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Migliore S, Toro S, Proietti F, Magliozzi A, Anzini G, Pistoia F, Di Lazzaro V, Curcio G, Marano M. Emotional atypical arousal ratings for unpleasant stimuli in patients with Parkinson's disease. Neurol Sci 2024; 45:3785-3790. [PMID: 38483677 DOI: 10.1007/s10072-024-07434-7] [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: 02/01/2024] [Accepted: 02/29/2024] [Indexed: 07/18/2024]
Abstract
INTRODUCTION Parkinson's disease (PD) is a neurodegenerative disorder characterized by motor and non-motor symptoms, including alteration in emotional processing and recognition of emotions. We explored the effects of PD on the emotional behavioral ratings using a battery of affective visual stimuli selected from the International Affective Picture System (IAPS). METHODS Twenty-two patients diagnosed with idiopathic PD and 22 healthy controls (HC), matched by age, gender, and education, were enrolled in the study. Following a clinical assessment, each participant was asked to evaluate the arousal and valence of affective visual stimuli, and response time was recorded. Disease-specific measures including the MDS Unified Parkinson's Disease Rating Scale (MDS UPDRS) and the Non-Motor Symptom Scale (NMSS) were also collected. RESULTS PD patients exhibited higher arousal responses compared to HC for negative/unpleasant pictures (scoring 7.32 ± 0.88 vs 5.43 ± 2.06, p < 0.001). The arousal response to negative/unpleasant pictures was correlated with measures of non-motor burden in PD (MDS UPDRS I and NMSS, rho = 0.480 and p = 0.023, rho = 0.533 and p = 0.010, respectively). CONCLUSION Impaired emotional processing characterizes PD patients with mild disease and is related to the non-motor symptom burden. Given the importance of emotional processing for the development and maintenance of close interpersonal relationship and for coping with specific medical situations, it is crucial to direct PD patients towards therapeutic interventions focused on the recognition and processing of emotions.
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Affiliation(s)
- Simone Migliore
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Stefano Toro
- Unit of Neurology, Neurophysiology, Neurobiology and Psychiatry, Department of Medicine, University Campus Bio-Medico of Rome, Rome, Italy
- Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Francesca Proietti
- Unit of Neurology, Neurophysiology, Neurobiology and Psychiatry, Department of Medicine, University Campus Bio-Medico of Rome, Rome, Italy
- Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Alessandro Magliozzi
- Unit of Neurology, Neurophysiology, Neurobiology and Psychiatry, Department of Medicine, University Campus Bio-Medico of Rome, Rome, Italy
- Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Gaia Anzini
- Unit of Neurology, Neurophysiology, Neurobiology and Psychiatry, Department of Medicine, University Campus Bio-Medico of Rome, Rome, Italy
- Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | | | - Vincenzo Di Lazzaro
- Unit of Neurology, Neurophysiology, Neurobiology and Psychiatry, Department of Medicine, University Campus Bio-Medico of Rome, Rome, Italy
- Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Giuseppe Curcio
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Massimo Marano
- Unit of Neurology, Neurophysiology, Neurobiology and Psychiatry, Department of Medicine, University Campus Bio-Medico of Rome, Rome, Italy.
- Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy.
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Niemi KJ, Huovinen A, Jaakkola E, Glerean E, Nummenmaa L, Joutsa J. Bodily Maps of Symptoms and Emotions in Parkinson's Disease. Mov Disord 2024; 39:1037-1043. [PMID: 38586892 DOI: 10.1002/mds.29785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 02/22/2024] [Accepted: 02/27/2024] [Indexed: 04/09/2024] Open
Abstract
BACKGROUND Emotions are reflected in bodily sensations, and these reflections are abnormal in psychiatric conditions. However, emotion-related bodily sensations have not been studied in neurological disorders. OBJECTIVE The aim of this study was to investigate whether Parkinson's disease (PD) is associated with altered bodily representations of emotions. METHODS Symptoms and emotion-related sensations were investigated in 380 patients with PD and 79 control subjects, using a topographical self-report method, termed body sensation mapping. The bodily mapping data were analyzed with pixelwise generalized linear models and principal component analyses. RESULTS Bodily maps of symptoms showed characteristic patterns of PD motor symptom distributions. Compared with control subjects, PD patients showed decreased parasternal sensation of anger, and longer PD symptom duration was associated with increased abdominal sensation of anger (PFWE < 0.05). The PD-related sensation patterns were abnormal across all basic emotions (P < 0.05). CONCLUSIONS The results demonstrate altered bodily maps of emotions in PD, providing novel insight into the nonmotor effects of PD. © 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Kalle J Niemi
- Turku Brain and Mind Center, University of Turku, Turku, Finland
- Clinical Neurosciences, University of Turku, Turku, Finland
- Neurocenter, Turku University Hospital, Turku, Finland
| | - Annu Huovinen
- Turku Brain and Mind Center, University of Turku, Turku, Finland
- Clinical Neurosciences, University of Turku, Turku, Finland
| | - Elina Jaakkola
- Turku Brain and Mind Center, University of Turku, Turku, Finland
- Clinical Neurosciences, University of Turku, Turku, Finland
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Enrico Glerean
- Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland
| | - Lauri Nummenmaa
- Turku PET Centre, Turku University Hospital, Turku, Finland
- Department of Psychology, University of Turku, Turku, Finland
| | - Juho Joutsa
- Turku Brain and Mind Center, University of Turku, Turku, Finland
- Clinical Neurosciences, University of Turku, Turku, Finland
- Neurocenter, Turku University Hospital, Turku, Finland
- Turku PET Centre, Turku University Hospital, Turku, Finland
