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Chen P, Tang G, Wang Y, Xiong W, Deng Y, Fei S, Zhang J. Spontaneous brain activity in the hippocampal regions could characterize cognitive impairment in patients with Parkinson's disease. CNS Neurosci Ther 2024; 30:e14706. [PMID: 38584347 PMCID: PMC10999557 DOI: 10.1111/cns.14706] [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: 11/12/2023] [Revised: 02/19/2024] [Accepted: 03/15/2024] [Indexed: 04/09/2024] Open
Abstract
OBJECTIVE This study aimed to investigate whether spontaneous brain activity can be used as a prospective indicator to identify cognitive impairment in patients with Parkinson's disease (PD). METHODS Resting-state functional magnetic resonance imaging (RS-fMRI) was performed on PD patients. The cognitive level of patients was assessed by the Montreal Cognitive Assessment (MoCA) scale. The fractional amplitude of low-frequency fluctuation (fALFF) was applied to measure the strength of spontaneous brain activity. Correlation analysis and between-group comparisons of fMRI data were conducted using Rest 1.8. By overlaying cognitively characterized brain regions and defining regions of interest (ROIs) based on their spatial distribution for subsequent cognitive stratification studies. RESULTS A total of 58 PD patients were enrolled in this study. They were divided into three groups: normal cognition (NC) group (27 patients, average MoCA was 27.96), mild cognitive impairment (MCI) group (21 patients, average MoCA was 23.52), and severe cognitive impairment (SCI) group (10 patients, average MoCA was 17.3). It is noteworthy to mention that those within the SCI group exhibited the most advanced chronological age, with an average of 74.4 years, whereas the MCI group displayed a higher prevalence of male participants at 85.7%. It was found hippocampal regions were a stable representative brain region of cognition according to the correlation analysis between the fALFF of the whole brain and cognition, and the comparison of fALFF between different cognitive groups. The parahippocampal gyrus was the only region with statistically significant differences in fALFF among the three cognitive groups, and it was also the only brain region to identify MCI from NC, with an AUC of 0.673. The paracentral lobule, postcentral gyrus was the region that identified SCI from NC, with an AUC of 0.941. The midbrain, hippocampus, and parahippocampa gyrus was the region that identified SCI from MCI, with an AUC of 0.926. CONCLUSION The parahippocampal gyrus was the potential brain region for recognizing cognitive impairment in PD, specifically for identifying MCI. Thus, the fALFF of parahippocampal gyrus is expected to contribute to future study as a multimodal fingerprint for early warning.
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Affiliation(s)
- Peng Chen
- Department of Neurosurgery, Chongqing Key Laboratory of Emergency Medicine, Chongqing Emergency Medical CenterChongqing University Central HospitalChongqingChina
| | - Guoqiang Tang
- Pre‐hospital Emergency Department, Chongqing Emergency Medical CenterChongqing University Central HospitalChongqingChina
| | - Yanglingxi Wang
- Department of Neurosurgery, Chongqing Key Laboratory of Emergency Medicine, Chongqing Emergency Medical CenterChongqing University Central HospitalChongqingChina
| | - Weiming Xiong
- Department of Neurosurgery, Chongqing Key Laboratory of Emergency Medicine, Chongqing Emergency Medical CenterChongqing University Central HospitalChongqingChina
| | - Yongbing Deng
- Department of Neurosurgery, Chongqing Key Laboratory of Emergency Medicine, Chongqing Emergency Medical CenterChongqing University Central HospitalChongqingChina
| | - She Fei
- Department of EmergencyThe Fourth Medical Center of the Chinese PLA General HospitalBeijingChina
| | - Jun Zhang
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical CollegeFudan UniversityShanghaiChina
- Department of NeurosurgeryClinical Medical College of Yangzhou UniversityYangzhouChina
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Yassine S, Almarouk S, Gschwandtner U, Auffret M, Fuhr P, Verin M, Hassan M. Electrophysiological signatures of anxiety in Parkinson's disease. Transl Psychiatry 2024; 14:66. [PMID: 38280864 PMCID: PMC10821912 DOI: 10.1038/s41398-024-02745-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 12/19/2023] [Accepted: 01/08/2024] [Indexed: 01/29/2024] Open
Abstract
