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Jones MB, Gibson L, Gimenez-Zapiola M, Guerra A, Bhatti G, Broadway D, Tea J, Prasad A, Gates R, Hinton E, Jorge RE, Marsh L. Physical Violence and Aggression in Parkinson's Disease: A Systematic Review. J Acad Consult Liaison Psychiatry 2024:S2667-2960(24)00015-6. [PMID: 38311061 DOI: 10.1016/j.jaclp.2024.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 01/10/2024] [Accepted: 01/28/2024] [Indexed: 02/06/2024]
Abstract
BACKGROUND Physical violence and aggression (PVA), defined as behaviors with the potential to cause bodily injury, are unfortunate risks in the management of all-cause neurodegenerative dementias. While dementia in Parkinson's disease (PD) may not be evident for many years after clinical onset, neuropsychiatric disturbances occur at all stages of the disease. At issue is whether PVA in PD is associated with clinical factors that can be targets for prevention and management in the absence of a prevailing dementia syndrome. OBJECTIVE This systematic review examined the extent to which PVA in PD without dementia is a clinically significant concern and whether it is associated with factors that could warrant proactive management. METHODS A systematic search of 9 electronic databases used MeSH headings and equivalent terms for PD, aggression, and violence. Eligible manuscripts were original articles that were published in peer-reviewed journals and reported on adults with PD in the awake state with PVA as possible outcomes. Extracted data included study design, PD ascertainment methods and characteristics, PVA assessment methods, subject demographics, psychiatric and medical comorbidities, and pertinent results. Inciting and confounding factors were extracted from case reports. Quality assessment tools were applied in accordance with the study design (e.g., observational, qualitative, or case report). RESULTS The search identified 10 manuscripts: 2 observational quantitative studies (total n with PD = 545), 1 qualitative study (n with PD = 20), and 7 case reports (n = 7). The observational studies suggested that PVA is less common than other neuropsychiatric disturbances, but heterogeneous methods and quality concerns prevented further conclusions. In the case reports, all patients were male, and most were early onset. In 6 of the reports, PVA occurred in the context of bilateral subthalamic nucleus deep brain stimulation. CONCLUSIONS PVA, while relatively rare in PD, can be a significant management issue that is associated with select premorbid characteristics and antiparkinsonian motor treatments. As PVA may be under-reported, further understanding of its frequency, causes, risk factors, and outcomes would benefit from its systematic assessment, ideally using self-report and informant-based questionnaires.
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Affiliation(s)
- Melissa B Jones
- Michael E. DeBakey VA Medical Center, Houston, TX; Department of Medicine, Baylor College of Medicine, Houston, TX.
| | - Lakeshia Gibson
- University of Mississippi Medical Center, Jackson, MS; Brigham and Women's Hospital, Boston, MA
| | - Malena Gimenez-Zapiola
- Michael E. DeBakey VA Medical Center, Houston, TX; Department of Medicine, Baylor College of Medicine, Houston, TX
| | - Ana Guerra
- Michael E. DeBakey VA Medical Center, Houston, TX; Department of Medicine, Baylor College of Medicine, Houston, TX
| | - Gursimrat Bhatti
- Michael E. DeBakey VA Medical Center, Houston, TX; Department of Medicine, Baylor College of Medicine, Houston, TX
| | - Dakota Broadway
- Michael E. DeBakey VA Medical Center, Houston, TX; Department of Medicine, Baylor College of Medicine, Houston, TX
| | - Juliann Tea
- Michael E. DeBakey VA Medical Center, Houston, TX; Department of Medicine, Baylor College of Medicine, Houston, TX
| | - Aksa Prasad
- Michael E. DeBakey VA Medical Center, Houston, TX; Department of Medicine, Baylor College of Medicine, Houston, TX; The University of Texas Rio Grande Valley, Edinburg, TX
| | - Rachel Gates
- Department of Medicine, Baylor College of Medicine, Houston, TX; UCHealth University of Colorado Hospital, Aurora, CO
| | | | - Ricardo E Jorge
- Michael E. DeBakey VA Medical Center, Houston, TX; Department of Medicine, Baylor College of Medicine, Houston, TX
| | - Laura Marsh
- Michael E. DeBakey VA Medical Center, Houston, TX; Department of Medicine, Baylor College of Medicine, Houston, TX