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Carey G, Lopes R, Moonen AJ, Mulders AE, de Jong JJ, Kuchcinski G, Defebvre L, Kuijf ML, Dujardin K, Leentjens AF. Cognitive Behavioral Therapy for Anxiety in Parkinson's Disease Induces Functional Brain Changes. JOURNAL OF PARKINSON'S DISEASE 2023; 13:93-103. [PMID: 36591659 PMCID: PMC9912714 DOI: 10.3233/jpd-223527] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Cognitive behavioral therapy (CBT) reduces anxiety symptoms in patients with Parkinson's disease (PD). OBJECTIVE The objective of this study was to identify changes in functional connectivity in the brain after CBT for anxiety in patients with PD. METHODS Thirty-five patients with PD and clinically significant anxiety were randomized over two groups: CBT plus clinical monitoring (10 CBT sessions) or clinical monitoring only (CMO). Changes in severity of anxiety symptoms were assessed with the Parkinson Anxiety Scale (PAS). Resting-state functional brain MRI was performed at baseline and after the intervention. Functional networks were extracted by an Independent Component Analysis (ICA). Functional connectivity (FC) changes between structures involved in the PD-related anxiety circuits, such as the fear circuit (involving limbic, frontal, and cingulate structures) and the cortico-striato-thalamo-cortical limbic circuit, and both within and between functional networks were compared between groups and regressed with anxiety symptoms changes. RESULTS Compared to CMO, CBT reduced the FC between the right thalamus and the bilateral orbitofrontal cortices and increased the striato-frontal FC. CBT also increased the fronto-parietal FC within the central executive network (CEN) and between the CEN and the salience network. After CBT, improvement of PAS-score was associated with an increased striato-cingulate and parieto-temporal FC, and a decreased FC within the default-mode network and between the dorsal attentional network and the language network. CONCLUSION CBT in PD-patients improves anxiety symptoms and is associated with functional changes reversing the imbalance between PD-related anxiety circuits and reinforcing cognitive control on emotional processing.
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Affiliation(s)
- Guillaume Carey
- School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands,Lille Neuroscience & Cognition, University of Lille, Lille, France,Department of Neurology and Movement Disorders, Lille University Medical Centre, Lille, France,Correspondence to: Guillaume Carey, MD, CHU de Lille, Hôpital Roger Salengro, Avenue du Professeur Emile Laine, Service de Neurologie A, 59037, Lille, France. E-mail:
| | - Renaud Lopes
- Lille Neuroscience & Cognition, University of Lille, Lille, France,Plateformes Lilloises en Biologie & Santé, University of Lille, Lille, France
| | - Anja J.H. Moonen
- School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands,Department of Psychiatry, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Anne E.P. Mulders
- School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands,Department of Psychiatry, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Joost J.A. de Jong
- School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands,Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Gregory Kuchcinski
- Lille Neuroscience & Cognition, University of Lille, Lille, France,Department of Neuroradiology, Lille University Medical Centre, Lille, France,Plateformes Lilloises en Biologie & Santé, University of Lille, Lille, France
| | - Luc Defebvre
- Lille Neuroscience & Cognition, University of Lille, Lille, France,Department of Neurology and Movement Disorders, Lille University Medical Centre, Lille, France
| | - Mark L. Kuijf
- School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands,Department of Neurology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Kathy Dujardin
- Lille Neuroscience & Cognition, University of Lille, Lille, France,Department of Neurology and Movement Disorders, Lille University Medical Centre, Lille, France
| | - Albert F.G. Leentjens
- School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands,Department of Psychiatry, Maastricht University Medical Centre, Maastricht, The Netherlands
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Nobis L, Maio MR, Saleh Y, Manohar S, Kienast A, McGann E, Husain M. Role of serotonin in modulation of decision-making in Parkinson's disease. J Psychopharmacol 2023; 37:420-431. [PMID: 36628992 PMCID: PMC10101180 DOI: 10.1177/02698811221144636] [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] [Indexed: 01/12/2023]
Abstract
BACKGROUND Dysfunction of dopaminergic pathways has been considered to play a pivotal role in Parkinson's disease (PD), affecting the processing of emotional and rewarding information, and potentially leading to symptoms of depression or apathy. However, some aspects of motivation in PD might be affected by non-dopaminergic mechanisms. AIM AND METHOD The objective of this experimental medicine study was to investigate the contribution of serotonergic modulation via administration of citalopram (20 mg) for 7 days on motivated decision-making in twenty PD patients, measured using several different computerised tasks and clinical questionnaires that probe different aspects of decision-making. Twenty healthy controls were additionally tested without medication to assess any baseline differences between the two groups. RESULTS Results indicated that PD patients were overall less motivated than controls on an effort- and reward-based decision-making task. Citalopram increased or decreased willingness to exert effort for reward, depending on whether baseline motivation was high or low, respectively. A task assessing decision-making under risk revealed higher levels of risk aversion for potential losses in PD patients, which neither serotonin nor the patient's regular dopaminergic medication seemed to restore. However, citalopram in PD was associated with more risk-seeking choices for gains, although patients and controls did not differ on this at baseline. CONCLUSION The results provide evidence for a role of the serotonergic system in influencing some aspects of motivated decision-making in PD processes.
