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Salomon A, Gazit E, Ginis P, Urazalinov B, Takoi H, Yamaguchi T, Goda S, Lander D, Lacombe J, Sinha AK, Nieuwboer A, Kirsch LC, Holbrook R, Manor B, Hausdorff JM. A machine learning contest enhances automated freezing of gait detection and reveals time-of-day effects. Nat Commun 2024; 15:4853. [PMID: 38844449 PMCID: PMC11156937 DOI: 10.1038/s41467-024-49027-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 05/22/2024] [Indexed: 06/09/2024] Open
Abstract
Freezing of gait (FOG) is a debilitating problem that markedly impairs the mobility and independence of 38-65% of people with Parkinson's disease. During a FOG episode, patients report that their feet are suddenly and inexplicably "glued" to the floor. The lack of a widely applicable, objective FOG detection method obstructs research and treatment. To address this problem, we organized a 3-month machine-learning contest, inviting experts from around the world to develop wearable sensor-based FOG detection algorithms. 1,379 teams from 83 countries submitted 24,862 solutions. The winning solutions demonstrated high accuracy, high specificity, and good precision in FOG detection, with strong correlations to gold-standard references. When applied to continuous 24/7 data, the solutions revealed previously unobserved patterns in daily living FOG occurrences. This successful endeavor underscores the potential of machine learning contests to rapidly engage AI experts in addressing critical medical challenges and provides a promising means for objective FOG quantification.
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Affiliation(s)
- Amit Salomon
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Eran Gazit
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Pieter Ginis
- KU Leuven, Department of Rehabilitation Science, Neuromotor Rehabilitation Research Group (eNRGy), Leuven, Belgium
| | | | | | | | | | | | | | | | - Alice Nieuwboer
- KU Leuven, Department of Rehabilitation Science, Neuromotor Rehabilitation Research Group (eNRGy), Leuven, Belgium
| | - Leslie C Kirsch
- Michael J. Fox Foundation for Parkinson's Research, New York, NY, USA
| | | | - Brad Manor
- Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife, Boston, MA, USA
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Harvard Medical School, MA, Boston, USA
| | - Jeffrey M Hausdorff
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Medical Center, Tel Aviv, Israel.
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.
- Department of Physical Therapy, Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel.
- Department of Orthopedic Surgery and Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.
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Li K, Wang M, Huang ZH, Wang M, Sun WY, Kurihara H, Huang RT, Wang R, Huang F, Liang L, Li YF, Duan WJ, He RR. ALOX5 inhibition protects against dopaminergic neurons undergoing ferroptosis. Pharmacol Res 2023:106779. [PMID: 37121496 DOI: 10.1016/j.phrs.2023.106779] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 04/06/2023] [Accepted: 04/21/2023] [Indexed: 05/02/2023]
Abstract
Oxidative disruption of dopaminergic neurons is regarded as a crucial pathogenesis in Parkinson's disease (PD), eventually causing neurodegenerative progression. (-)-Clausenamide (Clau) is an alkaloid isolated from plant Clausena lansium (Lour.), which is well-known as a scavenger of lipid peroxide products and exhibiting neuroprotective activities both in vivo and in vitro, yet with the in-depth molecular mechanism unrevealed. In this study, we evaluated the protective effects and mechanisms of Clau on dopaminergic neuron. Our results showed that Clau directly interacted with the Ser663 of ALOX5, the PKCα-phosphorylation site, and thus prevented the nuclear translocation of ALOX5, which was essential for catalyzing the production of toxic lipids 5-HETE. LC-MS/MS-based phospholipidomics analysis demonstrated that the oxidized membrane lipids were involved in triggering ferroptotic death in dopaminergic neurons. Furthermore, the inhibition of ALOX5 was found to significantly improving behavioral defects in PD mouse model, which was confirmed associated with the effects of attenuating the accumulation of lipid peroxides and neuronal damages. Collectively, our findings provide an attractive strategy for PD therapy by targeting ALOX5 and preventing ferroptosis in dopaminergic neurons.
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Affiliation(s)
- Kun Li
- Guangdong Engineering Research Center of Chinese Medicine & Disease Susceptibility/International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug Development of Chinese Ministry of Education (MOE)/Guangdong Province Key Laboratory of Pharmacodynamic Constituents of TCM and New Drugs Research
| | - Meng Wang
- Guangdong Engineering Research Center of Chinese Medicine & Disease Susceptibility/International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug Development of Chinese Ministry of Education (MOE)/Guangdong Province Key Laboratory of Pharmacodynamic Constituents of TCM and New Drugs Research
| | - Zi-Han Huang
- Guangdong Engineering Research Center of Chinese Medicine & Disease Susceptibility/International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug Development of Chinese Ministry of Education (MOE)/Guangdong Province Key Laboratory of Pharmacodynamic Constituents of TCM and New Drugs Research
| | - Min Wang
- Guangdong Engineering Research Center of Chinese Medicine & Disease Susceptibility/International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug Development of Chinese Ministry of Education (MOE)/Guangdong Province Key Laboratory of Pharmacodynamic Constituents of TCM and New Drugs Research
| | - Wan-Yang Sun
- Guangdong Engineering Research Center of Chinese Medicine & Disease Susceptibility/International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug Development of Chinese Ministry of Education (MOE)/Guangdong Province Key Laboratory of Pharmacodynamic Constituents of TCM and New Drugs Research
| | - Hiroshi Kurihara
- Guangdong Engineering Research Center of Chinese Medicine & Disease Susceptibility/International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug Development of Chinese Ministry of Education (MOE)/Guangdong Province Key Laboratory of Pharmacodynamic Constituents of TCM and New Drugs Research
| | - Rui-Ting Huang
- Guangdong Engineering Research Center of Chinese Medicine & Disease Susceptibility/International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug Development of Chinese Ministry of Education (MOE)/Guangdong Province Key Laboratory of Pharmacodynamic Constituents of TCM and New Drugs Research; State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China
| | - Rong Wang
- School of Chinese Materia Medica and Yunnan Key Laboratory of Southern Medicinal Utilization, Yunnan University of Chinese Medicine, Kunming 650500, China
| | - Feng Huang
- School of Chinese Materia Medica and Yunnan Key Laboratory of Southern Medicinal Utilization, Yunnan University of Chinese Medicine, Kunming 650500, China
| | - Lei Liang
- Guangdong Engineering Research Center of Chinese Medicine & Disease Susceptibility/International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug Development of Chinese Ministry of Education (MOE)/Guangdong Province Key Laboratory of Pharmacodynamic Constituents of TCM and New Drugs Research.
| | - Yi-Fang Li
- Guangdong Engineering Research Center of Chinese Medicine & Disease Susceptibility/International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug Development of Chinese Ministry of Education (MOE)/Guangdong Province Key Laboratory of Pharmacodynamic Constituents of TCM and New Drugs Research.
| | - Wen-Jun Duan
- Guangdong Engineering Research Center of Chinese Medicine & Disease Susceptibility/International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug Development of Chinese Ministry of Education (MOE)/Guangdong Province Key Laboratory of Pharmacodynamic Constituents of TCM and New Drugs Research.
| | - Rong-Rong He
- Guangdong Engineering Research Center of Chinese Medicine & Disease Susceptibility/International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug Development of Chinese Ministry of Education (MOE)/Guangdong Province Key Laboratory of Pharmacodynamic Constituents of TCM and New Drugs Research; State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China; School of Chinese Materia Medica and Yunnan Key Laboratory of Southern Medicinal Utilization, Yunnan University of Chinese Medicine, Kunming 650500, China.
