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Descamps E, Boussac M, Joineau K, Payoux P. Changes of cerebral functional connectivity induced by foot reflexology in a RCT. Sci Rep 2023; 13:17139. [PMID: 37816799 PMCID: PMC10564852 DOI: 10.1038/s41598-023-44325-x] [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: 02/20/2023] [Accepted: 10/06/2023] [Indexed: 10/12/2023] Open
Abstract
Non-Pharmacological Interventions (NPIs) are increasingly being introduced into healthcare, but their mechanisms are unclear. In this study, 30 healthy participants received foot reflexology (FR) and sham massage, and went through a resting-state functional magnetic resonance imaging (rs-fMRI) to evaluate NPIs effect on brain. Rs-fMRI revealed an effect of both NPIs on functional connectivity with changes occurring in the default-mode network, the sensorimotor network and a Neural Network Correlates of Pain (NNCP-a newly discovered network showing great robustness). Even if no differences were found between FR and SM, this study allowed to report brain biomarkers of well-being as well as the safety of NPIs. In further research, it could be relevant to study it in patients to look for a true reflexology induced-effect dependent of patient reported outcomes. Overall, these findings enrich the understanding of the neural correlates of well-being experienced with NPIs and provided insight into the basis of the mechanisms of NPIs.
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Affiliation(s)
- Emeline Descamps
- Inserm Unité ToNIC, UMR 1214, CHU PURPAN - Pavillon BAUDOT, Place du Dr Joseph Baylac, 31024, Toulouse CEDEX 3, France.
- CNRS, Toulouse, France.
| | - Mathilde Boussac
- Inserm Unité ToNIC, UMR 1214, CHU PURPAN - Pavillon BAUDOT, Place du Dr Joseph Baylac, 31024, Toulouse CEDEX 3, France.
| | - Karel Joineau
- Inserm Unité ToNIC, UMR 1214, CHU PURPAN - Pavillon BAUDOT, Place du Dr Joseph Baylac, 31024, Toulouse CEDEX 3, France
| | - Pierre Payoux
- Inserm Unité ToNIC, UMR 1214, CHU PURPAN - Pavillon BAUDOT, Place du Dr Joseph Baylac, 31024, Toulouse CEDEX 3, France
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Wang Y, Sun Z, Zhou Z. Aberrant changes of dynamic global synchronization in patients with Parkinson's disease. Acta Radiol 2023; 64:784-791. [PMID: 35484787 DOI: 10.1177/02841851221094967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Patients with Parkinson's disease (PD) have been documented with disrupted dynamic profiles of functional connectivity. However, the complementary information that is relevant to the dynamic pattern of global synchronization in patients with PD requires further investigation. PURPOSE To reveal the aberrant dynamic profiles of global synchronization involved in PD with a focus on temporal variability, strength, and property. MATERIAL AND METHODS A total of 46 patients with PD and 50 matched healthy controls (HCs) were enrolled. Degree centrality (DC) was used as the metric of global synchronization. The intergroup differences in the dynamic DC (dDC) pattern were compared, followed by further analysis of their clinical relevance in PD. RESULTS Relative to HCs, the PD group showed decreased dDC variability in right inferior occipital gyrus, right insula, right middle occipital gyrus (MOG), and bilateral postcentral gyrus. The dDC variability in the MOG was significantly correlated with MoCA score. Two states (state I and state II) were suggested. Relative to HCs, the PD group demonstrated a shorter mean dwell time (MDT) in state I, a longer MDT in state II, and fewer transitions. For the PD group, dDC properties were significantly correlated with UPDRS-III scores. In state II, significantly decreased dynamic dDC strength in bilateral supplementary motor area was observed in the PD group, with a significant correlation with UPDRS-III scores. CONCLUSION These findings on PD imply that dynamic alterations of global synchronization are engaged in the dysfunction of movement and cognition, deepening the understanding of deteriorations that underlie PD with complementary evidence.
