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Li X, Dong ZY, Dong M, Chen L. Early dopaminergic replacement treatment initiation benefits motor symptoms in patients with Parkinson's disease. Front Hum Neurosci 2024; 18:1325324. [PMID: 38807633 PMCID: PMC11131585 DOI: 10.3389/fnhum.2024.1325324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 04/29/2024] [Indexed: 05/30/2024] Open
Abstract
Background Parkinson's disease (PD) generally progresses slowly, but it is controversial whether delaying treatment accelerates the progression. Objective Determine the correlation between the time of dopaminergic replacement treatment initiation and the severity of clinical symptoms in PD, including motor and non-motor symptoms. Methods PD patients were divided between 155 people who were diagnosed de novo and 165 PD patients receiving dopamine replacement therapy. Basic patient characteristics included gender, age, age at onset, disease duration, and the time of dopaminergic replacement treatment initiation. We used MDS-UPDRS scores to evaluate the severity of motor symptoms and we also used the scale to assess the severity of non-motor symptoms such as cognition, mood, sleep, and quality of life. Results The mean time between symptom onset and the initiation of drug treatment was 31.0 (22.5) months. After adjusting for age, sex, age at onset, and disease duration, we found that the MDS-Unified Parkinson's Disease Rating Scale (UPDRS)-III score increased faster in the de novo group with a similar disease duration (F = 8.7, p = 0.0034) than the treatment group. The cumulative incidence of progression to H-Y score 3 in de novo PD group over disease duration was 39.7% in 50months and 92.2% in 100 months, while in treated group such cumulative incidence was 15.5% in 50 months, 51.4% in 100 months and 81.5% in 150 months. The cumulative incidence of patients in the de novo PD group was higher than that in the treated group (p = 0.001), suggesting that untreated patients were more likely to progress to the advanced stages. Symptoms onset, the time between symptom onset and treatment initiation, age, sex, and disease duration explained 28.95% of the total variation in the MDS-UPDRS-III score for motor symptoms. In drug-naïve patients, the time between symptom onset and treatment initiation explained 20.1% of the total variation in the MDS-UPDRS-III score for motor symptoms (t = 6.15, p < 0.001). Conclusions These data in our study showed that early dopaminergic replacement treatment have played a positive role in PD patients, while dopaminergic replacement delayed treatment might be detrimental to motor symptoms and non-motor state of PD patient. Recognizing early stage symptoms of PD and early diagnosis are of great significance to treatment.
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Affiliation(s)
- Xin Li
- Tianjin Medical University, Tianjin, China
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China
| | - Zhao-ying Dong
- Department of Neurology, Tianjin People's Hospital Tianjin Union Medical Center, Tianjin, China
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China
| | - Meng Dong
- Tianjin Medical University, Tianjin, China
| | - Lei Chen
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China
- Tianjin Key Laboratory of Cerebrovascular Diseases and Neurodegenerative Disease, Tianjin, China
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Matsumoto T, Koh J, Sakata M, Nakayama Y, Yorozu S, Taruya J, Takahashi M, Miyamoto K, Ito H. Noise Pareidolia Test in Parkinson's Disease and Atypical Parkinsonian Syndromes: A Retrospective Study. Cureus 2024; 16:e55436. [PMID: 38567204 PMCID: PMC10986643 DOI: 10.7759/cureus.55436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2024] [Indexed: 04/04/2024] Open
Abstract
INTRODUCTION Pareidolias, or visual misperceptions, are a non-motor symptom of Parkinson's disease (PD) with unclear pathophysiology. The noise pareidolia test (NPT) is a tool for screening pareidolias. The usefulness of the NPT in differentiating PD from atypical parkinsonian syndromes (APS) is also unknown. METHODS We retrospectively investigated 74 patients with PD and 18 patients with APS who took the NPT. Correlations between the number of pareidolic responses, gray matter volume, and cerebral blood flow were also examined in the patients with PD. RESULTS The median number of pareidolic responses in patients with PD and patients with APS was 0 (interquartile range (IQR): 0-3) and 0 (IQR: 0-1), respectively, and tended to be higher in patients with PD than in those with APS (p = 0.077). It was significantly higher in patients with PD who had hallucinations (2; IQR: 0-9) (p = 0.016). The area under the receiver operating characteristic curve for the number of pareidolic responses in the NPT was 0.62 when used to differentiate PD and APS, and the optimal cutoff number of pareidolic responses was 2/3. Sensitivity and specificity were 25.7% and 100%, respectively. In the PD group, the number of pareidolic responses was correlated with age (r = 0.27; p = 0.021) and the Frontal Assessment Battery (FAB) score (r = -0.34; p = 0.0099). Magnetic resonance imaging showed no significant correlation between the number of pareidolic responses and the volume of focal gray matter. On cerebral hypoperfusion mapping, the left parietal lobe had a significant correlation with the number of pareidolic responses (r = 0.35; p = 0.027). CONCLUSION The number of pareidolic responses in NPT was suggested to be useful as a red flag to rule out APS in differentiating PD from APS. In PD without dementia, the number of pareidolic responses was associated with reduced blood flow in the left parietal lobe.