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Zhou F, Tan C, Song C, Wang M, Yuan J, Liu Y, Cai S, Liu Q, Shen Q, Tang Y, Li X, Liao H. Abnormal intra- and inter-network functional connectivity of brain networks in early-onset Parkinson's disease and late-onset Parkinson's disease. Front Aging Neurosci 2023; 15:1132723. [PMID: 37032830 PMCID: PMC10080130 DOI: 10.3389/fnagi.2023.1132723] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 03/13/2023] [Indexed: 04/11/2023] Open
Abstract
Objective The purpose of this study is to look into the altered functional connectivity of brain networks in Early-Onset Parkinson's Disease (EOPD) and Late-Onset Parkinson's Disease (LOPD), as well as their relationship to clinical symptoms. Methods A total of 50 patients with Parkinson' disease (28 EOPD and 22 LOPD) and 49 healthy controls (25 Young Controls and 24 Old Controls) were admitted to our study. Employing independent component analysis, we constructed the brain networks of EOPD and Young Controls, LOPD and Old Controls, respectively, and obtained the functional connectivity alterations in brain networks. Results Cerebellar network (CN), Sensorimotor Network (SMN), Executive Control Network (ECN), and Default Mode Network (DMN) were selected as networks of interest. Compared with their corresponding health controls, EOPD showed increased functional connectivity within the SMN and ECN and no abnormalities of inter-network functional connectivity were found, LOPD demonstrated increased functional connectivity within the ECN while decreased functional connectivity within the CN. Furthermore, in LOPD, functional connectivity between the SMN and DMN was increased. The functional connectivity of the post-central gyrus within the SMN in EOPD was inversely correlated with the Unified Parkinson's Disease Rating Scale Part III scores. Age, age of onset, and MMSE scores are significantly different between EOPD and LOPD (p < 0.05). Conclusion There is abnormal functional connectivity of networks in EOPD and LOPD, which could be the manifestation of the associated pathological damage or compensation.
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Li Y, Huang X, Ruan X, Duan D, Zhang Y, Yu S, Chen A, Wang Z, Zou Y, Xia M, Wei X. Baseline cerebral structural morphology predict freezing of gait in early drug-naïve Parkinson's disease. NPJ Parkinsons Dis 2022; 8:176. [PMID: 36581626 PMCID: PMC9800563 DOI: 10.1038/s41531-022-00442-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 12/20/2022] [Indexed: 12/30/2022] Open
Abstract
Freezing of gait (FOG) greatly impacts the daily life of patients with Parkinson's disease (PD). However, predictors of FOG in early PD are limited. Moreover, recent neuroimaging evidence of cerebral morphological alterations in PD is heterogeneous. We aimed to develop a model that could predict the occurrence of FOG using machine learning, collaborating with clinical, laboratory, and cerebral structural imaging information of early drug-naïve PD and investigate alterations in cerebral morphology in early PD. Data from 73 healthy controls (HCs) and 158 early drug-naïve PD patients at baseline were obtained from the Parkinson's Progression Markers Initiative cohort. The CIVET pipeline was used to generate structural morphological features with T1-weighted imaging (T1WI). Five machine learning algorithms were calculated to assess the predictive performance of future FOG in early PD during a 5-year follow-up period. We found that models trained with structural morphological features showed fair to good performance (accuracy range, 0.67-0.73). Performance improved when clinical and laboratory data was added (accuracy range, 0.71-0.78). For machine learning algorithms, elastic net-support vector machine models (accuracy range, 0.69-0.78) performed the best. The main features used to predict FOG based on elastic net-support vector machine models were the structural morphological features that were mainly distributed in the left cerebrum. Moreover, the bilateral olfactory cortex (OLF) showed a significantly higher surface area in PD patients than in HCs. Overall, we found that T1WI morphometric markers helped predict future FOG occurrence in patients with early drug-naïve PD at the individual level. The OLF exhibits predominantly cortical expansion in early PD.
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Affiliation(s)
- Yuting Li
- grid.79703.3a0000 0004 1764 3838Department of Radiology, the Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangdong, China ,grid.284723.80000 0000 8877 7471Affiliated Dongguan Hospital, Southern Medical University (Dongguan People’s Hospital), Guangdong, China
| | - Xiaofei Huang
- grid.79703.3a0000 0004 1764 3838Department of Radiology, the Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangdong, China
| | - Xiuhang Ruan
- grid.79703.3a0000 0004 1764 3838Department of Radiology, the Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangdong, China
| | - Dingna Duan
- grid.20513.350000 0004 1789 9964State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Yihe Zhang
- grid.20513.350000 0004 1789 9964State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Shaode Yu
- grid.443274.20000 0001 2237 1871School of Information and Communication Engineering, Communication University of China, Beijing, China
| | - Amei Chen
- grid.79703.3a0000 0004 1764 3838Department of Radiology, the Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangdong, China
| | - Zhaoxiu Wang
- grid.79703.3a0000 0004 1764 3838Department of Radiology, the Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangdong, China
| | - Yujian Zou
- grid.284723.80000 0000 8877 7471Affiliated Dongguan Hospital, Southern Medical University (Dongguan People’s Hospital), Guangdong, China
| | - Mingrui Xia
- grid.20513.350000 0004 1789 9964State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Xinhua Wei
- grid.79703.3a0000 0004 1764 3838Department of Radiology, the Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangdong, China
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Zhou J, Chen Y, Gin T, Bao D, Zhou J. The effects of repetitive transcranial magnetic stimulation on standing balance and walking in older adults with age-related neurological disorders: a systematic review and meta-analysis. J Gerontol A Biol Sci Med Sci 2022; 78:842-852. [PMID: 35921153 PMCID: PMC10172986 DOI: 10.1093/gerona/glac158] [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: 04/06/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Considerable evidence showed that repetitive transcranial magnetic stimulation (rTMS) can improve standing balance and walking performance in older adults with age-related neurological disorders. We here thus completed a systematic review and meta-analysis to quantitatively examine such benefits of rTMS. METHODS A search strategy based on the PICOS principle was used to obtain the literature in four databases. The screening and assessments of quality and risk of bias in the included studies were independently completed by two researchers. Outcomes included scales related to standing balance, Timed Up and Go (TUG) time, and walking speed/time/distance. RESULTS Twenty-three studies consisting of 532 participants were included, and the meta-analysis was completed on 21 of these studies. The study quality was good. Compared to control, rTMS induced both short-term (≤3 days after last intervention session) and long-term (≥1 month following last intervention session) significant improvements in balance scales (e.g., Berg Balance Scale), TUG time, and walking speed/time/distance (short-term: standardized mean difference [SMD]=0.26~0.34, 95% confidence interval [CI]=0.05~0.62; long-term: SMD=0.40~0.44, 95% CI=0.04~0.79) for both PD and stroke cohorts. Subgroup analyses suggested that greater than nine sessions of high-frequency rTMS targeting primary motor cortex with greater than 3000 pulses per week can maximize such benefits. Only few mild-to-moderate adverse events/side effects were reported, which were similar between rTMS and control group. CONCLUSION The results suggest that rTMS holds promise to improve balance and walking performance in older adults with age-related neurological disorders. Future studies with more rigorous design are needed to confirm the observations in this work.
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Affiliation(s)
- Jun Zhou
- China Athletics College, Beijing Sport University, Beijing, China
| | - Yan Chen
- Sports Coaching College, Beijing Sport University, Beijing, China
| | - Trenton Gin
- Cornell University, Ithaca, New York, NY, United States
| | - Dapeng Bao
- China Institute of Sport and Health Science, Beijing Sport University, Beijing, China
| | - Junhong Zhou
- Hebrew SeniorLife Hinda and Arthur Marcus Institute for Aging Research, Harvard Medical School, Boston, MA, United States
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Steidel K, Ruppert MC, Palaghia I, Greuel A, Tahmasian M, Maier F, Hammes J, van Eimeren T, Timmermann L, Tittgemeyer M, Drzezga A, Pedrosa D, Eggers C. Dopaminergic pathways and resting-state functional connectivity in Parkinson's disease with freezing of gait. Neuroimage Clin 2021; 32:102899. [PMID: 34911202 PMCID: PMC8645514 DOI: 10.1016/j.nicl.2021.102899] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 11/23/2021] [Accepted: 11/24/2021] [Indexed: 11/15/2022]
Abstract
Freezing of gait is a common phenomenon of advanced Parkinson's disease. Besides locomotor function per se, a role of cognitive deficits has been suggested. Limited evidence of associated dopaminergic deficits points to caudatal denervation. Further, altered functional connectivity within resting-state networks with importance for cognitive functions has been described in freezers. A potential pathophysiological link between both imaging findings has not yet been addressed. The current study sought to investigate the association between dopaminergic pathway dysintegrity and functional dysconnectivity in relation to FOG severity and cognitive performance in a well-characterized PD cohort undergoing high-resolution 6-[18F]fluoro-L-Dopa PET and functional MRI. The freezing of gait questionnaire was applied to categorize patients (n = 59) into freezers and non-freezers. A voxel-wise group comparison of 6-[18F]fluoro-L-Dopa PET scans with focus on striatum was performed between both well-matched and neuropsychologically characterized patient groups. Seed-to-voxel resting-state functional connectivity maps of the resulting dopamine depleted structures and dopaminergic midbrain regions were created and compared between both groups. For a direct between-group comparison of dopaminergic pathway integrity, a molecular connectivity approach was conducted on 6-[18F]fluoro-L-Dopa scans. With respect to striatal regions, freezers showed significant dopaminergic deficits in the left caudate nucleus, which exhibited altered functional connectivity with regions of the visual network. Regarding midbrain structures, the bilateral ventral tegmental area showed altered functional coupling to regions of the default mode network. An explorative examination of the integrity of dopaminergic pathways by molecular connectivity analysis revealed freezing-associated impairments in mesolimbic and mesocortical pathways. This study represents the first characterization of a link between dopaminergic pathway dysintegrity and altered functional connectivity in Parkinson's disease with freezing of gait and hints at a specific involvement of striatocortical and mesocorticolimbic pathways in freezers.