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Affiliation(s)
- Yong Wang
- Department of Radiology, 372209Taizhou People's Hospital, Fifth Affiliated Hospital of Nantong University, Taizhou, Jiangsu, PR China
| | - Zhongru Sun
- Department of Radiology, 372209Taizhou People's Hospital, Fifth Affiliated Hospital of Nantong University, Taizhou, Jiangsu, PR China
| | - Zhijun Zhou
- Department of Radiology, 372209Taizhou People's Hospital, Fifth Affiliated Hospital of Nantong University, Taizhou, Jiangsu, PR China
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Jang JH, Kim J, Kwon O, Jung SY, Lee HJ, Cho SY, Park JM, Ko CN, Park SU, Kim H. Effectiveness and Therapeutic Mechanism of Pharmacopuncture for Pain in Parkinson's Disease: A Study Protocol for a Pilot Pragmatic Randomized, Assessor-Blinded, Usual Care-Controlled, Three-Arm Parallel Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1776. [PMID: 36767158 PMCID: PMC9914000 DOI: 10.3390/ijerph20031776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/06/2023] [Accepted: 01/17/2023] [Indexed: 06/18/2023]
Abstract
Pain in Parkinson's disease (PD) represents a complex phenotype known to decrease quality of life. This pragmatic randomized, controlled clinical trial evaluated the efficacy of pharmacopuncture (PA) for improving pain symptoms and investigated the corresponding therapeutic mechanisms in patients with PD. Ninety patients with PD-related pain were randomly allocated to receive either PA, manual acupuncture, or usual care in a 1:1:1 ratio; sixty healthy controls were included for comparative analysis of brain imaging data. Over 12 weeks, study treatment provided 2 days per week for 8 weeks with a follow-up period of 4 weeks. The primary outcome measure was the King's Parkinson's Disease Pain Scale score for assessing improvement in PD-related pain, including a sub-analysis to investigate the pattern of changes in pain according to a PD-related pain mechanism-based classification. Secondary outcome measures included a numerical rating scale-based assessment of the intensity and location of pain and changes in pain-associated symptoms, such as depression, anxiety, and sleep disorders. Exploratory outcome measures included structural and functional brain patterns on magnetic resonance imaging, blood molecular signature changes, gait analysis, facial expression and movement assessment in response to emotional stimuli, and a traditional Korean medicine syndrome differentiation questionnaire. The trial findings provided important clinical evidence for the effectiveness of PA in the management of PD-related pain and its associated symptoms, and helped elucidate the mechanism of its therapeutic effect on PD-related pain.
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Affiliation(s)
- Jung-Hee Jang
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
| | - Jieun Kim
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
| | - Ojin Kwon
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
| | - So Young Jung
- Clinical Research Coordinating Team, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
| | - Hye-Jin Lee
- Department of Korean Medicine Cardiology and Neurology, Graduate School, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Seung-Yeon Cho
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, 26, Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea
| | - Jung-Mi Park
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, 26, Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea
| | - Chang-Nam Ko
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, 26, Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea
| | - Seong-Uk Park
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, 26, Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea
| | - Hyungjun Kim
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
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Zheng JH, Sun WH, Ma JJ, Wang ZD, Chang QQ, Dong LR, Shi XX, Li MJ. Differences in Brain Activity Between Dopa-Responsive and -Unresponsive Pain in Parkinson's Disease. Pain Ther 2022; 11:959-970. [PMID: 35751780 PMCID: PMC9314530 DOI: 10.1007/s40122-022-00404-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 06/10/2022] [Indexed: 01/11/2023] Open
Abstract
INTRODUCTION Pain in Parkinson's disease is poorly understood, and most patients with pain do not respond to dopaminergic drugs. We aimed to explore the mechanisms of dopa-responsive and -unresponsive pain by comparing such patients against patients without pain in terms of neural activity and functional connectivity in the brain. METHODS We prospectively examined 31 Parkinson's patients with dopa-responsive pain, 51 with dopa-unresponsive pain and 93 without pain using resting-state functional magnetic resonance imaging. Neural activity was assessed in terms of the amplitude of low-frequency fluctuation, while functional connectivity was assessed based on analysis of regions of interest. RESULTS Patients with dopa-unresponsive pain showed significantly higher amplitude of low-frequency fluctuation in the right parahippocampal/lingual region than patients with no pain. However, there was no amplitude difference between the dopa-responsive pain group and the no pain group. Patients with dopa-unresponsive pain also differed significantly from patients with no pain in their functional connections between the superior temporal gyrus and other areas of cerebral cortex, between amygdala and thalamus and between the amygdala and putamen. Patients with dopa-responsive pain differed significantly from patients with no pain in their functional connections between temporal fusiform cortex and cerebellum, between precentral gyrus and temporal fusiform cortex and between precentral gyrus and cerebellum. CONCLUSIONS Regional neural activity and functional connectivity in the brain differ substantially among Parkinson's patients with dopa-unresponsive pain, dopa-responsive pain or no pain. Our results suggest that dopa-responsive and -unresponsive pain may arise through different mechanisms, which may help guide the development of targeted therapies.
