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Hutchison RM, Fraser K, Yang M, Fox T, Hirschhorn E, Njingti E, Scott D, Bedell BJ, Kistner KM, Cedarbaum JM, Evans KC, Graham D, Martarello L, Mollenhauer B, Lang AE, Dam T, Beaver J. Cinpanemab in Early Parkinson Disease: Evaluation of Biomarker Results From the Phase 2 SPARK Clinical Trial. Neurology 2024; 102:e209137. [PMID: 38315945 DOI: 10.1212/wnl.0000000000209137] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 11/29/2023] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Sensitive, reliable, and scalable biomarkers are needed to accelerate the development of therapies for Parkinson disease (PD). In this study, we evaluate the biomarkers of early PD diagnosis, disease progression, and treatment effect collected in the SPARK. METHODS Cinpanemab is a human-derived monoclonal antibody binding preferentially to aggregated forms of extracellular α-synuclein. SPARK was a randomized, double-blind, placebo-controlled, phase 2 multicenter trial evaluating 3 cinpanemab doses administered intravenously every 4 weeks for 52 weeks with an active treatment dose-blind extension period for up to 112 weeks. SPARK enrolled 357 participants diagnosed with PD within 3 years, aged 40-80 years, ≤2.5 on the modified Hoehn and Yahr scale, and with evidence of striatal dopaminergic deficit. The primary outcome was change from baseline in the Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale total score. Secondary and exploratory biomarker outcomes evaluated change from baseline at week 52 relative to placebo. Dopamine transporter SPECT and MRI were used to quantify changes in the nigrostriatal dopamine pathway and regional atrophy. CSF and plasma samples were used to assess change in total α-synuclein levels, α-synuclein seeding, and neurofilament light chain levels. SPARK was conducted from January 2018 to April 2021 and terminated due to lack of efficacy. RESULTS Approximately 3.8% (15/398) of SPECT-imaged participants did not have evidence of dopaminergic deficit and were screen-failed. Binary classification of α-synuclein seeding designated 93% (110/118) of the enrolled CSF subgroup as positive for α-synuclein seeds at baseline. Clinical disease progression was observed, with no statistically significant difference in cinpanemab groups compared with that in placebo. Ninety-nine percent of participants with positive α-synuclein seeding remained positive through week 52. No statistically significant changes from baseline were observed between treatment groups and placebo across biomarker measures. Broadly, there was minimal annual change with high interindividual variability across biomarkers-with striatal binding ratios of the ipsilateral putamen showing the greatest mean change/SD over time. DISCUSSION Biomarker results indicated enrollment of the intended population with early PD, but there was no significant correlation with disease progression or clear evidence of a cinpanemab treatment effect on biomarker measures. Suitable biomarkers for evaluating disease severity and progression in early PD trials are still needed. TRIAL REGISTRATION INFORMATION NCT03318523 (clinicaltrials.gov/ct2/show/NCT03318523); Submitted October 24, 2017; First patient enrolled January 2018.
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Affiliation(s)
- R Matthew Hutchison
- From Biogen Inc. (R.M.H., K.F., M.Y., E.H., K.C.E., D.G., L.M., J.B.), Cambridge, MA; Biogen Inc. (T.F.), Maidenhead, United Kingdom; Formerly Biogen Inc. at time of study (E.N., J.M.C., T.D.); Clario (D.S.), Princeton, NJ; Biospective Inc. (B.J.B.), Montreal, Quebec, Canada; Nucleus Global (K.M.K.), Atlanta, GA; Coeruleus Clinical Sciences LLC (J.M.C.), Woodbridge, CT; Department of Neurology (B.M.), University Medical Center, Göttingen and Paracelsus-Elena-Klinik, Kassel, and Scientific Employee with an Honorary Contract at German Center for Neurodegenerative Diseases (DZNE), Germany; Morton and Gloria Shulman Movement Disorders Clinic (A.E.L.); and Edmond J. Safra Program in Parkinson's Disease (A.E.L.), Toronto, Ontario, Canada
| | - Kyle Fraser
- From Biogen Inc. (R.M.H., K.F., M.Y., E.H., K.C.E., D.G., L.M., J.B.), Cambridge, MA; Biogen Inc. (T.F.), Maidenhead, United Kingdom; Formerly Biogen Inc. at time of study (E.N., J.M.C., T.D.); Clario (D.S.), Princeton, NJ; Biospective Inc. (B.J.B.), Montreal, Quebec, Canada; Nucleus Global (K.M.K.), Atlanta, GA; Coeruleus Clinical Sciences LLC (J.M.C.), Woodbridge, CT; Department of Neurology (B.M.), University Medical Center, Göttingen and Paracelsus-Elena-Klinik, Kassel, and Scientific Employee with an Honorary Contract at German Center for Neurodegenerative Diseases (DZNE), Germany; Morton and Gloria Shulman Movement Disorders Clinic (A.E.L.); and Edmond J. Safra Program in Parkinson's Disease (A.E.L.), Toronto, Ontario, Canada
| | - Minhua Yang
- From Biogen Inc. (R.M.H., K.F., M.Y., E.H., K.C.E., D.G., L.M., J.B.), Cambridge, MA; Biogen Inc. (T.F.), Maidenhead, United Kingdom; Formerly Biogen Inc. at time of study (E.N., J.M.C., T.D.); Clario (D.S.), Princeton, NJ; Biospective Inc. (B.J.B.), Montreal, Quebec, Canada; Nucleus Global (K.M.K.), Atlanta, GA; Coeruleus Clinical Sciences LLC (J.M.C.), Woodbridge, CT; Department of Neurology (B.M.), University Medical Center, Göttingen and Paracelsus-Elena-Klinik, Kassel, and Scientific Employee with an Honorary Contract at German Center for Neurodegenerative Diseases (DZNE), Germany; Morton and Gloria Shulman Movement Disorders Clinic (A.E.L.); and Edmond J. Safra Program in Parkinson's Disease (A.E.L.), Toronto, Ontario, Canada
