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Lu X, Wickens JR, Hyland BI. Multimodal convergence in the pedunculopontine tegmental nucleus: Motor, sensory and theta-frequency inputs influence activity of single neurons. Eur J Neurosci 2024; 60:3643-3658. [PMID: 38698531 DOI: 10.1111/ejn.16367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 04/03/2024] [Indexed: 05/05/2024]
Abstract
The pedunculopontine tegmental nucleus of the brainstem (PPTg) has extensive interconnections and neuronal-behavioural correlates. It is implicated in movement control and sensorimotor integration. We investigated whether single neuron activity in freely moving rats is correlated with components of skilled forelimb movement, and whether individual neurons respond to both motor and sensory events. We found that individual PPTg neurons showed changes in firing rate at different times during the reach. This type of temporally specific modulation is like activity seen elsewhere in voluntary movement control circuits, such as the motor cortex, and suggests that PPTg neural activity is related to different specific events occurring during the reach. In particular, many neuronal modulations were time-locked to the end of the extension phase of the reach, when fine distal movements related to food grasping occur, indicating strong engagement of PPTg in this phase of skilled individual forelimb movements. In addition, some neurons showed brief periods of apparent oscillatory firing in the theta range at specific phases of the reach-to-grasp movement. When movement-related neurons were tested with tone stimuli, many also responded to this auditory input, allowing for sensorimotor integration at the cellular level. Together, these data extend the concept of the PPTg as an integrative structure in generation of complex movements, by showing that this function extends to the highly coordinated control of the forelimb during skilled reach to grasp movement, and that sensory and motor-related information converges on single neurons, allowing for direct integration at the cellular level.
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Affiliation(s)
- Xiaodong Lu
- Department of Physiology, School of Biomedical Sciences and Brain Health Research Centre, University of Otago, Dunedin, New Zealand
- Brain Research New Zealand Centre of Research Excellence, Dunedin and Auckland, New Zealand
| | - Jeffery R Wickens
- Okinawa Institute for Science and Technology Graduate University, Okinawa, Japan
| | - Brian Ian Hyland
- Department of Physiology, School of Biomedical Sciences and Brain Health Research Centre, University of Otago, Dunedin, New Zealand
- Brain Research New Zealand Centre of Research Excellence, Dunedin and Auckland, New Zealand
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Wang C, Lin C, Zhao Y, Samantzis M, Sedlak P, Sah P, Balbi M. 40-Hz optogenetic stimulation rescues functional synaptic plasticity after stroke. Cell Rep 2023; 42:113475. [PMID: 37979173 DOI: 10.1016/j.celrep.2023.113475] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 10/18/2023] [Accepted: 11/03/2023] [Indexed: 11/20/2023] Open
Abstract
Evoked brain oscillations in the gamma range have been shown to assist in stroke recovery. However, the causal relationship between evoked oscillations and neuroprotection is not well understood. We have used optogenetic stimulation to investigate how evoked gamma oscillations modulate cortical dynamics in the acute phase after stroke. Our results reveal that stimulation at 40 Hz drives activity in interneurons at the stimulation frequency and phase-locked activity in principal neurons at a lower frequency, leading to increased cross-frequency coupling. In addition, 40-Hz stimulation after stroke enhances interregional communication. These effects are observed up to 24 h after stimulation. Our stimulation protocol also rescues functional synaptic plasticity 24 h after stroke and leads to an upregulation of plasticity genes and a downregulation of cell death genes. Together these results suggest that restoration of cortical dynamics may confer neuroprotection after stroke.
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Affiliation(s)
- Cong Wang
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD 4067, Australia; Engineering Research Centre of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, Shanghai 201203, China
| | - Caixia Lin
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD 4067, Australia
| | - Yue Zhao
- Departments of Thoracic Surgery and State Key Laboratory of Genetic Engineering, Fudan University Shanghai Cancer Centre, Shanghai 200032, China; Institute of Thoracic Oncology, Fudan University, Shanghai 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Montana Samantzis
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD 4067, Australia
| | - Petra Sedlak
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD 4067, Australia
| | - Pankaj Sah
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD 4067, Australia
| | - Matilde Balbi
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD 4067, Australia.
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Nepozitek J, Varga Z, Dostalova S, Perinova P, Keller J, Robinson S, Ibarburu V, Prihodova I, Bezdicek O, Ruzicka E, Sonka K, Dusek P. Magnetic susceptibility changes in the brainstem reflect REM sleep without atonia severity in isolated REM sleep behavior disorder. NPJ Parkinsons Dis 2023; 9:112. [PMID: 37452075 PMCID: PMC10349141 DOI: 10.1038/s41531-023-00557-2] [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: 02/19/2023] [Accepted: 07/05/2023] [Indexed: 07/18/2023] Open
Abstract
REM sleep without atonia (RWA) is the hallmark of isolated REM sleep behavior disorder (iRBD) and is caused by neurodegeneration of brainstem structures. Previously, quantitative susceptibility mapping (QSM) was shown to detect microstructural tissue changes in neurodegenerative diseases. The goal of the study was to compare brainstem magnetic susceptibility (MS) in iRBD and controls using the voxel-based QSM approach and to examine the association between brainstem MS and severity of RWA in iRBD. Sixty iRBD patients and 41 healthy controls were included in the study. Phasic, tonic, mixed RWA and SINBAR score was quantified. QSM maps were reconstructed with QSMbox software from a multi-gradient-echo sequence acquired at 3T MRI system and normalized using a custom T1 template. Voxel-based analysis with age and gender as covariates was performed using a two-sample t-test model for between-group comparison and using a linear regression model for association with the RWA parameters. Statistical maps were generated using threshold free cluster enhancement with p-value p < 0.05, corrected for family wise error. Compared to controls, the iRBD group had higher MS in bilateral substantia nigra (SN), red nucleus and the ventral tegmental area. MS positively correlated with iRBD duration in the right pedunculotegmental nucleus and white matter of caudal mesencephalic and pontine tegmentum and with phasic RWA in bilateral SN. QSM was able to detect MS abnormalities in several brainstem structures in iRBD. Association of MS levels in the brainstem with the intensity of RWA suggests that increased iron content in SN is related to RWA severity.