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Affiliation(s)
- Kenan Steidel
- Department of Neurology, University Hospital of Marburg, Germany.
| | - Marina C Ruppert
- Department of Neurology, University Hospital of Marburg, Germany; Center for Mind, Brain and Behavior - CMBB, Universities Marburg and Gießen, Germany
| | - Irina Palaghia
- Department of Neurology, University Hospital of Marburg, Germany
| | - Andrea Greuel
- Department of Neurology, University Hospital of Marburg, Germany
| | - Masoud Tahmasian
- Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany; Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany
| | - Franziska Maier
- Department of Psychiatry, University Hospital Cologne, Medical Faculty, Cologne, Germany
| | - Jochen Hammes
- Multimodal Neuroimaging Group, Department of Nuclear Medicine, Medical Faculty and University Hospital Cologne, University Hospital Cologne, Germany
| | - Thilo van Eimeren
- Multimodal Neuroimaging Group, Department of Nuclear Medicine, Medical Faculty and University Hospital Cologne, University Hospital Cologne, Germany; Department of Neurology, Medical Faculty and University Hospital Cologne, University Hospital Cologne, Germany; German Center for Neurodegenerative Diseases (DZNE), Bonn- Cologne, Germany
| | - Lars Timmermann
- Department of Neurology, University Hospital of Marburg, Germany; Center for Mind, Brain and Behavior - CMBB, Universities Marburg and Gießen, Germany
| | - Marc Tittgemeyer
- Max Planck Institute for Metabolism Research, Cologne, Germany; Cluster of Excellence in Cellular Stress and Aging Associated Disease (CECAD), Cologne, Germany
| | - Alexander Drzezga
- Multimodal Neuroimaging Group, Department of Nuclear Medicine, Medical Faculty and University Hospital Cologne, University Hospital Cologne, Germany; German Center for Neurodegenerative Diseases (DZNE), Bonn- Cologne, Germany; Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-2), Research Center Jülich, Germany
| | - David Pedrosa
- Department of Neurology, University Hospital of Marburg, Germany; Center for Mind, Brain and Behavior - CMBB, Universities Marburg and Gießen, Germany
| | - Carsten Eggers
- Department of Neurology, University Hospital of Marburg, Germany; Center for Mind, Brain and Behavior - CMBB, Universities Marburg and Gießen, Germany
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Silveira-Ciola AP, Simieli L, Rinaldi NM, Barbieri FA. The starting distance of obstacle circumvention did not affect intersegmental coordination in individuals with Parkinson's disease. Hum Mov Sci 2021; 80:102878. [PMID: 34678580 DOI: 10.1016/j.humov.2021.102878] [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: 01/28/2021] [Revised: 08/18/2021] [Accepted: 09/17/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Obstacle circumvention is a challenging task in Parkinson's disease (PD). Body segments adjustments, such as changing the direction of the trunk, followed by a change in the direction of the head, and modifications in the positioning of the feet, are necessary to circumvent an obstacle during walking. For that, individuals need to identify the distance to the obstacle, its characteristics (such as its dimension), and perform well-coordinated movements. However, PD is characterized by rigidity, which may be increased in the axial axis and compromise the task execution. Also, worsening sensory integration in PD may increase the time to perform these body segments adjustments, thus impairing the movement coordination when starting obstacle circumvention near to the obstacle. AIM To determine if the starting distance (1.5 m, 3 m, or 5 m) from the obstacle could modify the intersegmental coordination (specifically, the coordination between head, trunk, and pelvis) during the obstacle circumvention steps in individuals with PD. METHODS Fourteen individuals with a diagnosis of idiopathic PD and 15 neurologically healthy individuals (CG) from the community were included in this study. The participants were evaluated in three different gait conditions, according to the starting distance from the obstacle: 1.5 m, 3 m, and 5 m away from the obstacle. Vector coding technique was employed to establish the coupling between head, trunk, and pelvis in the steps immediately before and during obstacle circumvention. Three-way ANOVA's (group, distance, and step) were calculated with the level of significance at p < 0.05. RESULTS For all couplings of coordination, there were no effects of distance. However, significant main effects of group and steps (p < 0.05) were found for all couplings with different patterns of coordination: head/pelvis (group: in-phase and anti-phase variables; steps: anti-phase variable), head/trunk (group: trunk variable; steps: in-phase and anti-phase variables) and trunk/pelvis (group: anti-phase; steps: trunk and pelvis). Finally, only head/trunk coupling showed an interaction between group*steps. Individuals with PD showed 7.95% lower head movement (p < 0.024) and 14.85% greater trunk movement than CG (p < 0.002). Also, individuals with PD performed 17.56% greater head movement in the step before the circumvention compared to the step during circumvention (p < 0.044). CONCLUSION The starting distance from the obstacle did not influence the pattern of axial intersegmental coordination in both groups. However, how these segments interact in the preparation and during the obstacle circumvention are opposite in individuals with PD. While on the previous step to obstacle circumvention, the head movement was greater than the trunk, during the obstacle circumvention step, individuals with PD rotated the trunk more.
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Affiliation(s)
- Aline Prieto Silveira-Ciola
- São Paulo State University (UNESP), School of Sciences, Department of Physical Education, Human Movement Research Laboratory (MOVI-LAB), Graduate Program in Movement Sciences, Bauru, SP, Brazil.
| | - Lucas Simieli
- São Paulo State University (UNESP), School of Sciences, Department of Physical Education, Human Movement Research Laboratory (MOVI-LAB), Graduate Program in Movement Sciences, Bauru, SP, Brazil
| | - Natália Madalena Rinaldi
- Federal University of Espírito Santo (UFES), Center of Physical Education and Sports (CEFD), Vitória, ES, Brazil
| | - Fabio Augusto Barbieri
- São Paulo State University (UNESP), School of Sciences, Department of Physical Education, Human Movement Research Laboratory (MOVI-LAB), Graduate Program in Movement Sciences, Bauru, SP, Brazil.
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Corticomuscular control of walking in older people and people with Parkinson's disease. Sci Rep 2020; 10:2980. [PMID: 32076045 PMCID: PMC7031238 DOI: 10.1038/s41598-020-59810-w] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 01/30/2020] [Indexed: 12/29/2022] Open
Abstract
Changes in human gait resulting from ageing or neurodegenerative diseases are multifactorial. Here we assess the effects of age and Parkinson’s disease (PD) on corticospinal activity recorded during treadmill and overground walking. Electroencephalography (EEG) from 10 electrodes and electromyography (EMG) from bilateral tibialis anterior muscles were acquired from 22 healthy young, 24 healthy older and 20 adults with PD. Event-related power, corticomuscular coherence (CMC) and inter-trial coherence were assessed for EEG from bilateral sensorimotor cortices and EMG during the double-support phase of the gait cycle. CMC and EMG power at low beta frequencies (13–21 Hz) was significantly decreased in older and PD participants compared to young people, but there was no difference between older and PD groups. Older and PD participants spent shorter time in the swing phase than young individuals. These findings indicate age-related changes in the temporal coordination of gait. The decrease in low-beta CMC suggests reduced cortical input to spinal motor neurons in older people during the double-support phase. We also observed multiple changes in electrophysiological measures at low-gamma frequencies during treadmill compared to overground walking, indicating task-dependent differences in corticospinal locomotor control. These findings may be affected by artefacts and should be interpreted with caution.
