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Hu Y, Wei L, Li A, Liu T, Jiang Y, Xie C, Wang K. Cognitive impairment in Chinese adult patients with type III spinal muscular atrophy without disease-modifying treatment. Front Neurol 2023; 14:1226043. [PMID: 38020636 PMCID: PMC10655145 DOI: 10.3389/fneur.2023.1226043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 10/19/2023] [Indexed: 12/01/2023] Open
Abstract
Objective Spinal muscular atrophy (SMA) is a neurodegenerative disorder characterized by the degeneration of motor neurons in the spinal cord. It remains uncertain whether the cognitive performance of adult patients with SMA is impaired. The objective of this study was to assess the cognitive profile of adult Chinese patients with SMA and the association between clinical features and cognitive ability, particularly executive function. Methods This cross-sectional study included 22 untreated adult patients with type III SMA and 20 healthy subjects. The following variables were assessed: general intelligence, memory, attention, language, executive function, depression, anxiety, and other demographic and clinical parameters. In addition, physical function was evaluated using the Hammersmith Functional Motor Scale Expanded (HFMSE), the Revised Upper Limb Module (RULM), and the 6-Minute Walk Test (6MWT). Results SMA patients had lower scores than healthy subjects in the Verbal Fluency Test, Stroop effect, Total Errors, Perseverative Responses, Perseverative Errors, and Non-perseverative Errors in the Wisconsin Card Sorting Test, showing impaired abilities of SMA patients in executive function. In the Attention Network Test (ANT), the results indicated that the SMA patients also had selective deficits in their executive control networks. Ambulant patients had better executive function test performance than non-ambulant ones. Compromised executive abilities in patients with SMA were correlated with a younger age at onset, poorer motor function, and higher levels of anxiety and depression. Conclusion Our study presented the distribution of cognitive impairment in a Chinese cohort with SMA. Patients with type III SMA showed selective deficits in executive function, which may be associated with disease severity, physical impairment, depression and anxiety. Future cognitive studies, accounting for motor and emotional impairment, are needed to evaluate if executive impairment is driven by specific brain changes or by those confounding factors.
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Affiliation(s)
- Ying Hu
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | - Ling Wei
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | - Aonan Li
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | - Tingting Liu
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | - Yubao Jiang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | - Chengjuan Xie
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | - Kai Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
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Xia K, Han Y, Zhou L, Hu S, Rao R, Shan S, Hua L. Attention impairment in patients with cervical dystonia: An attention network test study. Front Psychol 2022; 13:952567. [PMID: 35992456 PMCID: PMC9386253 DOI: 10.3389/fpsyg.2022.952567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 07/04/2022] [Indexed: 11/24/2022] Open
Abstract
Objective The purpose of this study was to investigate attentional network functional characteristics in patients with cervical dystonia (CD). Methods A total of 29 patients with CD and 26 healthy controls (HCs) were recruited. All subjects participated in the study and underwent the Attention Network Test (ANT), which evaluated the efficiencies of three independent attention networks (alerting, orienting, and executive control), as well as reaction time (RT) and accuracy. Results Significant differences between CD patients (9.86 ± 27.95 ms) and HCs (33.62 ± 23.41 ms) were observed in the alerting network (t = −3.40, p < 0.05). In contrast, the orienting network (t = 0.26, p = 0.79), executive control network (Z = −0.55, p = 0.58), total mean reaction time (t = −2.6, p = 0.79), and total accuracy rate (Z = −1.67, p = 0.09) showed no significant differences between the two groups. Conclusion Patients with CD showed a significant deficit in the alerting network. However, they did not show any deficits in the orienting or executive control network. In addition, the alerting, orienting, and executive control network functions of CD patients were all affected by the severity of torticollis, especially the alerting network function.