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Monje MH, Mañez‐Miró JU, Obeso JA. The Apparent Impunity of the Basal Ganglia to Therapeutic Lesioning: Clinical and Scientific Lessons. Mov Disord Clin Pract 2023; 10:S42-S46. [PMID: 37637986 PMCID: PMC10448138 DOI: 10.1002/mdc3.13787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 05/08/2023] [Accepted: 05/09/2023] [Indexed: 08/29/2023] Open
Affiliation(s)
- Mariana H.G. Monje
- HM CINAC (Centro Integral de Neurociencias Abarca Campal)Hospital Universitario HM Puerta del Sur, HM HospitalesMadridSpain
- Ken and Ruth Davee Department of NeurologyNorthwestern University, Feinberg School of MedicineChicagoIllinoisUSA
| | - Jorge U. Mañez‐Miró
- HM CINAC (Centro Integral de Neurociencias Abarca Campal)Hospital Universitario HM Puerta del Sur, HM HospitalesMadridSpain
- PhD Program in NeuroscienceAutónoma de Madrid University‐Cajal InstituteMadridSpain
- Neurology Department, IMED HospitalesValenciaSpain
| | - José A. Obeso
- HM CINAC (Centro Integral de Neurociencias Abarca Campal)Hospital Universitario HM Puerta del Sur, HM HospitalesMadridSpain
- Universidad San Pablo‐CEUMadridSpain
- CIBERNED, Instituto de Salud Carlos IIIMadridSpain
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Molecular and Cellular Interactions in Pathogenesis of Sporadic Parkinson Disease. Int J Mol Sci 2022; 23:ijms232113043. [PMID: 36361826 PMCID: PMC9657547 DOI: 10.3390/ijms232113043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 10/16/2022] [Accepted: 10/25/2022] [Indexed: 11/23/2022] Open
Abstract
An increasing number of the population all around the world suffer from age-associated neurodegenerative diseases including Parkinson’s disease (PD). This disorder presents different signs of genetic, epigenetic and environmental origin, and molecular, cellular and intracellular dysfunction. At the molecular level, α-synuclein (αSyn) was identified as the principal molecule constituting the Lewy bodies (LB). The gut microbiota participates in the pathogenesis of PD and may contribute to the loss of dopaminergic neurons through mitochondrial dysfunction. The most important pathogenetic link is an imbalance of Ca2+ ions, which is associated with redox imbalance in the cells and increased generation of reactive oxygen species (ROS). In this review, genetic, epigenetic and environmental factors that cause these disorders and their cause-and-effect relationships are considered. As a constituent of environmental factors, the example of organophosphates (OPs) is also reviewed. The role of endothelial damage in the pathogenesis of PD is discussed, and a ‘triple hit hypothesis’ is proposed as a modification of Braak’s dual hit one. In the absence of effective therapies for neurodegenerative diseases, more and more evidence is emerging about the positive impact of nutritional structure and healthy lifestyle on the state of blood vessels and the risk of developing these diseases.
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Alpha-Synuclein: The Spark That Flames Dopaminergic Neurons, In Vitro and In Vivo Evidence. Int J Mol Sci 2022; 23:ijms23179864. [PMID: 36077253 PMCID: PMC9456396 DOI: 10.3390/ijms23179864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/15/2022] [Accepted: 08/21/2022] [Indexed: 11/16/2022] Open
Abstract
Mitochondria, α-syn fibrils and the endo-lysosomal system are key players in the pathophysiology of Parkinson’s disease. The toxicity of α-syn is amplified by cell-to-cell transmission and aggregation of endogenous species in newly invaded neurons. Toxicity of α-syn PFF was investigated using primary cultures of dopaminergic neurons or on aged mice after infusion in the SNpc and combined with mild inhibition of GBA. In primary dopaminergic neurons, application of α-syn PFF induced a progressive cytotoxicity associated with mitochondrial dysfunction, oxidative stress, and accumulation of lysosomes suggesting that exogenous α-syn reached the lysosome (from the endosome). Counteracting the α-syn endocytosis with a clathrin inhibitor, dopaminergic neuron degeneration was prevented. In vivo, α-syn PFF induced progressive neurodegeneration of dopaminergic neurons associated with motor deficits. Histology revealed progressive aggregation of α-syn and microglial activation and accounted for the seeding role of α-syn, injection of which acted as a spark suggesting a triggering of cell-to-cell toxicity. We showed for the first time that a localized SNpc α-syn administration combined with a slight lysosomal deficiency and aging triggered a progressive lesion. The cellular and animal models described could help in the understanding of the human disease and might contribute to the development of new therapies.