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Freezing of Gait can persist after an acute levodopa challenge in Parkinson's disease. NPJ PARKINSONS DISEASE 2019; 5:25. [PMID: 31799377 PMCID: PMC6874572 DOI: 10.1038/s41531-019-0099-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 10/31/2019] [Indexed: 02/01/2023]
Abstract
Study objectives included testing whether presumed levodopa-unresponsive freezing of gait (FOG) in Parkinson's disease (PD) actually persists in the presence of adequate dopaminergic dosing and to investigate whether the presence of other parkinsonian features and their responsiveness to therapy varies across patients without FOG (NO-FOG), with levodopa-responsive FOG (OFF-FOG), and with levodopa-unresponsive FOG (ONOFF-FOG). Fifty-five PD patients completed levodopa challenges after >12-h OFF with supratherapeutic doses of dopaminergic medications. Observed responses in FOG, measured with MDS-UPDRS-III during the patient reported full "ON", were used to classify them as NO-FOG, OFF-FOG, or ONOFF-FOG. Serum levodopa levels were measured. Only those with ≥20% improvement in MDS-UPDRS-III score were included in analyses. Levodopa challenge was sufficient to bring about a full "ON" state with ≥20% improvement in 45 patients. Levodopa-equivalent-dose utilized was 142 ± 56% of patients' typical morning doses. Overall, 19/45 patients exhibited FOG in the full "ON" state (ONOFF-FOG), 11 were classified as OFF-FOG, and 15 NO-FOG. Linear mixed models revealed a highly significant association between serum levodopa level and total MDS-UPDRS-III score that was similar across groups. The ONOFF-FOG group exhibited significantly higher New-FOG-questionnaire and MDS-UPDRS-II scores compared to the OFF-FOG group. Among MDS-UPDRS-III subdomains significant effects of group (highest in ONOFF-FOG) were identified for other axial parkinsonian features. We found that FOG can persist in the full "ON" state brought about by ample dopaminergic dosing in PD. Other axial measures can also be levodopa-unresponsive among those with ONOFF-FOG only. These data provide evidence that ONOFF-FOG is distinct from responsive freezing.
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Cabeleira MEP, Pagnussat AS, Pinho AS, Asquidamini ACD, Freire AB, Pereira BT, Mello Rieder CR, Schifino GP, Fornari LHT, Junior NDS, Corrêa PS, Cechetti F. Impairments in gait kinematics and postural control may not correlate with dopamine transporter depletion in individuals with mild to moderate Parkinson's disease. Eur J Neurosci 2019; 49:1640-1648. [DOI: 10.1111/ejn.14328] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 10/29/2018] [Accepted: 12/21/2018] [Indexed: 01/08/2023]
Affiliation(s)
| | - Aline Souza Pagnussat
- Federal University of Health Sciences of Porto AlegrePost‐Graduation Program in Rehabilitation Sciences Porto Alegre Brazil
- Federal University of Health Sciences of Porto AlegrePost‐Graduation Program in Health Sciences Porto Alegre Brazil
| | - Alexandre Severo Pinho
- Federal University of Health Sciences of Porto AlegrePost‐Graduation Program in Health Sciences Porto Alegre Brazil
| | - Ane Caroline Dotta Asquidamini
- Federal University of Health Sciences of Porto AlegrePost‐Graduation Program in Rehabilitation Sciences Porto Alegre Brazil
| | - Ariane Bolla Freire
- Federal University of Health Sciences of Porto AlegrePost‐Graduation Program in Rehabilitation Sciences Porto Alegre Brazil
| | - Brenda Tubelo Pereira
- Federal University of Health Sciences of Porto AlegrePost‐Graduation Program in Rehabilitation Sciences Porto Alegre Brazil
| | - Carlos Roberto Mello Rieder
- Federal University of Health Sciences of Porto AlegrePost‐Graduation Program in Rehabilitation Sciences Porto Alegre Brazil
- Federal University of Health Sciences of Porto AlegrePost‐Graduation Program in Health Sciences Porto Alegre Brazil
| | - Giulia Palermo Schifino
- Federal University of Health Sciences of Porto AlegrePost‐Graduation Program in Rehabilitation Sciences Porto Alegre Brazil
| | - Luis Henrique Tieppo Fornari
- Federal University of Health Sciences of Porto AlegrePost‐Graduation Program in Rehabilitation Sciences Porto Alegre Brazil
| | | | - Philipe Souza Corrêa
- Federal University of Health Sciences of Porto AlegrePost‐Graduation Program in Rehabilitation Sciences Porto Alegre Brazil
| | - Fernanda Cechetti
- Federal University of Health Sciences of Porto AlegrePost‐Graduation Program in Rehabilitation Sciences Porto Alegre Brazil
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11
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Gallardo MJ, Cabello JP, Corrales MJ, Torres-Donaire J, Bravo JJ, Talavera MP, León A, Vaamonde-Gamo J. Freezing of gait in Parkinson’s disease: functional neuroimaging studies of the frontal lobe. Neurol Res 2018; 40:900-905. [DOI: 10.1080/01616412.2018.1484985] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- María José Gallardo
- Neurology, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | - Juan Pablo Cabello
- Neurology, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | | | | | - Jose Javier Bravo
- Neurology, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | - María Prado Talavera
- Nuclear medicine, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | - Alberto León
- Neurology, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | - Julia Vaamonde-Gamo
- Neurology, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
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12
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Parry R, Buttelli O, Riff J, Sellam N, Vidailhet M, Welter ML, Lalo E. "The whole perimeter is difficult": Parkinson's disease and the conscious experience of walking in everyday environments. Disabil Rehabil 2018; 41:2784-2791. [PMID: 29916272 DOI: 10.1080/09638288.2018.1479779] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Purpose: This study sought to characterize the way patients with Parkinson's disease consciously perceive and respond to their surroundings while walking in everyday situations.Method: A qualitative research program designed around an ecological data collection protocol was employed. A convenience sample of 14 patients with a diagnosis of Parkinson's disease and a history of gait difficulties were recruited. Details regarding patients' subjective experience of walking in everyday environments were obtained using first person interviewing techniques with the support of video footage from their daily-life activity. Interview transcripts were analyzed using an interpretive phenomenological approach in order to derive key themes.Results: The sense of proximity and the way in which an individual perceived themselves with respect to their surroundings appeared central to the way patients organized their locomotor behavior. Further to this, the patient relationship to different features and obstacles appeared conditioned by prior experiences in those circumstances. Patients described managing gait difficulties by consciously regulating their walking trajectory and gaze with respect to their environment.Conclusion: Perceptual challenges, visual flow and the dynamic valence of features in the patient's surroundings may have important effects upon the gait stability of patients with Parkinson's disease and warrant further attention in planning rehabilitation interventions.Implications for rehabilitationWalking abilities of patients with Parkinson's disease should be conceptualized in terms of perceptuomotor coupling to a given environment.The functional significance of a patient's environment is dynamic and might be seen to vary in accordance with their physical capacities.Valency, or the subjective relationship between a patient and their surrounds, appears to be an important component of the "fit" between a person and their environment.Novel rehabilitation strategies for the management of parkinsonian gait disturbances might seek to integrate psychological, sensorimotor and environmental elements in order to have individually tailored, ecologically valid home assessment and community rehabilitation programs.