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Affiliation(s)
- Lisa Nobis
- Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, Department of Psychiatry, University of Oxford, Oxford, UK
| | - Maria Raquel Maio
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Youssuf Saleh
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Sanjay Manohar
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.,Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Annika Kienast
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Emily McGann
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Masud Husain
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.,Department of Experimental Psychology, University of Oxford, Oxford, UK
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Hegde S, Gothwal M, Arumugham S, Yadav R, Pal P. Deficits in emotion perception and cognition in patients with parkinson's disease: A systematic review. Ann Indian Acad Neurol 2022; 25:367-375. [PMID: 35936598 PMCID: PMC9350746 DOI: 10.4103/aian.aian_573_21] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 11/03/2021] [Accepted: 01/16/2022] [Indexed: 12/02/2022] Open
Abstract
Non-motor symptoms (NMS) are common among Parkinson's disease (PD) patients and have a significant impact on quality of life. NMS such as deficits in emotion perception are gaining due focus in the recent times. As emotion perception and cognitive functions share certain common neural substrates, it becomes pertinent to evaluate existing emotion perception deficits in view of underlying cognitive deficits. The current systematic review aimed at examining studies on emotion perception PD in the last decade. We carried out a systematic review of 44 studies from the PubMed database. We reviewed studies examining emotion perception and associated cognitive deficits, especially executive function and visuospatial function in PD. This review also examines how early and advanced PD differ in emotion perception deficits and how the presence of common neuropsychiatric conditions such as anxiety, apathy, and depression as well as neurosurgical procedure such as deep brain stimulation affect emotion perception. The need for future research employing a comprehensive evaluation of neurocognitive functions and emotion perception is underscored as it has a significant bearing on planning holistic intervention strategies.
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Bellot E, Garnier-Crussard A, Pongan E, Delphin-Combe F, Coste MH, Gentil C, Rouch I, Hénaff MA, Schmitz C, Tillmann B, Krolak-Salmon P. Blunted emotion judgments of body movements in Parkinson's disease. Sci Rep 2021; 11:18575. [PMID: 34535699 PMCID: PMC8448734 DOI: 10.1038/s41598-021-97788-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 08/05/2021] [Indexed: 11/22/2022] Open
Abstract
Some of the behavioral disorders observed in Parkinson’s disease (PD) may be related to an altered processing of social messages, including emotional expressions. Emotions conveyed by whole body movements may be difficult to generate and be detected by PD patients. The aim of the present study was to compare valence judgments of emotional whole body expressions in individuals with PD and in healthy controls matched for age, gender and education. Twenty-eight participants (13 PD patients and 15 healthy matched control participants) were asked to rate the emotional valence of short movies depicting emotional interactions between two human characters presented with the “Point Light Displays” technique. To ensure understanding of the perceived scene, participants were asked to briefly describe each of the evaluated movies. Patients’ emotional valence evaluations were less intense than those of controls for both positive (p < 0.001) and negative (p < 0.001) emotional expressions, even though patients were able to correctly describe the depicted scene. Our results extend the previously observed impaired processing of emotional facial expressions to impaired processing of emotions expressed by body language. This study may support the hypothesis that PD affects the embodied simulation of emotional expression and the potentially involved mirror neuron system.