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Affiliation(s)
- Takuya Matsumoto
- Department of Neurology, Wakayama Medical University, Wakayama, JPN
| | - Jinsoo Koh
- Department of Neurology, Wakayama Medical University, Wakayama, JPN
| | - Mayumi Sakata
- Department of Neurology, Wakayama Medical University, Wakayama, JPN
| | | | - Shoko Yorozu
- Department of Neurology, Wakayama Medical University, Wakayama, JPN
| | - Junko Taruya
- Department of Neurology, Wakayama Medical University, Wakayama, JPN
| | - Maiko Takahashi
- Department of Neurology, Wakayama Medical University, Wakayama, JPN
| | | | - Hidefumi Ito
- Department of Neurology, Wakayama Medical University, Wakayama, JPN
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Taubert J, Wally S, Dixson BJ. Preliminary evidence of an increased susceptibility to face pareidolia in postpartum women. Biol Lett 2023; 19:20230126. [PMID: 37700700 PMCID: PMC10498352 DOI: 10.1098/rsbl.2023.0126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 08/24/2023] [Indexed: 09/14/2023] Open
Abstract
As primates, we are hypersensitive to faces and face-like patterns in the visual environment, hence we often perceive illusory faces in otherwise inanimate objects, such as burnt pieces of toast and the surface of the moon. Although this phenomenon, known as face pareidolia, is a common experience, it is unknown whether our susceptibility to face pareidolia is static across our lifespan or what factors would cause it to change. Given the evidence that behaviour towards face stimuli is modulated by the neuropeptide oxytocin (OT), we reasoned that participants in stages of life associated with high levels of endogenous OT might be more susceptible to face pareidolia than participants in other stages of life. We tested this hypothesis by assessing pareidolia susceptibility in two groups of women; pregnant women (low endogenous OT) and postpartum women (high endogenous OT). We found evidence that postpartum women report seeing face pareidolia more easily than women who are currently pregnant. These data, collected online, suggest that our sensitivity to face-like patterns is not fixed and may change throughout adulthood, providing a crucial proof of concept that requires further research.
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Affiliation(s)
- Jessica Taubert
- School of Psychology, The University of Queensland, McElwain Building, St Lucia, 4072 Brisbane, Queensland, Australia
| | - Samantha Wally
- School of Psychology, The University of Queensland, McElwain Building, St Lucia, 4072 Brisbane, Queensland, Australia
| | - Barnaby J. Dixson
- School of Psychology, The University of Queensland, McElwain Building, St Lucia, 4072 Brisbane, Queensland, Australia
- Psychology and Social Sciences, The University of Sunshine Coast, Sippy Downs, Australia
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Effects of monotherapy with a monoamine oxidase B inhibitor on motor symptoms in Parkinson's disease are dependent on frontal function. Neurol Sci 2023; 44:913-918. [PMID: 36376554 DOI: 10.1007/s10072-022-06499-6] [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: 09/30/2022] [Accepted: 11/05/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Monotherapy with monoamine oxidase B (MAO-B) inhibitors enhances the level of endogenous dopamine in treatment for Parkinson's disease (PD) and provides some benefits. Certain neuropsychiatric functions are also regulated by central dopaminergic activity. AIM To investigate the relationship of the efficacy of monotherapy with MAO-B inhibitors on motor symptoms in PD with baseline cognitive function. PATIENTS AND METHODS Outcomes were examined for 27 consecutive drug-naïve PD patients who received initial treatment with a MAO-B inhibitor (selegiline: 11, rasagiline: 16). Selegiline was titrated to an optimal dose. The dose of rasagiline was fixed at 1 mg/day. Motor symptoms were assessed using the Movement Disorder Society-Unified Parkinson's Disease Rating Scale part III before treatment and after the efficacy reached a plateau within 19 weeks after drug initiation, and the % improvement in motor symptoms was calculated. Pre-treatment cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) and Frontal Assessment Battery (FAB). Correlations of % improvement in motor symptoms and baseline cognitive assessments were examined using Spearman correlation coefficients and multiple regression analysis. RESULTS In all patients, the mean % improvement in motor symptoms was 46.5% (range 0-83.3%). Spearman correlation coefficients showed the % improvement in motor symptoms was correlated with FAB (r = 0.631, p < 0.001). In multiple regression analysis with patient background factors as independent variables, only FAB was associated with improvement in motor symptoms in the MAO-B group. CONCLUSION Better FAB scores predict a significant improvement in motor symptoms with treatment with MAO-B inhibitors, suggesting high activity of endogenous dopamine.
