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Lal R, Singh A, Watts S, Chopra K. Experimental models of Parkinson's disease: Challenges and Opportunities. Eur J Pharmacol 2024:176819. [PMID: 39029778 DOI: 10.1016/j.ejphar.2024.176819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 05/29/2024] [Accepted: 07/17/2024] [Indexed: 07/21/2024]
Abstract
Parkinson's disease (PD) is a widespread neurodegenerative disorder occurs due to the degradation of dopaminergic neurons present in the substantia nigra pars compacta (SNpc). Millions of people are affected by this devastating disorder globally, and the frequency of the condition increases with the increase in the elderly population. A significant amount of progress has been made in acquiring more knowledge about the etiology and the pathogenesis of PD over the past decades. Animal models have been regarded to be a vital tool for the exploration of complex molecular mechanisms involved in PD. Various animals used as models for disease monitoring include vertebrates (zebrafish, rats, mice, guinea pigs, rabbits and monkeys) and invertebrate models (Drosophila, Caenorhabditis elegans). The animal models most relevant for study of PD are neurotoxin induction-based models (1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP), 6-Hydroxydopamine (6-OHDA) and agricultural pesticides (rotenone, paraquat), pharmacological models (reserpine or haloperidol treated rats), genetic models (α-synuclein, Leucine-rich repeat kinase 2 (LRRK2), DJ-1, PINK-1 and Parkin). Several non-mammalian genetic models such as zebrafish, Drosophila and Caenorhabditis elegance have also gained popularity in recent years due to easy genetic manipulation, presence of genes homologous to human PD, and rapid screening of novel therapeutic molecules. In addition, in vitro models (SH-SY5Y, PC12, Lund human mesencephalic (LUHMES) cells, Human induced pluripotent stem cell (iPSC), Neural organoids, organ-on-chip) are also currently in trend providing edge in investigating molecular mechanisms involved in PD as they are derived from PD patients. In this review, we explain the current situation and merits and demerits of the various animal models.
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Affiliation(s)
- Roshan Lal
- Pharmacology Division, University Institute of Pharmaceutical Sciences (UIPS), Panjab University, Chandigarh, 160014 India
| | - Aditi Singh
- TR(i)P for Health Laboratory, Centre for Excellence in Functional Foods, Department of Food and Nutritional Biotechnology, National Agri-Food Biotechnology Institute (NABI), Knowledge City, Sector 81, SAS Nagar, Punjab 140306, India
| | - Shivam Watts
- Pharmacology Division, University Institute of Pharmaceutical Sciences (UIPS), Panjab University, Chandigarh, 160014 India
| | - Kanwaljit Chopra
- Pharmacology Division, University Institute of Pharmaceutical Sciences (UIPS), Panjab University, Chandigarh, 160014 India.
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Tao W, Zhang Y, Wang B, Nie S, Fang L, Xiao J, Wu Y. Advances in molecular mechanisms and therapeutic strategies for central nervous system diseases based on gut microbiota imbalance. J Adv Res 2024:S2090-1232(24)00124-3. [PMID: 38579985 DOI: 10.1016/j.jare.2024.03.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 03/12/2024] [Accepted: 03/29/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUD Central nervous system (CNS) diseases pose a serious threat to human health, but the regulatory mechanisms and therapeutic strategies of CNS diseases need to be further explored. It has been demonstrated that the gut microbiota (GM) is closely related to CNS disease. GM structure disorders, abnormal microbial metabolites, intestinal barrier destruction and elevated inflammation exist in patients with CNS diseases and promote the development of CNS diseases. More importantly, GM remodeling alleviates CNS pathology to some extent. AIM OF REVIEW Here, we have summarized the regulatory mechanism of the GM in CNS diseases and the potential treatment strategies for CNS repair based on GM regulation, aiming to provide safer and more effective strategies for CNS repair from the perspective of GM regulation. KEY SCIENTIFIC CONCEPTS OF REVIEW The abundance and composition of GM is closely associated with the CNS diseases. On the basis of in-depth analysis of GM changes in mice with CNS disease, as well as the changes in its metabolites, therapeutic strategies, such as probiotics, prebiotics, and FMT, may be used to regulate GM balance and affect its microbial metabolites, thereby promoting the recovery of CNS diseases.
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Affiliation(s)
- Wei Tao
- The Institute of Life Sciences, Wenzhou University, Wenzhou 325035, China
| | - Yanren Zhang
- The Institute of Life Sciences, Wenzhou University, Wenzhou 325035, China
| | - Bingbin Wang
- The Institute of Life Sciences, Wenzhou University, Wenzhou 325035, China
| | - Saiqun Nie
- The Institute of Life Sciences, Wenzhou University, Wenzhou 325035, China
| | - Li Fang
- The Institute of Life Sciences, Wenzhou University, Wenzhou 325035, China
| | - Jian Xiao
- School of Pharmaceutical Science, Wenzhou Medical University, Wenzhou, Zhejiang 325035, China.
| | - Yanqing Wu
- The Institute of Life Sciences, Wenzhou University, Wenzhou 325035, China.
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He W, Song H, Yang Z, Zhao S, Min J, Jiang Y. Beneficial effect of GABA-rich fermented milk whey on nervous system and intestinal microenvironment of aging mice induced by D-galactose. Microbiol Res 2024; 278:127547. [PMID: 37976737 DOI: 10.1016/j.micres.2023.127547] [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: 09/21/2023] [Revised: 11/06/2023] [Accepted: 11/08/2023] [Indexed: 11/19/2023]
Abstract
This study aims to investigate the protective effect of a freeze-dried powder prepared from a fermentation milk whey containing a high-yield GABA strain (FDH-GABA) against D-galactose-induced brain injury and gut microbiota imbalances in mice by probing changes to the PI3K/AKT/mTOR signaling pathway. A prematurely aged mouse model was established by performing the subcutaneous injection of D-galactose. Subsequently, the effects of FDH-GABA on the nervous system and intestinal microenvironment of the mice were explored by measuring their antioxidant activities, anti-inflammatory state, autophagy, pathway-related target protein expression levels, and intestinal microorganisms. Compared to the D-gal group, FDH-GABA improved the levels of SOD, T-AOC, IL-10, and neurotransmitters, while it reduced the contents of MDA and TNF-α. FDH-GABA also promoted autophagy and inhibited the PI3K/AKT/mTOR signaling pathway in the brains of the aged mice. Moreover, FDH-GABA restored the diversity of their intestinal flora. Pathological observations indicated that FDH-GABA was protective against damage to the brain and intestine of D-galactose-induced aging mice. These results reveal that FDH-GABA not only improved antioxidant stress, attenuated inflammation, restored the neurotransmitter content, and protected the tissue structure of the intestine and brain, but also effectively improved their intestinal microenvironment. The ameliorative effect of FDH-GABA on premature aging showed a clear dose-response relationship, and at the same time, the changes of intestinal microorganisms showed a certain correlation with the relevant indexes of nervous system. These findings provide insight into the effect of the FDH-GABA intervention on aging, providing a novel means for alleviating detrimental neurodegenerative changes in the aging population.
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Affiliation(s)
- Wei He
- School of Public Health, Dali University, China
| | - He Song
- School of Public Health, Dali University, China
| | | | | | - Juan Min
- School of Public Health, Dali University, China
| | - Yan Jiang
- School of Public Health, Dali University, China.