Anxiety is a common non-motor symptom in Parkinson's disease (PD) occurring in up to 31% of the patients and affecting their quality of life. Despite the high prevalence, anxiety symptoms in PD are often underdiagnosed and, therefore, undertreated. To date, functional and structural neuroimaging studies have contributed to our understanding of the motor and cognitive symptomatology of PD. Yet, the underlying pathophysiology of anxiety symptoms in PD remains largely unknown and studies on their neural correlates are missing. Here, we used resting-state electroencephalography (RS-EEG) of 68 non-demented PD patients with or without clinically-defined anxiety and 25 healthy controls (HC) to assess spectral and functional connectivity fingerprints characterizing the PD-related anxiety. When comparing the brain activity of the PD anxious group (PD-A, N = 18) to both PD non-anxious (PD-NA, N = 50) and HC groups (N = 25) at baseline, our results showed increased fronto-parietal delta power and decreased frontal beta power depicting the PD-A group. Results also revealed hyper-connectivity networks predominating in delta, theta and gamma bands against prominent hypo-connectivity networks in alpha and beta bands as network signatures of anxiety in PD where the frontal, temporal, limbic and insular lobes exhibited the majority of significant connections. Moreover, the revealed EEG-based electrophysiological signatures were strongly associated with the clinical scores of anxiety and followed their progression trend over the course of the disease. We believe that the identification of the electrophysiological correlates of anxiety in PD using EEG is conducive toward more accurate prognosis and can ultimately support personalized psychiatric follow-up and the development of new therapeutic strategies.
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Affiliation(s)
- Sahar Yassine
- MRC Brain Dynamic Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom.
- University of Rennes, LTSI - U1099, F-35000, Rennes, France.
- Behavior & Basal Ganglia, CIC1414, CIC-IT, CHU Rennes, Rennes, France.
| | - Sourour Almarouk
- University of Rennes, LTSI - U1099, F-35000, Rennes, France
- Behavior & Basal Ganglia, CIC1414, CIC-IT, CHU Rennes, Rennes, France
- Neuroscience Research Centre, Lebanese University, Faculty of Medicine, Beirut, Lebanon
| | - Ute Gschwandtner
- Dept. of Neurology, Hospitals of the University of Basel, Basel, Switzerland
| | - Manon Auffret
- University of Rennes, LTSI - U1099, F-35000, Rennes, France
- Behavior & Basal Ganglia, CIC1414, CIC-IT, CHU Rennes, Rennes, France
- Institut des Neurosciences Cliniques de Rennes (INCR), Rennes, France
- France Développement Electronique, Monswiller, France
| | - Peter Fuhr
- Dept. of Neurology, Hospitals of the University of Basel, Basel, Switzerland
| | - Marc Verin
- University of Rennes, LTSI - U1099, F-35000, Rennes, France
- Behavior & Basal Ganglia, CIC1414, CIC-IT, CHU Rennes, Rennes, France
- Institut des Neurosciences Cliniques de Rennes (INCR), Rennes, France
- Movement Disorders Unit, Neurology Department, Pontchaillou University Hospital, Rennes, France
| | - Mahmoud Hassan
- Behavior & Basal Ganglia, CIC1414, CIC-IT, CHU Rennes, Rennes, France
- School of Science and Engineering, Reykjavik University, Reykjavik, Iceland
- MINDIG, F-35000, Rennes, France
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Citro S, Lazzaro GD, Cimmino AT, Giuffrè GM, Marra C, Calabresi P. A multiple hits hypothesis for memory dysfunction in Parkinson disease. Nat Rev Neurol 2024; 20:50-61. [PMID: 38052985 DOI: 10.1038/s41582-023-00905-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2023] [Indexed: 12/07/2023]
Abstract
Cognitive disorders are increasingly recognized in Parkinson disease (PD), even in early disease stages, and memory is one of the most affected cognitive domains. Classically, hippocampal cholinergic system dysfunction was associated with memory disorders, whereas nigrostriatal dopaminergic system impairment was considered responsible for executive deficits. Evidence from PD studies now supports involvement of the amygdala, which modulates emotional attribution to experiences. Here, we propose a tripartite model including the hippocampus, striatum and amygdala as key structures for cognitive disorders in PD. First, the anatomo-functional relationships of these structures are explored and experimental evidence supporting their role in cognitive dysfunction in PD is summarized. We then discuss the potential role of α-synuclein, a pathological hallmark of PD, in the tripartite memory system as a key mechanism in the pathogenesis of memory disorders in the disease.