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Affiliation(s)
- Kun Xia
- Institute of Neurology, Anhui University of Chinese Medicine, Hefei, China
| | - Yongsheng Han
- Institute of Neurology, Anhui University of Chinese Medicine, Hefei, China
- Department of Neurology, Anhui Hospital of Integrated Traditional Chinese and Western Medicine, Hefei, China
- *Correspondence: Yongsheng Han,
| | - Lanlan Zhou
- Department of Neurology, The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, China
| | - Sheng Hu
- School of Medical Information Engineering, Anhui University of Traditional Chinese Medicine, Hefei, China
| | - Rao Rao
- Institute of Neurology, Anhui University of Chinese Medicine, Hefei, China
| | - Shu Shan
- Institute of Neurology, Anhui University of Chinese Medicine, Hefei, China
| | - Lei Hua
- Institute of Neurology, Anhui University of Chinese Medicine, Hefei, China
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Kane JM, McDonnell JL, Neimat JS, Hedera P, van den Wildenberg WPM, Phibbs FT, Bradley EB, Wylie SA, van Wouwe NC. Essential tremor impairs the ability to suppress involuntary action impulses. Exp Brain Res 2022; 240:1957-1966. [PMID: 35562536 PMCID: PMC11150918 DOI: 10.1007/s00221-022-06373-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 04/13/2022] [Indexed: 11/04/2022]
Abstract
Essential tremor (ET) is a movement disorder characterized primarily by action tremor which affects the regulation of movements. Disruptions in cerebello-thalamocortical networks could interfere with cognitive control over actions in ET, for example, the ability to suppress a strong automatic impulse over a more appropriate action (conflict control). The current study investigated whether ET impacts conflict control proficiency. Forty-one ET patients and 29 age-matched healthy controls (HCs) performed a conflict control task (Simon task). Participants were instructed to give a left or right response to a spatially lateralized arrow (direction of the arrow). When the action signaled by the spatial location and direction of the arrow were non-corresponding (induced conflict), the inappropriate action impulse required suppression. Overall, ET patients responded slower and less accurately compared to HCs. ET patients were especially less accurate on non-corresponding conflict (Nc) versus corresponding (Cs) trials. A focused analysis on fast impulsive response rates (based on the accuracy rate at the fastest reaction times on Nc trials) showed that ET patients made more fast errors compared to HCs. Results suggest impaired conflict control in ET compared to HCs. The increased impulsive errors seen in the ET population may be a symptom of deficiencies in the cerebello-thalamocortical networks, or, be caused by indirect effects on the cortico-striatal pathways. Future studies into the functional networks impacted by ET (cortico-striatal and cerebello-thalamocortical pathways) could advance our understanding of inhibitory control in general and the cognitive deficits in ET.
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Affiliation(s)
- Jessi M Kane
- Department of Neurosurgery, University of Louisville, Louisville, KY, USA
- Department of Psychology, University of Louisville, Louisville, KY, USA
| | | | - Joseph S Neimat
- Department of Neurosurgery, University of Louisville, Louisville, KY, USA
| | - Peter Hedera
- Department of Neurology, University of Louisville, Louisville, KY, USA
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Wery P M van den Wildenberg
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Brain and Cognition (ABC), University of Amsterdam, Amsterdam, The Netherlands
| | - Fenna T Phibbs
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Elise B Bradley
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Scott A Wylie
- Department of Neurosurgery, University of Louisville, Louisville, KY, USA
| | - Nelleke C van Wouwe
- Department of Neurosurgery, University of Louisville, Louisville, KY, USA.
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA.
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4
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Essential tremor and cognitive impairment: who, how, and why. Neurol Sci 2022; 43:4133-4143. [DOI: 10.1007/s10072-022-06037-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 03/23/2022] [Indexed: 10/18/2022]
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Cosentino S, Shih LC. Does essential tremor increase risk of cognitive impairment and dementia? Yes. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2022; 163:195-231. [PMID: 35750363 DOI: 10.1016/bs.irn.2022.02.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Essential Tremor (ET), by definition, is a disorder of movement. Yet over the years, epidemiologic, clinical, pathologic, and neuroimaging studies have converged to reveal a cognitive side of ET. The cognitive symptoms in ET are heterogeneous and are likely to reflect heterogeneous underlying mechanisms. In this chapter, we review and synthesize a diverse set of studies from both population-based settings to cohorts with more detailed investigations into cognition to consider the various mechanisms by which cognitive symptoms may emerge in a subset of individuals with ET. As part of our analysis, we consider questions surrounding ET diagnosis and the possibility of comorbid disease as potential factors that, upon closer examination, appear to strengthen the argument in favor of ET as a risk factor for dementia. Importantly, we also consider the clinical relevance of cognitive impairment in ET. While ET is not universally characterized by significant cognitive deficits, the data from epidemiological, cognitive, neuroimaging, and postmortem neuropathologic studies converge to reveal an increased risk for cognitive impairment and dementia among individuals with ET. We conclude by offering directions for future research, and a neurocognitive framework with which to consider existing findings and to use in the design of novel studies dedicated to clarifying the basis, nature, and course of cognitive impairments in ET.