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Kroneberg D, Al-Fatly B, Morkos C, Steiner LA, Schneider GH, Kühn A. Kinematic Effects of Combined Subthalamic and Dorsolateral Nigral Deep Brain Stimulation in Parkinson's Disease. JOURNAL OF PARKINSON'S DISEASE 2024; 14:269-282. [PMID: 38363617 PMCID: PMC10977420 DOI: 10.3233/jpd-230181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/20/2023] [Indexed: 02/17/2024]
Abstract
Background Additional stimulation of the substantia nigra (SNr) has been proposed to target axial symptoms and gait impairment in patients with Parkinson's disease (PD). Objective This study aimed to characterize effects of combined deep brain stimulation (DBS) of the subthalamic nucleus (STN) and SNr on gait performance in PD and to map stimulation sites within the SNr. Methods In a double-blinded crossover design, 10 patients with PD and gait impairment underwent clinical examination and kinematic assessment with STN DBS, combined STN+SNr DBS and OFF DBS 30 minutes after reprogramming. To confirm stimulation within the SNr, electrodes, active contacts, and stimulation volumes were modeled in a common space and overlap with atlases of SNr was computed. Results Overlap of stimulation volumes with dorsolateral SNr was confirmed for all patients. UPDRS III, scoring of freezing during turning and transitioning, stride length, stride velocity, and range of motion of shank, knee, arm, and trunk as well as peak velocities during turning and transitions and turn duration were improved with STN DBS compared to OFF. On cohort level, no further improvement was observed with combined STN+SNr DBS but additive improvement of spatiotemporal gait parameters was observed in individual subjects. Conclusions Combined high frequency DBS of the STN and dorsolateral SNr did not consistently result in additional short-term kinematic or clinical benefit compared to STN DBS. Stimulation intervals, frequency, and patient selection for target symptoms as well as target region within the SNr need further refinement in future trials.
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Affiliation(s)
- Daniel Kroneberg
- Department of Neurology with Experimental Neurology, Movement Disorders and Neuromodulation Unit, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin Institute of Health, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Bassam Al-Fatly
- Department of Neurology with Experimental Neurology, Movement Disorders and Neuromodulation Unit, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Cornelia Morkos
- Department of Neurology with Experimental Neurology, Movement Disorders and Neuromodulation Unit, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Leon Amadeus Steiner
- Department of Neurology with Experimental Neurology, Movement Disorders and Neuromodulation Unit, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin Institute of Health, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Gerd-Helge Schneider
- Department of Neurosurgery, Charité – Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - A. Kühn
- Department of Neurology with Experimental Neurology, Movement Disorders and Neuromodulation Unit, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin Institute of Health, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Berlin School of Mind and Brain, Charite - Universitatsmedizin Berlin, Berlin, Germany
- German Center for Neurodegenerative Diseases (DZNE), Charité – Universitätsmedizin Berlin, Berlin, Germany
- NeuroCure, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Einstein Center for Neurosciences Berlin, Charité – Universitätsmedizin Berlin, Berlin, Germany
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Xu W, Wang J, Li XN, Liang J, Song L, Wu Y, Liu Z, Sun B, Li WG. Neuronal and synaptic adaptations underlying the benefits of deep brain stimulation for Parkinson's disease. Transl Neurodegener 2023; 12:55. [PMID: 38037124 PMCID: PMC10688037 DOI: 10.1186/s40035-023-00390-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 11/19/2023] [Indexed: 12/02/2023] Open
Abstract
Deep brain stimulation (DBS) is a well-established and effective treatment for patients with advanced Parkinson's disease (PD), yet its underlying mechanisms remain enigmatic. Optogenetics, primarily conducted in animal models, provides a unique approach that allows cell type- and projection-specific modulation that mirrors the frequency-dependent stimulus effects of DBS. Opto-DBS research in animal models plays a pivotal role in unraveling the neuronal and synaptic adaptations that contribute to the efficacy of DBS in PD treatment. DBS-induced neuronal responses rely on a complex interplay between the distributions of presynaptic inputs, frequency-dependent synaptic depression, and the intrinsic excitability of postsynaptic neurons. This orchestration leads to conversion of firing patterns, enabling both antidromic and orthodromic modulation of neural circuits. Understanding these mechanisms is vital for decoding position- and programming-dependent effects of DBS. Furthermore, patterned stimulation is emerging as a promising strategy yielding long-lasting therapeutic benefits. Research on the neuronal and synaptic adaptations to DBS may pave the way for the development of more enduring and precise modulation patterns. Advanced technologies, such as adaptive DBS or directional electrodes, can also be integrated for circuit-specific neuromodulation. These insights hold the potential to greatly improve the effectiveness of DBS and advance PD treatment to new levels.
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Affiliation(s)
- Wenying Xu
- Department of Rehabilitation Medicine, Huashan Hospital, Institute for Translational Brain Research, State Key Laboratory of Medical Neurobiology and Ministry of Education Frontiers Center for Brain Science, Fudan University, Shanghai, 200032, China
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Jie Wang
- Department of Rehabilitation Medicine, Huashan Hospital, Institute for Translational Brain Research, State Key Laboratory of Medical Neurobiology and Ministry of Education Frontiers Center for Brain Science, Fudan University, Shanghai, 200032, China
- Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Xin-Ni Li
- Department of Rehabilitation Medicine, Huashan Hospital, Institute for Translational Brain Research, State Key Laboratory of Medical Neurobiology and Ministry of Education Frontiers Center for Brain Science, Fudan University, Shanghai, 200032, China
| | - Jingxue Liang
- Department of Rehabilitation Medicine, Huashan Hospital, Institute for Translational Brain Research, State Key Laboratory of Medical Neurobiology and Ministry of Education Frontiers Center for Brain Science, Fudan University, Shanghai, 200032, China
- Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Lu Song
- Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Yi Wu
- Department of Rehabilitation Medicine, Huashan Hospital, Institute for Translational Brain Research, State Key Laboratory of Medical Neurobiology and Ministry of Education Frontiers Center for Brain Science, Fudan University, Shanghai, 200032, China
| | - Zhenguo Liu
- Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.
| | - Bomin Sun
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
| | - Wei-Guang Li
- Department of Rehabilitation Medicine, Huashan Hospital, Institute for Translational Brain Research, State Key Laboratory of Medical Neurobiology and Ministry of Education Frontiers Center for Brain Science, Fudan University, Shanghai, 200032, China.
- Ministry of Education-Shanghai Key Laboratory for Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.
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Neumann WJ, Steiner LA, Milosevic L. Neurophysiological mechanisms of deep brain stimulation across spatiotemporal resolutions. Brain 2023; 146:4456-4468. [PMID: 37450573 PMCID: PMC10629774 DOI: 10.1093/brain/awad239] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 06/04/2023] [Accepted: 06/28/2023] [Indexed: 07/18/2023] Open
Abstract
Deep brain stimulation is a neuromodulatory treatment for managing the symptoms of Parkinson's disease and other neurological and psychiatric disorders. Electrodes are chronically implanted in disease-relevant brain regions and pulsatile electrical stimulation delivery is intended to restore neurocircuit function. However, the widespread interest in the application and expansion of this clinical therapy has preceded an overarching understanding of the neurocircuit alterations invoked by deep brain stimulation. Over the years, various forms of neurophysiological evidence have emerged which demonstrate changes to brain activity across spatiotemporal resolutions; from single neuron, to local field potential, to brain-wide cortical network effects. Though fruitful, such studies have often led to debate about a singular putative mechanism. In this Update we aim to produce an integrative account of complementary instead of mutually exclusive neurophysiological effects to derive a generalizable concept of the mechanisms of deep brain stimulation. In particular, we offer a critical review of the most common historical competing theories, an updated discussion on recent literature from animal and human neurophysiological studies, and a synthesis of synaptic and network effects of deep brain stimulation across scales of observation, including micro-, meso- and macroscale circuit alterations.