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Rodriguez-Sabate C, Morales I, Rodriguez M. The Influence of Aging on the Functional Connectivity of the Human Basal Ganglia. Front Aging Neurosci 2022; 13:785666. [PMID: 35095470 PMCID: PMC8789673 DOI: 10.3389/fnagi.2021.785666] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 12/14/2021] [Indexed: 11/24/2022] Open
Abstract
Although basal ganglia (BG) are involved in the motor disorders of aged people, the effect of aging on the functional interaction of BG is not well-known. This work was aimed at studying the influence of aging on the functional connectivity of the motor circuit of BG (BGmC). Thirty healthy volunteers were studied (young-group 26.4 ± 5.7 years old; aged-group 63.1 ± 5.8 years old) with a procedure planned to prevent the spurious functional connectivity induced by the closed-loop arrangement of the BGmC. BG showed different functional interactions during the inter-task intervals and when subjects did not perform any voluntary task. Aging induced marked changes in the functional connectivity of the BGmC during these inter-task intervals. The finger movements changed the functional connectivity of the BG, these modifications were also different in the aged-group. Taken together, these data show a marked effect of aging on the functional connectivity of the BGmC, and these effects may be at the basis of the motor handicaps of aged people during the execution of motor-tasks and when they are not performing any voluntary motor task.
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Affiliation(s)
- Clara Rodriguez-Sabate
- Center for Networked Biomedical Research in Neurodegenerative Diseases, Madrid, Spain
- Laboratory of Neurobiology and Experimental Neurology, Department of Basic Medical Sciences, Physiology, Faculty of Medicine, University of La Laguna, San Cristóbal de La Laguna, Spain
| | - Ingrid Morales
- Center for Networked Biomedical Research in Neurodegenerative Diseases, Madrid, Spain
- Laboratory of Neurobiology and Experimental Neurology, Department of Basic Medical Sciences, Physiology, Faculty of Medicine, University of La Laguna, San Cristóbal de La Laguna, Spain
| | - Manuel Rodriguez
- Center for Networked Biomedical Research in Neurodegenerative Diseases, Madrid, Spain
- Laboratory of Neurobiology and Experimental Neurology, Department of Basic Medical Sciences, Physiology, Faculty of Medicine, University of La Laguna, San Cristóbal de La Laguna, Spain
- *Correspondence: Manuel Rodriguez
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Rodriguez-Rojas R, Pineda-Pardo JA, Mañez-Miro J, Sanchez-Turel A, Martinez-Fernandez R, Del Alamo M, DeLong M, Obeso JA. Functional Topography of the Human Subthalamic Nucleus: Relevance for Subthalamotomy in Parkinson's Disease. Mov Disord 2021; 37:279-290. [PMID: 34859498 DOI: 10.1002/mds.28862] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/26/2021] [Accepted: 11/03/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The subthalamic nucleus (STN) is considered a key structure in motor, behavioral, and emotional control. Although identification of the functional topography of the STN has therapeutic implications in the treatment of the motor features of Parkinson's disease (PD), the details of its functional and somatotopic organization in humans are not well understood. OBJECTIVE The aim of this study was to characterize the functional organization of the STN and its correlation with the motor outcomes induced by subthalamotomy. METHODS We used diffusion-weighted imaging to assess STN connectivity patterns in 23 healthy control subjects and 86 patients with PD, of whom 39 received unilateral subthalamotomy. Analytical tractography was used to reconstruct structural cortico-subthalamic connectivity. A diffusion-weighted imaging/functional magnetic resonance imaging-driven somatotopic parcellation of the STN was defined to delineate the representation of the upper and lower limb in the STN. RESULTS We confirmed a connectional gradient to sensorimotor, supplementary-motor, associative, and limbic cortical regions, spanning from posterior-dorsal-lateral to anterior-ventral-medial portions of the STN, with intermediate overlapping zones. Functional magnetic resonance imaging-driven parcellation demonstrated dual segregation of motor cortico-subthalamic projections in humans. Moreover, the relationship between lesion topography and functional anatomy of the STN explains specific improvement in bradykinesia, rigidity, and tremor induced by subthalamotomy. CONCLUSIONS Our results support an interplay between segregation and integration of cortico-subthalamic projections, suggesting the coexistence of parallel and convergent information processing. Identifying the functional topography of the STN will facilitate better definition of the optimal location for functional neurosurgical approaches, that is, electrode placement and lesion location, and improve specific cardinal features in PD. © 2021 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Rafael Rodriguez-Rojas