| | - Tara Fox
- From Biogen Inc. (R.M.H., K.F., M.Y., E.H., K.C.E., D.G., L.M., J.B.), Cambridge, MA; Biogen Inc. (T.F.), Maidenhead, United Kingdom; Formerly Biogen Inc. at time of study (E.N., J.M.C., T.D.); Clario (D.S.), Princeton, NJ; Biospective Inc. (B.J.B.), Montreal, Quebec, Canada; Nucleus Global (K.M.K.), Atlanta, GA; Coeruleus Clinical Sciences LLC (J.M.C.), Woodbridge, CT; Department of Neurology (B.M.), University Medical Center, Göttingen and Paracelsus-Elena-Klinik, Kassel, and Scientific Employee with an Honorary Contract at German Center for Neurodegenerative Diseases (DZNE), Germany; Morton and Gloria Shulman Movement Disorders Clinic (A.E.L.); and Edmond J. Safra Program in Parkinson's Disease (A.E.L.), Toronto, Ontario, Canada
| | - Elizabeth Hirschhorn
- From Biogen Inc. (R.M.H., K.F., M.Y., E.H., K.C.E., D.G., L.M., J.B.), Cambridge, MA; Biogen Inc. (T.F.), Maidenhead, United Kingdom; Formerly Biogen Inc. at time of study (E.N., J.M.C., T.D.); Clario (D.S.), Princeton, NJ; Biospective Inc. (B.J.B.), Montreal, Quebec, Canada; Nucleus Global (K.M.K.), Atlanta, GA; Coeruleus Clinical Sciences LLC (J.M.C.), Woodbridge, CT; Department of Neurology (B.M.), University Medical Center, Göttingen and Paracelsus-Elena-Klinik, Kassel, and Scientific Employee with an Honorary Contract at German Center for Neurodegenerative Diseases (DZNE), Germany; Morton and Gloria Shulman Movement Disorders Clinic (A.E.L.); and Edmond J. Safra Program in Parkinson's Disease (A.E.L.), Toronto, Ontario, Canada
| | - Edwin Njingti
- From Biogen Inc. (R.M.H., K.F., M.Y., E.H., K.C.E., D.G., L.M., J.B.), Cambridge, MA; Biogen Inc. (T.F.), Maidenhead, United Kingdom; Formerly Biogen Inc. at time of study (E.N., J.M.C., T.D.); Clario (D.S.), Princeton, NJ; Biospective Inc. (B.J.B.), Montreal, Quebec, Canada; Nucleus Global (K.M.K.), Atlanta, GA; Coeruleus Clinical Sciences LLC (J.M.C.), Woodbridge, CT; Department of Neurology (B.M.), University Medical Center, Göttingen and Paracelsus-Elena-Klinik, Kassel, and Scientific Employee with an Honorary Contract at German Center for Neurodegenerative Diseases (DZNE), Germany; Morton and Gloria Shulman Movement Disorders Clinic (A.E.L.); and Edmond J. Safra Program in Parkinson's Disease (A.E.L.), Toronto, Ontario, Canada
| | - David Scott
- From Biogen Inc. (R.M.H., K.F., M.Y., E.H., K.C.E., D.G., L.M., J.B.), Cambridge, MA; Biogen Inc. (T.F.), Maidenhead, United Kingdom; Formerly Biogen Inc. at time of study (E.N., J.M.C., T.D.); Clario (D.S.), Princeton, NJ; Biospective Inc. (B.J.B.), Montreal, Quebec, Canada; Nucleus Global (K.M.K.), Atlanta, GA; Coeruleus Clinical Sciences LLC (J.M.C.), Woodbridge, CT; Department of Neurology (B.M.), University Medical Center, Göttingen and Paracelsus-Elena-Klinik, Kassel, and Scientific Employee with an Honorary Contract at German Center for Neurodegenerative Diseases (DZNE), Germany; Morton and Gloria Shulman Movement Disorders Clinic (A.E.L.); and Edmond J. Safra Program in Parkinson's Disease (A.E.L.), Toronto, Ontario, Canada
| | - Barry J Bedell
- From Biogen Inc. (R.M.H., K.F., M.Y., E.H., K.C.E., D.G., L.M., J.B.), Cambridge, MA; Biogen Inc. (T.F.), Maidenhead, United Kingdom; Formerly Biogen Inc. at time of study (E.N., J.M.C., T.D.); Clario (D.S.), Princeton, NJ; Biospective Inc. (B.J.B.), Montreal, Quebec, Canada; Nucleus Global (K.M.K.), Atlanta, GA; Coeruleus Clinical Sciences LLC (J.M.C.), Woodbridge, CT; Department of Neurology (B.M.), University Medical Center, Göttingen and Paracelsus-Elena-Klinik, Kassel, and Scientific Employee with an Honorary Contract at German Center for Neurodegenerative Diseases (DZNE), Germany; Morton and Gloria Shulman Movement Disorders Clinic (A.E.L.); and Edmond J. Safra Program in Parkinson's Disease (A.E.L.), Toronto, Ontario, Canada
| | - Kristi M Kistner
- From Biogen Inc. (R.M.H., K.F., M.Y., E.H., K.C.E., D.G., L.M., J.B.), Cambridge, MA; Biogen Inc. (T.F.), Maidenhead, United Kingdom; Formerly Biogen Inc. at time of study (E.N., J.M.C., T.D.); Clario (D.S.), Princeton, NJ; Biospective Inc. (B.J.B.), Montreal, Quebec, Canada; Nucleus Global (K.M.K.), Atlanta, GA; Coeruleus Clinical Sciences LLC (J.M.C.), Woodbridge, CT; Department of Neurology (B.M.), University Medical Center, Göttingen and Paracelsus-Elena-Klinik, Kassel, and Scientific Employee with an Honorary Contract at German Center for Neurodegenerative Diseases (DZNE), Germany; Morton and Gloria Shulman Movement Disorders Clinic (A.E.L.); and Edmond J. Safra Program in Parkinson's Disease (A.E.L.), Toronto, Ontario, Canada
| | - Jesse M Cedarbaum
- From Biogen Inc. (R.M.H., K.F., M.Y., E.H., K.C.E., D.G., L.M., J.B.), Cambridge, MA; Biogen Inc. (T.F.), Maidenhead, United Kingdom; Formerly Biogen Inc. at time of study (E.N., J.M.C., T.D.); Clario (D.S.), Princeton, NJ; Biospective Inc. (B.J.B.), Montreal, Quebec, Canada; Nucleus Global (K.M.K.), Atlanta, GA; Coeruleus Clinical Sciences LLC (J.M.C.), Woodbridge, CT; Department of Neurology (B.M.), University Medical Center, Göttingen and Paracelsus-Elena-Klinik, Kassel, and Scientific Employee with an Honorary Contract at German Center for Neurodegenerative Diseases (DZNE), Germany; Morton and Gloria Shulman Movement Disorders Clinic (A.E.L.); and Edmond J. Safra Program in Parkinson's Disease (A.E.L.), Toronto, Ontario, Canada
| | - Karleyton C Evans