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Zhong M, Li C, Lu H, Xue D, Wang Y, Jiang Y, Zhu S, Gu R, Jiang X, Shen B, Zhu J, Zhang W, Pan Y, Yan J, Zhang L. Aberrant gray matter volume and functional connectivity in Parkinson’s disease with minor hallucination. Front Aging Neurosci 2022; 14:923560. [PMID: 36185475 PMCID: PMC9522711 DOI: 10.3389/fnagi.2022.923560] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 08/22/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundMinor hallucination (MH) is the most common psychotic symptom in Parkinson’s disease (PD); it can develop into well-structured visual hallucination (VH), suggesting that MH may be a staccato form of well-structured VH. However, it remains unclear whether the pathogenesis is the same. Therefore, the aim of this study was to investigate the altered gray matter volume (GMV) and functional connectivity (FC) of MH in PD to further understand the complex mechanisms.Materials and methodsWe included 67 PD patients who attended the outpatient clinic of Nanjing Medical University Affiliated Brain Hospital and recruited 31 healthy controls (HC). Demographic data and clinical characteristics of all subjects were recorded, and cranial structural magnetic resonance imaging (MRI) and resting-state functional MRI data were acquired. Patients were classified into the PD with MH (PD-MH) group and PD without hallucinations or delusions (PD-NH) group. Voxel-based morphometry was used to analyze the differences in GMV in the structural pattern. Seed-based FC was used to analyze the functional pattern. Gaussian random field correction was used, with voxel level P < 0.001 and cluster level P < 0.05 representing statistically significant differences. Finally, the correlation between FC values and scores on the clinical characteristics assessment scale was analyzed.ResultsIn the GMV analysis, compared to the PD-NH group, the PD-MH group had reduced GMV in the medial superior frontal gyrus (SFGmed). In the FC analysis, the FC between the SFGmed and the left middle occipital gyrus and right calcarine sulcus decreased in the PD-MH group compared with the PD-NH group, while the FC between SFGmed and the left middle temporal gyrus increased. Correlation analysis revealed that the FC values of the SFGmed and right calcarine sulcus were correlated with the assessment scores for anxiety and sleep symptoms. The FC values of the SFGmed and left middle occipital gyrus were correlated with assessment scores for rapid eye movement disorder.ConclusionThe aberrant structure and function of the default mode network and visual processing areas seems to facilitate the generation of MH in PD, as the alteration was previously found in well-structured VH, suggesting that the two hallucinations have similar pathophysiological mechanisms.