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain.,Universidad CEU-San Pablo University, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Carlos III Institute, Madrid, Spain
| | - Jose A Pineda-Pardo
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain.,Universidad CEU-San Pablo University, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Carlos III Institute, Madrid, Spain
| | - Jorge Mañez-Miro
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
| | - Alicia Sanchez-Turel
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
| | - Raul Martinez-Fernandez
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain.,Universidad CEU-San Pablo University, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Carlos III Institute, Madrid, Spain
| | - Marta Del Alamo
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
| | - Mahlon DeLong
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Jose A Obeso
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain.,Universidad CEU-San Pablo University, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Carlos III Institute, Madrid, Spain
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7
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Menopausal Women's Health Care Method Based on Computer Nursing Diagnosis Intelligent System. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:4963361. [PMID: 34367537 PMCID: PMC8346312 DOI: 10.1155/2021/4963361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 06/26/2021] [Indexed: 11/17/2022]
Abstract
Taking into account the current feature extraction speed and recognition effect of intelligent diagnosis of menopausal women's health care behavior, this paper proposes to use a cross-layer convolutional neural network to extract behavior features autonomously and use support vector machine multiclass behavior classifier to classify behavior. Compared with the feature images extracted by traditional methods, the behavioral features extracted in this paper are related to the individual menopausal women and have better semantic information, and the feature description ability in the time domain and the space domain has been enhanced. Through Matlab software, using the database established in this paper to compare its feature extraction time, test classification time, and final recognition accuracy with ordinary convolutional neural networks, it is concluded that the cross-layer CNN-SVM model can ensure the speed of feature extraction. It proves that the method in this paper can be applied to the behavioral intelligent diagnosis system for intelligently nursing menopausal women and has good practical value. This paper designs a home care bed intelligent monitoring system, which can automatically detect the posture of the care bed, and not only can change the posture of the bed under the control of personnel, but also can automatically complete the posture conversion according to the setting. At the same time, the system has the function of monitoring the physical condition of the person being cared for and can detect the heart rate, blood oxygen, and other physiological indicators of the bedridden person. In addition, the system can also provide a remote diagnosis function, allowing nursing staff to remotely view the current state of the nursing bed and the physical condition of the person. After testing, the system works stably, improves the automation and safety of the nursing bed control, and enriches the functions of the nursing bed.
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Máñez-Miró JU, Rodríguez-Rojas R, Del Álamo M, Martínez-Fernández R, Obeso JA. Present and future of subthalamotomy in the management of Parkinson´s disease: a systematic review. Expert Rev Neurother 2021; 21:533-545. [PMID: 33788645 DOI: 10.1080/14737175.2021.1911649] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Introduction: The subthalamic nucleus (STN) is known to be involved in the pathophysiology of Parkinson´s disease and by reducing its abnormal activity, normal output of basal ganglia can be restored along with improvement in PD cardinal motor features. Deep brain stimulation of the STN is currently the main surgical procedure for PD with motor complications, but lesioning can be an alternative.Areas covered: Here, the authors systematically review the current evidence regarding subthalamotomy both with radiofrequency and, more recently, with focused ultrasound (FUS) for the treatment of PD.Expert opinion: Unilateral subthalamotomy for the treatment of PD motor features can be considered a viable option in asymmetric patients, particularly with FUS which allows a minimally invasive safe and effective ablation of the STN. Risk of inducing dyskinesia (i.e., hemichorea/ballism) may be strikingly reduced when lesions enlarge dorsally to impinge on pallidothalamic fibers.