- From Biogen Inc. (R.M.H., K.F., M.Y., E.H., K.C.E., D.G., L.M., J.B.), Cambridge, MA; Biogen Inc. (T.F.), Maidenhead, United Kingdom; Formerly Biogen Inc. at time of study (E.N., J.M.C., T.D.); Clario (D.S.), Princeton, NJ; Biospective Inc. (B.J.B.), Montreal, Quebec, Canada; Nucleus Global (K.M.K.), Atlanta, GA; Coeruleus Clinical Sciences LLC (J.M.C.), Woodbridge, CT; Department of Neurology (B.M.), University Medical Center, Göttingen and Paracelsus-Elena-Klinik, Kassel, and Scientific Employee with an Honorary Contract at German Center for Neurodegenerative Diseases (DZNE), Germany; Morton and Gloria Shulman Movement Disorders Clinic (A.E.L.); and Edmond J. Safra Program in Parkinson's Disease (A.E.L.), Toronto, Ontario, Canada
| | - Danielle Graham
- From Biogen Inc. (R.M.H., K.F., M.Y., E.H., K.C.E., D.G., L.M., J.B.), Cambridge, MA; Biogen Inc. (T.F.), Maidenhead, United Kingdom; Formerly Biogen Inc. at time of study (E.N., J.M.C., T.D.); Clario (D.S.), Princeton, NJ; Biospective Inc. (B.J.B.), Montreal, Quebec, Canada; Nucleus Global (K.M.K.), Atlanta, GA; Coeruleus Clinical Sciences LLC (J.M.C.), Woodbridge, CT; Department of Neurology (B.M.), University Medical Center, Göttingen and Paracelsus-Elena-Klinik, Kassel, and Scientific Employee with an Honorary Contract at German Center for Neurodegenerative Diseases (DZNE), Germany; Morton and Gloria Shulman Movement Disorders Clinic (A.E.L.); and Edmond J. Safra Program in Parkinson's Disease (A.E.L.), Toronto, Ontario, Canada
| | - Laurent Martarello
- From Biogen Inc. (R.M.H., K.F., M.Y., E.H., K.C.E., D.G., L.M., J.B.), Cambridge, MA; Biogen Inc. (T.F.), Maidenhead, United Kingdom; Formerly Biogen Inc. at time of study (E.N., J.M.C., T.D.); Clario (D.S.), Princeton, NJ; Biospective Inc. (B.J.B.), Montreal, Quebec, Canada; Nucleus Global (K.M.K.), Atlanta, GA; Coeruleus Clinical Sciences LLC (J.M.C.), Woodbridge, CT; Department of Neurology (B.M.), University Medical Center, Göttingen and Paracelsus-Elena-Klinik, Kassel, and Scientific Employee with an Honorary Contract at German Center for Neurodegenerative Diseases (DZNE), Germany; Morton and Gloria Shulman Movement Disorders Clinic (A.E.L.); and Edmond J. Safra Program in Parkinson's Disease (A.E.L.), Toronto, Ontario, Canada
| | - Brit Mollenhauer
- From Biogen Inc. (R.M.H., K.F., M.Y., E.H., K.C.E., D.G., L.M., J.B.), Cambridge, MA; Biogen Inc. (T.F.), Maidenhead, United Kingdom; Formerly Biogen Inc. at time of study (E.N., J.M.C., T.D.); Clario (D.S.), Princeton, NJ; Biospective Inc. (B.J.B.), Montreal, Quebec, Canada; Nucleus Global (K.M.K.), Atlanta, GA; Coeruleus Clinical Sciences LLC (J.M.C.), Woodbridge, CT; Department of Neurology (B.M.), University Medical Center, Göttingen and Paracelsus-Elena-Klinik, Kassel, and Scientific Employee with an Honorary Contract at German Center for Neurodegenerative Diseases (DZNE), Germany; Morton and Gloria Shulman Movement Disorders Clinic (A.E.L.); and Edmond J. Safra Program in Parkinson's Disease (A.E.L.), Toronto, Ontario, Canada
| | - Anthony E Lang
- From Biogen Inc. (R.M.H., K.F., M.Y., E.H., K.C.E., D.G., L.M., J.B.), Cambridge, MA; Biogen Inc. (T.F.), Maidenhead, United Kingdom; Formerly Biogen Inc. at time of study (E.N., J.M.C., T.D.); Clario (D.S.), Princeton, NJ; Biospective Inc. (B.J.B.), Montreal, Quebec, Canada; Nucleus Global (K.M.K.), Atlanta, GA; Coeruleus Clinical Sciences LLC (J.M.C.), Woodbridge, CT; Department of Neurology (B.M.), University Medical Center, Göttingen and Paracelsus-Elena-Klinik, Kassel, and Scientific Employee with an Honorary Contract at German Center for Neurodegenerative Diseases (DZNE), Germany; Morton and Gloria Shulman Movement Disorders Clinic (A.E.L.); and Edmond J. Safra Program in Parkinson's Disease (A.E.L.), Toronto, Ontario, Canada
| | - Tien Dam
- From Biogen Inc. (R.M.H., K.F., M.Y., E.H., K.C.E., D.G., L.M., J.B.), Cambridge, MA; Biogen Inc. (T.F.), Maidenhead, United Kingdom; Formerly Biogen Inc. at time of study (E.N., J.M.C., T.D.); Clario (D.S.), Princeton, NJ; Biospective Inc. (B.J.B.), Montreal, Quebec, Canada; Nucleus Global (K.M.K.), Atlanta, GA; Coeruleus Clinical Sciences LLC (J.M.C.), Woodbridge, CT; Department of Neurology (B.M.), University Medical Center, Göttingen and Paracelsus-Elena-Klinik, Kassel, and Scientific Employee with an Honorary Contract at German Center for Neurodegenerative Diseases (DZNE), Germany; Morton and Gloria Shulman Movement Disorders Clinic (A.E.L.); and Edmond J. Safra Program in Parkinson's Disease (A.E.L.), Toronto, Ontario, Canada
| | - John Beaver
- From Biogen Inc. (R.M.H., K.F., M.Y., E.H., K.C.E., D.G., L.M., J.B.), Cambridge, MA; Biogen Inc. (T.F.), Maidenhead, United Kingdom; Formerly Biogen Inc. at time of study (E.N., J.M.C., T.D.); Clario (D.S.), Princeton, NJ; Biospective Inc. (B.J.B.), Montreal, Quebec, Canada; Nucleus Global (K.M.K.), Atlanta, GA; Coeruleus Clinical Sciences LLC (J.M.C.), Woodbridge, CT; Department of Neurology (B.M.), University Medical Center, Göttingen and Paracelsus-Elena-Klinik, Kassel, and Scientific Employee with an Honorary Contract at German Center for Neurodegenerative Diseases (DZNE), Germany; Morton and Gloria Shulman Movement Disorders Clinic (A.E.L.); and Edmond J. Safra Program in Parkinson's Disease (A.E.L.), Toronto, Ontario, Canada