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Affiliation(s)
- Wolf-Julian Neumann
- Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin 10117, Germany
| | - Leon A Steiner
- Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin 10117, Germany
- Department of Clinical and Computational Neuroscience, Krembil Brain Institute, University Health Network, Toronto M5T 1M8, Canada
| | - Luka Milosevic
- Department of Clinical and Computational Neuroscience, Krembil Brain Institute, University Health Network, Toronto M5T 1M8, Canada
- Institute of Biomedical Engineering, Institute of Medical Sciences, and CRANIA Neuromodulation Institute, University of Toronto, Toronto M5S 3G9, Canada
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Alosaimi F, Boonstra JT, Tan S, Temel Y, Jahanshahi A. The role of neurotransmitter systems in mediating deep brain stimulation effects in Parkinson’s disease. Front Neurosci 2022; 16:998932. [PMID: 36278000 PMCID: PMC9579467 DOI: 10.3389/fnins.2022.998932] [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: 07/20/2022] [Accepted: 09/14/2022] [Indexed: 11/24/2022] Open
Abstract
Deep brain stimulation (DBS) is among the most successful paradigms in both translational and reverse translational neuroscience. DBS has developed into a standard treatment for movement disorders such as Parkinson’s disease (PD) in recent decades, however, specific mechanisms behind DBS’s efficacy and side effects remain unrevealed. Several hypotheses have been proposed, including neuronal firing rate and pattern theories that emphasize the impact of DBS on local circuitry but detail distant electrophysiological readouts to a lesser extent. Furthermore, ample preclinical and clinical evidence indicates that DBS influences neurotransmitter dynamics in PD, particularly the effects of subthalamic nucleus (STN) DBS on striatal dopaminergic and glutamatergic systems; pallidum DBS on striatal dopaminergic and GABAergic systems; pedunculopontine nucleus DBS on cholinergic systems; and STN-DBS on locus coeruleus (LC) noradrenergic system. DBS has additionally been associated with mood-related side effects within brainstem serotoninergic systems in response to STN-DBS. Still, addressing the mechanisms of DBS on neurotransmitters’ dynamics is commonly overlooked due to its practical difficulties in monitoring real-time changes in remote areas. Given that electrical stimulation alters neurotransmitter release in local and remote regions, it eventually exhibits changes in specific neuronal functions. Consequently, such changes lead to further modulation, synthesis, and release of neurotransmitters. This narrative review discusses the main neurotransmitter dynamics in PD and their role in mediating DBS effects from preclinical and clinical data.
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Affiliation(s)
- Faisal Alosaimi
- Department of Neurosurgery, Maastricht University Medical Centre, Maastricht, Netherlands
- Department of Physiology, Faculty of Medicine, King Abdulaziz University, Rabigh, Saudi Arabia
- *Correspondence: Faisal Alosaimi,
| | - Jackson Tyler Boonstra
- Department of Neurosurgery, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Sonny Tan
- Department of Neurosurgery, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Yasin Temel
- Department of Neurosurgery, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Ali Jahanshahi
- Department of Neurosurgery, Maastricht University Medical Centre, Maastricht, Netherlands
- Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, Netherlands
- Ali Jahanshahi,
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Steiner LA, Kühn AA, Geiger JR, Alle H, Popovic MR, Kalia SK, Hodaie M, Lozano AM, Hutchison WD, Milosevic L. Persistent synaptic inhibition of the subthalamic nucleus by high frequency stimulation. Brain Stimul 2022; 15:1223-1232. [PMID: 36058524 DOI: 10.1016/j.brs.2022.08.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 05/10/2022] [Accepted: 08/25/2022] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND Deep brain stimulation (DBS) provides symptomatic relief in a growing number of neurological indications, but local synaptic dynamics in response to electrical stimulation that may relate to its mechanism of action have not been fully characterized. OBJECTIVE The objectives of this study were to (1) study local synaptic dynamics during high frequency extracellular stimulation of the subthalamic nucleus (STN), and (2) compare STN synaptic dynamics with those of the neighboring substantia nigra pars reticulata (SNr). METHODS Two microelectrodes were advanced into the STN and SNr of patients undergoing DBS surgery for Parkinson's disease (PD). Neuronal firing and evoked field potentials (fEPs) were recorded with one microelectrode during stimulation from an adjacent microelectrode. RESULTS Inhibitory fEPs could be discerned within the STN and their amplitudes predicted bidirectional effects on neuronal firing (p = .013). There were no differences between STN and SNr inhibitory fEP dynamics at low stimulation frequencies (p > .999). However, inhibitory neuronal responses were sustained over time in STN during high frequency stimulation but not in SNr (p < .001) where depression of inhibitory input was coupled with a return of neuronal firing (p = .003). INTERPRETATION Persistent inhibitory input to the STN suggests a local synaptic mechanism for the suppression of subthalamic firing during high frequency stimulation. Moreover, differences in the resiliency versus vulnerability of inhibitory inputs to the STN and SNr suggest a projection source- and frequency-specificity for this mechanism. The feasibility of targeting electrophysiologically-identified neural structures may provide insight into how DBS achieves frequency-specific modulation of neuronal projections.
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Affiliation(s)
- Leon A Steiner
- Krembil Brain Institute, University Health Network, Canada; Department of Neurology, Charité-Universitätsmedizin Berlin, Germany; Berlin Institute of Health (BIH), Germany; Institute of Neurophysiology, Charité-Universitätsmedizin Berlin, Germany
| | - Andrea A Kühn
- Department of Neurology, Charité-Universitätsmedizin Berlin, Germany
| | - Jörg Rp Geiger
- Institute of Neurophysiology, Charité-Universitätsmedizin Berlin, Germany
| | - Henrik Alle
- Institute of Neurophysiology, Charité-Universitätsmedizin Berlin, Germany
| | - Milos R Popovic
- KITE Research Institute, University Health Network, Canada; Institute of Biomedical Engineering, University of Toronto, Canada
| | - Suneil K Kalia
- Krembil Brain Institute, University Health Network, Canada; KITE Research Institute, University Health Network, Canada; Department of Surgery, University of Toronto, Canada
| | - Mojgan Hodaie
- Krembil Brain Institute, University Health Network, Canada; Department of Surgery, University of Toronto, Canada
| | - Andres M Lozano
- Krembil Brain Institute, University Health Network, Canada; Department of Surgery, University of Toronto, Canada
| | - William D Hutchison
- Krembil Brain Institute, University Health Network, Canada; Department of Surgery, University of Toronto, Canada; Department of Physiology, University of Toronto, Canada
| | - Luka Milosevic
- Krembil Brain Institute, University Health Network, Canada; KITE Research Institute, University Health Network, Canada; Institute of Biomedical Engineering, University of Toronto, Canada.