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Affiliation(s)
- Ross Parry
- Institut du Cerveau et de la Moelle épinière, Paris, France.,Institut des Systèmes Intelligents et de Robotique, Paris, France
| | | | - Jacques Riff
- Pôle STAPS, Université d'Orléans, Orléans, France
| | - Narjis Sellam
- Institut du Cerveau et de la Moelle épinière, Paris, France
| | - Marie Vidailhet
- Institut du Cerveau et de la Moelle épinière, Paris, France.,Département de Neurologie, Groupe Hospitalier Pitie´-Salpêtrière, Paris, France
| | - Marie-Laure Welter
- Institut du Cerveau et de la Moelle épinière, Paris, France.,Plateforme d'Analyse du Mouvement (PANAM-CENIR), Institut du Cerveau et de la Moelle Epinière, Paris, France.,Service de Neurophysiologie, Hôpital Charles Nicolle, Rouen, France
| | - Elodie Lalo
- Institut du Cerveau et de la Moelle épinière, Paris, France.,Pôle STAPS, Université d'Orléans, Orléans, France
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13
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Pietracupa S, Suppa A, Upadhyay N, Giannì C, Grillea G, Leodori G, Modugno N, Di Biasio F, Zampogna A, Colonnese C, Berardelli A, Pantano P. Freezing of gait in Parkinson's disease: gray and white matter abnormalities. J Neurol 2017; 265:52-62. [PMID: 29128929 DOI: 10.1007/s00415-017-8654-1] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 10/16/2017] [Accepted: 10/21/2017] [Indexed: 10/18/2022]
Abstract
Freezing of gait (FOG) is a disabling disorder that often affects Parkinson's disease (PD) patients in advanced stages of the disease. To study structural gray matter (GM) and white matter (WM) changes in PD patients with and without FOG, twenty-one PD patients with FOG (PD-FOG), 16 PD patients without FOG (PD-nFOG) and 19 healthy subjects (HS) underwent a standardized MRI protocol. For the gray matter evaluation, cortical volume (CV), cortical thickness (CTh), and surface area (SA) were analyzed using the FreeSurfer pipeline. For the white matter evaluation, DTI images were analyzed using tracts constrained by underlying anatomy (TRACULA) toolbox in FreeSurfer. PD-FOG patients exhibited lower CTh than HS in the mesial surface of both cerebral hemispheres, including the superior frontal gyrus, paracentral lobule, posterior cingulate cortex, precuneus and pericalcarine cortex, and in the right dorsolateral prefrontal cortex. Moreover, significant WM changes were observed in PD-FOG patients in comparison with HS in the superior longitudinal fasciculus, uncinate fasciculus, cingulum cingulate gyrus and inferior longitudinal fasciculus (prevalently in the right hemisphere) and in the frontal radiations of the corpus callosum. DTI abnormalities in specific WM bundles correlated significantly with cognitive measures. The damage of multiple cortical areas involved in high-level gait control together with WM disruption between motor, cognitive and limbic structures may represent the anatomical correlate of FOG.
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Affiliation(s)
| | - Antonio Suppa
- IRCCS Neuromed Institute, Pozzilli, IS, Italy.,Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Neeraj Upadhyay
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Costanza Giannì
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | | | - Giorgio Leodori
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | | | | | - Alessandro Zampogna
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Claudio Colonnese
- IRCCS Neuromed Institute, Pozzilli, IS, Italy.,Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Alfredo Berardelli
- IRCCS Neuromed Institute, Pozzilli, IS, Italy.,Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Patrizia Pantano
- IRCCS Neuromed Institute, Pozzilli, IS, Italy. .,Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy.
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14
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Naduthota RM, Honnedevasthana AA, Lenka A, Saini J, Geethanath S, Bharath RD, Christopher R, Yadav R, Gupta AK, Pal PK. Association of freezing of gait with nigral iron accumulation in patients with Parkinson's disease. J Neurol Sci 2017; 382:61-65. [PMID: 29111022 DOI: 10.1016/j.jns.2017.09.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 08/08/2017] [Accepted: 09/22/2017] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND PURPOSE The objective of this work was to investigate whether patients with and without freezing of gait (FOG) in Parkinson's disease (PD) have differences in iron accumulation in substantia nigra using R2* relaxometry. MATERIALS AND METHODS This study included seventeen PD patients with FOG [FOG (+)], equal number of age and gender matched patients without FOG [FOG (-)] and 34 healthy controls (HC). T2* images were obtained from a 3-Tesla MRI system using multi-echo sequence. R2* values were extracted from Substantia Nigra (SN) and red nucleus and were compared among the three groups and correlated with clinical findings. RESULTS R2* values were increased in PD group as a whole compared to HC in rostral and caudal segments of Substantia Nigra pars compacta (SNc) and in Substantia Nigra pars reticulata (SNr) but not in red nucleus. Within PD subgroups, FOG (+) group had increased iron accumulation in SNc compared to FOG (-) and HC. FOG score positively correlated with R2* values in the caudal region of SNc in FOG (+) group. CONCLUSIONS Our study reveals higher nigral iron content in FOG (+) compared to FOG (-) and HCs. In addition, we observed positive correlation of FOG score with iron accumulation in SNc. Results of this study emphasize possible role of higher nigral iron content in the pathogenesis of FOG in PD.
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Affiliation(s)
- Rajini M Naduthota
- Department of Neurology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India
| | - Arush Arun Honnedevasthana
- Medical Imaging Research Center, Dayanand Sagar Institutions, Kumara Swamy Layout, Bangalore 560078, India
| | - Abhishek Lenka
- Department of Neurology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India; Department of Clinical Neurosciences, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India
| | - Jitender Saini
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India
| | - Sairam Geethanath
- Medical Imaging Research Center, Dayanand Sagar Institutions, Kumara Swamy Layout, Bangalore 560078, India
| | - Rose Dawn Bharath
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India
| | - Rita Christopher
- Department of Neurochemistry, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India
| | - Ravi Yadav
- Department of Neurology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India
| | - Arun Kumar Gupta
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India
| | - Pramod Kumar Pal
- Department of Neurology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India.
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15
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Hu X, Jiang Y, Jiang X, Zhang J, Liang M, Li J, Zhang Y, Yao D, Luo C, Wang J. Altered Functional Connectivity Density in Subtypes of Parkinson's Disease. Front Hum Neurosci 2017; 11:458. [PMID: 28970788 PMCID: PMC5609108 DOI: 10.3389/fnhum.2017.00458] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 08/30/2017] [Indexed: 02/04/2023] Open
Abstract
Parkinson's disease (PD) can be classified into tremor-dominant and akinetic-rigid subtypes, each of which exhibits a unique clinical course and prognosis. The neural basis for these disparate manifestations is not well-understood, however. This study comprehensively investigated the altered functional connectivity patterns of these two subtypes. Twenty-five tremor-dominant patients, 25 akinetic-rigid patients and 26 normal control subjects participated in this study. Resting-state functional MRI data were analyzed using functional connectivity density (FCD) and seed-based functional connectivity approaches. Correlations between neuroimaging measures and clinical variables were also calculated. Compared with normal control, increased global FCD occurred most extensively in frontal lobe and cerebellum in both subtypes. Compared with akinetic-rigid patients, the tremor-dominant patients showed significantly increased global FCD in the cerebellum and decreased global FCD in portions of the bilateral frontal lobe. Furthermore, different subtypes demonstrated different cerebello-cortical functional connectivity patterns. Moreover, the identified FCD and functional connectivity correlated significantly with clinical variables in the PD patients, and particularly the FCD indices distinguished the different subtypes with high sensitivity (95%) and specificity (80%). These findings indicate that the functional connectivity patterns in the cerebellum and frontal lobe are altered in both subtypes of PD, especially cerebellum are highly related to tremor.
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Affiliation(s)
- Xiaofei Hu
- Department of Radiology, Southwest Hospital, Third Military Medical UniversityChongqing, China
| | - Yuchao Jiang
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of ChinaChengdu, China
| | - Xiaomei Jiang
- Department of Centre for Disease Prevention and Control, Chengdu Military RegionChengdu, China
| | - Jiuquan Zhang
- Department of Radiology, Southwest Hospital, Third Military Medical UniversityChongqing, China
| | - Minglong Liang
- Department of Radiology, Southwest Hospital, Third Military Medical UniversityChongqing, China
| | - Jing Li
- Department of Neurology, Southwest Hospital, Third Military Medical UniversityChongqing, China
| | - Yanling Zhang
- Department of Neurology, Southwest Hospital, Third Military Medical UniversityChongqing, China
| | - Dezhong Yao
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of ChinaChengdu, China
| | - Cheng Luo
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of ChinaChengdu, China
| | - Jian Wang
- Department of Radiology, Southwest Hospital, Third Military Medical UniversityChongqing, China
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16
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Freezing during tapping tasks in patients with advanced Parkinson's disease and freezing of gait. PLoS One 2017; 12:e0181973. [PMID: 28886015 PMCID: PMC5590736 DOI: 10.1371/journal.pone.0181973] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 07/10/2017] [Indexed: 11/19/2022] Open
Abstract
Introduction Parkinson’s disease patients with freezing of gait also experience sudden motor blocks (freezing) during other repetitive motor tasks. We assessed the proportion of patients with advanced PD and freezing of gait who also displayed segmental “freezing” in tapping tasks. Methods Fifteen Parkinson’s disease patients with freezing of gait were assessed. Freezing of gait was evaluated using a standardized gait trajectory with the usual triggers. Patients performed repetitive tapping movements (as described in the MDS-UPDRS task) with the hands or the feet in the presence or absence of a metronome set to 4 Hz. Movements were recorded with a video motion system. The primary endpoint was the occurrence of segmental freezing in these tapping tasks. The secondary endpoints were (i) the relationship between segmental episodic phenomena and FoG severity, and (ii) the reliability of the measurements. Results For the upper limbs, freezing was observed more frequently with a metronome (21% of trials) than without a metronome (5%). For the lower limbs, the incidence of freezing was higher than for the upper limbs, and was again observed more frequently in the presence of an auditory cue (47%) than in its absence (14%). Conclusion Although freezing of the lower limbs was easily assessed during an MDS-UPDRS task with a metronome, it was not correlated with the severity of freezing of gait (as evaluated during a standardized gait trajectory). Only this latter was a reliable measurement in patients with advanced Parkinson’s disease.