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Affiliation(s)
- Salvatore Citro
- Neurology Section, Department of Neuroscience, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giulia Di Lazzaro
- Neurology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Angelo Tiziano Cimmino
- Neurology Section, Department of Neuroscience, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Guido Maria Giuffrè
- Neurology Section, Department of Neuroscience, Università Cattolica del Sacro Cuore, Rome, Italy
- Neurology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Camillo Marra
- Neurology Section, Department of Neuroscience, Università Cattolica del Sacro Cuore, Rome, Italy
- Neurology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Paolo Calabresi
- Neurology Section, Department of Neuroscience, Università Cattolica del Sacro Cuore, Rome, Italy.
- Neurology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
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Lai TT, Gericke B, Feja M, Conoscenti M, Zelikowsky M, Richter F. Anxiety in synucleinopathies: neuronal circuitry, underlying pathomechanisms and current therapeutic strategies. NPJ Parkinsons Dis 2023; 9:97. [PMID: 37349373 DOI: 10.1038/s41531-023-00547-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 06/09/2023] [Indexed: 06/24/2023] Open
Abstract
Synucleinopathies are neurodegenerative disorders characterized by alpha-synuclein (αSyn) accumulation in neurons or glial cells, including Parkinson's disease (PD), dementia with Lewy bodies (DLB), and multiple system atrophy (MSA). αSyn-related pathology plays a critical role in the pathogenesis of synucleinopathies leading to the progressive loss of neuronal populations in specific brain regions and the development of motor and non-motor symptoms. Anxiety is among the most frequent non-motor symptoms in patients with PD, but it remains underrecognized and undertreated, which significantly reduces the quality of life for patients. Anxiety is defined as a neuropsychiatric complication with characteristics such as nervousness, loss of concentration, and sweating due to the anticipation of impending danger. In patients with PD, neuropathology in the amygdala, a central region in the anxiety and fear circuitry, may contribute to the high prevalence of anxiety. Studies in animal models reported αSyn pathology in the amygdala together with alteration of anxiety or fear learning response. Therefore, understanding the progression, extent, and specifics of pathology in the anxiety and fear circuitry in synucleinopathies will suggest novel approaches to the diagnosis and treatment of neuropsychiatric symptoms. Here, we provide an overview of studies that address neuropsychiatric symptoms in synucleinopathies. We offer insights into anxiety and fear circuitry in animal models and the current implications for therapeutic intervention. In summary, it is apparent that anxiety is not a bystander symptom in these disorders but reflects early pathogenic mechanisms in the cortico-limbic system which may even contribute as a driver to disease progression.
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Affiliation(s)
- Thuy Thi Lai
- Department of Pharmacology, Toxicology and Pharmacy, University of Veterinary Medicine, Hannover, Germany
- Center for Systems Neuroscience, Hannover, Germany
| | - Birthe Gericke
- Department of Pharmacology, Toxicology and Pharmacy, University of Veterinary Medicine, Hannover, Germany
- Center for Systems Neuroscience, Hannover, Germany
| | - Malte Feja
- Department of Pharmacology, Toxicology and Pharmacy, University of Veterinary Medicine, Hannover, Germany
- Center for Systems Neuroscience, Hannover, Germany
| | | | | | - Franziska Richter
- Department of Pharmacology, Toxicology and Pharmacy, University of Veterinary Medicine, Hannover, Germany.
- Center for Systems Neuroscience, Hannover, Germany.