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Chen R, Berardelli A, Bhattacharya A, Bologna M, Chen KHS, Fasano A, Helmich RC, Hutchison WD, Kamble N, Kühn AA, Macerollo A, Neumann WJ, Pal PK, Paparella G, Suppa A, Udupa K. Clinical neurophysiology of Parkinson's disease and parkinsonism. Clin Neurophysiol Pract 2022; 7:201-227. [PMID: 35899019 PMCID: PMC9309229 DOI: 10.1016/j.cnp.2022.06.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 06/11/2022] [Accepted: 06/22/2022] [Indexed: 01/01/2023] Open
Abstract
This review is part of the series on the clinical neurophysiology of movement disorders and focuses on Parkinson’s disease and parkinsonism. The pathophysiology of cardinal parkinsonian motor symptoms and myoclonus are reviewed. The recordings from microelectrode and deep brain stimulation electrodes are reported in detail.
This review is part of the series on the clinical neurophysiology of movement disorders. It focuses on Parkinson’s disease and parkinsonism. The topics covered include the pathophysiology of tremor, rigidity and bradykinesia, balance and gait disturbance and myoclonus in Parkinson’s disease. The use of electroencephalography, electromyography, long latency reflexes, cutaneous silent period, studies of cortical excitability with single and paired transcranial magnetic stimulation, studies of plasticity, intraoperative microelectrode recordings and recording of local field potentials from deep brain stimulation, and electrocorticography are also reviewed. In addition to advancing knowledge of pathophysiology, neurophysiological studies can be useful in refining the diagnosis, localization of surgical targets, and help to develop novel therapies for Parkinson’s disease.
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Affiliation(s)
- Robert Chen
- Krembil Research Institute, University Health Network, Toronto, Ontario, Canada.,Division of Neurology, Department of Medicine, University of Toronto, Ontario, Canada.,Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Alfredo Berardelli
- Department of Human Neurosciences, Sapienza University of Rome, Italy.,IRCCS Neuromed Pozzilli (IS), Italy
| | - Amitabh Bhattacharya
- Department of Neurology, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | - Matteo Bologna
- Department of Human Neurosciences, Sapienza University of Rome, Italy.,IRCCS Neuromed Pozzilli (IS), Italy
| | - Kai-Hsiang Stanley Chen
- Department of Neurology, National Taiwan University Hospital Hsinchu Branch, Hsinchu, Taiwan
| | - Alfonso Fasano
- Krembil Research Institute, University Health Network, Toronto, Ontario, Canada.,Division of Neurology, Department of Medicine, University of Toronto, Ontario, Canada.,Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Rick C Helmich
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology and Centre of Expertise for Parkinson & Movement Disorders, Nijmegen, the Netherlands
| | - William D Hutchison
- Krembil Research Institute, University Health Network, Toronto, Ontario, Canada.,Departments of Surgery and Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Nitish Kamble
- Department of Neurology, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | - Andrea A Kühn
- Department of Neurology, Movement Disorder and Neuromodulation Unit, Charité - Universitätsmedizin Berlin, Germany
| | - Antonella Macerollo
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, United Kingdom.,The Walton Centre NHS Foundation Trust for Neurology and Neurosurgery, Liverpool, United Kingdom
| | - Wolf-Julian Neumann
- Department of Neurology, Movement Disorder and Neuromodulation Unit, Charité - Universitätsmedizin Berlin, Germany
| | - Pramod Kumar Pal
- Department of Neurology, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | | | - Antonio Suppa
- Department of Human Neurosciences, Sapienza University of Rome, Italy.,IRCCS Neuromed Pozzilli (IS), Italy
| | - Kaviraja Udupa
- Department of Neurophysiology National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
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10
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Paparella G, Fasano A, Hallett M, Berardelli A, Bologna M. Emerging concepts on bradykinesia in non-parkinsonian conditions. Eur J Neurol 2021; 28:2403-2422. [PMID: 33793037 DOI: 10.1111/ene.14851] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/24/2021] [Accepted: 03/29/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND PURPOSE Bradykinesia is one of the cardinal motor symptoms of Parkinson's disease. However, clinical and experimental studies indicate that bradykinesia may also be observed in various neurological diseases not primarily characterized by parkinsonism. These conditions include hyperkinetic movement disorders, such as dystonia, chorea, and essential tremor. Bradykinesia may also be observed in patients with neurological conditions that are not seen as "movement disorders," including those characterized by the involvement of the cerebellum and corticospinal system, dementia, multiple sclerosis, and psychiatric disorders. METHODS We reviewed clinical reports and experimental studies on bradykinesia in non-parkinsonian conditions and discussed the major findings. RESULTS Bradykinesia is a common motor abnormality in non-parkinsonian conditions. From a pathophysiological standpoint, bradykinesia in neurological conditions not primarily characterized by parkinsonism may be explained by brain network dysfunction. CONCLUSION In addition to the pathophysiological implications, the present paper highlights important terminological issues and the need for a new, more accurate, and more widely used definition of bradykinesia in the context of movement disorders and other neurological conditions.
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Affiliation(s)
| | - Alfonso Fasano
- Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.,Division of Neurology, University of Toronto, Toronto, Ontario, Canada.,Krembil Brain Institute, Toronto, Ontario, Canada
| | - Mark Hallett
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA
| | - Alfredo Berardelli
- IRCCS Neuromed, Pozzilli, Italy.,Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Matteo Bologna
- IRCCS Neuromed, Pozzilli, Italy.,Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
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11
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Molecular Factors Mediating Neural Cell Plasticity Changes in Dementia Brain Diseases. Neural Plast 2021; 2021:8834645. [PMID: 33854544 PMCID: PMC8021472 DOI: 10.1155/2021/8834645] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 02/25/2021] [Accepted: 03/16/2021] [Indexed: 11/18/2022] Open
Abstract
Neural plasticity-the ability to alter a neuronal response to environmental stimuli-is an important factor in learning and memory. Short-term synaptic plasticity and long-term synaptic plasticity, including long-term potentiation and long-term depression, are the most-characterized models of learning and memory at the molecular and cellular level. These processes are often disrupted by neurodegeneration-induced dementias. Alzheimer's disease (AD) accounts for 50% of cases of dementia. Vascular dementia (VaD), Parkinson's disease dementia (PDD), dementia with Lewy bodies (DLB), and frontotemporal dementia (FTD) constitute much of the remaining cases. While vascular lesions are the principal cause of VaD, neurodegenerative processes have been established as etiological agents of many dementia diseases. Chief among such processes is the deposition of pathological protein aggregates in vivo including β-amyloid deposition in AD, the formation of neurofibrillary tangles in AD and FTD, and the accumulation of Lewy bodies composed of α-synuclein aggregates in DLB and PDD. The main symptoms of dementia are cognitive decline and memory and learning impairment. Nonetheless, accurate diagnoses of neurodegenerative diseases can be difficult due to overlapping clinical symptoms and the diverse locations of cortical lesions. Still, new neuroimaging and molecular biomarkers have improved clinicians' diagnostic capabilities in the context of dementia and may lead to the development of more effective treatments. Both genetic and environmental factors may lead to the aggregation of pathological proteins and altered levels of cytokines, such that can trigger the formation of proinflammatory immunological phenotypes. This cascade of pathological changes provides fertile ground for the development of neural plasticity disorders and dementias. Available pharmacotherapy and disease-modifying therapies currently in clinical trials may modulate synaptic plasticity to mitigate the effects neuropathological changes have on cognitive function, memory, and learning. In this article, we review the neural plasticity changes seen in common neurodegenerative diseases from pathophysiological and clinical points of view and highlight potential molecular targets of disease-modifying therapies.