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17
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Rosenberg-Katz K, Maidan I, Jacob Y, Giladi N, Mirelman A, Hausdorff JM. Alterations in conflict monitoring are related to functional connectivity in Parkinson's disease. Cortex 2016; 82:277-286. [DOI: 10.1016/j.cortex.2016.06.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2016] [Revised: 06/02/2016] [Accepted: 06/16/2016] [Indexed: 02/03/2023]
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18
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Heremans E, Nackaerts E, Broeder S, Vervoort G, Swinnen SP, Nieuwboer A. Handwriting Impairments in People With Parkinson's Disease and Freezing of Gait. Neurorehabil Neural Repair 2016; 30:911-919. [PMID: 27094858 DOI: 10.1177/1545968316642743] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Recent studies show that patients with Parkinson's disease (PD) and freezing of gait (FOG) experience motor problems outside their gait freezing episodes. Because handwriting is also a sequential movement, it may be affected in PD patients with FOG relative to those without. OBJECTIVE The current study aimed to assess the quality of writing in PD patients with and without FOG in comparison to healthy controls (CTs) during various writing tasks. METHODS Handwriting was assessed by the writing of cursive loops on a touch-sensitive writing tablet and by means of the Systematic Screening of Handwriting Difficulties (SOS) test in 30 PD patients with and without freezing and 15 healthy age-matched CTs. The tablet tests were performed at 2 different sizes, either continuously or alternatingly, as indicated by visual target lines. RESULTS Patients with freezing showed decreased writing amplitudes and increased variability compared with CTs and patients without freezing on the writing tablet tests. Writing problems were present during both tests but were more pronounced during writing at alternating compared with writing at continuous size. Patients with freezing also had a higher total score on the SOS test than patients without freezing and CTs, reflecting more extensive handwriting problems, particularly with writing fluency. CONCLUSIONS Writing is more severely affected in PD patients with FOG than in those without FOG. These results indicate that deficient movement sequencing and adaptation is a generic problem in patients with FOG.
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19
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Stuart S, Lord S, Hill E, Rochester L. Gait in Parkinson's disease: A visuo-cognitive challenge. Neurosci Biobehav Rev 2016; 62:76-88. [PMID: 26773722 DOI: 10.1016/j.neubiorev.2016.01.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 12/15/2015] [Accepted: 01/05/2016] [Indexed: 12/18/2022]
Abstract
Vision and cognition have both been related to gait impairment in Parkinson's disease (PD) through separate strands of research. The cumulative and interactive effect of both (which we term visuo-cognition) has not been previously investigated and little is known about the influence of cognition on vision with respect to gait. Understanding the role of vision, cognition and visuo-cognition in gait in PD is critical for data interpretation and to infer and test underlying mechanisms. The purpose of this comprehensive narrative review was to examine the interdependent and interactive role of cognition and vision in gait in PD and older adults. Evidence from a broad range of research disciplines was reviewed and summarised. A key finding was that attention appears to play a pivotal role in mediating gait, cognition and vision, and should be considered emphatically in future research in this field.
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Affiliation(s)
- Samuel Stuart
- Institute of Neuroscience/Newcastle University Institute of Ageing, Clinical Ageing Research Unit, Campus for Ageing and Vitality Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Sue Lord
- Institute of Neuroscience/Newcastle University Institute of Ageing, Clinical Ageing Research Unit, Campus for Ageing and Vitality Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Elizabeth Hill
- Institute of Neuroscience/Newcastle University Institute of Ageing, Clinical Ageing Research Unit, Campus for Ageing and Vitality Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Lynn Rochester
- Institute of Neuroscience/Newcastle University Institute of Ageing, Clinical Ageing Research Unit, Campus for Ageing and Vitality Newcastle University, Newcastle upon Tyne, United Kingdom.
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20
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Delval A, Tard C, Rambour M, Defebvre L, Moreau C. Characterization and quantification of freezing of gait in Parkinson's disease: Can detection algorithms replace clinical expert opinion? Neurophysiol Clin 2015; 45:305-13. [PMID: 26547546 DOI: 10.1016/j.neucli.2015.09.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 09/16/2015] [Accepted: 09/16/2015] [Indexed: 10/22/2022] Open
Abstract
Freezing of gait is a paroxysmal phenomenon that is frequently reported by the parkinsonian patients or their entourage. The phenomenon significantly alters quality of life but is often difficult to characterize in the physician's office. In the present review, we focus on the clinical characterization and quantification of freezing of gait. Various biomechanical methods (based mainly on time-frequency analysis) can be used to determine time-domain characteristics of freezing of gait. Methods already used to study non-gait freezing of other effectors (the lower limbs, upper limbs and orofacial area) are also being developed for the analysis of freezing in functional magnetic resonance imaging protocols. Here, we review the reliability of these methods and compare them with reliability of information obtained from physical examination and detailed analysis of the patient's medical history.
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Affiliation(s)
- A Delval
- U1171, Université de Lille, Lille, France; Clinical Neurophysiology Department, Lille University Medical Center, Lille, France.
| | - C Tard
- U1171, Université de Lille, Lille, France; Clinical Neurophysiology Department, Lille University Medical Center, Lille, France; Neurology and Movement Disorders Department, Lille University Medical Center, Lille, France
| | - M Rambour
- U1171, Université de Lille, Lille, France; Neurology and Movement Disorders Department, Lille University Medical Center, Lille, France
| | - L Defebvre
- U1171, Université de Lille, Lille, France; Neurology and Movement Disorders Department, Lille University Medical Center, Lille, France
| | - C Moreau
- U1171, Université de Lille, Lille, France; Neurology and Movement Disorders Department, Lille University Medical Center, Lille, France
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21
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Association between Community Ambulation Walking Patterns and Cognitive Function in Patients with Parkinson's Disease: Further Insights into Motor-Cognitive Links. PARKINSONS DISEASE 2015; 2015:547065. [PMID: 26605103 PMCID: PMC4641932 DOI: 10.1155/2015/547065] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 09/10/2015] [Accepted: 10/04/2015] [Indexed: 11/30/2022]
Abstract
Background. Cognitive function is generally evaluated based on testing in the clinic, but this may not always reflect real-life function. We tested whether parameters derived from long-term, continuous monitoring of gait are associated with cognitive function in patients with Parkinson's disease (PD). Methods. 107 patients with PD (age: 64.9 ± 9.3 yrs; UPDRS motor sum “off”: 40.4 ± 13.2; 25.23% women) wore a 3D accelerometer on their lower back for 3 days. Computerized measures of global cognitive function, executive function, attention, and nonverbal memory were assessed. Three-day acceleration derived measures included cadence, variability, bilateral coordination, and dynamic postural control. Associations between the acceleration derived measures and cognitive function were determined. Results. Linear regression showed associations between vertical gait variability and cadence and between global cognitive score, attention, and executive function (p ≤ 0.048). Dynamic postural control was associated with global cognitive score and attention (p ≤ 0.027). Nonverbal memory was not associated with the acceleration-derived measures. Conclusions. These findings suggest that metrics derived from a 3-day worn body-fixed sensor reflect cognitive function, further supporting the idea that the gait pattern may be altered as cognition declines and that gait provides a window into cognitive function in patients with PD.