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Affiliation(s)
- Emmanuelle Bellot
- UMR 5292, Lyon Neuroscience Research Center (CRNL), CNRS, INSERM, U1028, Université Claude Bernard Lyon 1, Université of Lyon, Lyon, France.,University of Lyon, Lyon, France
| | - Antoine Garnier-Crussard
- University of Lyon, Lyon, France.,Clinical and Research Memory Center of Lyon, Lyon Institute for Elderly, Charpennes Hospital, Hospices Civils de Lyon, 27 rue Gabriel Péri, 69100, Villeurbanne, France
| | - Elodie Pongan
- Clinical and Research Memory Center of Lyon, Lyon Institute for Elderly, Charpennes Hospital, Hospices Civils de Lyon, 27 rue Gabriel Péri, 69100, Villeurbanne, France.,Neurology Unit, Clinical and Research Memory Center, University Hospital of Saint-Etienne, 42055, Saint-Étienne, France
| | - Floriane Delphin-Combe
- University of Lyon, Lyon, France.,Clinical and Research Memory Center of Lyon, Lyon Institute for Elderly, Charpennes Hospital, Hospices Civils de Lyon, 27 rue Gabriel Péri, 69100, Villeurbanne, France
| | - Marie-Hélène Coste
- University of Lyon, Lyon, France.,Clinical and Research Memory Center of Lyon, Lyon Institute for Elderly, Charpennes Hospital, Hospices Civils de Lyon, 27 rue Gabriel Péri, 69100, Villeurbanne, France
| | - Claire Gentil
- University of Lyon, Lyon, France.,Clinical and Research Memory Center of Lyon, Lyon Institute for Elderly, Charpennes Hospital, Hospices Civils de Lyon, 27 rue Gabriel Péri, 69100, Villeurbanne, France
| | - Isabelle Rouch
- Clinical and Research Memory Center of Lyon, Lyon Institute for Elderly, Charpennes Hospital, Hospices Civils de Lyon, 27 rue Gabriel Péri, 69100, Villeurbanne, France.,Neurology Unit, Clinical and Research Memory Center, University Hospital of Saint-Etienne, 42055, Saint-Étienne, France.,Bordeaux Population Health Center, INSERM, U1219, University of Bordeaux, Bordeaux, France
| | - Marie-Anne Hénaff
- UMR 5292, Lyon Neuroscience Research Center (CRNL), CNRS, INSERM, U1028, Université Claude Bernard Lyon 1, Université of Lyon, Lyon, France.,University of Lyon, Lyon, France
| | - Christina Schmitz
- UMR 5292, Lyon Neuroscience Research Center (CRNL), CNRS, INSERM, U1028, Université Claude Bernard Lyon 1, Université of Lyon, Lyon, France.,University of Lyon, Lyon, France
| | - Barbara Tillmann
- UMR 5292, Lyon Neuroscience Research Center (CRNL), CNRS, INSERM, U1028, Université Claude Bernard Lyon 1, Université of Lyon, Lyon, France.,University of Lyon, Lyon, France
| | - Pierre Krolak-Salmon
- UMR 5292, Lyon Neuroscience Research Center (CRNL), CNRS, INSERM, U1028, Université Claude Bernard Lyon 1, Université of Lyon, Lyon, France. .,University of Lyon, Lyon, France. .,Clinical and Research Memory Center of Lyon, Lyon Institute for Elderly, Charpennes Hospital, Hospices Civils de Lyon, 27 rue Gabriel Péri, 69100, Villeurbanne, France.
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7
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Salamone PC, Legaz A, Sedeño L, Moguilner S, Fraile-Vazquez M, Campo CG, Fittipaldi S, Yoris A, Miranda M, Birba A, Galiani A, Abrevaya S, Neely A, Caro MM, Alifano F, Villagra R, Anunziata F, Okada de Oliveira M, Pautassi RM, Slachevsky A, Serrano C, García AM, Ibañez A. Interoception Primes Emotional Processing: Multimodal Evidence from Neurodegeneration. J Neurosci 2021; 41:4276-4292. [PMID: 33827935 PMCID: PMC8143206 DOI: 10.1523/jneurosci.2578-20.2021] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 03/17/2021] [Accepted: 03/18/2021] [Indexed: 12/15/2022] Open
Abstract
Recent frameworks in cognitive neuroscience and behavioral neurology underscore interoceptive priors as core modulators of negative emotions. However, the field lacks experimental designs manipulating the priming of emotions via interoception and exploring their multimodal signatures in neurodegenerative models. Here, we designed a novel task that involves interoceptive and control-exteroceptive priming conditions followed by post-interoception and post-exteroception facial emotion recognition (FER). We recruited 114 participants, including healthy controls (HCs) as well as patients with behavioral variant frontotemporal dementia (bvFTD), Parkinson's disease (PD), and Alzheimer's disease (AD). We measured online EEG modulations of the heart-evoked potential (HEP), and associations with both brain structural and resting-state functional connectivity patterns. Behaviorally, post-interoception negative FER was enhanced in HCs but selectively disrupted in bvFTD and PD, with AD presenting generalized disruptions across emotion types. Only bvFTD presented impaired interoceptive accuracy. Increased HEP modulations during post-interoception negative FER was observed in HCs and AD, but not in bvFTD or PD patients. Across all groups, post-interoception negative FER correlated with the volume of the insula and the ACC. Also, negative FER was associated with functional connectivity along the (a) salience network in the post-interoception condition, and along the (b) executive network in the post-exteroception condition. These patterns were selectively disrupted in bvFTD (a) and PD (b), respectively. Our approach underscores the