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12
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Pingale T, Gupta GL. Classic and evolving animal models in Parkinson's disease. Pharmacol Biochem Behav 2020; 199:173060. [PMID: 33091373 DOI: 10.1016/j.pbb.2020.173060] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 10/10/2020] [Accepted: 10/12/2020] [Indexed: 02/07/2023]
Abstract
Parkinson's disease (PD) is a progressive neurodegenerative disease with motor and non-motor symptoms. PD is characterized by the degeneration of dopaminergic neurons in the substantia nigra pars compacta (SNpc) and deficiency of dopamine in the striatal region. The primary objective in PD research is to understand the pathogenesis, targets, and development of therapeutic interventions to control the progress of the disease. The anatomical and physiological resemblances between humans and animals gathered the researcher's attention towards the use of animals in PD research. Due to varying age of onset, symptoms, and progression rate, PD becomes heterogeneous which demands the variety of animal models to study diverse features of the disease. Parkinson is a multifactorial disorder, selection of models become important as not a single model shows all the biochemical features of the disease. Currently, conventional pharmacological, neurotoxin-induced, genetically modified and cellular models are available for PD research, but none of them recapitulate all the biochemical characteristics of the disease. In this review, we included the updated knowledge on the main features of currently available in vivo and in vitro models as well as their strengths and weaknesses.
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Affiliation(s)
- Tanvi Pingale
- Shobhaben Pratapbhai Patel School of Pharmacy & Technology Management, SVKM'S NMIMS, V.L. Mehta Road, Vile Parle (W), Mumbai 400 056, India
| | - Girdhari Lal Gupta
- Shobhaben Pratapbhai Patel School of Pharmacy & Technology Management, SVKM'S NMIMS, V.L. Mehta Road, Vile Parle (W), Mumbai 400 056, India; School of Pharmacy & Technology Management, SVKM'S NMIMS, Shirpur, Maharashtra, India.
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13
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Baladron J, Hamker FH. Habit learning in hierarchical cortex-basal ganglia loops. Eur J Neurosci 2020; 52:4613-4638. [PMID: 32237250 DOI: 10.1111/ejn.14730] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 03/21/2020] [Accepted: 03/22/2020] [Indexed: 12/17/2022]
Abstract
How do the multiple cortico-basal ganglia-thalamo-cortical loops interact? Are they parallel and fully independent or controlled by an arbitrator, or are they hierarchically organized? We introduce here a set of four key concepts, integrated and evaluated by means of a neuro-computational model, that bring together current ideas regarding cortex-basal ganglia interactions in the context of habit learning. According to key concept 1, each loop learns to select an intermediate objective at a different abstraction level, moving from goals in the ventral striatum to motor in the putamen. Key concept 2 proposes that the cortex integrates the basal ganglia selection with environmental information regarding the achieved objective. Key concept 3 claims shortcuts between loops, and key concept 4 predicts that loops compute their own prediction error signal for learning. Computational benefits of the key concepts are demonstrated. Contrasting with former concepts of habit learning, the loops collaborate to select goal-directed actions while training slower shortcuts develops habitual responses.
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Affiliation(s)
- Javier Baladron
- Department of Computer Science, Chemnitz University of Technology, Chemnitz, Germany
| | - Fred H Hamker
- Department of Computer Science, Chemnitz University of Technology, Chemnitz, Germany
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14
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Bingbing G, Yujing Z, Yanwei M, Chunbo D, Weiwei W, Shiyun T, Yangyingqiu L, Jin S, Qingwei S, Ailian L, Lizhi X. Diffusion Kurtosis Imaging of Microstructural Changes in Gray Matter Nucleus in Parkinson Disease. Front Neurol 2020; 11:252. [PMID: 32362865 PMCID: PMC7180218 DOI: 10.3389/fneur.2020.00252] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 03/17/2020] [Indexed: 12/29/2022] Open
Abstract
Objective: To explore the microstructural damage of extrapyramidal system gray matter nuclei in Parkinson disease (PD) using diffusion kurtosis imaging (DKI). Materials and Methods: We enrolled 35 clinically confirmed PD patients and 23 healthy volunteers. All patients underwent MR examination with conventional MRI scan sequences and an additional DKI sequence. We subsequently reconstructed the DKI raw images and analyzed the data. A radiologist in our hospital collected the Mini-Mental State Examination (MMSE) score of all subjects. Results: In the PD group, the mean kurtosis and axial kurtosis level decreased in the red nucleus (RN) and thalamus; the radial kurtosis increased in the substantia nigra (SN) and globus pallidus (GP). Fractional anisotropy decreased in the putamen. The largest area under the ROC curve of mean diffusion in GP was 0.811. Most kurtosis parameters demonstrated a positive correlation with the MMSE score, while several diffusion parameters showed a negative correlation with the same. Conclusion: DKI can qualitatively distinguish PD from healthy controls; furthermore, DKI-derived parameters can quantitatively evaluate the modifications of microstructures in extrapyramidal system gray matter nucleus in PD.
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Affiliation(s)
- Gao Bingbing
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Zhou Yujing
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Miao Yanwei
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Dong Chunbo
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Wang Weiwei
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Tian Shiyun
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Liu Yangyingqiu
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Shang Jin
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Song Qingwei
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Liu Ailian
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Xie Lizhi
- GE Healthcare, MR Research, Beijing, China
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15
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Milosevic L, De Vloo P, Gramer R, Kalia SK, Fasano A, Popovic MR, Hutchison WD. Neuronal Activity and Synaptic Plasticity in a Reimplanted STN-DBS Patient with Parkinson's Disease: Recordings from Two Surgeries. Stereotact Funct Neurosurg 2020; 98:206-212. [PMID: 32294659 DOI: 10.1159/000505705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 12/31/2019] [Indexed: 11/19/2022]
Abstract
The authors report the case of an elderly male in his 60s who, after 5 months of efficacious treatment with chronic deep brain stimulation of the subthalamic nucleus (STN-DBS), developed a hardware-related erosion necessitating removal of the complete DBS system. One and a half years following the first implantation, a new STN-DBS system was implanted along an immediately adjacent trajectory, and reproduction of clinical efficacy was reported. Additionally, 2 microstimulation protocols were compared between the 2 surgeries, i.e., one to assess the stimulation frequency response of STN neurons and another to assess inhibitory synaptic plasticity in the substantia nigra pars reticulata (SNr). The spontaneous neuronal firing rates of STN neurons in each hemisphere were also compared between the 2 surgeries. The results suggest that the frequency-sensitivity of STN neurons may have been reduced (i.e., more resistant to neuronal suppression), while the spontaneous baseline firing rates of STN neurons and the plasticity measured in the SNr remained unchanged (2 factors that may be indicative of neurodegenerative processes).