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Affiliation(s)
- Jiri Nepozitek
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic.
| | - Zsoka Varga
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Simona Dostalova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Pavla Perinova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Jiri Keller
- Radiodiagnostic Department, Na Homolce Hospital, Prague, Czech Republic
| | - Simon Robinson
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
- Centre of Advanced Imaging, University of Queensland, Brisbane, Queensland, Australia
| | - Veronika Ibarburu
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Iva Prihodova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Ondrej Bezdicek
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Evzen Ruzicka
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Karel Sonka
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Petr Dusek
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
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Patelaki E, Foxe JJ, Mazurek KA, Freedman EG. Young adults who improve performance during dual-task walking show more flexible reallocation of cognitive resources: a mobile brain-body imaging (MoBI) study. Cereb Cortex 2023; 33:2573-2592. [PMID: 35661873 PMCID: PMC10016048 DOI: 10.1093/cercor/bhac227] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/09/2022] [Accepted: 05/10/2022] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION In young adults, pairing a cognitive task with walking can have different effects on gait and cognitive task performance. In some cases, performance clearly declines whereas in others compensatory mechanisms maintain performance. This study investigates the preliminary finding of behavioral improvement in Go/NoGo response inhibition task performance during walking compared with sitting, which was observed at the piloting stage. MATERIALS AND METHODS Mobile brain/body imaging (MoBI) was used to record electroencephalographic (EEG) activity, 3-dimensional (3D) gait kinematics and behavioral responses in the cognitive task, during sitting or walking on a treadmill. RESULTS In a cohort of 26 young adults, 14 participants improved in measures of cognitive task performance while walking compared with sitting. These participants exhibited walking-related EEG amplitude reductions over frontal scalp regions during key stages of inhibitory control (conflict monitoring, control implementation, and pre-motor stages), accompanied by reduced stride-to-stride variability and faster responses to stimuli compared with those who did not improve. In contrast, 12 participants who did not improve exhibited no EEG amplitude differences across physical condition. DISCUSSION The neural activity changes associated with performance improvement during dual tasking hold promise as cognitive flexibility markers that can potentially help assess cognitive decline in aging and neurodegeneration.
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Affiliation(s)
- Eleni Patelaki
- The Frederick J. and Marion A. Schindler Cognitive Neurophysiology Laboratory, The Del Monte Institute for Neuroscience, Department of Neuroscience, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Rochester, NY 14642, United States
- Department of Biomedical Engineering, University of Rochester, 201 Robert B. Goergen Hall Rochester, NY 14627, United States
| | - John J Foxe
- The Frederick J. and Marion A. Schindler Cognitive Neurophysiology Laboratory, The Del Monte Institute for Neuroscience, Department of Neuroscience, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Rochester, NY 14642, United States
| | - Kevin A Mazurek
- The Frederick J. and Marion A. Schindler Cognitive Neurophysiology Laboratory, The Del Monte Institute for Neuroscience, Department of Neuroscience, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Rochester, NY 14642, United States
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Joseph Building 4-184W, 200 First Street SW, Rochester, MN 55905, United States
- Well Living Lab, Well Living Lab, Inc., 221 First Avenue SW, Rochester, MN 55902, United States
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Nwogo RO, Kammermeier S, Singh A. Abnormal neural oscillations during gait and dual-task in Parkinson’s disease. Front Syst Neurosci 2022; 16:995375. [PMID: 36185822 PMCID: PMC9522469 DOI: 10.3389/fnsys.2022.995375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 08/23/2022] [Indexed: 12/03/2022] Open
Abstract
Gait dysfunctions are debilitating motor symptoms of Parkinson’s disease (PD) and may result in frequent falling with health complications. The contribution of the motor-cognitive network to gait disturbance can be studied more thoroughly by challenging motor-cognitive dual-task gait performances. Gait is a complex motor task that requires an appropriate contribution from motor and cognitive networks, reflected in frequency modulations among several cortical and subcortical networks. Electrophysiological recordings by scalp electroencephalography and implanted deep brain stimulation (DBS) electrodes have unveiled modulations of specific oscillatory patterns in the cortical-subcortical circuits in PD. In this review, we summarize oscillatory contributions of the cortical, basal ganglia, mesencephalic locomotor, and cerebellar regions during gait and dual-task activities in PD. We detail the involvement of the cognitive network in dual-task settings and compare how abnormal oscillations in the specific frequency bands in the cortical and subcortical regions correlate with gait deficits in PD, particularly freezing of gait (FOG). We suggest that altered neural oscillations in different frequencies can cause derangements in broader brain networks, so neuromodulation and pharmacological therapies should be considered to normalize those network oscillations to improve challenged gait and dual-task motor functions in PD. Specifically, the theta and beta bands in premotor cortical areas, subthalamic nucleus, as well as alpha band activity in the brainstem prepontine nucleus, modulate under clinically effective levodopa and DBS therapies, improving gait and dual-task performance in PD with FOG, compared to PD without FOG and age-matched healthy control groups.
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Affiliation(s)
- Rachel O. Nwogo
- Division of Basic Biomedical Sciences, Sanford School of Medicine, University of South Dakota, Vermillion, SD, United States
| | | | - Arun Singh
- Division of Basic Biomedical Sciences, Sanford School of Medicine, University of South Dakota, Vermillion, SD, United States
- *Correspondence: Arun Singh,
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Le Ray D, Bertrand SS, Dubuc R. Cholinergic Modulation of Locomotor Circuits in Vertebrates. Int J Mol Sci 2022; 23:ijms231810738. [PMID: 36142651 PMCID: PMC9501616 DOI: 10.3390/ijms231810738] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/08/2022] [Accepted: 09/09/2022] [Indexed: 11/24/2022] Open
Abstract
Locomotion is a basic motor act essential for survival. Amongst other things, it allows animals to move in their environment to seek food, escape predators, or seek mates for reproduction. The neural mechanisms involved in the control of locomotion have been examined in many vertebrate species and a clearer picture is progressively emerging. The basic muscle synergies responsible for propulsion are generated by neural networks located in the spinal cord. In turn, descending supraspinal inputs are responsible for starting, maintaining, and stopping locomotion as well as for steering and controlling speed. Several neurotransmitter systems play a crucial role in modulating the neural activity during locomotion. For instance, cholinergic inputs act both at the spinal and supraspinal levels and the underlying mechanisms are the focus of the present review. Much information gained on supraspinal cholinergic modulation of locomotion was obtained from the lamprey model. Nicotinic cholinergic inputs increase the level of excitation of brainstem descending command neurons, the reticulospinal neurons (RSNs), whereas muscarinic inputs activate a select group of hindbrain neurons that project to the RSNs to boost their level of excitation. Muscarinic inputs also reduce the transmission of sensory inputs in the brainstem, a phenomenon that could help in sustaining goal directed locomotion. In the spinal cord, intrinsic cholinergic inputs strongly modulate the activity of interneurons and motoneurons to control the locomotor output. Altogether, the present review underlines the importance of the cholinergic inputs in the modulation of locomotor activity in vertebrates.
