks, National Institute of Information and Communications Technology, Osaka UniversityOsaka, Japan; Research Center for Behavioral Economics, Osaka UniversityOsaka, Japan
| |
Collapse
|
27
|
Georgiades MJ, Gilat M, Ehgoetz Martens KA, Walton CC, Bissett PG, Shine JM, Lewis SJ. Investigating motor initiation and inhibition deficits in patients with Parkinson’s disease and freezing of gait using a virtual reality paradigm. Neuroscience 2016; 337:153-162. [DOI: 10.1016/j.neuroscience.2016.09.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 09/05/2016] [Accepted: 09/11/2016] [Indexed: 10/21/2022]
|
28
|
Anxiety is associated with freezing of gait and attentional set-shifting in Parkinson's disease: A new perspective for early intervention. Gait Posture 2016; 49:431-436. [PMID: 27513741 DOI: 10.1016/j.gaitpost.2016.07.182] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 07/25/2016] [Accepted: 07/26/2016] [Indexed: 02/02/2023]
Abstract
Previous research has shown that anxiety in Parkinson's disease (PD) is associated with freezing of gait (FOG), and may even contribute to the underlying mechanism. However, limited research has investigated whether PD patients with FOG (PD+FOG) have higher anxiety levels when compared directly to non-freezing PD patients (PD-NF) and moreover, how anxiety might contribute to FOG. The current study evaluated whether: (i) PD+FOG have greater anxiety compared to PD-NF, and (ii) anxiety in PD is related to attentional set-shifting, in order to better understand how anxiety might be contributing to FOG. In addition, we explored whether anxiety levels differed between those PD patients with mild FOG (PD+MildFOG) compared to PD-NF. Four hundred and sixty-one patients with PD (231 PD-NF, 180 PD+FOG, 50 PD+MildFOG) were assessed using the Freezing of Gait Questionnaire item 3 (FOG-Q3), Hospital Anxiety and Depression Scale (HADS), Digit Span Test, Logical Memory Retention Test and Trail Making Tests. Compared to PD-NF, PD+FOG had significantly greater anxiety (p<0.001). PD+MildFOG, however, demonstrated similar levels of anxiety as the PD+FOG. In all patients, the severity of anxiety symptoms was significantly correlated to their degree of self-reported FOG on FOG-Q3 (p<0.001) and TMT B-A (p=0.039). Similar results were found for depression. In conclusion, these results confirm the key role played by anxiety in FOG and also suggest that anxiety might be a promising biomarker for FOG. Future research should consider whether treating anxiety with pharmacological and/or cognitive behavioural therapies at early stages of gait impairment in PD may alleviate troublesome FOG.
Collapse
|
29
|
Shine JM. Electrophysiological insights into freezing in Parkinson's disease. Clin Neurophysiol 2016; 127:2334-6. [PMID: 27178847 DOI: 10.1016/j.clinph.2016.03.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Accepted: 03/21/2016] [Indexed: 11/18/2022]
Affiliation(s)
- James M Shine
- Department of Psychology, Stanford University, Stanford, CA, USA; Neuroscience Research Australia, The University of New South Wales, Sydney, NSW, Australia.
| |
Collapse
|
30
|
Nemanich ST, Earhart GM. Freezing of gait is associated with increased saccade latency and variability in Parkinson's disease. Clin Neurophysiol 2016; 127:2394-401. [PMID: 27178858 DOI: 10.1016/j.clinph.2016.03.017] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 03/11/2016] [Accepted: 03/14/2016] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Freezing of gait (FOG) is a locomotor disturbance in Parkinson disease (PD) related to impaired motor automaticity. In this study, we investigated the impact of freezing on automaticity in the oculomotor system using an anti-saccade paradigm. METHODS Subjects with PD with (PD-FOG, n=13) and without (PD-NON, n=13) FOG, and healthy age-matched controls (CTRL, n=12) completed automatic pro-saccades and non-automatic anti-saccades. Primary outcomes were saccade latency, velocity, and gain. RESULTS PD-FOG (pro-saccade latency=271ms, anti-saccade latency=412ms) were slower to execute both types of saccades compared to PD-NON (253ms, 330ms) and CTRL (246ms, 327ms). Saccade velocity and gain variability was also increased in PD-FOG. CONCLUSIONS Saccade performance was affected in PD-FOG for both types of saccades, indicating differences in automaticity and control in the oculomotor system related to freezing. SIGNIFICANCE These results and others show that FOG impacts non-gait motor functions, suggesting global motor impairment in PD-FOG.
Collapse
Affiliation(s)
- Samuel T Nemanich
- Program in Physical Therapy, Washington University School of Medicine in St. Louis, 4444 Forest Park Ave., Campus Box 8502, St. Louis, MO 63108, USA
| | - Gammon M Earhart
- Program in Physical Therapy, Washington University School of Medicine in St. Louis, 4444 Forest Park Ave., Campus Box 8502, St. Louis, MO 63108, USA; Department of Neuroscience, Washington University School of Medicine in St. Louis, 660 S. Euclid Ave., Campus Box 8108, St. Louis, MO 63110, USA; Department of Neurology, Washington University School of Medicine in St. Louis, 660 S. Euclid Ave., Campus Box 8111, St. Louis, MO 63110, USA.
| |
Collapse
|