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Ma DR, Li SJ, Shi JJ, Liang YY, Hu ZW, Hao XY, Li MJ, Guo MN, Zuo CY, Yu WK, Mao CY, Tang MB, Zhang C, Xu YM, Wu J, Sun SL, Shi CH. Shared Genetic Architecture between Parkinson's Disease and Brain Structural Phenotypes. Mov Disord 2023; 38:2258-2268. [PMID: 37990409 DOI: 10.1002/mds.29598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 08/02/2023] [Accepted: 08/21/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Patients with Parkinson's disease (PD) have consistently demonstrated brain structure abnormalities, indicating the presence of shared etiological and pathological processes between PD and brain structures; however, the genetic relationship remains poorly understood. OBJECTIVE The aim of this study was to investigate the extent of shared genetic architecture between PD and brain structural phenotypes (BSPs) and to identify shared genomic loci. METHODS We used the summary statistics from genome-wide association studies to conduct MiXeR and conditional/conjunctional false discovery rate analyses to investigate the shared genetic signatures between PD and BSPs. Subsequent expression quantitative trait loci mapping in the human brain and enrichment analyses were also performed. RESULTS MiXeR analysis identified genetic overlap between PD and various BSPs, including total cortical surface area, average cortical thickness, and specific brain volumetric structures. Further analysis using conditional false discovery rate (FDR) identified 21 novel PD risk loci on associations with BSPs at conditional FDR < 0.01, and the conjunctional FDR analysis demonstrated that PD shared several genomic loci with certain BSPs at conjunctional FDR < 0.05. Among the shared loci, 16 credible mapped genes showed high expression in the brain tissues and were primarily associated with immune function-related biological processes. CONCLUSIONS We confirmed the polygenic overlap with mixed directions of allelic effects between PD and BSPs and identified multiple shared genomic loci and risk genes, which are likely related to immune-related biological processes. These findings provide insight into the complex genetic architecture associated with PD. © 2023 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Dong-Rui Ma
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Shuang-Jie Li
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Jing-Jing Shi
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Yuan-Yuan Liang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Zheng-Wei Hu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Xiao-Yan Hao
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Meng-Jie Li
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Meng-Nan Guo
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Chun-Yan Zuo
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Wen-Kai Yu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Cheng-Yuan Mao
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Cerebrovascular Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Mi-Bo Tang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Cerebrovascular Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Chan Zhang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Cerebrovascular Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Yu-Ming Xu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Cerebrovascular Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
- Institute of Neuroscience, Zhengzhou University, Zhengzhou, China
| | - Jun Wu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Cerebrovascular Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
- Institute of Neuroscience, Zhengzhou University, Zhengzhou, China
| | - Shi-Lei Sun
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Cerebrovascular Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
- Institute of Neuroscience, Zhengzhou University, Zhengzhou, China
| | - Chang-He Shi
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Cerebrovascular Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
- Institute of Neuroscience, Zhengzhou University, Zhengzhou, China
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Loehrer PA, Weber I, Oehrn CR, Nettersheim FS, Dafsari HS, Knake S, Tittgemeyer M, Timmermann L, Belke M. Microstructural alterations predict impaired bimanual control in Parkinson’s disease. Brain Commun 2022; 4:fcac137. [PMID: 35702729 PMCID: PMC9185383 DOI: 10.1093/braincomms/fcac137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 03/25/2022] [Accepted: 05/20/2022] [Indexed: 11/25/2022] Open
Abstract
Bimanual coordination is impaired in Parkinson’s disease affecting patients’ ability to perform activities of daily living and to maintain independence. Conveyance of information between cortical and subcortical areas is essential for bimanual coordination and relies on the integrity of cerebral microstructure. As pathological deposition of alpha-synuclein compromises microstructure in Parkinson’s disease, we investigated the relationship between microstructural integrity and bimanual coordination using diffusion-weighted MRI in 23 patients with Parkinson’s disease (mean age ± standard deviation: 56.0 ± 6.45 years; 8 female) and 26 older adults (mean age ± standard deviation: 58.5 ± 5.52 years). Whole-brain analysis revealed specific microstructural alterations between patients and healthy controls matched for age, sex, handedness, and cognitive status congruent with the literature and known Parkinson’s disease pathology. A general linear model revealed distinct microstructural alterations associated with poor bimanual coordination in Parkinson’s disease, corrected for multiple comparisons using a permutation-based approach. Integrating known functional topography, we conclude that distinct changes in microstructure cause an impediment of structures involved in attention, working memory, executive function, motor planning, motor control, and visual processing contributing to impaired bimanual coordination in Parkinson’s disease.