multidimensional impact of interoception on emotion, while revealing a specific pathophysiological marker of bvFTD. These findings inform a promising theoretical and clinical agenda in the fields of nteroception, emotion, allostasis, and neurodegeneration.SIGNIFICANCE STATEMENT We examined whether and how emotions are primed by interoceptive states combining multimodal measures in healthy controls and neurodegenerative models. In controls, negative emotion recognition and ongoing HEP modulations were increased after interoception. These patterns were selectively disrupted in patients with atrophy across key interoceptive-emotional regions (e.g., the insula and the cingulate in frontotemporal dementia, frontostriatal networks in Parkinson's disease), whereas persons with Alzheimer's disease presented generalized emotional processing abnormalities with preserved interoceptive mechanisms. The integration of both domains was associated with the volume and connectivity (salience network) of canonical interoceptive-emotional hubs, critically involving the insula and the anterior cingulate. Our study reveals multimodal markers of interoceptive-emotional priming, laying the groundwork for new agendas in cognitive neuroscience and behavioral neurology.
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Affiliation(s)
- Paula C Salamone
- Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
- Facultad de Psicología, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Agustina Legaz
- Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
- Facultad de Psicología, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Lucas Sedeño
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - Sebastián Moguilner
- Global Brain Health Institute, University of California-San Francisco, San Francisco, California, and Trinity College Dublin, Dublin, Ireland
- Nuclear Medicine School Foundation, National Commission of Atomic Energy, Mendoza, Argentina
| | | | - Cecilia Gonzalez Campo
- Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - Sol Fittipaldi
- Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
- Facultad de Psicología, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Adrián Yoris
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
- Institute of Cognitive and Translational Neuroscience, INECO Foundation, Favaloro University, CONICET, Buenos Aires, Argentina
| | - Magdalena Miranda
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
- Institute of Cognitive and Translational Neuroscience, INECO Foundation, Favaloro University, CONICET, Buenos Aires, Argentina
| | - Agustina Birba
- Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - Agostina Galiani
- Institute of Cognitive and Translational Neuroscience, INECO Foundation, Favaloro University, CONICET, Buenos Aires, Argentina
| | - Sofía Abrevaya
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
- Institute of Cognitive and Translational Neuroscience, INECO Foundation, Favaloro University, CONICET, Buenos Aires, Argentina
| | - Alejandra Neely
- Latin American Brain Health (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Miguel Martorell Caro
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
- Institute of Cognitive and Translational Neuroscience, INECO Foundation, Favaloro University, CONICET, Buenos Aires, Argentina
| | - Florencia Alifano
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
- Institute of Cognitive and Translational Neuroscience, INECO Foundation, Favaloro University, CONICET, Buenos Aires, Argentina
| | - Roque Villagra
- Memory and Neuropsychiatric Clinic, Neurology Department, Hospital del Salvador, SSMO & Faculty of Medicine, University of Chile, Santiago, Chile
| | - Florencia Anunziata
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
- Facultad de Psicología, Universidad Nacional de Córdoba, Córdoba, Argentina
- Instituto de Investigación Médica M. y M. Ferreyra, INIMEC-CONICET-UNC, Córdoba, Argentina
| | - Maira Okada de Oliveira
- Global Brain Health Institute, University of California-San Francisco, San Francisco, California, and Trinity College Dublin, Dublin, Ireland
- Department of Neurology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP Brazil
- Department of Neurology, Hospital Santa Marcelina, Sao Paulo, SP Brazil
| | - Ricardo M Pautassi
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
- Facultad de Psicología, Universidad Nacional de Córdoba, Córdoba, Argentina
- Instituto de Investigación Médica M. y M. Ferreyra, INIMEC-CONICET-UNC, Córdoba, Argentina
| | - Andrea Slachevsky
- Memory and Neuropsychiatric Clinic, Neurology Department, Hospital del Salvador, SSMO & Faculty of Medicine, University of Chile, Santiago, Chile
- Gerosciences Center for Brain Health and Metabolism, Santiago, Chile
- Neuropsychology and Clinical Neuroscience Laboratory, Physiopathology Department, ICBM, Neurosciences Department, Faculty of Medicine, University of Chile, Santiago, Chile
- Servicio de Neurología, Departamento de Medicina, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
| | - Cecilia Serrano
- Neurología Cognitiva, Hospital Cesar Milstein, Buenos Aires, Argentina
| | - Adolfo M García
- Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
