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Tabari F, Patron C, Cryer H, Johari K. HD-tDCS over left supplementary motor area differentially modulated neural correlates of motor planning for speech vs. limb movement. Int J Psychophysiol 2024; 201:112357. [PMID: 38701898 DOI: 10.1016/j.ijpsycho.2024.112357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 04/15/2024] [Accepted: 04/30/2024] [Indexed: 05/05/2024]
Abstract
The supplementary motor area (SMA) is implicated in planning, execution, and control of speech production and limb movement. The SMA is among putative generators of pre-movement EEG activity which is thought to be neural markers of motor planning. In neurological conditions such as Parkinson's disease, abnormal pre-movement neural activity within the SMA has been reported during speech production and limb movement. Therefore, this region can be a potential target for non-invasive brain stimulation for both speech and limb movement. The present study took an initial step in examining the application of high-definition transcranial direct current stimulation (HD-tDCS) over the left SMA in 24 neurologically intact adults. Subsequently, event-related potentials (ERPs) were recorded while participants performed speech and limb movement tasks. Participants' data were collected in three counterbalanced sessions: anodal, cathodal and sham HD-tDCS. Relative to sham stimulation, anodal, but not cathodal, HD-tDCS significantly attenuated ERPs prior to the onset of the speech production. In contrast, neither anodal nor cathodal HD-tDCS significantly modulated ERPs prior to the onset of limb movement compared to sham stimulation. These findings showed that neural correlates of motor planning can be modulated using HD-tDCS over the left SMA in neurotypical adults, with translational implications for neurological conditions that impair speech production. The absence of a stimulation effect on ERPs prior to the onset of limb movement was not expected in this study, and future studies are warranted to further explore this effect.
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Affiliation(s)
- Fatemeh Tabari
- Human Neurophysiology and Neuromodulation Lab, Communication Sciences and Disorders, Louisiana State University, Baton Rouge, LA, USA
| | - Celeste Patron
- Human Neurophysiology and Neuromodulation Lab, Communication Sciences and Disorders, Louisiana State University, Baton Rouge, LA, USA
| | - Hope Cryer
- Human Neurophysiology and Neuromodulation Lab, Communication Sciences and Disorders, Louisiana State University, Baton Rouge, LA, USA
| | - Karim Johari
- Human Neurophysiology and Neuromodulation Lab, Communication Sciences and Disorders, Louisiana State University, Baton Rouge, LA, USA.
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Baarbé J, Brown MJN, Saha U, Tran S, Weissbach A, Saravanamuttu J, Cheyne D, Hutchison WD, Chen R. Cortical modulations before lower limb motor blocks are associated with freezing of gait in Parkinson's disease: an EEG source localization study. Neurobiol Dis 2024; 199:106557. [PMID: 38852752 DOI: 10.1016/j.nbd.2024.106557] [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: 03/26/2024] [Revised: 05/15/2024] [Accepted: 06/05/2024] [Indexed: 06/11/2024] Open
Abstract
BACKGROUND Freezing of gait (FOG) is a debilitating symptom of Parkinson's disease (PD) characterized by paroxysmal episodes in which patients are unable to step forward. A research priority is identifying cortical changes before freezing in PD-FOG. METHODS We tested 19 patients with PD who had been assessed for FOG (n=14 with FOG and 5 without FOG). While seated, patients stepped bilaterally on pedals to progress forward through a virtual hallway while 64-channel EEG was recorded. We assessed cortical activities before and during lower limb motor blocks (LLMB), defined as a break in rhythmic pedaling, and stops, defined as movement cessation following an auditory stop cue. This task was selected because LLMB correlates with FOG severity in PD and allows recording of high-quality EEG. Patients were tested after overnight withdrawal from dopaminergic medications ("off" state) and in the "on" medications state. EEG source activities were evaluated using individual MRI and standardized low resolution brain electromagnetic tomography (sLORETA). Functional connectivity was evaluated by phase lag index between seeds and pre-defined cortical regions of interest. RESULTS EEG source activities for LLMB vs. cued stops localized to right posterior parietal area (Brodmann area 39), lateral premotor area (Brodmann area 6), and inferior frontal gyrus (Brodmann area 47). In these areas, PD-FOG (n=14) increased alpha rhythms (8-12 Hz) before LLMB vs. typical stepping, whereas PD without FOG (n=5) decreased alpha power. Alpha rhythms were linearly correlated with LLMB severity, and the relationship became an inverted U-shape when assessing alpha rhythms as a function of percent time in LLMB in the "off" medication state. Right inferior frontal gyrus and supplementary motor area connectivity was observed before LLMB in the beta band (13-30 Hz). This same pattern of connectivity was seen before stops. Dopaminergic medication improved FOG and led to less alpha synchronization and increased functional connections between frontal and parietal areas. CONCLUSIONS Right inferior parietofrontal structures are implicated in PD-FOG. The predominant changes were in the alpha rhythm, which increased before LLMB and with LLMB severity. Similar connectivity was observed for LLMB and stops between the right inferior frontal gyrus and supplementary motor area, suggesting that FOG may be a form of "unintended stopping." These findings may inform approaches to neurorehabilitation of PD-FOG.