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Affiliation(s)
- Luka Milosevic
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada.,KITE, Toronto Rehabilitation Institute - University Health Network, Toronto, Ontario, Canada.,CRANIA, University Health Network and University of Toronto, Toronto, Ontario, Canada
| | - Philippe De Vloo
- Division of Neurosurgery, Toronto Western Hospital - University Health Network, Toronto, Ontario, Canada
| | - Robert Gramer
- Division of Neurosurgery, Toronto Western Hospital - University Health Network, Toronto, Ontario, Canada
| | - Suneil K Kalia
- KITE, Toronto Rehabilitation Institute - University Health Network, Toronto, Ontario, Canada.,CRANIA, University Health Network and University of Toronto, Toronto, Ontario, Canada.,Division of Neurosurgery, Toronto Western Hospital - University Health Network, Toronto, Ontario, Canada.,Department of Surgery, University of Toronto, Toronto, Ontario, Canada.,Krembil Research Institute - University Health Network, Toronto, Ontario, Canada
| | - Alfonso Fasano
- CRANIA, University Health Network and University of Toronto, Toronto, Ontario, Canada.,Division of Neurosurgery, Toronto Western Hospital - University Health Network, Toronto, Ontario, Canada.,Krembil Research Institute - University Health Network, Toronto, Ontario, Canada.,Edmond J. Safra Program in Parkinson's Disease and Morton and Gloria Shulman Movement Disorders Center, Toronto Western Hospital - University Health Network, Toronto, Ontario, Canada.,Division of Neurology, University of Toronto, Toronto, Ontario, Canada
| | - Milos R Popovic
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada.,KITE, Toronto Rehabilitation Institute - University Health Network, Toronto, Ontario, Canada.,CRANIA, University Health Network and University of Toronto, Toronto, Ontario, Canada
| | - William D Hutchison
- CRANIA, University Health Network and University of Toronto, Toronto, Ontario, Canada, .,Division of Neurosurgery, Toronto Western Hospital - University Health Network, Toronto, Ontario, Canada, .,Department of Surgery, University of Toronto, Toronto, Ontario, Canada, .,Division of Neurology, University of Toronto, Toronto, Ontario, Canada, .,Department of Physiology, University of Toronto, Toronto, Ontario, Canada,
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16
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Gandolfi D, Bigiani A, Porro CA, Mapelli J. Inhibitory Plasticity: From Molecules to Computation and Beyond. Int J Mol Sci 2020; 21:E1805. [PMID: 32155701 PMCID: PMC7084224 DOI: 10.3390/ijms21051805] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 02/28/2020] [Accepted: 03/03/2020] [Indexed: 11/17/2022] Open
Abstract
Synaptic plasticity is the cellular and molecular counterpart of learning and memory and, since its first discovery, the analysis of the mechanisms underlying long-term changes of synaptic strength has been almost exclusively focused on excitatory connections. Conversely, inhibition was considered as a fixed controller of circuit excitability. Only recently, inhibitory networks were shown to be finely regulated by a wide number of mechanisms residing in their synaptic connections. Here, we review recent findings on the forms of inhibitory plasticity (IP) that have been discovered and characterized in different brain areas. In particular, we focus our attention on the molecular pathways involved in the induction and expression mechanisms leading to changes in synaptic efficacy, and we discuss, from the computational perspective, how IP can contribute to the emergence of functional properties of brain circuits.
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Affiliation(s)
- Daniela Gandolfi
- Department of Biomedical, Metabolic and Neural Sciences and Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy; (D.G.); (A.B.); (C.A.P.)
- Department of Brain and behavioral sciences, University of Pavia, 27100 Pavia, Italy
| | - Albertino Bigiani
- Department of Biomedical, Metabolic and Neural Sciences and Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy; (D.G.); (A.B.); (C.A.P.)
| | - Carlo Adolfo Porro
- Department of Biomedical, Metabolic and Neural Sciences and Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy; (D.G.); (A.B.); (C.A.P.)
| | - Jonathan Mapelli
- Department of Biomedical, Metabolic and Neural Sciences and Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy; (D.G.); (A.B.); (C.A.P.)
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17
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Bologna M, Paparella G, Fasano A, Hallett M, Berardelli A. Evolving concepts on bradykinesia. Brain 2020; 143:727-750. [PMID: 31834375 PMCID: PMC8205506 DOI: 10.1093/brain/awz344] [Citation(s) in RCA: 108] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 09/02/2019] [Accepted: 09/06/2019] [Indexed: 12/20/2022] Open
Abstract
Bradykinesia is one of the cardinal motor symptoms of Parkinson's disease and other parkinsonisms. The various clinical aspects related to bradykinesia and the pathophysiological mechanisms underlying bradykinesia are, however, still unclear. In this article, we review clinical and experimental studies on bradykinesia performed in patients with Parkinson's disease and atypical parkinsonism. We also review studies on animal experiments dealing with pathophysiological aspects of the parkinsonian state. In Parkinson's disease, bradykinesia is characterized by slowness, the reduced amplitude of movement, and sequence effect. These features are also present in atypical parkinsonisms, but the sequence effect is not common. Levodopa therapy improves bradykinesia, but treatment variably affects the bradykinesia features and does not significantly modify the sequence effect. Findings from animal and patients demonstrate the role of the basal ganglia and other interconnected structures, such as the primary motor cortex and cerebellum, as well as the contribution of abnormal sensorimotor processing. Bradykinesia should be interpreted as arising from network dysfunction. A better understanding of bradykinesia pathophysiology will serve as the new starting point for clinical and experimental purposes.
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Affiliation(s)
- Matteo Bologna
- Department of Human Neurosciences, Sapienza University of Rome, Italy
- IRCCS Neuromed, Pozzilli (IS), Italy
| | | | - Alfonso Fasano
- Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Toronto, Ontario, Canada
- Division of Neurology, University of Toronto, Toronto, Ontario, Canada
- Krembil Brain Institute, Toronto, Ontario, Canada
- Center for Advancing Neurotechnological Innovation to Application (CRANIA), Toronto, ON, Canada
| | - Mark Hallett
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD, USA
| | - Alfredo Berardelli
- Department of Human Neurosciences, Sapienza University of Rome, Italy
- IRCCS Neuromed, Pozzilli (IS), Italy
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18
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The regulation of glutamic acid decarboxylases in GABA neurotransmission in the brain. Arch Pharm Res 2019; 42:1031-1039. [PMID: 31786745 DOI: 10.1007/s12272-019-01196-z] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 11/26/2019] [Indexed: 12/18/2022]
Abstract
Gamma-aminobutyric acid (GABA) is the main inhibitory neurotransmitter that is required for the control of synaptic excitation/inhibition and neural oscillation. GABA is synthesized by glutamic acid decarboxylases (GADs) that are widely distributed and localized to axon terminals of inhibitory neurons as well as to the soma and, to a lesser extent, dendrites. The expression and activity of GADs is highly correlated with GABA levels and subsequent GABAergic neurotransmission at the inhibitory synapse. Dysregulation of GADs has been implicated in various neurological disorders including epilepsy and schizophrenia. Two isoforms of GADs, GAD67 and GAD65, are expressed from separate genes and have different regulatory processes and molecular properties. This review focuses on the recent advances in understanding the structure of GAD, its transcriptional regulation and post-transcriptional modifications in the central nervous system. This may provide insights into the pathological mechanisms underlying neurological diseases that are associated with GAD dysfunction.