- Global Brain Health Institute, University of California-San Francisco, San Francisco, California, and Trinity College Dublin, Dublin, Ireland
- Faculty of Education, National University of Cuyo, Mendoza, M5502JMA, Argentina
- Departamento de Lingüística y Literatura, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago, Chile
| | - Agustín Ibañez
- Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
- Global Brain Health Institute, University of California-San Francisco, San Francisco, California, and Trinity College Dublin, Dublin, Ireland
- Latin American Brain Health (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile
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8
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Deep Brain Stimulation for Treatment-Resistant Depression: Towards a More Personalized Treatment Approach. J Clin Med 2020; 9:jcm9092729. [PMID: 32846987 PMCID: PMC7565181 DOI: 10.3390/jcm9092729] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 08/18/2020] [Accepted: 08/19/2020] [Indexed: 12/13/2022] Open
Abstract
Major depressive disorder (MDD) affects approximately 4.4% of the world’s population. One third of MDD patients do not respond to routine psychotherapeutic and pharmacotherapeutic treatment and are said to suffer from treatment-resistant depression (TRD). Deep brain stimulation (DBS) is increasingly being investigated as a treatment modality for TRD. Although early case studies showed promising results of DBS, open-label trials and placebo-controlled studies have reported inconsistent outcomes. This has raised discussion about the correct interpretation of trial results as well as the criteria for patient selection, the choice of stimulation target, and the optimal stimulation parameters. In this narrative review, we summarize recent studies of the effectiveness of DBS in TRD and address the relation between the targeted brain structures and clinical outcomes. Elaborating upon that, we hypothesize that the effectiveness of DBS in TRD can be increased by a more personalized and symptom-based approach. This may be achieved by using resting-state connectivity mapping for neurophysiological subtyping of TRD, by using individualized tractography to help decisions about stimulation target and electrode placement, and by using a more detailed registration of symptomatic improvements during DBS, for instance by using ‘experience sampling’ methods.
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Knolle F, Garofalo S, Viviani R, Justicia A, Ermakova AO, Blank H, Williams GB, Arrondo G, Ramachandra P, Tudor-Sfetea C, Bunzeck N, Duezel E, Robbins TW, Barker RA, Murray GK. Altered subcortical emotional salience processing differentiates Parkinson's patients with and without psychotic symptoms. NEUROIMAGE-CLINICAL 2020; 27:102277. [PMID: 32540629 PMCID: PMC7298672 DOI: 10.1016/j.nicl.2020.102277] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 03/30/2020] [Accepted: 05/05/2020] [Indexed: 01/03/2023]
Abstract
Emotional salience processing differentiates PD patients with and without psychosis. Enhanced striatal, hippocampal and midbrain responses in PD patients with psychosis. Indication for ‘jumping to conclusions’ bias in the same PD patients with psychosis. Aberrant top-down and salience processing associated with PD psychosis. Similar deficits as proposed in ‘aberrant salience hypothesis’ of schizophrenia.
Objective Current research does not provide a clear explanation for why some patients with Parkinson’s Disease (PD) develop psychotic symptoms. The ‘aberrant salience hypothesis’ of psychosis has been influential and proposes that dopaminergic dysregulation leads to inappropriate attribution of salience to irrelevant/non-informative stimuli, facilitating the formation of hallucinations and delusions. The aim of this study is to investigate whether non-motivational salience is altered in PD patients and possibly linked to the development of psychotic symptoms. Methods We investigated salience processing in 14 PD patients with psychotic symptoms, 23 PD patients without psychotic symptoms and 19 healthy controls. All patients were on dopaminergic medication for their PD. We examined emotional salience using a visual oddball fMRI paradigm that has been used to investigate early stages of schizophrenia spectrum psychosis, controlling for resting cerebral blood flow as assessed with arterial spin labelling fMRI. Results We found significant differences between patient groups in brain responses to emotional salience. PD patients with psychotic symptoms had enhanced brain responses in the striatum, dopaminergic midbrain, hippocampus and amygdala compared to patients without psychotic symptoms. PD patients with psychotic symptoms showed significant correlations between the levels of dopaminergic drugs they were taking and BOLD signalling, as well as psychotic symptom scores. Conclusion Our study suggests that enhanced signalling in the striatum, dopaminergic midbrain, the hippocampus and amygdala is associated with the development of psychotic symptoms in PD, in line with that proposed in the ‘aberrant salience hypothesis’ of psychosis in schizophrenia.