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Affiliation(s)
- Julianne Baarbé
- Department of Medicine, University of Toronto and Division of Brain, Imaging & Behaviour, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada; Faculty of Health, York University, Toronto, Ontario, Canada.
| | - Matt J N Brown
- Department of Kinesiology, California State University, Sacramento, CA, USA
| | - Utpal Saha
- Department of Medicine, University of Toronto and Division of Brain, Imaging & Behaviour, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Stephanie Tran
- Department of Medicine, University of Toronto and Division of Brain, Imaging & Behaviour, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Anne Weissbach
- Institute of Systems Motor Science, Center of Brain, Behavior and Metabolism, University of Lübeck, Germany
| | - James Saravanamuttu
- Department of Medicine, University of Toronto and Division of Brain, Imaging & Behaviour, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Douglas Cheyne
- Program in Neurosciences and Mental Health, Hospital for Sick Children Research Institute, Toronto, ON, Canada
| | - William D Hutchison
- Department of Medicine, University of Toronto and Division of Brain, Imaging & Behaviour, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada; Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Robert Chen
- Department of Medicine, University of Toronto and Division of Brain, Imaging & Behaviour, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada; Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
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Johari K, Berger JI. Theta oscillations within right dorsolateral prefrontal cortex contribute differently to speech versus limb inhibition. J Neurosci Res 2024; 102:e25298. [PMID: 38361410 DOI: 10.1002/jnr.25298] [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: 08/23/2023] [Revised: 01/03/2024] [Accepted: 01/14/2024] [Indexed: 02/17/2024]
Abstract
Evidence suggests that speech and limb movement inhibition are subserved by common neural mechanisms, particularly within the right prefrontal cortex. In a recent study, we found that cathodal stimulation of right dorsolateral prefrontal cortex (rDLPFC) differentially modulated P3 event-related potentials for speech versus limb inhibition. In the present study, we further analyzed these data to examine the effects of cathodal high-definition transcranial direct current stimulation (HD-tDCS) over rDLPFC on frontal theta - an oscillatory marker of cognitive control - in response to speech and limb inhibition, during a Go/No-Go task in 21 neurotypical adults. Electroencephalography data demonstrated that both speech and limb No-Go elicited prominent theta activity over right prefrontal electrodes, with stronger activity for speech compared to limb. Moreover, we found that cathodal stimulation significantly increased theta power over right prefrontal electrodes for speech versus limb No-Go. Source analysis revealed that cathodal, but not sham, stimulation increased theta activity within rDLPFC and bilateral premotor cortex for speech No-Go compared to limb movement inhibition. These findings complement our previous report and suggest (1) right prefrontal theta activity is an amodal oscillatory mechanism supporting speech and limb inhibition, (2) larger theta activity in prefrontal electrodes for speech versus limb following cathodal stimulation may reflect allocation of additional neural resources for a more complex motor task, such as speech compared to limb movement. These findings have translational implications for conditions such as Parkinson's disease, wherein both speech and limb movement are impaired.