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Affiliation(s)
- Didier Le Ray
- Institut des Neurosciences Cognitives et Intégratives d’Aquitaine (INCIA), UMR 5287, Université de Bordeaux-CNRS, F-33076 Bordeaux, France
- Correspondence: (D.L.R.); (R.D.)
| | - Sandrine S. Bertrand
- Institut des Neurosciences Cognitives et Intégratives d’Aquitaine (INCIA), UMR 5287, Université de Bordeaux-CNRS, F-33076 Bordeaux, France
| | - Réjean Dubuc
- Department of Neurosciences, Université de Montréal, Montréal, QC H3C 3J7, Canada
- Department of Physical Activity Sciences and Research Group in Adapted Physical Activity, Université du Québec à Montréal, Montréal, QC H3C 3P8, Canada
- Correspondence: (D.L.R.); (R.D.)
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Cai J, Liu A, Wang Y, Tan SN, Chomiak T, Burt J, Camicioli R, Hu B, McKeown MJ, Ba F. Walking exercise alters pedunculopontine nucleus connectivity in Parkinson’s disease in a dose-dependent manner. Front Neurosci 2022; 16:930810. [PMID: 36017180 PMCID: PMC9397130 DOI: 10.3389/fnins.2022.930810] [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: 04/28/2022] [Accepted: 07/07/2022] [Indexed: 11/13/2022] Open
Abstract
Background Gait disturbances are critical motor symptoms in Parkinson’s disease (PD). The mechanisms of gait impairment in PD are not entirely understood but likely involve changes in the Pedunculopontine Nucleus (PPN), a critical locomotion center, and its associated connections. Exercise is universally accepted as helpful in PD, but the extent and intensity of exercise required for plastic changes are unclear. Methods Twenty-seven PD subjects participated in a 3-month gait training intervention. Clinical assessments and resting-state functional magnetic resonance imaging were performed at baseline and 3 months after exercise. Functional connectivity of PPN was assessed by combining the methods of partial least squares, conditional dependence and partial correlation. In addition, paired t-tests were used to examine the effect of exercise on PPN functional connectivity and clinical measures, and Pearson’s correlation was used to assess the association between altered PPN functional connectivity and clinical measures. Results Exercise significantly improved Unified Parkinson’s Disease Rating Scale-III (UPDRS-III). A significant increase in right PPN functional connectivity was observed after exercise, which did not correlate with motor improvement. However, the decrease in left PPN functional connectivity significantly correlated with the improvement in UPDRS-III and was linearly related to both number of walks and the duration of walks. In addition, exercise induced a significant increase in the laterality of PPN connectivity strength, which correlated with motor improvement. Conclusion PPN functional connectivity is modifiable by walking exercise in both a dose-independent (right PPN and laterality of PPN connectivity strength) and dose-dependent (left PPN) manner. The PPN may contribute to pathological and compensatory processes in PD gait control. The observed gait improvement by walking exercise is most likely due to the reversal of the maladaptive compensatory mechanism. Altered PPN functional connectivity can be a marker for exercise-induced motor improvement in PD.
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Affiliation(s)
- Jiayue Cai
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China
- Division of Neurology, Department of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Aiping Liu
- Department of Electronic Science and Technology, University of Science and Technology of China, Hefei, China
| | - Yuheng Wang
- School of Biomedical Engineering, The University of British Columbia, Vancouver, BC, Canada
- *Correspondence: Yuheng Wang,
| | - Sun Nee Tan
- Graduate Program in Neuroscience, The University of British Columbia, Vancouver, BC, Canada
| | - Taylor Chomiak
- Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
| | - Jacqueline Burt
- Division of Neurology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Richard Camicioli
- Division of Neurology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Bin Hu
- Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
| | - Martin J. McKeown
- Division of Neurology, Department of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Fang Ba
- Division of Neurology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
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Yako T, Kitazawa K, Kobayashi S, Yomo S, Sato H, Johnson LA, Vitek JL, Hashimoto T. Role of Microelectrode Recording in Deep Brain Stimulation of the Pedunculopontine Nucleus: A Physiological Study of Two Cases. Neuromodulation 2022; 25:925-934. [PMID: 34435731 DOI: 10.1111/ner.13479] [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: 02/01/2021] [Revised: 04/23/2021] [Accepted: 05/18/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Deep brain stimulation (DBS) of the pedunculopontine nucleus (PPN) has been reported to improve gait disturbances in Parkinson's disease (PD); however, there are controversies on the radiological and electrophysiological techniques for intraoperative and postoperative confirmation of the target and determination of optimal stimulation parameters. OBJECTIVES We investigated the correlation between the location of the estimated PPN (ePPN) and neuronal activity collected during intraoperative electrophysiological mapping to evaluate the role of microelectrode recording (MER) in identifying the effective stimulation site in two PD patients. MATERIALS AND METHODS Bilateral PPN DBS was performed in two patients who had suffered from levodopa refractory gait disturbance. They had been implanted previously with DBS in the internal globus pallidus and the subthalamic nucleus, respectively. The PPN was determined on MRI and identified by intraoperative MER. Neuronal activity recorded was analyzed for mean discharge rate, bursting, and oscillatory activity. The effects were assessed by clinical ratings for motor signs before and after surgery. RESULTS The PPN location was detected by MER. Groups of neurons characterized by tonic discharges were found 9-10 mm below the thalamus. The mean discharge rate in the ePPN was 19.1 ± 15.1 Hz, and 33% of the neurons of the ePPN responded with increased discharge rate during passive manipulation of the limbs and orofacial structures. PPN DBS with bipolar stimulation at a frequency range 10-30 Hz improved gait disturbances in both patients. Although PPN DBS provided therapeutic effects post-surgery in both cases, the effects waned after a year in case 1 and three years in case 2. CONCLUSIONS Estimation of stimulation site within the PPN is possible by combining physiological guidance using MER and MRI findings. The PPN is a potential target for gait disturbances, although the efficacy of PPN DBS may depend on the location of the electrode and the stimulation parameters.