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Affiliation(s)
- F Knolle
- Department of Psychiatry, University of Cambridge, Cambridge, UK; Department of Neuroradiology, Technical University Munich, Munich, Germany.
| | - S Garofalo
- University of Bologna, Department of Psychology, Bologna, Italy
| | - R Viviani
- Institute of Psychology, University of Innsbruck, Innsbruck, Austria; Psychiatry and Psychotherapy Clinic III, University of Ulm, Ulm, Germany
| | - A Justicia
- Department of Psychiatry, University of Cambridge, Cambridge, UK; IMIM (Hospital del Mar Medical Research Institute), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - A O Ermakova
- Faculty of Natural Sciences, Imperial College London, UK
| | - H Blank
- Institute of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - G B Williams
- Department of Clinical Neuroscience and WT-MRC Cambridge Stem Cell Institute, University of Cambridge, Cambridge, UK
| | - G Arrondo
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - P Ramachandra
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - C Tudor-Sfetea
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - N Bunzeck
- Institute of Psychology I, University of Lübeck, Lübeck, Germany
| | - E Duezel
- Otto-von-Guericke University Magdeburg, Institute of Cognitive Neurology and Dementia Research, Magdeburg, Germany; German Centre for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - T W Robbins
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - R A Barker
- Department of Clinical Neuroscience and WT-MRC Cambridge Stem Cell Institute, University of Cambridge, Cambridge, UK
| | - G K Murray
- Department of Psychiatry, University of Cambridge, Cambridge, UK
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The association of antihypertensive use and depressive symptoms in a large older population with hypertension living in Australia and the United States: a cross-sectional study. J Hum Hypertens 2020; 34:787-794. [PMID: 32001828 DOI: 10.1038/s41371-020-0303-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 12/23/2019] [Accepted: 01/16/2020] [Indexed: 12/19/2022]
Abstract
Cardiovascular drugs impact many pathways involved in depression pathophysiology and treatment. However, their distinct impact on mood is underrecognized and the literature is conflicting. Therefore, using a very large and well-characterised sample of older adults with hypertension, we aimed to investigate the prevalence of depressive symptoms in users of different antihypertensive classes. We analysed baseline data from 14,195 older individuals with hypertension enroled in a large clinical trial. Median age was 75 years. The association of antihypertensive use by class and depression prevalence, as measured by a validated depression scale, was determined using logistic regression models. Multivariable logistic models were implemented to account for important confounding factors. Our analyses showed a positive association between depressive symptoms and the use of beta blockers (BB) (OR: 1.37; 95% CI: 1.17-1.60, p < 0.01), compared with users of other antihypertensive classes. All other classes of antihypertensives (including angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, and calcium channel blockers) were not significantly associated with depressive symptoms. In secondary analysis, this relationship was stronger for lipophilic (39%) and nonselective BB (52%) compared with hydrophilic (26%) and selective medications (31%), respectively. This study adds further evidence for a probable association between BB and depression in a large sample of older adults with hypertension and no history of cardiovascular disease or heart failure. These findings should regenerate interest and increase awareness of clinicians about the possible adverse effects of these medications in an otherwise healthy older population.
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Abstract
Catalepsy - an immobile state in which individuals fail to change imposed postures - can be induced by haloperidol. In rats, the pattern of haloperidol-induced catalepsy is very similar to that observed in Parkinson's disease (PD). As some PD symptoms seem to depend on the patient's emotional state, and as anxiety disorders are common in PD, it is possible that the central mechanisms regulating emotional and cataleptic states interplay. Previously, we showed that haloperidol impaired contextual-induced alarm calls in rats, without affecting footshock-evoked calls. Here, we evaluated the influence of distinct aversive stimulations on the haloperidol-induced catalepsy. First, male Wistar rats were subjected to catalepsy tests to establish a baseline state after haloperidol or saline administration. Next, distinct cohorts were exposed to open-field; elevated plus-maze; open-arm confinement; inescapable footshocks; contextual conditioned fear; or corticosterone administration. Subsequently, catalepsy tests were performed again. Haloperidol-induced catalepsy was verified in all drug-treated animals. Exposure to open-field, elevated plus-maze, open-arm confinement, footshocks, or administration of corticosterone had no significant effect on haloperidol-induced catalepsy. Contextual conditioned fear, which is supposed to promote a more intense fear, increased catalepsy over time. Our findings suggest that only specific defensive circuitries modulate the nigrostriatal system mediating the haloperidol-induced cataleptic state.