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22
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Gilat M, Shine JM, Walton CC, O'Callaghan C, Hall JM, Lewis SJG. Brain activation underlying turning in Parkinson's disease patients with and without freezing of gait: a virtual reality fMRI study. NPJ PARKINSONS DISEASE 2015; 1:15020. [PMID: 28725687 PMCID: PMC5516618 DOI: 10.1038/npjparkd.2015.20] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 07/21/2015] [Accepted: 08/24/2015] [Indexed: 11/09/2022]
Abstract
BACKGROUND Freezing of gait is a debilitating symptom affecting many patients with Parkinson's disease (PD), causing severe immobility and decreased quality of life. Turning is known to be the most common trigger for freezing and also causes the highest rates of falls. However, the pathophysiological basis for these effects is not well understood. METHODS This study used a virtual reality paradigm in combination with functional magnetic resonance imaging to explore the neural correlates underlying turning in 17 PD patients with freezing of gait (FOG) and 10 PD patients without FOG while off their dopaminergic medication. Participants used foot pedals to navigate a virtual environment, which allowed for blood oxygen level-dependent (BOLD) responses and footstep latencies to be compared between periods of straight "walking" and periods of turning through 90°. BOLD data were then analyzed using a mixed effects analysis. RESULTS Within group similarities revealed that overall, PD patients with freezing relied heavily on cortical control to enable effective stepping with increased visual cortex activation during turning. Between groups differences showed that when turning, patients with freezing preferentially activated inferior frontal regions that have been implicated in the recruitment of a putative stopping network. In addition, freezers failed to activate premotor and superior parietal cortices. Finally, increased task-based functional connectivity was found in subcortical regions associated with gait and stopping within the freezers group during turning. CONCLUSIONS These findings suggest that an increased propensity towards stopping in combination with reduced sensorimotor integration may underlie the neurobiology of freezing of gait during turning.
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Affiliation(s)
- Moran Gilat
- Parkinson's Disease Research Clinic, Brain and Mind Research Institute, The University of Sydney, Sydney, NSW, Australia
| | - James M Shine
- Parkinson's Disease Research Clinic, Brain and Mind Research Institute, The University of Sydney, Sydney, NSW, Australia.,Department of Psychology, Stanford University, Stanford, CA, USA
| | - Courtney C Walton
- Parkinson's Disease Research Clinic, Brain and Mind Research Institute, The University of Sydney, Sydney, NSW, Australia
| | - Claire O'Callaghan
- Parkinson's Disease Research Clinic, Brain and Mind Research Institute, The University of Sydney, Sydney, NSW, Australia.,Department of Psychology, Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - Julie M Hall
- Parkinson's Disease Research Clinic, Brain and Mind Research Institute, The University of Sydney, Sydney, NSW, Australia.,School of Social Sciences and Psychology, University of Western Sydney, Sydney, NSW, Australia
| | - Simon J G Lewis
- Parkinson's Disease Research Clinic, Brain and Mind Research Institute, The University of Sydney, Sydney, NSW, Australia
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Tard C, Delval A, Devos D, Lopes R, Lenfant P, Dujardin K, Hossein-Foucher C, Semah F, Duhamel A, Defebvre L, Le Jeune F, Moreau C. Brain metabolic abnormalities during gait with freezing in Parkinson’s disease. Neuroscience 2015; 307:281-301. [DOI: 10.1016/j.neuroscience.2015.08.063] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Revised: 08/25/2015] [Accepted: 08/25/2015] [Indexed: 11/28/2022]
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Neuromuscular correlates of subthalamic stimulation and upper limb freezing in Parkinson's disease. Clin Neurophysiol 2015; 127:610-620. [PMID: 25792072 DOI: 10.1016/j.clinph.2015.02.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Revised: 02/05/2015] [Accepted: 02/13/2015] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The pathophysiology of deep brain stimulation mechanisms and resistant freezing phenomena in idiopathic Parkinson's disease (iPD) remains incompletely understood. Further studies on the neuromuscular substrates are needed. METHODS We analyzed 16 patients with advanced iPD and bilateral subthalamic nucleus stimulation, and 13 age- and gender-matched healthy controls. Patients were tested after overnight withdrawal of medication with 'stimulation off' (StimOff) and 'stimulation on' (StimOn). Subjects performed continuous tapping of the right index finger with simultaneous recordings of biomechanical registration, EMG of finger flexors and extensors, and EEG. First, we analyzed EEG and EMG spectral measures comparing StimOff with healthy controls and StimOff with StimOn (irrespective of freezing). Second, we contrasted 'regular (unimpaired) tapping' and 'freezing' resistant to subthalamic neurostimulation as obtained in StimOn. RESULTS iPD showed increased intermuscular coherence around 8Hz in StimOff that was reduced in StimOn. This 8Hz muscular activity was not coherent to cortical activity. 'Freezing' episodes showed increased muscle activity of finger flexors and extensors at 6-9Hz, and increased cortical activity at 7-11Hz. During transition from regular tapping to 'freezing' the cortical activity first increased over the left sensorimotor area followed by a spread to the left frontal and right parietal areas. CONCLUSIONS We identified neuromuscular motor network features of subthalamic neurostimulation therapy and resistant upper limb freezing that point to increased low-frequency muscular and cortical activity. SIGNIFICANCE Together, our findings demonstrate several motor network abnormalities associated with upper limb freezing that may translate into future research on freezing of gait in iPD.
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Maidan I, Bernad-Elazari H, Gazit E, Giladi N, Hausdorff JM, Mirelman A. Changes in oxygenated hemoglobin link freezing of gait to frontal activation in patients with Parkinson disease: an fNIRS study of transient motor-cognitive failures. J Neurol 2015; 262:899-908. [PMID: 25636682 DOI: 10.1007/s00415-015-7650-6] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Revised: 01/13/2015] [Accepted: 01/16/2015] [Indexed: 11/25/2022]
Abstract
Recent studies have suggested that deficits in executive function contribute to freezing of gait (FOG), an episodic disturbance common among patients with Parkinson's disease (PD). To date, most findings provide only indirect evidence of this relationship. Here, we evaluated a more direct link between FOG and frontal lobe dysfunction. Functional, near infrared spectroscopy measured frontal activation, i.e., oxygenated hemoglobin (HbO2) levels in Brodmann area 10 before and during FOG. Eleven patients with PD and eleven healthy older adults were studied. Changes in frontal lobe activation before and during FOG that occurred during turns were determined. Altogether, 49 FOG episodes were observed-28 occurred during turns that were anticipated (i.e., the patient knew in advance that the turn was coming), 21 during unanticipated turns that were performed "abruptly", according to the examiner's request. During anticipated turns, HbO2 increased by 0.22 ± 0.08 µM (p = 0.004) before FOG and by an additional 0.19 ± 0.13 µM (p = 0.072) during FOG. In contrast, during unanticipated turns, HbO2 did not increase before or during FOG. HbO2 decreased by 0.32 ± 0.08 µM (p = 0.004) during turns without FOG; in healthy controls HbO2 did not change during turns. These findings support the existence of an association between FOG episodes and changes in frontal lobe HbO2. Increased activation in Brodmann area 10 before FOG, specifically during anticipated turns, highlights the connections between motor planning, information processing, and FOG. These results support the idea that alterations in executive control play a role in this debilitating motor disturbance.