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Affiliation(s)
- Takehiro Yako
- Department of Neurosurgery, Aizawa Hospital, Matsumoto, Japan.
| | - Kazuo Kitazawa
- Department of Neurosurgery, Aizawa Hospital, Matsumoto, Japan
| | | | - Shoji Yomo
- Division of Radiation Oncology, Aizawa Comprehensive Cancer Center, Aizawa Hospital, Matsumoto, Japan
| | - Hiromasa Sato
- Department of Neurology, Aizawa Hospital, Matsumoto, Japan
| | - Luke A Johnson
- Department of Neurology, University of Minnesota, Minneapolis, MN, USA
| | - Jerrold L Vitek
- Department of Neurology, University of Minnesota, Minneapolis, MN, USA
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Ali F, Benarroch E. What Is the Brainstem Control of Locomotion? Neurology 2022; 98:446-451. [PMID: 35288473 DOI: 10.1212/wnl.0000000000200108] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 12/29/2021] [Indexed: 12/12/2022] Open
Affiliation(s)
- Farwa Ali
- From the Department of Neurology, Mayo Clinic, Rochester, MN
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Ehgoetz Martens KA, Matar E, Phillips JR, Shine JM, Grunstein RR, Halliday GM, Lewis SJG. Narrow doorways alter brain connectivity and step patterns in isolated REM sleep behaviour disorder. Neuroimage Clin 2022; 33:102958. [PMID: 35151040 PMCID: PMC8844611 DOI: 10.1016/j.nicl.2022.102958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 02/03/2022] [Accepted: 02/04/2022] [Indexed: 11/19/2022]
Abstract
iRBD had slower and more variable stepping compared to controls in this VR task. iRBD showed exaggerated responses when passing narrow compared to wide doorways iRBD had altered task-related brain connectivity which was correlated to motor deficits.
Background Motor impairments in those with isolated REM sleep behaviour disorder (iRBD) significantly increases the likelihood of developing Lewy body disease (e.g. Parkinson’s disease and Dementia with Lewy Bodies). Objective This study sought to explore the prodromal process of neurodegeneration by examining the neural signature underlying motor deficits in iRBD patients. Methods A virtual reality (VR) gait paradigm (which has previously been shown to elicit adaptive changes in gait performance whilst navigating doorways in Parkinson’s Disease - PD) was paired with fMRI to investigate whether iRBD patients demonstrated worsened motor performance and altered connectivity across frontoparietal, motor and basal ganglia networks compared to healthy controls. Forty participants (23 iRBD and 17 healthy controls) completed the virtual reality gait task whilst in the MRI scanner, and an additional cohort of 19 Early PD patients completed the behavioural virtual reality gait task. Results As predicted, iRBD patients demonstrated slower and more variable stepping compared to healthy control participants and demonstrated an exaggerated response when navigating narrow compared to wide doorways, a phenomenon characteristically seen in PD. The iRBD patients also demonstrated less BOLD signal change in the left posterior putamen and right mesencephalic locomotor region, as well as reduced functional connectivity between the frontoparietal network and the motor network, when navigating narrow versus wide doorways compared to healthy control participants. Conclusions Taken together, this study demonstrates that iRBD patients have altered task-related brain connectivity, which may represent the neural underpinnings of early motor impairments that are evident in iRBD.
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Affiliation(s)
- Kaylena A Ehgoetz Martens
- ForeFront Research Team, Brain and Mind Centre, University of Sydney, Australia; Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, Australia; Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Canada.
| | - Elie Matar
- ForeFront Research Team, Brain and Mind Centre, University of Sydney, Australia; Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, Australia; Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Canada
| | - Joseph R Phillips
- ForeFront Research Team, Brain and Mind Centre, University of Sydney, Australia; Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, Australia; School of Social Sciences and Psychology, Western Sydney University, Sydney, Australia
| | - James M Shine
- ForeFront Research Team, Brain and Mind Centre, University of Sydney, Australia; Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, Australia
| | - Ron R Grunstein
- ForeFront Research Team, Brain and Mind Centre, University of Sydney, Australia; Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Canada
| | - Glenda M Halliday
- ForeFront Research Team, Brain and Mind Centre, University of Sydney, Australia
| | - Simon J G Lewis
- ForeFront Research Team, Brain and Mind Centre, University of Sydney, Australia; Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, Australia; Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Canada; Sleep and Circadian Group (CIRUS), Woolcock Institute of Medical Research, University of Sydney and Royal Prince Alfred Hospital, Australia
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Foffani G, Alegre M. Brain oscillations and Parkinson disease. HANDBOOK OF CLINICAL NEUROLOGY 2022; 184:259-271. [PMID: 35034740 DOI: 10.1016/b978-0-12-819410-2.00014-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Brain oscillations have been associated with Parkinson's disease (PD) for a long time mainly due to the fundamental oscillatory nature of parkinsonian rest tremor. Over the years, this association has been extended to frequencies well above that of tremor, largely owing to the opportunities offered by deep brain stimulation (DBS) to record electrical activity directly from the patients' basal ganglia. This chapter reviews the results of research on brain oscillations in PD focusing on theta (4-7Hz), beta (13-35Hz), gamma (70-80Hz) and high-frequency oscillations (200-400Hz). For each of these oscillations, we describe localization and interaction with brain structures and between frequencies, changes due to dopamine intake, task-related modulation, and clinical relevance. The study of brain oscillations will also help to dissect the mechanisms of action of DBS. Overall, the chapter tentatively depicts PD in terms of "oscillopathy."
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Affiliation(s)
- Guglielmo Foffani
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain; Neural Bioengineering, Hospital Nacional de Parapléjicos, SESCAM, Toledo, Spain; CIBERNED, Instituto de Salud Carlos III, Madrid, Spain.
| | - Manuel Alegre
- Clinical Neurophysiology Section, Clínica Universidad de Navarra, Pamplona, Spain; Systems Neuroscience Lab, Program of Neuroscience, CIMA, Universidad de Navarra, Pamplona, Spain; IdisNA, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain.