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Chen L, Xie J. Commentary: The impact of iron deposition on the fear circuit of the brain in patients with Parkinson's disease and anxiety. Front Aging Neurosci 2023; 15:1223421. [PMID: 37404689 PMCID: PMC10315570 DOI: 10.3389/fnagi.2023.1223421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 06/07/2023] [Indexed: 07/06/2023] Open
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Goodyear BG, Heidari F, Ingram RJM, Cortese F, Sharifi N, Kaplan GG, Ma C, Panaccione R, Sharkey KA, Swain MG. Multimodal Brain MRI of Deep Gray Matter Changes Associated With Inflammatory Bowel Disease. Inflamm Bowel Dis 2023; 29:405-416. [PMID: 35590449 PMCID: PMC9977255 DOI: 10.1093/ibd/izac089] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Behavioral symptoms, including mood disorders, substantially impact the quality of life of patients with inflammatory bowel disease (IBD), even when clinical remission is achieved. Here, we used multimodal magnetic resonance imaging (MRI) to determine if IBD is associated with changes in the structure and function of deep gray matter brain regions that regulate and integrate emotional, cognitive, and stress responses. METHODS Thirty-five patients with ulcerative colitis (UC) or Crohn's disease (CD) and 32 healthy controls underwent 3 Tesla MRIs to assess volume, neural activity, functional connection strength (connectivity), inflammation, and neurodegeneration of key deep gray matter brain regions (thalamus, caudate, pallidum, putamen, amygdala, hippocampus, and hypothalamus) involved in emotional, cognitive and stress processing. Associations with sex, presence of pain, disease activity, and C-reactive protein (CRP) concentration were examined. RESULTS Significantly increased activity and functional connectivity were observed in cognitive and emotional processing brain regions, including parts of the limbic system, basal ganglia, and hypothalamus of IBD patients compared with healthy controls. Inflammatory bowel disease patients exhibited significantly increased volumes of the amygdala and hypothalamus, as well as evidence of neurodegeneration in the putamen and pallidum. Hippocampal neural activity was increased in IBD patients with active disease. The volume of the thalamus was positively correlated with CRP concentration and was increased in females experiencing pain. CONCLUSIONS Patients with IBD exhibit functional and structural changes in the limbic and striatal systems. These changes may be targets for assessing or predicting the response to therapeutic interventions aimed at improving comorbid emotional and cognitive symptoms.
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Affiliation(s)
- Bradley G Goodyear
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada.,Department of Radiology, University of Calgary, Calgary, Alberta, Canada.,Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.,The Seaman Family MR Research Centre, University of Calgary, Calgary, Alberta, Canada.,The Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Faranak Heidari
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada.,The Seaman Family MR Research Centre, University of Calgary, Calgary, Alberta, Canada
| | - Richard J M Ingram
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada.,The Division of Gastroenterology and Hepatology, University of Calgary, Calgary, Alberta, Canada
| | - Filomeno Cortese
- The Seaman Family MR Research Centre, University of Calgary, Calgary, Alberta, Canada
| | - Nastaran Sharifi
- The Division of Gastroenterology and Hepatology, University of Calgary, Calgary, Alberta, Canada
| | - Gilaad G Kaplan
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada.,The Division of Gastroenterology and Hepatology, University of Calgary, Calgary, Alberta, Canada
| | - Christopher Ma
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada.,The Division of Gastroenterology and Hepatology, University of Calgary, Calgary, Alberta, Canada
| | - Remo Panaccione
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada.,The Division of Gastroenterology and Hepatology, University of Calgary, Calgary, Alberta, Canada
| | - Keith A Sharkey
- Department of Physiology & Pharmacology, University of Calgary, Calgary, Alberta, Canada.,The Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada.,The Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Mark G Swain
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada.,The Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada.,The Division of Gastroenterology and Hepatology, University of Calgary, Calgary, Alberta, Canada
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7
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Chen K, Zhang L, Mao H, Chen K, Shi Y, Meng X, Wang F, Hu X, Fang X. The impact of iron deposition on the fear circuit of the brain in patients with Parkinson's disease and anxiety. Front Aging Neurosci 2023; 15:1116516. [PMID: 36845658 PMCID: PMC9951615 DOI: 10.3389/fnagi.2023.1116516] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 01/24/2023] [Indexed: 02/11/2023] Open