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Affiliation(s)
- Philipp A. Loehrer
- Correspondence to: Philipp A. Loehrer Department of Neurology Philipps-University Marburg, Baldinger Str 35043 Marburg, Germany E-mail:
| | - Immo Weber
- Department of Neurology, Philipps-University Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Philipps-University Marburg, Marburg, Germany
| | - Carina R. Oehrn
- Department of Neurology, Philipps-University Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Philipps-University Marburg, Marburg, Germany
- Department of Cardiology, University Hospital Cologne, Cologne, Germany
| | | | - Haidar S. Dafsari
- Department of Neurology, University Hospital Cologne, Cologne, Germany
| | - Susanne Knake
- Department of Neurology, Philipps-University Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Philipps-University Marburg, Marburg, Germany
- Center for Personalized Translational Epilepsy Research (CePTER) Consortium, Frankfurt am Main, Germany
| | - Marc Tittgemeyer
- Max Planck Institute for Metabolism Research, Cologne, Germany
- Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
| | - Lars Timmermann
- Department of Neurology, Philipps-University Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Philipps-University Marburg, Marburg, Germany
| | - Marcus Belke
- Department of Neurology, Philipps-University Marburg, Marburg, Germany
- Center for Personalized Translational Epilepsy Research (CePTER) Consortium, Frankfurt am Main, Germany
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Ragothaman A, Miranda-Dominguez O, Brumbach BH, Giritharan A, Fair DA, Nutt JG, Mancini M, Horak FB. Relationship Between Brain Volumes and Objective Balance and Gait Measures in Parkinson's Disease. JOURNAL OF PARKINSON'S DISEASE 2022; 12:283-294. [PMID: 34657849 DOI: 10.3233/jpd-202403] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Instrumented measures of balance and gait measure more specific balance and gait impairments than clinical rating scales. No prior studies have used objective balance/gait measures to examine associations with ventricular and brain volumes in people with Parkinson's disease (PD). OBJECTIVE To test the hypothesis that larger ventricular and smaller cortical and subcortical volumes are associated with impaired balance and gait in people with PD. METHODS Regional volumes from structural brain images were included from 96 PD and 50 control subjects. Wearable inertial sensors quantified gait, anticipatory postural adjustments prior to step initiation (APAs), postural responses to a manual push, and standing postural sway on a foam surface. Multiple linear regression models assessed the relationship between brain volumes and balance/gait and their interactions in PD and controls, controlling for sex, age and corrected for multiple comparisons. RESULTS Smaller brainstem and subcortical gray matter volumes were associated with larger sway area in people with PD, but not healthy controls. In contrast, larger ventricle volume was associated with smaller APAs in healthy controls, but not in people with PD. A sub-analysis in PD showed significant interactions between freezers and non-freezers, in several subcortical areas with stride time variability, gait speed and step initiation. CONCLUSION Our models indicate that smaller subcortical and brainstem volumes may be indicators of standing balance dysfunction in people with PD whereas enlarged ventricles may be related to step initiation difficulties in healthy aging. Also, multiple subcortical region atrophy may be associated with freezing of gait in PD.