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Giorni A, Coyne T, Silburn PA, Mellick GD, Sah P, Windels F. Changes in pallidal neural activity following long-term symptom improvement from botulinum toxin treatment in DYT6 dystonia: a case report. J Med Case Rep 2022; 16:15. [PMID: 34998426 PMCID: PMC8742936 DOI: 10.1186/s13256-021-03215-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 12/01/2021] [Indexed: 11/10/2022] Open
Abstract
Background The globus pallidus internus is the main target for the treatment of dystonia by deep brain stimulation. Unfortunately, for some genetic etiologies, the therapeutic outcome of dystonia is less predictable. In particular, therapeutic outcomes for deep brain stimulation in craniocervical and orolaryngeal dystonia in DYT6-positive patients are poor. Little is known about the neurophysiology of the globus pallidus internus in DYT6-positive dystonia, and how symptomatic treatment affects the neural activity of this region. Case presentation We present here the case of a 55-year-old Caucasian female DYT6-dystonic patient with blepharospasm, spasmodic dysphonia, and oromandibular dystonia where single-unit and local field potential activity was recorded from the globus pallidus internus during two deep brain stimulation revision surgeries 4 years apart with no symptomatic improvement. Botulinum toxin injections consistently improved dysphonia, while some of the other symptoms were only inconsistently or marginally improved. Neural activity in the globus pallidus internus during both revision surgeries were compared with previously published results from an idiopathic dystonic cohort. Single-cell firing characteristics and local field potential from the first revision surgery showed no differences with our control group. However, during the second revision surgery, the mean firing rate of single units and local field potential power in the gamma range were lower than those present during the first revision surgery or the control group. Conclusions Symptoms related to facial movements were greatly improved by botulinum toxin treatment between revision surgeries, which coincided with lower discharge rate and changes in gamma local field oscillations.
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Affiliation(s)
- Andrea Giorni
- Synaptic Plasticity Laboratory, The Queensland Brain Institute, The University of Queensland, Saint Lucia, QLD, 4072, Australia.,Asia Pacific Center for Neuromodulation, St Andrews War Memorial Hospital, Brisbane, QLD, Australia
| | - Terry Coyne
- Synaptic Plasticity Laboratory, The Queensland Brain Institute, The University of Queensland, Saint Lucia, QLD, 4072, Australia.,Asia Pacific Center for Neuromodulation, St Andrews War Memorial Hospital, Brisbane, QLD, Australia
| | - Peter A Silburn
- Synaptic Plasticity Laboratory, The Queensland Brain Institute, The University of Queensland, Saint Lucia, QLD, 4072, Australia.,Asia Pacific Center for Neuromodulation, St Andrews War Memorial Hospital, Brisbane, QLD, Australia
| | - George D Mellick
- Griffith Institute of Drug Discovery (GRIDD), Griffith University, Brisbane, Australia
| | - Pankaj Sah
- Synaptic Plasticity Laboratory, The Queensland Brain Institute, The University of Queensland, Saint Lucia, QLD, 4072, Australia.,Brain Research Centre and Department of Biology, Southern University of Science and Technology, Nanshan District, Shenzhen, Guangdong Province, People's Republic of China
| | - François Windels
- Synaptic Plasticity Laboratory, The Queensland Brain Institute, The University of Queensland, Saint Lucia, QLD, 4072, Australia.
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13
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Hippocampus-Prefrontal Coupling Regulates Recognition Memory for Novelty Discrimination. J Neurosci 2021; 41:9617-9632. [PMID: 34642213 DOI: 10.1523/jneurosci.1202-21.2021] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 09/05/2021] [Accepted: 09/27/2021] [Indexed: 11/21/2022] Open
Abstract
Recognition memory provides the ability to distinguish familiar from novel objects and places, and is important for recording and updating events to guide appropriate behavior. The hippocampus (HPC) and medial prefrontal cortex (mPFC) have both been implicated in recognition memory, but the nature of HPC-mPFC interactions, and its impact on local circuits in mediating this process is not known. Here we show that novelty discrimination is accompanied with higher theta activity (4-10 Hz) and increased c-Fos expression in both these regions. Moreover, theta oscillations were highly coupled between the HPC and mPFC during recognition memory retrieval for novelty discrimination, with the HPC leading the mPFC, but not during initial learning. Principal neurons and interneurons in the mPFC responded more strongly during recognition memory retrieval compared with learning. Optogenetic silencing of HPC input to the mPFC disrupted coupled theta activity between these two structures, as well as the animals' (male Sprague Dawley rats) ability to differentiate novel from familiar objects. These results reveal a key role of monosynaptic connections between the HPC and mPFC in novelty discrimination via theta coupling and identify neural populations that underlie this recognition memory-guided behavior.SIGNIFICANCE STATEMENT Many memory processes are highly dependent on the interregional communication between the HPC and mPFC via neural oscillations. However, how these two brain regions coordinate their oscillatory activity to engage local neural populations to mediate recognition memory for novelty discrimination is poorly understood. This study revealed that the HPC and mPFC theta oscillations and their temporal coupling is correlated with recognition memory-guided behavior. During novel object recognition, the HPC drives mPFC interneurons to effectively reduce the activity of principal neurons. This study provides the first evidence for the requirement of the HPC-mPFC pathway to mediate recognition memory for novelty discrimination and describes a mechanism for how this memory is regulated.
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14
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Bourilhon J, Olivier C, You H, Collomb-Clerc A, Grabli D, Belaid H, Mullie Y, François C, Czernecki V, Lau B, Pérez-García F, Bardinet E, Fernandez-Vidal S, Karachi C, Welter ML. Pedunculopontine and Cuneiform Nuclei Deep Brain Stimulation for Severe Gait and Balance Disorders in Parkinson's Disease: Interim Results from a Randomised Double-Blind Clinical Trial. JOURNAL OF PARKINSONS DISEASE 2021; 12:639-653. [PMID: 34744048 DOI: 10.3233/jpd-212793] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Dopa-resistant freezing of gait (FOG) and falls represent the dominant motor disabilities in advanced Parkinson's disease (PD). OBJECTIVE We investigate the effects of deep brain stimulation (DBS) of the mesencephalic locomotor region (MLR), comprised of the pedunculopontine (PPN) and cuneiform (CuN) nuclei, for treating gait and balance disorders, in a randomized double-blind cross-over trial. METHODS Six PD patients with dopa-resistant FOG and/or falls were operated for MLR-DBS. Patients received three DBS conditions, PPN, CuN, or sham, in a randomized order for 2-months each, followed by an open-label phase. The primary outcome was the change in anteroposterior anticipatory-postural-adjustments (APAs) during gait initiation on a force platformResults:The anteroposterior APAs were not significantly different between the DBS conditions (median displacement [1st-3rd quartile] of 3.07 [3.12-4.62] cm with sham-DBS, 1.95 [2.29-3.85] cm with PPN-DBS and 2.78 [1.66-4.04] cm with CuN-DBS; p = 0.25). Step length and velocity were significantly higher with CuN-DBS vs. both sham-DBS and PPN-DBS. Conversely, step length and velocity were lower with PPN-DBS vs. sham-DBS, with greater double stance and gait initiation durations. One year after surgery, step length was significantly lower with PPN-DBS vs. inclusion. We did not find any significant change in clinical scales between DBS conditions or one year after surgery. CONCLUSION Two months of PPN-DBS or CuN-DBS does not effectively improve clinically dopa-resistant gait and balance disorders in PD patients.