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19
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Milosevic L, Dallapiazza RF, Munhoz RP, Kalia SK, Popovic MR, Hutchison WD. Case Studies in Neuroscience: Lack of inhibitory synaptic plasticity in the substantia nigra pars reticulata of a patient with lithium-induced tremor. J Neurophysiol 2019; 122:1367-1372. [PMID: 31411948 DOI: 10.1152/jn.00203.2019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Tremor is a well-known side effect from many psychiatric medications, including lithium and dopamine antagonists. In patients whose psychiatric symptoms are stabilized and only respond to certain medications, deep brain stimulation may offer relief of the consequent motor complications. We report the case of an elderly male with disabling tremor related to lithium therapy for bipolar affective disorder, who was subsequently treated with deep brain stimulation. In this patient, we obtained recordings from the substantia nigra pars reticulata and performed a high-frequency stimulation protocol that robustly elicits long-term potentiation (LTP)-like changes in patients with Parkinson's disease. We hypothesized that in this patient, who did not have Parkinson's disease, the levels of inhibitory plasticity would be much greater. However, we found an unanticipated lack of plasticity in the patient with lithium-induced tremor, compared with two de novo control patients with Parkinson's disease. This patient was successfully treated with deep brain stimulation in the vicinity of the ventral oral posterior nucleus, an area of the thalamus that receives inputs from the basal ganglia. We postulate that the lithium-induced blockade of LTP may bring about motor complications such as tremor while simultaneously contributing to the therapeutic mechanism for treating the symptoms of psychiatric disorders such as bipolar affective disorder.NEW & NOTEWORTHY Use of a dual-microelectrode technique enabled us to compare long-term potentiation (LTP)-like changes in a patient with lithium-induced tremor to that of patients with Parkinson's disease. This study corroborated the findings in rodent brain slices that chronic lithium treatment may block LTP. Whereas a deficit in LTP may underlie the therapeutic mechanism for treating psychiatric disorders such as bipolar affective disorder, it may simultaneously contribute to consequent appearance of tremor.
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Affiliation(s)
- Luka Milosevic
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada
| | - Robert F Dallapiazza
- Division of Neurosurgery, Toronto Western Hospital - University Health Network, Toronto, Ontario, Canada
| | - Renato P Munhoz
- Division of Neurology, University of Toronto, Toronto, Ontario, Canada
| | - Suneil K Kalia
- Division of Neurosurgery, Toronto Western Hospital - University Health Network, Toronto, Ontario, Canada.,Department of Surgery, University of Toronto, Toronto, Ontario, Canada.,Krembil Research Institute, Toronto, Ontario, Canada
| | - Milos R Popovic
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada.,KITE, Toronto Rehabilitation Institute - University Health Network, Toronto, Ontario, Canada
| | - William D Hutchison
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada.,Krembil Research Institute, Toronto, Ontario, Canada.,Department of Physiology, University of Toronto, Toronto, Ontario, Canada
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20
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Liu Y, Zong X, Huang J, Guan Y, Li Y, Du T, Liu K, Kang X, Dou C, Sun X, Wu R, Wen L, Zhang Y. Ginsenoside Rb1 regulates prefrontal cortical GABAergic transmission in MPTP-treated mice. Aging (Albany NY) 2019; 11:5008-5034. [PMID: 31314744 PMCID: PMC6682523 DOI: 10.18632/aging.102095] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 07/10/2019] [Indexed: 04/12/2023]
Abstract
Parkinson's disease (PD) is a common neurodegenerative disease, featured by motor deficits and non-motor symptoms such as cognitive impairment, and malfunction of gamma-aminobutyric acid (GABA) mediated inhibitory transmission plays an important role in PD pathogenesis. The ginsenoside Rb1 molecule, a major constituent of the extract from the Ginseng root, has been demonstrated to ameliorate motor deficits and prevent dopaminergic neuron death in PD. However, whether Rb1 can regulate GABAergic transmission in PD-associated deficits and its underlying mechanisms are still unclear. In this study, we explored the effects of Rb1 on the GABAergic synaptic transmission in 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) mouse model of PD. We demonstrated that Rb1 can bind with GABAARα1 and increase its expression in the SH-SY5Y cells and in the prefrontal cortex (PFC) of MPTP model in vitro and in vivo. Furthermore, Rb1 can promote prefrontal cortical GABA level and GABAergic transmission in MPTP-treated mice. We also revealed that Rb1 may suppress presynaptic GABABR1 to enhance GABA release and GABAA receptor-mediated inhibitory transmission. In addition, Rb1 attenuated MPTP-induced dysfunctional gait dynamic and cognitive impairment, and this neuroprotective mechanism possibly involved regulating prefrontal cortical GABAergic transmission. Thus, Rb1 may serve as a potential drug candidate for the treatment of PD.
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Affiliation(s)
- Yan Liu
- Department of Traditional Chinese Medicine, School of Medicine, Xiamen University, Xiamen 361102, China
- Key Laboratory of Neuroscience, School of Basic Medical Sciences, Guangzhou Medical University, Guangzhou 511436, China
| | - Xiaodan Zong
- Department of Medical Imaging, The Second Affiliated Hospital, Medical College of Shantou University, Shantou 515041, China
| | - Jie Huang
- School of Basic Medical Sciences, Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China
| | - Yanfei Guan
- School of Basic Medical Sciences, Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China
| | - Yuanquan Li
- School of Basic Medical Sciences, Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China
| | - Ting Du
- Department of Traditional Chinese Medicine, School of Medicine, Xiamen University, Xiamen 361102, China
| | - Keyin Liu
- Department of Traditional Chinese Medicine, School of Medicine, Xiamen University, Xiamen 361102, China
| | - Xinpan Kang
- Department of Traditional Chinese Medicine, School of Medicine, Xiamen University, Xiamen 361102, China
| | - Chunyan Dou
- Department of Traditional Chinese Medicine, School of Medicine, Xiamen University, Xiamen 361102, China
| | - Xiangdong Sun
- School of Basic Medical Sciences, Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China
| | - Renhua Wu
- Department of Medical Imaging, The Second Affiliated Hospital, Medical College of Shantou University, Shantou 515041, China
- Provincial Key Laboratory of Medical Molecular Imaging, Shantou 515041, China
| | - Lei Wen
- Department of Traditional Chinese Medicine, School of Medicine, Xiamen University, Xiamen 361102, China
- Fujian Provincial Key Laboratory of Neurodegenerative Disease and Aging Research, Institute of Neuroscience, School of Medicine, Xiamen University, Xiamen 361102, China
| | - Yunlong Zhang
- Key Laboratory of Neuroscience, School of Basic Medical Sciences, Guangzhou Medical University, Guangzhou 511436, China
- Shenzhen Research Institute of Xiamen University, Shenzhen 518000, China
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21
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Jellinger KA. Neuropathology and pathogenesis of extrapyramidal movement disorders: a critical update-I. Hypokinetic-rigid movement disorders. J Neural Transm (Vienna) 2019; 126:933-995. [PMID: 31214855 DOI: 10.1007/s00702-019-02028-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 06/05/2019] [Indexed: 02/06/2023]
Abstract
Extrapyramidal movement disorders include hypokinetic rigid and hyperkinetic or mixed forms, most of them originating from dysfunction of the basal ganglia (BG) and their information circuits. The functional anatomy of the BG, the cortico-BG-thalamocortical, and BG-cerebellar circuit connections are briefly reviewed. Pathophysiologic classification of extrapyramidal movement disorder mechanisms distinguish (1) parkinsonian syndromes, (2) chorea and related syndromes, (3) dystonias, (4) myoclonic syndromes, (5) ballism, (6) tics, and (7) tremor syndromes. Recent genetic and molecular-biologic classifications distinguish (1) synucleinopathies (Parkinson's disease, dementia with Lewy bodies, Parkinson's disease-dementia, and multiple system atrophy); (2) tauopathies (progressive supranuclear palsy, corticobasal degeneration, FTLD-17; Guamian Parkinson-dementia; Pick's disease, and others); (3) polyglutamine disorders (Huntington's disease and related disorders); (4) pantothenate kinase-associated neurodegeneration; (5) Wilson's disease; and (6) other hereditary neurodegenerations without hitherto detected genetic or specific markers. The diversity of phenotypes is related to the deposition of pathologic proteins in distinct cell populations, causing neurodegeneration due to genetic and environmental factors, but there is frequent overlap between various disorders. Their etiopathogenesis is still poorly understood, but is suggested to result from an interaction between genetic and environmental factors. Multiple etiologies and noxious factors (protein mishandling, mitochondrial dysfunction, oxidative stress, excitotoxicity, energy failure, and chronic neuroinflammation) are more likely than a single factor. Current clinical consensus criteria have increased the diagnostic accuracy of most neurodegenerative movement disorders, but for their definite diagnosis, histopathological confirmation is required. We present a timely overview of the neuropathology and pathogenesis of the major extrapyramidal movement disorders in two parts, the first one dedicated to hypokinetic-rigid forms and the second to hyperkinetic disorders.