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Affiliation(s)
- Min Zhong
- Department of Geriatric Neurology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Chenglin Li
- Department of Radiology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Hongquan Lu
- Department of Radiology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Donghui Xue
- Department of Geriatric Neurology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yaxi Wang
- Department of Geriatric Neurology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yinyin Jiang
- Department of Geriatric Neurology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Sha Zhu
- Department of Geriatric Neurology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Ruxin Gu
- Department of Geriatric Neurology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Xu Jiang
- Department of Geriatric Neurology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Bo Shen
- Department of Geriatric Neurology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Jun Zhu
- Department of Geriatric Neurology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Wenbin Zhang
- Department of Neurosurgery, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yang Pan
- Department of Geriatric Neurology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Jun Yan
- Department of Geriatric Neurology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Li Zhang
- Department of Geriatric Neurology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- Institute of Neuropsychiatric Diseases, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- *Correspondence: Li Zhang,
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Göbel N, Möller JC, Hollenstein N, Binder A, Oechsner M, Ide J, Urwyler P, Cazzoli D, Müri RM. Face Perception and Pareidolia Production in Patients With Parkinson's Disease. Front Neurol 2021; 12:669691. [PMID: 34413822 PMCID: PMC8370466 DOI: 10.3389/fneur.2021.669691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 07/09/2021] [Indexed: 11/13/2022] Open
Abstract
In Parkinson's disease (PD) patients, visual misperceptions are a major problem within the non-motor symptoms. Pareidolia, i.e., the tendency to perceive a specific, meaningful image in an ambiguous visual pattern, is a phenomenon that occurs also in healthy subjects. Literature suggests that the perception of face pareidolia may be increased in patients with neurodegenerative diseases. We aimed to examine, within the same experiment, face perception and the production of face pareidolia in PD patients and healthy controls (HC). Thirty participants (15 PD patients and 15 HC) were presented with 47 naturalistic photographs in which faces were embedded or not. The likelihood to perceive the embedded faces was modified by manipulating their transparency. Participants were asked to decide for each photograph whether a face was embedded or not. We found that PD patients were significantly less likely to recognize embedded faces than controls. However, PD patients also perceived faces significantly more often in locations where none were actually present than controls. Linear regression analyses showed that gender, age, hallucinations, and Multiple-Choice Vocabulary Intelligence Test (MWT) score were significant predictors of face pareidolia production in PD patients. Montreal Cognitive Assessment (MoCA) was a significant predictor for pareidolia production in PD patients in trials in which a face was embedded in another region [F (1, 13) = 24.4, p = <0.001]. We conclude that our new embedded faces paradigm is a useful tool to distinguish face perception performance between HC and PD patients. Furthermore, we speculate that our results observed in PD patients rely on disturbed interactions between the Dorsal (DAN) and Ventral Attention Networks (VAN). In photographs in which a face is present, the VAN may detect this as a behaviourally relevant stimulus. However, due to the deficient communication with the DAN in PD patients, the DAN would not direct attention to the correct location, identifying a face at a location where actually none is present.
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Affiliation(s)
- Nicole Göbel
- Perception and Eye Movement Laboratory, Departments of Neurology and BioMedical Research, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland.,Department of Neurology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Jens Carsten Möller
- Rehaklinik Zihlschlacht, Centre for Neurological Rehabilitation, Zihlschlacht-Sitterdorf, Switzerland.,Department of Neurology, Philipps University, Marburg, Germany
| | - Nathalie Hollenstein
- Rehaklinik Zihlschlacht, Centre for Neurological Rehabilitation, Zihlschlacht-Sitterdorf, Switzerland
| | - Andreas Binder
- Rehaklinik Zihlschlacht, Centre for Neurological Rehabilitation, Zihlschlacht-Sitterdorf, Switzerland
| | - Matthias Oechsner
- Rehaklinik Zihlschlacht, Centre for Neurological Rehabilitation, Zihlschlacht-Sitterdorf, Switzerland
| | - Jörg Ide
- Rehaklinik Zihlschlacht, Centre for Neurological Rehabilitation, Zihlschlacht-Sitterdorf, Switzerland
| | - Prabitha Urwyler
- Department of Neurology, Inselspital, Bern University Hospital, Bern, Switzerland.,Gerontechnology and Rehabilitation Group, ARTORG Center, University of Bern, Bern, Switzerland
| | - Dario Cazzoli
- Perception and Eye Movement Laboratory, Departments of Neurology and BioMedical Research, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland.,Department of Neurology, Inselspital, Bern University Hospital, Bern, Switzerland.,Gerontechnology and Rehabilitation Group, ARTORG Center, University of Bern, Bern, Switzerland
| | - René M Müri
- Perception and Eye Movement Laboratory, Departments of Neurology and BioMedical Research, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland.,Department of Neurology, Inselspital, Bern University Hospital, Bern, Switzerland.,Gerontechnology and Rehabilitation Group, ARTORG Center, University of Bern, Bern, Switzerland
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