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Affiliation(s)
- Julie Bourilhon
- Department of Neurophysiology, Rouen UniversityHospital and University of Rouen, France.,Sorbonne Universités, UPMC Univ Paris 06, CNRS, INSERM, Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France PANAM platform, Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France
| | - Claire Olivier
- Sorbonne Universités, UPMC Univ Paris 06, CNRS, INSERM, Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France PANAM platform, Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France.,PANAM platform, Institut du Cerveau et de la Moelle É14 pinière (ICM), Paris, France
| | - Hana You
- Sorbonne Universités, UPMC Univ Paris 06, CNRS, INSERM, Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France PANAM platform, Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France.,Clinical Investigation Center, Pitié-Salpêtrière, Charles Foix University Hospital, Assistance Publique-Hôpitaux de Paris, Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France
| | - Antoine Collomb-Clerc
- Sorbonne Universités, UPMC Univ Paris 06, CNRS, INSERM, Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France PANAM platform, Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France
| | - David Grabli
- Sorbonne Universités, UPMC Univ Paris 06, CNRS, INSERM, Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France PANAM platform, Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France.,Fédération des Maladies du Système Nerveux, Pitié-Salpêtrière, Charles Foix University Hospital, Assistance Publique-Hôpitaux de Paris Paris, Paris, France
| | - Hayat Belaid
- Department of Neurosurgery, Pitié-Salpêtrière, Charles Foix University Hospital, Assistance Publique-Hôpitaux Paris, Paris, France
| | - Yannick Mullie
- Sorbonne Universités, UPMC Univ Paris 06, CNRS, INSERM, Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France PANAM platform, Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France
| | - Chantal François
- Sorbonne Universités, UPMC Univ Paris 06, CNRS, INSERM, Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France PANAM platform, Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France
| | - Virginie Czernecki
- Fédération des Maladies du Système Nerveux, Pitié-Salpêtrière, Charles Foix University Hospital, Assistance Publique-Hôpitaux de Paris Paris, Paris, France
| | - Brian Lau
- Sorbonne Universités, UPMC Univ Paris 06, CNRS, INSERM, Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France PANAM platform, Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France
| | - Fernando Pérez-García
- Sorbonne Universités, UPMC Univ Paris 06, CNRS, INSERM, Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France PANAM platform, Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France.,CENIR Platform, Institut du Cerveau et de la Moelle É22 pinière (ICM), Paris, France
| | - Eric Bardinet
- Sorbonne Universités, UPMC Univ Paris 06, CNRS, INSERM, Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France PANAM platform, Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France.,CENIR Platform, Institut du Cerveau et de la Moelle É22 pinière (ICM), Paris, France
| | - Sara Fernandez-Vidal
- Sorbonne Universités, UPMC Univ Paris 06, CNRS, INSERM, Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France PANAM platform, Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France.,STIM Platform, Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France
| | - Carine Karachi
- Sorbonne Universités, UPMC Univ Paris 06, CNRS, INSERM, Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France PANAM platform, Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France.,Department of Neurosurgery, Pitié-Salpêtrière, Charles Foix University Hospital, Assistance Publique-Hôpitaux Paris, Paris, France
| | - Marie-Laure Welter
- Department of Neurophysiology, Rouen UniversityHospital and University of Rouen, France.,Sorbonne Universités, UPMC Univ Paris 06, CNRS, INSERM, Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France PANAM platform, Institut du Cerveau et de la Moelle Épinière (ICM), Paris, France
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15
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Özkan M, Köse B, Algın O, Oğuz S, Erden ME, Çavdar S. Non-motor connections of the pedunculopontine nucleus of the rat and human brain. Neurosci Lett 2021; 767:136308. [PMID: 34715273 DOI: 10.1016/j.neulet.2021.136308] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 10/21/2021] [Accepted: 10/21/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The connections of the pedunculopontine nucleus (PPN) with motor areas of the central nervous system (CNS) are well described in the literature, in contrast relations with non-motor areas are lacking. Thus, the aim of the present study is to define the non-motor connections of the PPN in rats using the fluoro-gold (FG) tracer and compare the presence of these connections in healthy human adults using diffusion tensor tractography (DTI). MATERIALS AND METHODS We injected FG into the PPN of 12 rats. The non-motor connections of the PPN with cortical, subcortical, and brainstem structures were documented. The non-motor connections of the rats were compared with the DTI obtained from 35 healthy adults. RESULTS The results of the tract-tracing study in the rat showed that the PPN was connected to non-motor cortical (cingulate, somatosensory, visual, auditory, medial frontal cortices), subcortical (amygdala, hypothalamus, thalamus, habenular, and bed nucleus of stria terminalis), and brainstem (medullary reticular, trigeminal spinal, external cuneate, pontine reticular, vestibular, superior and inferior colliculus, locus ceruleus, periaqueductal gray, parabrachial, dorsal raphe, pretectal, lateral lemniscus nuclei, and the contralateral PPN) structures. The DTI obtained from healthy adults showed similar PPN non-motor connections as in rats. CONCLUSION Understanding the connections of the PPN with non-motor cortical, subcortical, and brainstem areas of the CNS will enrich our knowledge of its contribution in various circuits and the areas that PPN activity can influence. Further, it will provide insight into the role of Parkinson's disease and related disorders and explain the non-motor complications which occur subsequent to deep brain stimulation (DBS) of the PPN.
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Affiliation(s)
- Mazhar Özkan
- Department of Anatomy, Tekirdağ Namık Kemal University, School of Medicine, Istanbul, Turkey
| | - Büşra Köse
- Department of Anatomy, Koç University, School of Medicine, Rumelifener Yolu, Istanbul, Turkey
| | - Oktay Algın
- Department of Radiology, City Hospital, Yıldırım Beyazıt University, Ankara, Turkey and National MR Research Center (UMRAM), Bilkent University, Ankara, Turkey
| | - Sinem Oğuz
- Department of Anatomy, Koç University, School of Medicine, Rumelifener Yolu, Istanbul, Turkey
| | - Mert Emre Erden
- Department of Anatomy, Koç University, School of Medicine, Rumelifener Yolu, Istanbul, Turkey
| | - Safiye Çavdar
- Department of Anatomy, Koç University, School of Medicine, Rumelifener Yolu, Istanbul, Turkey.