Abstract
Objective Anxiety is one of the most common psychiatric symptoms of Parkinson's disease (PD), and brain iron deposition is considered to be one of the pathological mechanisms of PD. The objective of this study was to explore alterations in brain iron deposition in PD patients with anxiety compared to PD patients without anxiety, especially in the fear circuit. Methods Sixteen PD patients with anxiety, 23 PD patients without anxiety, and 26 healthy elderly controls were enrolled prospectively. All subjects underwent neuropsychological assessments and brain magnetic resonance imaging (MRI) examinations. Voxel-based morphometry (VBM) was used to study morphological brain differences between the groups. Quantitative susceptibility mapping (QSM), an MRI technique capable of quantifying susceptibility changes in brain tissue, was used to compare susceptibility changes in the whole brain among the three groups. The correlations between brain susceptibility changes and anxiety scores quantified using the Hamilton Anxiety Rating Scale (HAMA) were compared and analyzed. Results PD patients with anxiety had a longer duration of PD and higher HAMA scores than PD patients without anxiety. No morphological brain differences were observed between the groups. In contrast, voxel-based and ROI-based QSM analyses showed that PD patients with anxiety had significantly increased QSM values in the medial prefrontal cortex, anterior cingulate cortex, hippocampus, precuneus, and angular cortex. Furthermore, the QSM values of some of these brain regions were positively correlated with the HAMA scores (medial prefrontal cortex: r = 0.255, p = 0.04; anterior cingulate cortex: r = 0.381, p < 0.01; hippocampus: r = 0.496, p < 0.01). Conclusion Our findings support the idea that anxiety in PD is associated with iron burden in the brain fear circuit, providing a possible new approach to explaining the potential neural mechanism of anxiety in PD.
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Affiliation(s)
- Kaidong Chen
- Department of Radiology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, China
| | - Li Zhang
- Department of Neurology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, China
| | - Haixia Mao
- Department of Radiology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, China
| | - Kefei Chen
- Department of Neurology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, China
| | - Yachen Shi
- Department of Neurology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, China
| | - Xiangpan Meng
- Department of Radiology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, China
| | - Feng Wang
- Department of Neurology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, China,*Correspondence: Xiangming Fang, ✉
| | - Xiaoyun Hu
- Department of Radiology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, China,Feng Wang, ✉
| | - Xiangming Fang
- Department of Radiology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, China,Xiaoyun Hu, ✉
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Wang Y, Sun Z, Zhou Z. Aberrant changes of dynamic global synchronization in patients with Parkinson's disease. Acta Radiol 2023; 64:784-791. [PMID: 35484787 DOI: 10.1177/02841851221094967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Patients with Parkinson's disease (PD) have been documented with disrupted dynamic profiles of functional connectivity. However, the complementary information that is relevant to the dynamic pattern of global synchronization in patients with PD requires further investigation. PURPOSE To reveal the aberrant dynamic profiles of global synchronization involved in PD with a focus on temporal variability, strength, and property. MATERIAL AND METHODS A total of 46 patients with PD and 50 matched healthy controls (HCs) were enrolled. Degree centrality (DC) was used as the metric of global synchronization. The intergroup differences in the dynamic DC (dDC) pattern were compared, followed by further analysis of their clinical relevance in PD. RESULTS Relative to HCs, the PD group showed decreased dDC variability in right inferior occipital gyrus, right insula, right middle occipital gyrus (MOG), and bilateral postcentral gyrus. The dDC variability in the MOG was significantly correlated with MoCA score. Two states (state I and state II) were suggested. Relative to HCs, the PD group demonstrated a shorter mean dwell time (MDT) in state I, a longer MDT in state II, and fewer transitions. For the PD group, dDC properties were significantly correlated with UPDRS-III scores. In state II, significantly decreased dynamic dDC strength in bilateral supplementary motor area was observed in the PD group, with a significant correlation with UPDRS-III scores. CONCLUSION These findings on PD imply that dynamic alterations of global synchronization are engaged in the dysfunction of movement and cognition, deepening the understanding of deteriorations that underlie PD with complementary evidence.