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Affiliation(s)
- Karim Johari
- Human Neurophysiology and Neuromodulation Lab, Department of Communication Sciences and Disorders, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Joel I Berger
- Human Brain Research Laboratory, Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
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Xue X, Huang A, Zeng J, Song H, Xing Y, Chan P, Xu E, Zhou L. The mechanism of impaired delayed recall verbal memory function in Parkinson's disease with orthostatic hypotension: a multiple imaging study. Front Neurol 2023; 14:1149577. [PMID: 37533464 PMCID: PMC10393246 DOI: 10.3389/fneur.2023.1149577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 03/27/2023] [Indexed: 08/04/2023] Open
Abstract
Introduction Orthostatic hypotension (OH) frequently accompanies autonomic dysfunction and is an important risk factor for cognitive impairment in Parkinson's disease (PD). However, the association between different cognitive functions and OH in PD patients is not yet fully understood. Methods This study aimed to evaluate the scores of different cognitive domains and multiple parameters using different imaging techniques on PD patients with or without OH. A total number of 31 PD patients with OH (n = 20) and without OH (n = 11) were recruited from the Department of Neurology, Beijing Xuanwu Hospital for this study. All patients underwent beat-to-beat non-invasive blood pressure recordings and an active standing test to evaluate neurogenic OH and a global neuropsychological test to assess cognitive function. All patients underwent dynamic cerebral autoregulation (dCA) measurement, brain magnetic resonance imaging (MRI), and brain 18fluorine-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT). Results The results showed that OH patients had poor delayed recall verbal memory when compared with the PD patients without OH (1.75 ± 1.59 vs. 3.10 ± 1.73, p = 0.042). The dCA test indicated a significant difference in the right very low-frequency (VLF) gain between two groups (1.27 ± 0.17 vs. 1.10 ± 0.26, p = 0.045) and the brain 18F-FDG PET/CT indicated a significant difference in the SUV (right medial temporal lobe) to SUV (occipital lobe) ratio (0.60 ± 0.08 vs. 0.67 ± 0.11, p = 0.049). Meanwhile, these two imaging parameters were negatively correlated (p < 0.001). Furthermore, the score of a delayed recall verbal memory in the OH group was positively correlated with the right medial temporal lobe to occipital lobe ratio (p < 0.001) and was negatively correlated with the right VLF gain (p = 0.023). Discussion PD with OH patients had poor delayed recall memory, which might have been caused by the decreased metabolic dysfunction of specific medial temporal lobe due to the impaired dCA ability.
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Affiliation(s)
- Xiaofan Xue
- Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
- Department of Neurology, Beijing Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Anqi Huang
- Department of Neurology, Beijing Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jingrong Zeng
- Department of Neurology, Beijing Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Haixia Song
- Department of Neurology, The People's Hospital of Shijiazhuang, Shijiazhuang, Hebei, China
| | - Yingqi Xing
- Department of Neurology, Beijing Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Piu Chan
- Department of Neurology, Beijing Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Erhe Xu
- Department of Neurology, Beijing Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Lichun Zhou
- Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
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Johari K, Lai VT, Riccardi N, Desai RH. Temporal features of concepts are grounded in time perception neural networks: An EEG study. BRAIN AND LANGUAGE 2023; 237:105220. [PMID: 36587493 PMCID: PMC10100101 DOI: 10.1016/j.bandl.2022.105220] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 11/18/2022] [Accepted: 12/16/2022] [Indexed: 06/17/2023]
Abstract
Experimental evidence suggests that modality-specific concept features such as action, motion, and sound partially rely on corresponding action/perception neural networks in the human brain.Little is known, however, about time-related features of concepts. We examined whether temporal features of concepts recruit networks that subserve time perception in the brain in an EEG study using event and object nouns. Results showed significantly larger ERPs for event duration vs object size judgments over right parietal electrodes, a region associated with temporal processing. Additionally, alpha/beta (10-15 Hz) neural oscillation showed a stronger desynchronization for event duration compared to object size in the right parietal electrodes. This difference was not seen in control tasks comparing event vs object valence, suggesting that it is not likely to reflect a general difference between event and object nouns. These results indicate that temporal features of words may be subserved by time perception circuits in the human brain.
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Affiliation(s)
- Karim Johari
- Human Neurophysiology and Neuromodulation Lab, Department of Communication Sciences and Disorders, Louisiana State University, Baton Rouge, LA, USA
| | - Vicky T Lai
- Department of Psychology, University of Arizona, Tucson, AZ, USA
| | - Nicholas Riccardi
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Rutvik H Desai
- Department of Psychology, University of South Carolina, Columbia, SC, USA; Institute for Mind and Brain, University of South Carolina, Columbia, SC, USA.
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Tankus A, Lustig Y, Fried I, Strauss I. Impaired Timing of Speech-Related Neurons in the Subthalamic Nucleus of Parkinson Disease Patients Suffering Speech Disorders. Neurosurgery 2021; 89:800-809. [PMID: 34392374 DOI: 10.1093/neuros/nyab293] [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: 08/25/2020] [Accepted: 06/06/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Our previous study found degradation to subthalamic neuronal encoding of speech features in Parkinson disease (PD) patients suffering from speech disorders. OBJECTIVE To find how timing of speech-related neuronal firing changes in PD patients with speech disorders compared to PD patients without speech disorders. METHODS During the implantation of deep brain stimulator (DBS), we recorded the activity of single neurons in the subthalamic nucleus (STN) of 18 neurosurgical patients with PD while they articulated, listened to, or imagined articulation of 5 vowel sounds, each following a beep. We compared subthalamic activity of PD patients with (n = 10) vs without speech disorders. RESULTS In this comparison, patients with speech disorders had longer reaction times and shorter lengths of articulation. Their speech-related neuronal activity preceding speech onset (planning) was delayed relative to the beep, but the time between this activity and the emission of speech sound was similar. Notwithstanding, speech-related neuronal activity following the onset of speech (feedback) was delayed when computed relative to the onset. Only in these patients was the time lag of planning neurons significantly correlated with the reaction time. Neuronal activity in patients with speech disorders was delayed during imagined articulation of vowel sounds but earlier during speech perception. CONCLUSION Our findings indicate that longer reaction times in patients with speech disorders are due to STN or earlier activity of the speech control network. This is a first step in locating the source(s) of PD delays within this network and is therefore of utmost importance for future treatment of speech disorders.