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Affiliation(s)
| | - Oscar Miranda-Dominguez
- Masonic Institute for the Developing Brain (MIDB), University of Minnesota, Minneapolis, MN, USA
- Institute of Child Development, College of Education and Human Development, University of Minnesota, Minneapolis, MN, USA
- Department of Pediatrics, University of Minnesota Medical School, University of Minnesota, Minneapolis, MN, USA
| | - Barbara H Brumbach
- Biostatistics and Design Program, Oregon Health and Science University, Portland, OR, USA
| | - Andrew Giritharan
- Department of Neurology, Oregon Health and Science University, Portland, OR, USA
| | - Damien A Fair
- Masonic Institute for the Developing Brain (MIDB), University of Minnesota, Minneapolis, MN, USA
- Institute of Child Development, College of Education and Human Development, University of Minnesota, Minneapolis, MN, USA
- Department of Pediatrics, University of Minnesota Medical School, University of Minnesota, Minneapolis, MN, USA
- Department of Behavioral Neuroscience, Oregon Health and Science University, Portland, OR, USA
| | - John G Nutt
- Department of Neurology, Oregon Health and Science University, Portland, OR, USA
| | - Martina Mancini
- Department of Biomedical Engineering, Oregon Health and Science University, Portland, OR, USA
- Department of Neurology, Oregon Health and Science University, Portland, OR, USA
| | - Fay B Horak
- Department of Biomedical Engineering, Oregon Health and Science University, Portland, OR, USA
- Department of Behavioral Neuroscience, Oregon Health and Science University, Portland, OR, USA
- Department of Neurology, Oregon Health and Science University, Portland, OR, USA
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5
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Baglio F, Pirastru A, Bergsland N, Cazzoli M, Tavazzi E. Neuroplasticity mediated by motor rehabilitation in Parkinson's disease: a systematic review on structural and functional MRI markers. Rev Neurosci 2021; 33:213-226. [PMID: 34461010 DOI: 10.1515/revneuro-2021-0064] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 07/30/2021] [Indexed: 01/06/2023]
Abstract
Parkinson's disease (PD) is the second most common neurological disease affecting the elderly population. Pharmacological and surgical interventions usually employed for PD treatment show transient effectiveness and are associated with the insurgence of side effects. Therefore, motor rehabilitation has been proposed as a promising supplement in the treatment of PD, reducing the global burden of the disease and improving patients quality of life. The present systematic review aimed to critically analyse the literature concerning MRI markers of brain functional and structural response to motor rehabilitation in PD. Fourteen out of 1313 studies were selected according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. Despite the limited number of retrieved studies coupled with their heterogeneity prevent ultimate conclusions from being drawn, motor rehabilitation seems to have beneficial effects on PD as measured both with clinical outcomes and MRI derived indices. Interestingly, consistent results seem to indicate that motor rehabilitation acts via a dual mechanism of strengthening cortico-subcortical pathways, restoring movements automaticity, or activating compensatory networks such as the fronto-parietal one. The employment of more advanced and quantitative MRI methods is warranted to establish and validate standardized metrics capable of reliably determining the changes induced by rehabilitative intervention.
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Affiliation(s)
- Francesca Baglio
- IRCCS, Fondazione Don Carlo Gnocchi ONLUS, via Capecelatro 66, 20148Milan, Italy
| | - Alice Pirastru
- IRCCS, Fondazione Don Carlo Gnocchi ONLUS, via Capecelatro 66, 20148Milan, Italy
| | - Niels Bergsland
- IRCCS, Fondazione Don Carlo Gnocchi ONLUS, via Capecelatro 66, 20148Milan, Italy.,Department of Neurology, Buffalo Neuroimaging Analysis Center, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, 100 High Street, Buffalo, NY14203, USA
| | - Marta Cazzoli
- IRCCS, Fondazione Don Carlo Gnocchi ONLUS, via Capecelatro 66, 20148Milan, Italy
| | - Eleonora Tavazzi
- IRCCS, Fondazione Don Carlo Gnocchi ONLUS, via Capecelatro 66, 20148Milan, Italy.,Department of Neurology, Buffalo Neuroimaging Analysis Center, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, 100 High Street, Buffalo, NY14203, USA
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6
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Laansma MA, Bright JK, Al-Bachari S, Anderson TJ, Ard T, Assogna F, Baquero KA, Berendse HW, Blair J, Cendes F, Dalrymple-Alford JC, de Bie RMA, Debove I, Dirkx MF, Druzgal J, Emsley HCA, Garraux G, Guimarães RP, Gutman BA, Helmich RC, Klein JC, Mackay CE, McMillan CT, Melzer TR, Parkes LM, Piras F, Pitcher TL, Poston KL, Rango M, Ribeiro LF, Rocha CS, Rummel C, Santos LSR, Schmidt R, Schwingenschuh P, Spalletta G, Squarcina L, van den Heuvel OA, Vriend C, Wang JJ, Weintraub D, Wiest R, Yasuda CL, Jahanshad N, Thompson PM, van der Werf YD. International Multicenter Analysis of Brain Structure Across Clinical Stages of Parkinson's Disease. Mov Disord 2021; 36:2583-2594. [PMID: 34288137 PMCID: PMC8595579 DOI: 10.1002/mds.28706] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 06/07/2021] [Accepted: 06/09/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Brain structure abnormalities throughout the course of Parkinson's disease have yet to be fully elucidated. OBJECTIVE Using a multicenter approach and harmonized analysis methods, we aimed to shed light on Parkinson's disease stage-specific profiles of pathology, as suggested by in vivo neuroimaging. METHODS Individual brain MRI and clinical data from 2357 Parkinson's disease patients and 1182 healthy controls were collected from 19 sources. We analyzed regional cortical thickness, cortical surface area, and subcortical volume using mixed-effects models. Patients grouped according to Hoehn and Yahr stage were compared with age- and sex-matched controls. Within the patient sample, we investigated associations with Montreal Cognitive Assessment score. RESULTS Overall, patients showed a thinner cortex in 38 of 68 regions compared with controls (dmax = -0.20, dmin = -0.09). The bilateral putamen (dleft = -0.14, dright = -0.14) and left amygdala (d = -0.13) were smaller in patients, whereas the left thalamus was larger (d = 0.13). Analysis of staging demonstrated an initial presentation of thinner occipital, parietal, and temporal cortices, extending toward rostrally located cortical regions with increased disease severity. From stage 2 and onward, the bilateral putamen and amygdala were consistently smaller with larger differences denoting each increment. Poorer cognition was associated with widespread cortical thinning and lower volumes of core limbic structures. CONCLUSIONS Our findings offer robust and novel imaging signatures that are generally incremental across but in certain regions specific to disease stages. Our findings highlight the importance of adequately powered multicenter collaborations.