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Affiliation(s)
- Yong Wang
- Department of Radiology, 372209Taizhou People's Hospital, Fifth Affiliated Hospital of Nantong University, Taizhou, Jiangsu, PR China
| | - Zhongru Sun
- Department of Radiology, 372209Taizhou People's Hospital, Fifth Affiliated Hospital of Nantong University, Taizhou, Jiangsu, PR China
| | - Zhijun Zhou
- Department of Radiology, 372209Taizhou People's Hospital, Fifth Affiliated Hospital of Nantong University, Taizhou, Jiangsu, PR China
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Cortical Synaptic Mechanism for Chronic Pain and Anxiety in Parkinson's Disease. J Transl Int Med 2023; 10:300-303. [PMID: 36860635 PMCID: PMC9969574 DOI: 10.2478/jtim-2022-0046] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
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10
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Altered Fractional Amplitude of Low-Frequency Fluctuation in Anxious Parkinson's Disease. Brain Sci 2023; 13:brainsci13010087. [PMID: 36672068 PMCID: PMC9857220 DOI: 10.3390/brainsci13010087] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/17/2022] [Accepted: 12/27/2022] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE Anxiety symptoms are persistent in Parkinson's disease (PD), but the underlying neural substrates are still unclear. In the current study, we aimed to explore the underlying neural mechanisms in PD patients with anxiety symptoms. METHODS 42 PD-A patients, 41 PD patients without anxiety symptoms (PD-NA), and 40 healthy controls (HCs) were recruited in the present study. All the subjects performed 3.0T fMRI scans. The fractional amplitude of low-frequency fluctuation (fALFF) analysis was used to investigate the alterations in neural activity among the three groups. A Pearson correlation analysis was performed between the altered fALFF value of the PD-A group and anxiety scores. RESULTS Compared with HCs, PD-A patients had higher fALFF values in the left cerebellum, cerebellum posterior lobe, bilateral temporal cortex, and brainstem and lower fALFF values in the bilateral inferior gyrus, bilateral basal ganglia areas, and left inferior parietal lobule. Moreover, between the two PD groups, PD-A patients showed higher fALFF values in the right precuneus and lower fALFF values in the bilateral inferior gyrus, bilateral basal ganglia areas, left inferior parietal lobule, and left occipital lobe. Furthermore, Pearson's correlation analysis demonstrated that the right precuneus and left caudate were correlated with the Hamilton Anxiety Rating Scale scores. CONCLUSION Our study found that anxiety symptoms in PD patients may be related to alterations of neurological activities in multiple brain regions. Furthermore, these may be critical radiological biomarkers for PD-A patients. Therefore, these findings can improve our understanding of the pathophysiological mechanisms underlying PD-A.
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Imaging the Limbic System in Parkinson's Disease-A Review of Limbic Pathology and Clinical Symptoms. Brain Sci 2022; 12:brainsci12091248. [PMID: 36138984 PMCID: PMC9496800 DOI: 10.3390/brainsci12091248] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/05/2022] [Accepted: 09/13/2022] [Indexed: 01/09/2023] Open
Abstract
The limbic system describes a complex of brain structures central for memory, learning, as well as goal directed and emotional behavior. In addition to pathological studies, recent findings using in vivo structural and functional imaging of the brain pinpoint the vulnerability of limbic structures to neurodegeneration in Parkinson's disease (PD) throughout the disease course. Accordingly, dysfunction of the limbic system is critically related to the symptom complex which characterizes PD, including neuropsychiatric, vegetative, and motor symptoms, and their heterogeneity in patients with PD. The aim of this systematic review was to put the spotlight on neuroimaging of the limbic system in PD and to give an overview of the most important structures affected by the disease, their function, disease related alterations, and corresponding clinical manifestations. PubMed was searched in order to identify the most recent studies that investigate the limbic system in PD with the help of neuroimaging methods. First, PD related neuropathological changes and corresponding clinical symptoms of each limbic system region are reviewed, and, finally, a network integration of the limbic system within the complex of PD pathology is discussed.
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