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Affiliation(s)
- Jin Hua Zheng
- Department of Neurology, Henan Provincial People's Hospital, Weiwu Road, Building 7, Zhengzhou, 450003, Henan Province, People's Republic of China
- Department of Neurology, People's Hospital of Zhengzhou University, Zhengzhou, Henan Province, People's Republic of China
- Department of Neurology, People's Hospital of Henan University, Zhengzhou, Henan Province, People's Republic of China
| | - Wen Hua Sun
- Department of Neurology, Henan Provincial People's Hospital, Weiwu Road, Building 7, Zhengzhou, 450003, Henan Province, People's Republic of China
- Department of Neurology, People's Hospital of Zhengzhou University, Zhengzhou, Henan Province, People's Republic of China
| | - Jian Jun Ma
- Department of Neurology, Henan Provincial People's Hospital, Weiwu Road, Building 7, Zhengzhou, 450003, Henan Province, People's Republic of China.
- Department of Neurology, People's Hospital of Zhengzhou University, Zhengzhou, Henan Province, People's Republic of China.
- Department of Neurology, People's Hospital of Henan University, Zhengzhou, Henan Province, People's Republic of China.
| | - Zhi Dong Wang
- Department of Neurology, Henan Provincial People's Hospital, Weiwu Road, Building 7, Zhengzhou, 450003, Henan Province, People's Republic of China
- Department of Neurology, People's Hospital of Zhengzhou University, Zhengzhou, Henan Province, People's Republic of China
| | - Qing Qing Chang
- Department of Neurology, Henan Provincial People's Hospital, Weiwu Road, Building 7, Zhengzhou, 450003, Henan Province, People's Republic of China
- Department of Neurology, People's Hospital of Zhengzhou University, Zhengzhou, Henan Province, People's Republic of China
| | - Lin Rui Dong
- Department of Neurology, Henan Provincial People's Hospital, Weiwu Road, Building 7, Zhengzhou, 450003, Henan Province, People's Republic of China
- Department of Neurology, People's Hospital of Zhengzhou University, Zhengzhou, Henan Province, People's Republic of China
| | - Xiao Xue Shi
- Department of Neurology, Henan Provincial People's Hospital, Weiwu Road, Building 7, Zhengzhou, 450003, Henan Province, People's Republic of China
- Department of Neurology, People's Hospital of Zhengzhou University, Zhengzhou, Henan Province, People's Republic of China
| | - Ming Jian Li
- Department of Neurology, Henan Provincial People's Hospital, Weiwu Road, Building 7, Zhengzhou, 450003, Henan Province, People's Republic of China
- Department of Neurology, People's Hospital of Henan University, Zhengzhou, Henan Province, People's Republic of China
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Kinugawa K, Mano T, Yamatani Y, Miyasaka T, Kataoka H, Sugie K. Pain-Related Abnormal Neuronal Synchronization of the Nucleus Accumbens in Parkinson’s Disease. Brain Sci 2022; 12:brainsci12010084. [PMID: 35053828 PMCID: PMC8773786 DOI: 10.3390/brainsci12010084] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/16/2021] [Accepted: 01/05/2022] [Indexed: 02/04/2023] Open
Abstract
Patients with Parkinson’s disease (PD) often experience pain, which fluctuates in “on” and “off” states, but the underlying mechanism is unclear. The nucleus accumbens (NAc) is a central component of the mesolimbic dopaminergic pathway involved in pain processing. We conducted resting-state functional magnetic resonance imaging (rsfMRI) analysis to explore the relationship between the neuronal synchronization of NAc with pain-related brain regions and pain intensity in “on” and “off” states. We assessed 23 patients with sporadic PD based on rsfMRI and pain intensity using the revised Short-Form McGill Pain Questionnaire. Patients with PD displayed higher pain intensity scores in the “off” state than in the “on” state. The pain intensity in the “off” state was substantially correlated with the functional connectivity (FC) between the NAc and primary motor/sensory cortices and contralateral NAc. Changes in pain intensity from the “on” to “off” state displayed correlations with those between the right (rNA) and left NAc (lNAc) and the right precentral gyrus (rPreCG) /right insular cortex (rIC) from the “off” to “on” state. Aberrant bilateral NAc and rNAc–rPreCG/rIC FC in the “off” state were closely related to pain symptoms developed from the “on” to “off” states. These results suggest that the NAc in the mesolimbic pathway is related to pain in PD and may help understand the mechanism of pain development in patients with PD.