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Affiliation(s)
- Ariel Tankus
- Functional Neurosurgery Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Department of Neurology and Neurosurgery, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Yael Lustig
- Department of Neurology and Neurosurgery, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Itzhak Fried
- Functional Neurosurgery Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Department of Neurology and Neurosurgery, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California
| | - Ido Strauss
- Functional Neurosurgery Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Department of Neurology and Neurosurgery, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Johari K, Behroozmand R. Neural correlates of speech and limb motor timing deficits revealed by aberrant beta band desynchronization in Parkinson's disease. Clin Neurophysiol 2021; 132:2711-2721. [PMID: 34373199 DOI: 10.1016/j.clinph.2021.06.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 05/25/2021] [Accepted: 06/06/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE We used a classical motor reaction time paradigm to examine the effects of Parkinson's disease (PD) on the mechanisms of speech production and upper limb movement. METHODS Electro-encephalography (EEG) signals were recorded in PD and control groups during speech vowel production and button press tasks in response to temporally predictable and unpredictable visual stimuli. RESULTS Motor reaction times were slower in PD vs. control group independent of stimulus timing and movement modality. This effect was accompanied by stronger desynchronizations of low beta (13-18 Hz) and high beta (18-25 Hz) band neural oscillations in PD vs. control prior to the onset of speech and hand movement. In addition, pre-movement desynchronization of beta band oscillations were correlated with motor reaction time in control subjects with faster responses associated with weaker beta band desynchronizations during the planning phase of movement. However, no such effect was found in the PD group. CONCLUSIONS We suggest that the aberrant pattern of beta band desynchronization is a neural correlate of speech and upper limb motor timing deficits as a result of cortico-striatal pathology in PD. SIGNIFICANCE These findings motivate interventions targeted toward normalizing beta band activities for improving speech and upper limb movement timing in PD.
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Affiliation(s)
- Karim Johari
- Speech Neuroscience Lab, Department of Communication Sciences and Disorders, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, United States; Human Brain Research Lab, Department of Neurosurgery, University of Iowa, 200 Hawkins Dr., Iowa City, IA 52242, United States
| | - Roozbeh Behroozmand
- Speech Neuroscience Lab, Department of Communication Sciences and Disorders, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, United States.
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Low-Frequency Repetitive Transcranial Magnetic Stimulation over Right Dorsolateral Prefrontal Cortex in Parkinson's Disease. PARKINSONS DISEASE 2020; 2020:7295414. [PMID: 33005318 PMCID: PMC7509565 DOI: 10.1155/2020/7295414] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 07/01/2020] [Accepted: 08/26/2020] [Indexed: 11/25/2022]
Abstract
Background Repetitive transcranial magnetic stimulation (rTMS) is a promising therapeutic tool for Parkinson's disease (PD), and many stimulation targets have been implicated. We aim to explore whether low-frequency rTMS over the right dorsolateral prefrontal cortex (DLPFC) improves motor and nonmotor symptoms of individuals with PD. Methods We conducted a randomized, single-blind, sham-controlled parallel trial to compare the effect of 10 consecutive daily sessions of 1 Hz rTMS over right DLPFC on individuals with idiopathic PD between active and sham rTMS group. Primary outcomes were changes in Unified Parkinson's Disease Rating Scale (UPDRS) part III and Nonmotor Symptom Questionnaire (NMSQ). Secondary outcomes were changes in UPDRS total score, Hamilton Rating Scale for Depression (HRSD), Pittsburgh Sleep Quality Index (PSQI), and Montreal Cognitive Assessment (MoCA). Assessments were completed at baseline, after treatment, and at 1 month, 3 months, and 6 months after treatment. Results A total of 33 participants with PD were randomized. All participants completed the study and no severe adverse effect was noticed. Compared to baseline, active rTMS showed significant improvements in UPDRS part III and NMSQ at 1 month. Change of scores on UPDRS part III, HRSD, and PSQI persisted for 3 months after rTMS intervention. The beneficial effect on cognitive performance assessed by MoCA was maintained for at least 6 months in the follow-up. No significant changes were observed in the group with sham rTMS. Conclusions Low-frequency rTMS of right DLPFC could be a potential selection in managing motor and nonmotor symptoms in PD.
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