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Affiliation(s)
- Jorge U Máñez-Miró
- HM CINAC (Centro Integral De Neurociencias Abarca Campal), Hospital Universitario HM Puerta Del Sur, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto De Salud Carlos III, Madrid, Spain
| | - Rafael Rodríguez-Rojas
- HM CINAC (Centro Integral De Neurociencias Abarca Campal), Hospital Universitario HM Puerta Del Sur, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto De Salud Carlos III, Madrid, Spain
| | - Marta Del Álamo
- HM CINAC (Centro Integral De Neurociencias Abarca Campal), Hospital Universitario HM Puerta Del Sur, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto De Salud Carlos III, Madrid, Spain
| | - R Martínez-Fernández
- HM CINAC (Centro Integral De Neurociencias Abarca Campal), Hospital Universitario HM Puerta Del Sur, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto De Salud Carlos III, Madrid, Spain
| | - José A Obeso
- HM CINAC (Centro Integral De Neurociencias Abarca Campal), Hospital Universitario HM Puerta Del Sur, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto De Salud Carlos III, Madrid, Spain.,CEU-San Pablo University, Móstoles, Madrid, Spain
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The levels of the NMDA receptor co-agonist D-serine are reduced in the substantia nigra of MPTP-lesioned macaques and in the cerebrospinal fluid of Parkinson's disease patients. Sci Rep 2019; 9:8898. [PMID: 31222058 PMCID: PMC6586824 DOI: 10.1038/s41598-019-45419-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 06/03/2019] [Indexed: 01/31/2023] Open
Abstract
Dysfunction of NMDA receptor (NMDAR)-mediated transmission is supposed to contribute to the motor and non-motor symptoms of Parkinson’s Disease (PD), and to L-DOPA-induced dyskinesia. Besides the main agonist L-glutamate, two other amino acids in the atypical D-configuration, D-serine and D-aspartate, activate NMDARs. In the present work, we investigated the effect of dopamine depletion on D-amino acids metabolism in the brain of MPTP-lesioned Macaca mulatta, and in the serum and cerebrospinal fluid of PD patients. We found that MPTP treatment increases D-aspartate and D-serine in the monkey putamen while L-DOPA rescues both D-amino acids levels. Conversely, dopaminergic denervation is associated with selective D-serine reduction in the substantia nigra. Such decrease suggests that the beneficial effect of D-serine adjuvant therapy previously reported in PD patients may derive from the normalization of endogenous D-serine levels and consequent improvement of nigrostriatal hypoglutamatergic transmission at glycine binding site. We also found reduced D-serine concentration in the cerebrospinal fluid of L-DOPA-free PD patients. These results further confirm the existence of deep interaction between dopaminergic and glutamatergic neurotransmission in PD and disclose a possible direct influence of D-amino acids variations in the changes of NMDAR transmission occurring under dopamine denervation and L-DOPA therapy.
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Muddapu VR, Mandali A, Chakravarthy VS, Ramaswamy S. A Computational Model of Loss of Dopaminergic Cells in Parkinson's Disease Due to Glutamate-Induced Excitotoxicity. Front Neural Circuits 2019; 13:11. [PMID: 30858799 PMCID: PMC6397878 DOI: 10.3389/fncir.2019.00011] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 02/05/2019] [Indexed: 01/04/2023] Open
Abstract
Parkinson's disease (PD) is a neurodegenerative disease associated with progressive and inexorable loss of dopaminergic cells in Substantia Nigra pars compacta (SNc). Although many mechanisms have been suggested, a decisive root cause of this cell loss is unknown. A couple of the proposed mechanisms, however, show potential for the development of a novel line of PD therapeutics. One of these mechanisms is the peculiar metabolic vulnerability of SNc cells compared to other dopaminergic clusters; the other is the SubThalamic Nucleus (STN)-induced excitotoxicity in SNc. To investigate the latter hypothesis computationally, we developed a spiking neuron network-model of SNc-STN-GPe system. In the model, prolonged stimulation of SNc cells by an overactive STN leads to an increase in ‘stress' variable; when the stress in a SNc neuron exceeds a stress threshold, the neuron dies. The model shows that the interaction between SNc and STN involves a positive-feedback due to which, an initial loss of SNc cells that crosses a threshold causes a runaway-effect, leading to an inexorable loss of SNc cells, strongly resembling the process of neurodegeneration. The model further suggests a link between the two aforementioned mechanisms of SNc cell loss. Our simulation results show that the excitotoxic cause of SNc cell loss might initiate by weak-excitotoxicity mediated by energy deficit, followed by strong-excitotoxicity, mediated by a disinhibited STN. A variety of conventional therapies were simulated to test their efficacy in slowing down SNc cell loss. Among them, glutamate inhibition, dopamine restoration, subthalamotomy and deep brain stimulation showed superior neuroprotective-effects in the proposed model.