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Affiliation(s)
- Stephanie Cosentino
- Cognitive Neuroscience Division of the Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Irving Medical Center, New York, United States; Department of Neurology, Columbia University Irving Medical Center, New York, United States.
| | - Ludy C Shih
- Department of Neurology, Parkinson's Disease and Movement Disorders Center, Boston Medical Center, Boston, Massachusetts, United States; Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, United States.
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Ren Y, Suzuki K, Hirata K, Yang W, Wu J. Changes in efficiencies and interactions of attentional networks in Parkinson's disease with sleep disturbance. Neurosci Res 2021; 170:236-244. [PMID: 33992661 DOI: 10.1016/j.neures.2021.05.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 04/30/2021] [Accepted: 05/10/2021] [Indexed: 10/21/2022]
Abstract
Attention is composed of three distinct attentional networks: alerting, orienting, and executive control. Previous studies have confirmed that Parkinson's disease (PD) is associated with executive control deficits; however, the interactions among the three attentional networks and the influence of sleep disturbance in PD patients have not been investigated. Herein, the efficiencies for the three attentional networks and their interactions were evaluated using the revised attention network test. The results showed a significantly slower response and lower accuracy in the PD group than in the normal control group and a significantly slower response and lower accuracy in PD patients with sleep disturbance (PDS) than in PD patients without sleep disturbance (PDnS), which indicates a response deficit in PD and worsening in PDS. Additionally, the executive control efficiency was reduced in both PDS and PDnS, and significantly higher alerting efficiency and lower orienting efficiency were found in PDS. Furthermore, largely changed interactions and correlation patterns of attentional networks were found in PDS but not in PDnS. These results suggested that attentional networks were impaired in PD patients, particularly in those affected by sleep disturbances, and that PDS might establish special connections between attentional networks to compensate for cognitive dysfunction.
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Affiliation(s)
- Yanna Ren
- Department of Psychology, College of Humanities and Management, Guizhou University of Traditional Chinese Medicine, Guiyang, 550025, China
| | - Keisuke Suzuki
- Department of Neurology, Dokkyo Medical University, Tochigi, 3210293, Japan
| | - Koichi Hirata
- Department of Neurology, Dokkyo Medical University, Tochigi, 3210293, Japan
| | - Weiping Yang
- Department of Psychology, Faculty of Education, Hubei University, Wuhan, 430062, China.
| | - Jinglong Wu
- Cognitive Neuroscience Laboratory, Graduate School of Natural Science and Technology, Okayama University, Okayama, 7008530, Japan.
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Hughes S, Claassen DO, van den Wildenberg WPM, Phibbs FT, Bradley EB, Wylie SA, van Wouwe NC. Action Control Deficits in Patients With Essential Tremor. J Int Neuropsychol Soc 2019; 25:156-164. [PMID: 30501660 PMCID: PMC6374198 DOI: 10.1017/s1355617718001054] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Essential tremor (ET) is a movement disorder characterized by action tremor which impacts motor execution. Given the disrupted cerebellar-thalamo-cortical networks in ET, we hypothesized that ET could interfere with the control mechanisms involved in regulating motor performance. The ability to inhibit or stop actions is critical for navigating many daily life situations such as driving or social interactions. The current study investigated the speed of action initiation and two forms of action control, response stopping and proactive slowing in ET. METHODS Thirty-three ET patients and 25 healthy controls (HCs) completed a choice reaction task and a stop-signal task, and measures of going speed, proactive slowing and stop latencies were assessed. RESULTS Going speed was significantly slower in ET patients (649 ms) compared to HCs (526 ms; F(1,56) = 42.37; p <.001; η 2 = .43), whereas proactive slowing did not differ between groups. ET patients exhibited slower stop signal reaction times (320 ms) compared to HCs (258 ms, F(1,56) = 15.3; p <.00; η 2 = .22) and more severe motor symptoms of ET were associated with longer stopping latencies in a subset of patients (Spearman rho = .48; p <.05). CONCLUSIONS In line with previous studies, ET patients showed slower action initiation. Additionally, inhibitory control was impaired whereas proactive slowing remained intact relative to HCs. More severe motor symptoms of ET were associated with slower stopping speed, and may reflect more progressive changes to the cerebellar-thalamo-cortical network. Future imaging studies should specify which structural and functional changes in ET can explain changes in inhibitory action control. (JINS, 2019, 25, 156-164).