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Affiliation(s)
- Max A Laansma
- Department of Anatomy & Neurosciences, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Joanna K Bright
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, California, USA
| | - Sarah Al-Bachari
- Faculty of Health and Medicine, The University of Lancaster, Lancaster, UK.,Division of Neuroscience and Experimental Psychology, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.,Department of Neurology, Royal Preston Hospital, Preston, UK
| | - Tim J Anderson
- Department of Medicine, University of Otago, Christchurch, Christchurch, New Zealand
| | - Tyler Ard
- Department of Neurology, USC Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, California, USA
| | - Francesca Assogna
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, Rome, Italy
| | | | - Henk W Berendse
- Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Jamie Blair
- Department of Medical Imaging, University of Virginia Health System, Charlottesville, Virginia, USA
| | - Fernando Cendes
- Neuroimaging Laboratory, Department of Neurology, University of Campinas, Campinas, Brazil
| | - John C Dalrymple-Alford
- New Zealand Brain Research Institute, Christchurch, New Zealand.,School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand.,Brain Research New Zealand - Rangahau Roro Aotearoa, Centre of Research Excellence, Auckland, New Zealand
| | - Rob M A de Bie
- Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Ines Debove
- Department of Neurology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland
| | - Michiel F Dirkx
- Department of Neurology and Center of Expertise for Parkinson & Movement Disorders, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.,Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Jason Druzgal
- Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, Virginia, USA
| | - Hedley C A Emsley
- Division of Neuroscience and Experimental Psychology, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.,Lancaster Medical School, Lancaster University, Preston, UK
| | - Gäetan Garraux
- GIGA-CRC In Vivo Imaging, University of Liège, Liège, Belgium.,Department of Neurology, CHU Liège, Liège, Belgium
| | - Rachel P Guimarães
- Neuroimaging Laboratory, Department of Neurology, University of Campinas, Campinas, Brazil
| | - Boris A Gutman
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, Illinois, USA
| | - Rick C Helmich
- Department of Neurology and Center of Expertise for Parkinson & Movement Disorders, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.,Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Johannes C Klein
- Department of Clinical Neurosciences, Division of Clinical Neurology, Oxford Parkinson's Disease Centre, Nuffield, University of Oxford, Oxford, UK
| | - Clare E Mackay
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Corey T McMillan
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Tracy R Melzer
- Department of Medicine, University of Otago, Christchurch, Christchurch, New Zealand.,New Zealand Brain Research Institute, Christchurch, New Zealand.,Brain Research New Zealand - Rangahau Roro Aotearoa, Centre of Research Excellence, Auckland, New Zealand
| | - Laura M Parkes
- Division of Neuroscience and Experimental Psychology, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Fabrizio Piras
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Toni L Pitcher
- Department of Medicine, University of Otago, Christchurch, Christchurch, New Zealand.,New Zealand Brain Research Institute, Christchurch, New Zealand.,Brain Research New Zealand - Rangahau Roro Aotearoa, Centre of Research Excellence, Auckland, New Zealand
| | - Kathleen L Poston
- Department of Neurology & Neurological Sciences, Stanford University, Palo Alto, California, USA
| | - Mario Rango
- Excellence Center for Advanced MR Techniques and Parkinson's Disease Center, Neurology Unit, Fondazione IRCCS Cà Granda Maggiore Policlinico Hospital, University of Milan, Milan, Italy
| | - Letícia F Ribeiro
- Neuroimaging Laboratory, Department of Neurology, University of Campinas, Campinas, Brazil
| | - Cristiane S Rocha
- Neuroimaging Laboratory, Department of Neurology, University of Campinas, Campinas, Brazil.,Department of Medical Genetics, University of Campinas, Campinas, Brazil
| | - Christian Rummel
- Support Center for Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Bern, Switzerland
| | - Lucas S R Santos
- Neuroimaging Laboratory, Department of Neurology, University of Campinas, Campinas, Brazil
| | - Reinhold Schmidt
- Department of Neurology, Clinical Division of Neurogeriatrics, Medical University Graz, Graz, Austria
| | | | | | - Letizia Squarcina
- Excellence Center for Advanced MR Techniques and Parkinson's Disease Center, Neurology Unit, Fondazione IRCCS Cà Granda Maggiore Policlinico Hospital, University of Milan, Milan, Italy
| | - Odile A van den Heuvel
- Department of Anatomy & Neurosciences, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Chris Vriend
- Department of Anatomy & Neurosciences, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jiun-Jie Wang
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan City, Taiwan.,Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Keelung Branch, Keelung City, Taiwan
| | - Daniel Weintraub
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Roland Wiest
- Support Center for Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Bern, Switzerland
| | - Clarissa L Yasuda
- Neuroimaging Laboratory, Department of Neurology, University of Campinas, Campinas, Brazil
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, California, USA
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, California, USA
| | - Ysbrand D van der Werf
- Department of Anatomy & Neurosciences, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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7
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Vitale A, Villa R, Ugga L, Romeo V, Stanzione A, Cuocolo R. Artificial intelligence applied to neuroimaging data in Parkinsonian syndromes: Actuality and expectations. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2021; 18:1753-1773. [PMID: 33757209 DOI: 10.3934/mbe.2021091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Idiopathic Parkinson's Disease (iPD) is a common motor neurodegenerative disorder. It affects more frequently the elderly population, causing a significant emotional burden both for the patient and caregivers, due to the disease-related onset of motor and cognitive disabilities. iPD's clinical hallmark is the onset of cardinal motor symptoms such as bradykinesia, rest tremor, rigidity, and postural instability. However, these symptoms appear when the neurodegenerative process is already in an advanced stage. Furthermore, the greatest challenge is to distinguish iPD from other similar neurodegenerative disorders, "atypical parkinsonisms", such as Multisystem Atrophy, Progressive Supranuclear Palsy and Cortical Basal Degeneration, since they share many phenotypic manifestations, especially in the early stages. The diagnosis of these neurodegenerative motor disorders is essentially clinical. Consequently, the diagnostic accuracy mainly depends on the professional knowledge and experience of the physician. Recent advances in artificial intelligence have made it possible to analyze the large amount of clinical and instrumental information in the medical field. The application machine learning algorithms to the analysis of neuroimaging data appear to be a promising tool for identifying microstructural alterations related to the pathological process in order to explain the onset of symptoms and the spread of the neurodegenerative process. In this context, the search for quantitative biomarkers capable of identifying parkinsonian patients in the prodromal phases of the disease, of correctly distinguishing them from atypical parkinsonisms and of predicting clinical evolution and response to therapy represent the main goal of most current clinical research studies. Our aim was to review the recent literature and describe the current knowledge about the contribution given by machine learning applications to research and clinical management of parkinsonian syndromes.