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16
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Gait-Phase Modulates Alpha and Beta Oscillations in the Pedunculopontine Nucleus. J Neurosci 2021; 41:8390-8402. [PMID: 34413208 PMCID: PMC8496192 DOI: 10.1523/jneurosci.0770-21.2021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 06/21/2021] [Accepted: 08/04/2021] [Indexed: 11/21/2022] Open
Abstract
The pedunculopontine nucleus (PPN) is a reticular collection of neurons at the junction of the midbrain and pons, playing an important role in modulating posture and locomotion. Deep brain stimulation of the PPN has been proposed as an emerging treatment for patients with Parkinson's disease (PD) or multiple system atrophy (MSA) who have gait-related atypical parkinsonian syndromes. In this study, we investigated PPN activities during gait to better understand its functional role in locomotion. Specifically, we investigated whether PPN activity is rhythmically modulated by gait cycles during locomotion. PPN local field potential (LFP) activities were recorded from PD or MSA patients with gait difficulties during stepping in place or free walking. Simultaneous measurements from force plates or accelerometers were used to determine the phase within each gait cycle at each time point. Our results showed that activities in the alpha and beta frequency bands in the PPN LFPs were rhythmically modulated by the gait phase within gait cycles, with a higher modulation index when the stepping rhythm was more regular. Meanwhile, the PPN-cortical coherence was most prominent in the alpha band. Both gait phase-related modulation in the alpha/beta power and the PPN-cortical coherence in the alpha frequency band were spatially specific to the PPN and did not extend to surrounding regions. These results suggest that alternating PPN modulation may support gait control. Whether enhancing alternating PPN modulation by stimulating in an alternating fashion could positively affect gait control remains to be tested.SIGNIFICANCE STATEMENT The therapeutic efficacy of pedunculopontine nucleus (PPN) deep brain stimulation (DBS) and the extent to which it can improve quality of life are still inconclusive. Understanding how PPN activity is modulated by stepping or walking may offer insight into how to improve the efficacy of PPN DBS in ameliorating gait difficulties. Our study shows that PPN alpha and beta activity was modulated by the gait phase, and that this was most pronounced when the stepping rhythm was regular. It remains to be tested whether enhancing alternating PPN modulation by stimulating in an alternating fashion could positively affect gait control.
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17
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Chang SJ, Cajigas I, Guest JD, Noga BR, Widerström-Noga E, Haq I, Fisher L, Luca CC, Jagid JR. Deep brain stimulation of the Cuneiform nucleus for levodopa-resistant freezing of gait in Parkinson's disease: study protocol for a prospective, pilot trial. Pilot Feasibility Stud 2021; 7:117. [PMID: 34078477 PMCID: PMC8169408 DOI: 10.1186/s40814-021-00855-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 05/21/2021] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Freezing of gait (FOG) is a particularly debilitating motor deficit seen in a subset of Parkinson's disease (PD) patients that is poorly responsive to standard levodopa therapy or deep brain stimulation (DBS) of established PD targets such as the subthalamic nucleus and the globus pallidus interna. The proposal of a DBS target in the midbrain, known as the pedunculopontine nucleus (PPN) to address FOG, was based on its observed pathology in PD and its hypothesized involvement in locomotor control as a part of the mesencephalic locomotor region, a functionally defined area of the midbrain that elicits locomotion in both intact animals and decerebrate animal preparations with electrical stimulation. Initial reports of PPN DBS were met with much enthusiasm; however, subsequent studies produced mixed results, and recent meta-analysis results have been far less convincing than initially expected. A closer review of the extensive mesencephalic locomotor region (MLR) preclinical literature, including recent optogenetics studies, strongly suggests that the closely related cuneiform nucleus (CnF), just dorsal to the PPN, may be a superior target to promote gait initiation. METHODS We will conduct a prospective, open-label, single-arm pilot study to assess safety and feasibility of CnF DBS in PD patients with levodopa-refractory FOG. Four patients will receive CnF DBS and have gait assessments with and without DBS during a 6-month follow-up. DISCUSSION This paper presents the study design and rationale for a pilot study investigating a novel DBS target for gait dysfunction, including targeting considerations. This pilot study is intended to support future larger scale clinical trials investigating this target. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT04218526 (registered January 6, 2020).
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Affiliation(s)
- Stephano J Chang
- The Miami Project to Cure Paralysis, Miami, FL, USA.,Department of Neurosurgery, University of British Columbia, Vancouver, BC, Canada
| | - Iahn Cajigas
- The Miami Project to Cure Paralysis, Miami, FL, USA.,Department of Neurological Surgery, University of Miami Miller School of Medicine, 1095 N.W. 14th Terrace, Miami, FL, 33136, USA
| | - James D Guest
- The Miami Project to Cure Paralysis, Miami, FL, USA.,Department of Neurological Surgery, University of Miami Miller School of Medicine, 1095 N.W. 14th Terrace, Miami, FL, 33136, USA
| | - Brian R Noga
- The Miami Project to Cure Paralysis, Miami, FL, USA.,Department of Neurological Surgery, University of Miami Miller School of Medicine, 1095 N.W. 14th Terrace, Miami, FL, 33136, USA
| | - Eva Widerström-Noga
- The Miami Project to Cure Paralysis, Miami, FL, USA.,Department of Neurological Surgery, University of Miami Miller School of Medicine, 1095 N.W. 14th Terrace, Miami, FL, 33136, USA
| | - Ihtsham Haq
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Letitia Fisher
- The Miami Project to Cure Paralysis, Miami, FL, USA.,Department of Neurological Surgery, University of Miami Miller School of Medicine, 1095 N.W. 14th Terrace, Miami, FL, 33136, USA
| | - Corneliu C Luca
- The Miami Project to Cure Paralysis, Miami, FL, USA.,Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jonathan R Jagid
- The Miami Project to Cure Paralysis, Miami, FL, USA. .,Department of Neurological Surgery, University of Miami Miller School of Medicine, 1095 N.W. 14th Terrace, Miami, FL, 33136, USA.