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Affiliation(s)
- Kurt A Jellinger
- Institute of Clinical Neurobiology, Alberichgasse 5/13, 1150, Vienna, Austria.
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22
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Wang Z, Hou L, Wang D. Effects of exercise-induced fatigue on the morphology of asymmetric synapse and synaptic protein levels in rat striatum. Neurochem Int 2019; 129:104476. [PMID: 31145967 DOI: 10.1016/j.neuint.2019.104476] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 04/20/2019] [Accepted: 05/26/2019] [Indexed: 12/12/2022]
Abstract
Corticostriatal synaptic plasticity is considered to be a cellular basis for somatic motor regulation and motor skill learning. Changes in synaptic transmission efficiency underlie functional plasticity, while structural plasticity involves changes in the ultrastructure of the synapse and the levels of synaptic proteins. Exercise-induced fatigue may impair corticostriatal synaptic plasticity, and this impairment may be an important mechanism for exercise-induced fatigue. However, prior research focused mainly on functional plasticity such that the structural plasticity was not well understood. Because corticostriatal synapses are typical asymmetric synapses, here we have used transmission electron microscopy to examine the changes of asymmetry synaptic ultrastructure in rat striatum before and after repetitive exercise-induced fatigue; we have also used western blotting to detect the levels of synaptic active region protein Munc 13, RIM1 and synaptic vesicle protein Rab3A and postsynaptic density PSD-95 protein in rat striatum before and after exercise-induced fatigue. The results showed that the ultrastructure of asymmetry corticostriatal synapses and synaptic protein levels in the striatum of rats were abnormally changed after repetitive exercise-induced fatigue. These abnormal changes in synaptic ultrastructure and related protein levels may be the structural basis for the corticostriatal plasticity impairment after exercise-induced fatigue.
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Affiliation(s)
- Zhifeng Wang
- Department of Physical Education, Xi'an Polytechnic University, Xi'an, Shanxi, 710048, China
| | - Lijuan Hou
- Physical Education and Sports College, Beijing Normal University, Beijing, 100875, China
| | - Dongmei Wang
- College of Sports Medicine and Rehabilitation, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, Shandong, 271000, China.
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23
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Differential diagnosis of multiple system atrophy with predominant parkinsonism and Parkinson's disease using neural networks. J Neurol Sci 2019; 401:19-26. [PMID: 31005759 DOI: 10.1016/j.jns.2019.04.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 03/18/2019] [Accepted: 04/09/2019] [Indexed: 02/08/2023]
Abstract
Differential diagnosis between Parkinson's disease (PD) and atypical parkinsonism, such as multiple system atrophy (MSA), can be difficult, especially in the early stages of the disease. Deep learning using neural networks (NNs) makes possible the prediction of the diagnosis using various types of biomarkers, unlike conventional linear statistics. We aimed to differentiate the Parkinson's variant of MSA (MSA-P) from PD both in the early stages by clinical utilization of NN analyses before the hot cross-bun and putaminal rim imaging features of MSA appeared. Analysis by NN involved the data of voxel-based morphometry (VBM) that indicate morphological changes and magnetic resonance spectroscopy (MRS) that indicate qualitative changes. VBM analysis showed that compared with PD patients, MSA-P patients showed atrophy in the superior cerebellar peduncle, middle cerebellar peduncle, cerebellar hemisphere, pons, midbrain, and putamen, but not in the globus pallidus. Proton MRS on the globus pallidus in the diseased hemisphere, lacking atrophy as observed with VBM, revealed decreased neurons and gliosis in both groups. Clinical differentiation of MSA-P from PD using NN analysis, involved measuring the prediction potential using the area under the receiver operator characteristic (ROC) curves (AUC). Using both VBM and MRS data, NNs contributed adequately to the clinical diagnosis.
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Raza C, Anjum R, Shakeel NUA. Parkinson's disease: Mechanisms, translational models and management strategies. Life Sci 2019; 226:77-90. [PMID: 30980848 DOI: 10.1016/j.lfs.2019.03.057] [Citation(s) in RCA: 277] [Impact Index Per Article: 55.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 03/22/2019] [Accepted: 03/23/2019] [Indexed: 12/21/2022]
Abstract
Parkinson's disease is a progressive neurodegenerative disorder. The classical motor symptoms include resting tremors, bradykinesia, rigidity and postural instability and are accompanied by the loss of dopaminergic neurons and Lewy pathology. Diminished neurotransmitter level, oxidative stress, mitochondrial dysfunction and perturbed protein homeostasis over time worsen the disease manifestations in elderly people. Current management strategies aim to provide symptomatic relief and to slow down the disease progression. However, no pharmacological breakthrough has been made to protect dopaminergic neurons and associated motor circuitry components. Deep brain stimulation, stem cells-derived dopaminergic neurons transplantation, gene editing and gene transfer remain promising approaches for the potential management of neurodegenerative disease. Toxin or genetically induced rodent models replicating Parkinson's disease pathology are of high predictive value for translational research. This review addresses the current understanding, management strategies and the Parkinson's disease models for translational research. Preclinical research may provide powerful tools to quest the potential therapeutic and neuroprotective compounds for dopaminergic neurons and hence possible cure for the Parkinson's disease.
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Affiliation(s)
- Chand Raza
- Department of Zoology, Government College University, Lahore 54000, Pakistan.
| | - Rabia Anjum
- Department of Zoology, Government College University, Lahore 54000, Pakistan
| | - Noor Ul Ain Shakeel
- Department of Zoology, Government College University, Lahore 54000, Pakistan
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