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Affiliation(s)
- Annalisa Vitale
- Department of Advanced Biomedical Sciences, University of Naples "Federico Ⅱ", Via S. Pansini 5, 80131-Naples, Italy
| | - Rossella Villa
- Department of Advanced Biomedical Sciences, University of Naples "Federico Ⅱ", Via S. Pansini 5, 80131-Naples, Italy
| | - Lorenzo Ugga
- Department of Advanced Biomedical Sciences, University of Naples "Federico Ⅱ", Via S. Pansini 5, 80131-Naples, Italy
| | - Valeria Romeo
- Department of Advanced Biomedical Sciences, University of Naples "Federico Ⅱ", Via S. Pansini 5, 80131-Naples, Italy
| | - Arnaldo Stanzione
- Department of Advanced Biomedical Sciences, University of Naples "Federico Ⅱ", Via S. Pansini 5, 80131-Naples, Italy
| | - Renato Cuocolo
- Department of Clinical Medicine and Surgery, University of Naples "Federico Ⅱ", Via S. Pansini 5, 80131-Naples, Italy
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8
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Sarasso E, Agosta F, Piramide N, Filippi M. Progression of grey and white matter brain damage in Parkinson's disease: a critical review of structural MRI literature. J Neurol 2020; 268:3144-3179. [PMID: 32378035 DOI: 10.1007/s00415-020-09863-8] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 04/23/2020] [Indexed: 10/24/2022]
Abstract
The current review summarizes the current knowledge on longitudinal cortical and subcortical grey and white matter MRI findings assessed using T1-weighted and one-tensor diffusion-weighted MRI in Parkinson's disease (PD) patients. Results were reviewed according to disease duration, disease severity and cognitive impairment. The most consistent findings are those showing a progressive cortical atrophy accumulation in caudate, putamen, temporal/hippocampal, frontal and parietal areas in de novo PD cases and in the early/middle phase of the disease, with the achievement of a plateau in the later stage. Analyzing results according to the patient cognitive status, only a few studies used longitudinal MRI metrics to predict mild cognitive impairment or dementia conversion in PD patients, suggesting that atrophy of the hippocampus, fronto-temporal areas, caudate, thalamus and accumbens might play a role in this process. Stratifying patients according to disease severity, findings appear partially controversial, although showing a progressive atrophy of basal ganglia over 1 year of follow up and a widespread cortical thinning over 3-6 years in mild to moderate PD patients. Finally, microstructural damage of the main motor and associative WM tracts seems to be present, and rapidly progress, even in the early phase of PD. The utility of structural MRI metrics as biomarkers of PD progression and their role in improving the accuracy of disease progression prediction is still debated.
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Affiliation(s)
- Elisabetta Sarasso
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy.,Laboratory of Movement Analysis, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Federica Agosta
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Noemi Piramide
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy. .,Vita-Salute San Raffaele University, Milan, Italy. .,Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy. .,Neurophysiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
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9
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Larijani B, Goodarzi P, Payab M, Tayanloo-Beik A, Sarvari M, Gholami M, Gilany K, Nasli-Esfahani E, Yarahmadi M, Ghaderi F, Arjmand B. The Design and Application of an Appropriate Parkinson's Disease Animal Model in Regenerative Medicine. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1341:89-105. [PMID: 31485993 DOI: 10.1007/5584_2019_422] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Aging as an inevitable and complex physiological process occurs through a progressive decrease in the potential of tissue regeneration. Given the increasing global outbreak of aging and age-related disorders, it is important to control this phenomenon. Parkinson's disease (one of the age-related neurodegenerative and progressive disorders) resulted from predominant dopaminergic neurons deficiency. Usual Parkinson's disease treatments just can lead to symptomatically relieving. Recently, cell therapy and regenerative medicine a great promise in the treatment of several types of disorders including Parkinson's disease. Herein, before starting clinical trials, preclinical studies should be performed to answer some fundamental questions about the safety and efficacy of various treatments. Additionally, developing a well-designed and approved study is required to provide an appropriate animal model with strongly reliable validation methods. Hereupon, this review will discuss about the design and application of an appropriate Parkinson's disease animal model in regenerative medicine. EVIDENCE ACQUISITION In order to conduct the present review, numbers of Parkinson's disease preclinical studies, as well as literatures related to the animal modeling, were considered. RESULTS Appropriate animal models which approved by related authorize committees should have a high similarity to humans from anatomical, physiological, behavioral, and genetic characteristics view of point. CONCLUSION It is concluded that animal studies before starting clinical trials have an important role in answering the crucial questions about the various treatments safety and efficacy. Therein, it is recommended that all of animal modeling stages be assessed by animal ethics and welfare guidelines and also evaluated by different validation tests. However, it is better to find some alternatives to replacement, refinement, and, reduction of animals. Nowadays, some novel technologies such as using imaging methods have been introduced.
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Affiliation(s)
- Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical sciences, Tehran, Iran
| | - Parisa Goodarzi
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Moloud Payab
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Akram Tayanloo-Beik
- Cell Therapy and Regenerative Medicine Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoumeh Sarvari
- Metabolomics and Genomics Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdi Gholami
- Department of Toxicology & Pharmacology, Faculty of Pharmacy, Toxicology and Poisoning Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Kambiz Gilany
- Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium.,Integrative Oncology Department, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
| | - Ensieh Nasli-Esfahani
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrnoosh Yarahmadi
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical sciences, Tehran, Iran
| | - Firoozeh Ghaderi
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Babak Arjmand
- Cell Therapy and Regenerative Medicine Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. .,Metabolomics and Genomics Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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