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Affiliation(s)
- Shelby Hughes
- 1Department of Neurology,Vanderbilt University Medical Center,Nashville, Tennessee
| | - Daniel O Claassen
- 1Department of Neurology,Vanderbilt University Medical Center,Nashville, Tennessee
| | | | - Fenna T Phibbs
- 1Department of Neurology,Vanderbilt University Medical Center,Nashville, Tennessee
| | - Elise B Bradley
- 1Department of Neurology,Vanderbilt University Medical Center,Nashville, Tennessee
| | - Scott A Wylie
- 2Department of Neurosurgery,University of Louisville,Louisville, Kentucky, Tennessee
| | - Nelleke C van Wouwe
- 1Department of Neurology,Vanderbilt University Medical Center,Nashville, Tennessee
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8
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Hou D, Ma Y, Wang B, Hou X, Chen J, Hong Y, Xu S, Nie S, Liu X. Selective Impairment of Attentional Networks of Executive Control in Middle-Aged Subjects with Type 2 Diabetes Mellitus. Med Sci Monit 2018; 24:5355-5362. [PMID: 30067608 PMCID: PMC6085979 DOI: 10.12659/msm.909142] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background The influence of type 2 diabetes mellitus (T2DM) on attention has been elusive. The Attention Network Test (ANT) was developed to evaluate the functioning of 3 individual attentional networks: orienting, alerting, and executive control. The purpose of this study was to use the ANT to assess attentional function and its sub-components in T2DM patients ages 40–60 years. Material/Methods Thirty T2DM patients and 30 healthy controls ages 40–60 years were recruited in this investigation. The ANT was used to statistically compare the efficiency among 3 sub-components of the attention networks between middle-aged T2DM patients (n=30) and gender-, age-, and education-matched healthy controls (n=30). Results The ANT demonstrated a significant difference in executive control network between the T2DM patients and healthy controls (t=3.242, P=0.002), whereas no significant difference was observed regarding the domains of alerting (t=0.515, P=0.609) and orienting control (t=0.078, P=0.938) between the T2DM patient group and the healthy control group. Moreover, the mean reaction time in the ANT in the T2DM patients was significantly longer compared with that in the healthy controls (t=3.561, P=0.001). Conclusions The ANT reveals significant impairment in the executive control of middle-aged patients diagnosed with T2DM, whereas no significant impairment was observed in the domains of alerting and orienting.
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Affiliation(s)
- Dianlong Hou
- Department of Senile Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland).,Department of Neurology, The People's Hospital of Huantai County, Huantai, Shandong, China (mainland)
| | - Yingjuan Ma
- Department of Senile Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland).,Department of Anti-Ageing, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland).,Anti-Aging Monitoring Laboratory, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland)
| | - Baolan Wang
- Department of Endocrinology, The People's Hospital of Huantai County, Huantai, Shandong, China (mainland)
| | - Xunyao Hou
- Department of Senile Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland).,Department of Anti-Ageing, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland).,Anti-Aging Monitoring Laboratory, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland)
| | - Jian Chen
- Department of Senile Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland).,Department of Anti-Ageing, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland).,Anti-Aging Monitoring Laboratory, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland)
| | - Yan Hong
- Department of Senile Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland).,Department of Anti-Ageing, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland).,Anti-Aging Monitoring Laboratory, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland)
| | - Song Xu
- Department of Senile Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland).,Department of Anti-Ageing, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland).,Anti-Aging Monitoring Laboratory, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland)
| | - Shanjing Nie
- Department of Senile Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland).,Department of Anti-Ageing, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland).,Anti-Aging Monitoring Laboratory, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland)
| | - Xueping Liu
- Department of Senile Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland).,Department of Anti-Ageing, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland).,Anti-Aging Monitoring Laboratory, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China (mainland)