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Affiliation(s)
- Kaoru Kinugawa
- Department of Neurology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8521, Japan; (K.K.); (H.K.); (K.S.)
| | - Tomoo Mano
- Department of Neurology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8521, Japan; (K.K.); (H.K.); (K.S.)
- Correspondence: ; Tel.: +81-744-22-3051
| | - Yuya Yamatani
- Division of Central Radiology, Nara Medical University Hospital, 840 Shijo-cho, Kashihara 634-8521, Japan;
| | - Toshiteru Miyasaka
- Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8521, Japan;
| | - Hiroshi Kataoka
- Department of Neurology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8521, Japan; (K.K.); (H.K.); (K.S.)
| | - Kazuma Sugie
- Department of Neurology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8521, Japan; (K.K.); (H.K.); (K.S.)
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Kinugawa K, Mano T, Sugie K. Neuronal Dynamics of Pain in Parkinson's Disease. Brain Sci 2021; 11:brainsci11091224. [PMID: 34573244 PMCID: PMC8468705 DOI: 10.3390/brainsci11091224] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 09/05/2021] [Accepted: 09/14/2021] [Indexed: 11/16/2022] Open
Abstract
Pain is an important non-motor symptom of Parkinson’s disease (PD). It negatively impacts the quality of life. However, the pathophysiological mechanisms underlying pain in PD remain to be elucidated. This study sought to use electroencephalographic (EEG) coherence analysis to compare neuronal synchronization in neuronal networks between patients with PD, with and without pain. Twenty-four patients with sporadic PD were evaluated for the presence of pain. Time-frequency and coherence analyses were performed on their EEG data. Whole-brain and regional coherence were calculated and compared between pain-positive and pain-negative patients. There was no significant difference in the whole-brain coherence between the pain-positive and pain-negative groups. However, temporal–temporal coherence differed significantly between the two groups (p = 0.031). Our findings indicate that aberrant synchronization of inter-temporal regions is involved in PD-related pain. This will further our understanding of the mechanisms underlying pain in PD.
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McCoy B, Jahfari S, Engels G, Knapen T, Theeuwes J. Dopaminergic medication reduces striatal sensitivity to negative outcomes in Parkinson's disease. Brain 2019; 142:3605-3620. [PMID: 31603493 PMCID: PMC6821230 DOI: 10.1093/brain/awz276] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 07/13/2019] [Accepted: 07/17/2019] [Indexed: 01/07/2023] Open
Abstract
Reduced levels of dopamine in Parkinson's disease contribute to changes in learning, resulting from the loss of midbrain neurons that transmit a dopaminergic teaching signal to the striatum. Dopamine medication used by patients with Parkinson's disease has previously been linked to behavioural changes during learning as well as to adjustments in value-based decision-making after learning. To date, however, little is known about the specific relationship between dopaminergic medication-driven differences during learning and subsequent changes in approach/avoidance tendencies in individual patients. Twenty-four Parkinson's disease patients ON and OFF dopaminergic medication and 24 healthy controls subjects underwent functional MRI while performing a probabilistic reinforcement learning experiment. During learning, dopaminergic medication reduced an overemphasis on negative outcomes. Medication reduced negative (but not positive) outcome learning rates, while concurrent striatal blood oxygen level-dependent responses showed reduced prediction error sensitivity. Medication-induced shifts in negative learning rates were predictive of changes in approach/avoidance choice patterns after learning, and these changes were accompanied by systematic striatal blood oxygen level-dependent response alterations. These findings elucidate the role of dopamine-driven learning differences in Parkinson's disease, and show how these changes during learning impact subsequent value-based decision-making.
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Affiliation(s)
- Brónagh McCoy
- Department of Experimental and Applied Psychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - Sara Jahfari
- Spinoza Centre for Neuroimaging, Royal Academy of Sciences, Amsterdam, The Netherlands
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Gwenda Engels
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - Tomas Knapen
- Department of Experimental and Applied Psychology, Vrije Universiteit, Amsterdam, The Netherlands
- Spinoza Centre for Neuroimaging, Royal Academy of Sciences, Amsterdam, The Netherlands
| | - Jan Theeuwes
- Department of Experimental and Applied Psychology, Vrije Universiteit, Amsterdam, The Netherlands
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