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Affiliation(s)
- Inbal Maidan
- Center for the study of Movement, Cognition and Mobility, Department of Neurology, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel
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Vercruysse S, Leunissen I, Vervoort G, Vandenberghe W, Swinnen S, Nieuwboer A. Microstructural changes in white matter associated with freezing of gait in Parkinson's disease. Mov Disord 2015; 30:567-76. [PMID: 25640958 DOI: 10.1002/mds.26130] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2014] [Revised: 12/03/2014] [Accepted: 12/05/2014] [Indexed: 11/09/2022] Open
Abstract
In Parkinson's disease (PD), freezing of gait (FOG) is associated with widespread functional and structural gray matter changes throughout the brain. Previous study of freezing-related white matter changes was restricted to brainstem and cerebellar locomotor tracts. This study was undertaken to determine the spatial distribution of white matter damage associated with FOG by combining whole brain and striatofrontal seed-based diffusion tensor imaging. Diffusion-weighted images were collected in 26 PD patients and 16 age-matched controls. Parkinson's disease groups with (n = 11) and without freezing of gait (n = 15) were matched for age and disease severity. We applied tract-based spatial statistics to compare fractional anisotropy and mean diffusivity of white matter structure across the whole brain between groups. Probabilistic tractography was used to evaluate fractional anisotropy and mean diffusivity of key subcortico-cortical tracts. Tract-based spatial statistics revealed decreased fractional anisotropy in PD with FOG in bilateral cerebellar and superior longitudinal fascicle clusters. Increased mean diffusivity values were apparent in the right internal capsule, superior frontal cortex, anterior corona radiata, the left anterior thalamic radiation, and cerebellum. Tractography showed consistent white matter alterations in striatofrontal tracts through the putamen, caudate, pallidum, subthalamic nucleus, and in connections of the cerebellar peduncle with subthalamic nucleus and pedunculopontine nucleus bilaterally. We conclude that FOG is associated with diffuse white matter damage involving major cortico-cortical, corticofugal motor, and several striatofrontal tracts in addition to previously described cerebello-pontine connectivity changes. These distributed white matter abnormalities may contribute to the motor and non-motor correlates of FOG.
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Affiliation(s)
- Sarah Vercruysse
- Katholieke Universiteit Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
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27
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Ko JH, Lerner RP, Eidelberg D. Effects of levodopa on regional cerebral metabolism and blood flow. Mov Disord 2014; 30:54-63. [PMID: 25296957 DOI: 10.1002/mds.26041] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 09/01/2014] [Indexed: 01/24/2023] Open
Abstract
Levodopa (L-dopa) has been at the forefront of antiparkinsonian therapy for a half century. Recent advances in functional brain imaging have contributed substantially to the understanding of the effects of L-dopa and other dopaminergic treatment on the activity of abnormal motor and cognitive brain circuits in Parkinson's disease patients. Progress has also been made in understanding the functional pathology of dyskinesias, a common side effect of l-dopa treatment, at both regional and network levels. Here, we review these studies, focusing mainly on the new mechanistic insights provided by metabolic brain imaging and network analysis.
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Affiliation(s)
- Ji Hyun Ko
- Center for Neurosciences, The Feinstein Institute for Medical Research, Manhasset, New York, USA
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28
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Factor SA, Scullin MK, Sollinger AB, Land JO, Wood-Siverio C, Zanders L, Freeman A, Bliwise DL, Goldstein FC. Freezing of gait subtypes have different cognitive correlates in Parkinson's disease. Parkinsonism Relat Disord 2014; 20:1359-64. [PMID: 25446341 DOI: 10.1016/j.parkreldis.2014.09.023] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2014] [Revised: 09/17/2014] [Accepted: 09/19/2014] [Indexed: 11/18/2022]
Abstract
BACKGROUND Freezing of gait (FOG) is a major concern for Parkinson's disease (PD) patients because it is a leading cause of falls and is associated with poor quality of life. The pathophysiology is unknown but it is hypothesized that it relates to cognitive abnormalities; particularly executive and visuospatial dysfunction. However, prior results have been discrepant. Pharmacologic subtypes of FOG include those that are responsive and unresponsive to levodopa. OBJECTIVE To determine whether executive and visuospatial dysfunction are associated specifically with the levodopa unresponsive subtype of FOG. METHODS 135 PD subjects completed a single assessment included FOG questionnaire, UPDRS motor scale, comprehensive cognitive battery and measure of hallucinations. Analyses compared unresponsive (n = 16), responsive (n = 20) and no FOG (n = 99) subtypes. RESULTS The unresponsive subtype had a significantly older age of onset of PD than the responsive group (p = .03) and had worse motor scores (p = .003) than the no FOG group. Longer disease duration was associated with the responsive group compared to the no FOG group (p = .002). The unresponsive FOG group had significantly poorer visuospatial ability (p = .001) and executive functioning (p = .02) than both the no and responsive FOG subgroups. These latter groups were not significantly different. The responsive FOG group was associated with the presence of hallucinations. CONCLUSION Aside from pharmacological differences, unresponsive FOG is associated with executive and visuospatial dysfunction implicating frontostriatal pathways while responsive FOG is associated with hallucinations suggesting involvement of posterior cortical regions. Further study and treatment of FOG should include appropriate subtype classification.
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Affiliation(s)
- S A Factor
- Emory University School of Medicine, Department of Neurology, USA.
| | - M K Scullin
- Emory University School of Medicine, Department of Neurology, USA
| | - A B Sollinger
- Emory University School of Medicine, Department of Neurology, USA
| | - J O Land
- Emory University School of Medicine, Department of Neurology, USA
| | - C Wood-Siverio
- Emory University School of Medicine, Department of Neurology, USA
| | - L Zanders
- Emory University School of Medicine, Department of Neurology, USA
| | - A Freeman
- Emory University School of Medicine, Department of Neurology, USA
| | - D L Bliwise
- Emory University School of Medicine, Department of Neurology, USA
| | - F C Goldstein
- Emory University School of Medicine, Department of Neurology, USA
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Weiss A, Herman T, Giladi N, Hausdorff JM. New evidence for gait abnormalities among Parkinson’s disease patients who suffer from freezing of gait: insights using a body-fixed sensor worn for 3 days. J Neural Transm (Vienna) 2014; 122:403-10. [PMID: 25069586 DOI: 10.1007/s00702-014-1279-y] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 07/17/2014] [Indexed: 12/13/2022]
Affiliation(s)
- Aner Weiss
- Laboratory for Gait and Neurodynamics, Movement Disorders Unit, Department of Neurology, Tel Aviv Sourasky Medical Center, 6 Weizman Street, 64239, Tel Aviv, Israel
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Holtzer R, Epstein N, Mahoney JR, Izzetoglu M, Blumen HM. Neuroimaging of mobility in aging: a targeted review. J Gerontol A Biol Sci Med Sci 2014; 69:1375-88. [PMID: 24739495 DOI: 10.1093/gerona/glu052] [Citation(s) in RCA: 210] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The relationship between mobility and cognition in aging is well established, but the relationship between mobility and the structure and function of the aging brain is relatively unknown. This, in part, is attributed to the technological limitations of most neuroimaging procedures, which require the individual to be immobile or in a supine position. Herein, we provide a targeted review of neuroimaging studies of mobility in aging to promote (i) a better understanding of this relationship, (ii) future research in this area, and (iii) development of applications for improving mobility. METHODS A systematic search of peer-reviewed studies was performed using PubMed. Search terms included (i) aging, older adults, or elderly; (ii) gait, walking, balance, or mobility; and (iii) magnetic resonance imaging, voxel-based morphometry, fluid-attenuated inversion recovery, diffusion tensor imaging, positron emission tomography, functional magnetic resonance imaging, electroencephalography, event-related potential, and functional near-infrared spectroscopy. RESULTS Poor mobility outcomes were reliably associated with reduced gray and white matter volume. Fewer studies examined the relationship between changes in task-related brain activation and mobility performance. Extant findings, however, showed that activation patterns in the cerebellum, basal ganglia, parietal and frontal cortices were related to mobility. Increased involvement of the prefrontal cortex was evident in both imagined walking conditions and conditions where the cognitive demands of locomotion were increased. CONCLUSIONS Cortical control of gait in aging is bilateral, widespread, and dependent on the integrity of both gray and white matter.
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Affiliation(s)
- Roee Holtzer
- Department of Neurology, Albert Einstein College of Medicine of Yeshiva University, Bronx, New York. Ferkauf Graduate School of Psychology of Yeshiva University, Bronx, New York.
| | - Noah Epstein
- Ferkauf Graduate School of Psychology of Yeshiva University, Bronx, New York
| | - Jeannette R Mahoney
- Department of Neurology, Albert Einstein College of Medicine of Yeshiva University, Bronx, New York
| | - Meltem Izzetoglu
- Drexel University School of Biomedical Engineering, Philadelphia, Pennsylvania
| | - Helena M Blumen
- Department of Medicine, Albert Einstein College of Medicine of Yeshiva University, Bronx, New York
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