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Affiliation(s)
| | - Alekhya Mandali
- Department of Psychiatry, Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
| | - V Srinivasa Chakravarthy
- Computational Neuroscience Lab, Department of Biotechnology, Bhupat and Jyoti Mehta School of Biosciences, IIT-Madras, Chennai, India
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Pramipexole-induced impulsivity in mildparkinsonian rats: a model of impulse control disorders in Parkinson's disease. Neurobiol Aging 2018; 75:126-135. [PMID: 30572183 DOI: 10.1016/j.neurobiolaging.2018.11.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 10/20/2018] [Accepted: 11/17/2018] [Indexed: 11/21/2022]
Abstract
Treatment with dopaminergic agonists such as pramipexole (PPX) contributes to the development of impulse control disorders (ICDs) in patients with Parkinson's disease (PD). As such, animal models of abnormal impulse control in PD are needed to better study the pathophysiology of these behaviors. Thus, we investigated impulsivity and related behaviors using the 5-choice serial reaction time task, as well as FosB/ΔFosB expression, in rats with mild parkinsonism induced by viral-mediated substantia nigra overexpression of human A53T mutated α-synuclein, and following chronic PPX treatment (0.25 mg/kg/d) for 4 weeks. The bilateral loss of striatal dopamine transporters (64%) increased the premature response rate of these rats, indicating enhanced waiting impulsivity. This behavior persisted in the OFF state after the second week of PPX treatment and it was further exacerbated in the ON state throughout the treatment period. The enhanced rate of premature responses following dopaminergic denervation was positively correlated with the premature response rate following PPX treatment (both in the ON and OFF states). Moreover, the striatal dopaminergic deficit was negatively correlated with the premature response rate at all times (pretreatment, ON and OFF states) and it was positively correlated with the striatal FosB/ΔFosB expression. By contrast, PPX treatment was not associated with changes in compulsivity (perseverative responses rate). This model recapitulates some features of PD with ICD, namely the dopaminergic deficit of early PD and the impulsivity traits provoked by dopaminergic loss in association with PPX treatment, making this model a useful tool to study the pathophysiology of ICDs.
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Lei H, Huang Z, Zhou F, Elazab A, Tan EL, Li H, Qin J, Lei B. Parkinson's Disease Diagnosis via Joint Learning From Multiple Modalities and Relations. IEEE J Biomed Health Inform 2018; 23:1437-1449. [PMID: 30183649 DOI: 10.1109/jbhi.2018.2868420] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Parkinson's disease (PD) is a neurodegenerative progressive disease that mainly affects the motor systems of patients. To slow this disease deterioration, early and accurate diagnosis of PD is an effective way, which alleviates mental and physical sufferings by clinical intervention. In this paper, we propose a joint regression and classification framework for PD diagnosis via magnetic resonance and diffusion tensor imaging data. Specifically, we devise a unified multitask feature selection model to explore multiple relationships among features, samples, and clinical scores. We regress four clinical variables of depression, sleep, olfaction, cognition scores, as well as perform the classification of PD disease from the multimodal data. The multitask model explores the relationships at the level of clinical scores, image features, and subjects, to select the most informative and diseased-related features for diagnosis. The proposed method is evaluated on the public Parkinson's progression markers initiative dataset. The extensive experimental results show that the multitask framework can effectively boost the performance of regression and classification and outperforms other state-of-the-art methods. The computerized predictions of clinical scores and label for PD diagnosis may offer quantitative reference for decision support as well.
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Stefani A, Cerroni R, Mazzone P, Liguori C, Di Giovanni G, Pierantozzi M, Galati S. Mechanisms of action underlying the efficacy of deep brain stimulation of the subthalamic nucleus in Parkinson's disease: central role of disease severity. Eur J Neurosci 2018; 49:805-816. [DOI: 10.1111/ejn.14088] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 06/19/2018] [Accepted: 07/17/2018] [Indexed: 12/11/2022]
Affiliation(s)
- Alessandro Stefani
- Department of System Medicine UOSD Parkinson Center University of Rome “Tor Vergata” Fondazione Policlinico Tor Vergata viale Oxford 81 Rome 00133 Italy
| | - Rocco Cerroni
- Department of System Medicine UOSD Parkinson Center University of Rome “Tor Vergata” Fondazione Policlinico Tor Vergata viale Oxford 81 Rome 00133 Italy
| | | | - Claudio Liguori
- Department of System Medicine UOSD Parkinson Center University of Rome “Tor Vergata” Fondazione Policlinico Tor Vergata viale Oxford 81 Rome 00133 Italy
| | - Giuseppe Di Giovanni
- Department of Physiology and Biochemistry Faculty of Medicine and Surgery University of Malta La Valletta Malta
| | - Mariangela Pierantozzi
- Department of System Medicine UOSD Parkinson Center University of Rome “Tor Vergata” Fondazione Policlinico Tor Vergata viale Oxford 81 Rome 00133 Italy
| | - Salvatore Galati
- Movement disorders service Neurocenter of Southern Switzerland Lugano Switzerland
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