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Mulders AEP, Moonen AJH, Dujardin K, Kuijf ML, Duits A, Flinois B, Handels RLH, Lopes R, Leentjens AFG. Cognitive behavioural therapy for anxiety disorders in Parkinson's disease: Design of a randomised controlled trial to assess clinical effectiveness and changes in cerebral connectivity. J Psychosom Res 2018; 112:32-39. [PMID: 30097133 DOI: 10.1016/j.jpsychores.2018.04.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 04/03/2018] [Accepted: 04/05/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Anxiety disorders occur in up to 35% of patients with Parkinson's disease (PD) and have a negative effect on motor symptoms and quality of life. To date, no clinical trials specifically targeting anxiety in PD patients have been published. OBJECTIVE To describe the rationale and methodology of a randomised controlled trial (RCT) that aims to study the clinical effectiveness, alterations in brain circuitry, and cost-effectiveness of cognitive behavioural therapy (CBT) for anxiety in PD. METHODS This study is a prospective, two-centre RCT in which sixty PD patients with anxiety will be randomised to CBT treatment and clinical monitoring (intervention group) or to clinical monitoring only (control group). The CBT module used in this study was specifically developed to address symptoms of anxiety in PD patients. Participants will undergo standardised clinical, cognitive and behavioural assessment at baseline and at 2 follow-up measurements, as well as resting-state fMRI and DTI scanning before and after the intervention. The primary outcome measure is changes in severity of anxiety symptoms. Secondary outcome measures involve long-term changes in anxiety symptoms, changes in functional and structural connectivity between limbic and frontal cortices, and cost-effectiveness of the treatment. The study is registered at the ClinicalTrials.gov database under registration number NCT02648737. CONCLUSION This study is the first that evaluates both the clinical effectiveness, cost-effectiveness, as well as the biological impact of CBT for anxiety in PD patients that, if proven effective, will hopefully contribute to a better and evidence-based approach for these non-motor symptoms.
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Affiliation(s)
- A E P Mulders
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - A J H Moonen
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - K Dujardin
- Degenerative & Vascular Cognitive Disorders, University of Lille, Lille, France; Neurology and Movement Disorders Department, CHU, Lille, France
| | - M L Kuijf
- Department of Neurology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - A Duits
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - B Flinois
- Neurology and Movement Disorders Department, CHU, Lille, France
| | - R L H Handels
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - R Lopes
- Degenerative & Vascular Cognitive Disorders, University of Lille, Lille, France; Neuroimaging Department, CHU Lille, Lille, France
| | - A F G Leentjens
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, The Netherlands.
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Stefano GB, Pilonis N, Ptacek R, Raboch J, Vnukova M, Kream RM. Gut, Microbiome, and Brain Regulatory Axis: Relevance to Neurodegenerative and Psychiatric Disorders. Cell Mol Neurobiol 2018; 38:1197-1206. [PMID: 29802603 PMCID: PMC6061125 DOI: 10.1007/s10571-018-0589-2] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 05/07/2018] [Indexed: 12/23/2022]
Abstract
It has become apparent that the molecular and biochemical integrity of interactive families, genera, and species of human gut microflora is critically linked to maintaining complex metabolic and behavioral processes mediated by peripheral organ systems and central nervous system neuronal groupings. Relatively recent studies have established intrinsic ratios of enterotypes contained within the human microbiome across demographic subpopulations and have empirically linked significant alterations in the expression of bacterial enterotypes with the initiation and persistence of several major metabolic and psychiatric disorders. Accordingly, the goal of our review is to highlight potential thematic/functional linkages of pathophysiological alterations in gut microbiota and bidirectional gut-brain signaling pathways with special emphasis on the potential roles of gut dysbiosis on the pathophysiology of psychiatric illnesses. We provide critical discussion of putative thematic linkages of Parkinson's disease (PD) data sets to similar pathophysiological events as potential causative factors in the development and persistence of diverse psychiatric illnesses. Finally, we include a concise review of preclinical paradigms that involve immunologically-induced GI deficits and dysbiosis of maternal microflora that are functionally linked to impaired neurodevelopmental processes leading to affective behavioral syndromes in the offspring.
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Affiliation(s)
- G B Stefano
- Department of Psychiatry, First Faculty of Medicine Charles University in Prague and General University Hospital in Prague, Center for Cognitive and Molecular Neuroscience, Ke Karlovu 11, 120 00, Prague 2, Czech Republic.
| | - N Pilonis
- Warsaw Medical University, Public Central Teaching Hospital, Warsaw, Poland
| | - R Ptacek
- Department of Psychiatry, First Faculty of Medicine Charles University in Prague and General University Hospital in Prague, Center for Cognitive and Molecular Neuroscience, Ke Karlovu 11, 120 00, Prague 2, Czech Republic
| | - J Raboch
- Department of Psychiatry, First Faculty of Medicine Charles University in Prague and General University Hospital in Prague, Center for Cognitive and Molecular Neuroscience, Ke Karlovu 11, 120 00, Prague 2, Czech Republic
| | - M Vnukova
- Department of Psychiatry, First Faculty of Medicine Charles University in Prague and General University Hospital in Prague, Center for Cognitive and Molecular Neuroscience, Ke Karlovu 11, 120 00, Prague 2, Czech Republic
| | - R M Kream
- Department of Psychiatry, First Faculty of Medicine Charles University in Prague and General University Hospital in Prague, Center for Cognitive and Molecular Neuroscience, Ke Karlovu 11, 120 00, Prague 2, Czech Republic
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