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Absent Audiovisual Integration Elicited by Peripheral Stimuli in Parkinson's Disease. PARKINSONS DISEASE 2018; 2018:1648017. [PMID: 29850014 PMCID: PMC5924975 DOI: 10.1155/2018/1648017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2017] [Revised: 01/01/2018] [Accepted: 01/29/2018] [Indexed: 01/22/2023]
Abstract
The basal ganglia, which have been shown to be a significant multisensory hub, are disordered in Parkinson's disease (PD). This study was to investigate the audiovisual integration of peripheral stimuli in PD patients with/without sleep disturbances. Thirty-six age-matched normal controls (NC) and 30 PD patients were recruited for an auditory/visual discrimination experiment. The mean response times for each participant were analyzed using repeated measures ANOVA and race model. The results showed that the response to all stimuli was significantly delayed for PD compared to NC (all p < 0.01). The response to audiovisual stimuli was significantly faster than that to unimodal stimuli in both NC and PD (p < 0.001). Additionally, audiovisual integration was absent in PD; however, it did occur in NC. Further analysis showed that there was no significant audiovisual integration in PD with/without cognitive impairment or in PD with/without sleep disturbances. Furthermore, audiovisual facilitation was not associated with Hoehn and Yahr stage, disease duration, or the presence of sleep disturbances (all p > 0.05). The current results showed that audiovisual multisensory integration for peripheral stimuli is absent in PD regardless of sleep disturbances and further suggested the abnormal audiovisual integration might be a potential early manifestation of PD.
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Pauletti C, Mannarelli D, Locuratolo N, Pollini L, Currà A, Marinelli L, Rinalduzzi S, Fattapposta F. Attention in Parkinson's disease with fatigue: evidence from the attention network test. J Neural Transm (Vienna) 2016; 124:335-345. [PMID: 27783210 DOI: 10.1007/s00702-016-1637-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Accepted: 10/19/2016] [Indexed: 12/26/2022]
Abstract
Fatigue is a non-specific symptom that is common in chronic diseases and represents one of the most disabling symptoms in Parkinson's disease. PD patients often experience cognitive deficits related above all to executive functions. The relationship between cognitive changes and fatigue in PD patients has not been explored in depth. The Attention Network Test (ANT) is a rapid, widely used test to measure the efficiency of three attentional networks, i.e., alerting, orienting, and executive, by evaluating reaction times (RTs) in response to visual stimuli. To assess the association between fatigue and the efficiency of the attentional networks, according to the Posnerian view, ANT was administered to 15 parkinsonian patients with fatigue (PFS-16 > 2.95), 17 parkinsonian patients without fatigue, and 37 age- and sex-matched healthy controls. Anxiety, depression, quality of sleep, and quality of life were also assessed. Parkinsonian patients displayed significantly longer RTs and lower executive network efficiency than controls. Patients with fatigue displayed significantly lower executive network efficiency than patients without fatigue. Moreover, patients with fatigue exhibited a lower accuracy than either patients without fatigue or controls. Finally, patients without fatigue displayed a more efficient alerting network than either patients with fatigue or controls. Although the pathogenesis of fatigue is multifactorial, our results indicate that fatigue may be closely related to an alteration of the striato-thalamo-cortical loop connecting the neostriatum to the prefrontal cortex, which is also responsible for the executive dysfunction that is typical of Parkinson's disease.
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Affiliation(s)
- Caterina Pauletti
- Department of Neurology and Psychiatry, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy. .,Vaclav Vojta Rehabilitation Center, Via Pincherle 186, 00146, Rome, Italy.
| | - Daniela Mannarelli
- Department of Neurology and Psychiatry, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy
| | - Nicoletta Locuratolo
- Department of Neurology and Psychiatry, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy
| | - Luca Pollini
- Department of Neurology and Psychiatry, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy
| | - Antonio Currà
- Academic Neurologic Unit, A. Fiorini Hospital, Sapienza University of Rome, Terracina, LT, Italy
| | - Lucio Marinelli
- Department of Neurosciences Rehabilitation Ophthalmology Genetics Maternal and Child Health (DiNOGMI), Institute of Neurology, University of Genova, Largo Daneo 3, 16132, Genova, Italy
| | - Steno Rinalduzzi
- Neurology and Neurophysiopathology Unit, Sandro Pertini Hospital, Rome, Italy
| | - Francesco Fattapposta
- Department of Neurology and Psychiatry, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy
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