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18
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Yin Z, Zhu G, Zhao B, Bai Y, Jiang Y, Neumann WJ, Kühn AA, Zhang J. Local field potentials in Parkinson's disease: A frequency-based review. Neurobiol Dis 2021; 155:105372. [PMID: 33932557 DOI: 10.1016/j.nbd.2021.105372] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 04/25/2021] [Accepted: 04/26/2021] [Indexed: 12/19/2022] Open
Abstract
Deep brain stimulation (DBS) surgery offers a unique opportunity to record local field potentials (LFPs), the electrophysiological population activity of neurons surrounding the depth electrode in the target area. With direct access to the subcortical activity, LFP research has provided valuable insight into disease mechanisms and cognitive processes and inspired the advent of adaptive DBS for Parkinson's disease (PD). A frequency-based framework is usually employed to interpret the implications of LFP signatures in LFP studies on PD. This approach standardizes the methodology, simplifies the interpretation of LFP patterns, and makes the results comparable across studies. Importantly, previous works have found that activity patterns do not represent disease-specific activity but rather symptom-specific or task-specific neuronal signatures that relate to the current motor, cognitive or emotional state of the patient and the underlying disease. In the present review, we aim to highlight distinguishing features of frequency-specific activities, mainly within the motor domain, recorded from DBS electrodes in patients with PD. Associations of the commonly reported frequency bands (delta, theta, alpha, beta, gamma, and high-frequency oscillations) to motor signs are discussed with respect to band-related phenomena such as individual tremor and high/low beta frequency activity, as well as dynamic transients of beta bursts. We provide an overview on how electrophysiology research in DBS patients has revealed and will continuously reveal new information about pathophysiology, symptoms, and behavior, e.g., when combining deep LFP and surface electrocorticography recordings.
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Affiliation(s)
- Zixiao Yin
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Neurostimulation, Beijing, China
| | - Guanyu Zhu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Neurostimulation, Beijing, China
| | - Baotian Zhao
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Neurostimulation, Beijing, China
| | - Yutong Bai
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Neurostimulation, Beijing, China
| | - Yin Jiang
- Beijing Key Laboratory of Neurostimulation, Beijing, China
| | - Wolf-Julian Neumann
- Movement Disorder and Neuromodulation Unit, Department of Neurology, Charite´ Campus Mitte, Charite´ - University Medicine Berlin, Berlin, Germany
| | - Andrea A Kühn
- Movement Disorder and Neuromodulation Unit, Department of Neurology, Charite´ Campus Mitte, Charite´ - University Medicine Berlin, Berlin, Germany; Berlin School of Mind and Brain, Charité - Universitätsmedizin Berlin, Unter den Linden 6, 10099 Berlin, Germany; NeuroCure, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany.
| | - Jianguo Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Neurostimulation, Beijing, China.
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Tractography patterns of pedunculopontine nucleus deep brain stimulation. J Neural Transm (Vienna) 2021; 128:659-670. [PMID: 33779812 PMCID: PMC8105200 DOI: 10.1007/s00702-021-02327-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 03/08/2021] [Indexed: 11/11/2022]
Abstract
Deep brain stimulation of the pedunculopontine nucleus is a promising surgical procedure for the treatment of Parkinsonian gait and balance dysfunction. It has, however, produced mixed clinical results that are poorly understood. We used tractography with the aim to rationalise this heterogeneity. A cohort of eight patients with postural instability and gait disturbance (Parkinson’s disease subtype) underwent pre-operative structural and diffusion MRI, then progressed to deep brain stimulation targeting the pedunculopontine nucleus. Pre-operative and follow-up assessments were carried out using the Gait and Falls Questionnaire, and Freezing of Gait Questionnaire. Probabilistic diffusion tensor tractography was carried out between the stimulating electrodes and both cortical and cerebellar regions of a priori interest. Cortical surface reconstructions were carried out to measure cortical thickness in relevant areas. Structural connectivity between stimulating electrode and precentral gyrus (r = 0.81, p = 0.01), Brodmann areas 1 (r = 0.78, p = 0.02) and 2 (r = 0.76, p = 0.03) were correlated with clinical improvement. A negative correlation was also observed for the superior cerebellar peduncle (r = −0.76, p = 0.03). Lower cortical thickness of the left parietal lobe and bilateral premotor cortices were associated with greater pre-operative severity of symptoms. Both motor and sensory structural connectivity of the stimulated surgical target characterises the clinical benefit, or lack thereof, from surgery. In what is a challenging region of brainstem to effectively target, these results provide insights into how this can be better achieved. The mechanisms of action are likely to have both motor and sensory components, commensurate with the probable nature of the underlying dysfunction.
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20
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Bertino S, Basile GA, Anastasi G, Bramanti A, Fonti B, Cavallaro F, Bruschetta D, Milardi D, Cacciola A. Anatomical Characterization of the Human Structural Connectivity between the Pedunculopontine Nucleus and Globus Pallidus via Multi-Shell Multi-Tissue Tractography. ACTA ACUST UNITED AC 2020; 56:medicina56090452. [PMID: 32906651 PMCID: PMC7557768 DOI: 10.3390/medicina56090452] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/22/2020] [Accepted: 08/28/2020] [Indexed: 12/14/2022]
Abstract
Background and objectives: The internal (GPi) and external segments (GPe) of the globus pallidus represent key nodes in the basal ganglia system. Connections to and from pallidal segments are topographically organized, delineating limbic, associative and sensorimotor territories. The topography of pallidal afferent and efferent connections with brainstem structures has been poorly investigated. In this study we sought to characterize in-vivo connections between the globus pallidus and the pedunculopontine nucleus (PPN) via diffusion tractography. Materials and Methods: We employed structural and diffusion data of 100 subjects from the Human Connectome Project repository in order to reconstruct the connections between the PPN and the globus pallidus, employing higher order tractography techniques. We assessed streamline count of the reconstructed bundles and investigated spatial relations between pallidal voxels connected to the PPN and pallidal limbic, associative and sensorimotor functional territories. Results: We successfully reconstructed pallidotegmental tracts for the GPi and GPe in all subjects. The number of streamlines connecting the PPN with the GPi was greater than the number of those joining it with the GPe. PPN maps within pallidal segments exhibited a distinctive spatial organization, being localized in the ventromedial portion of the GPi and in the ventral-anterior portion in the GPe. Regarding their spatial relations with tractography-derived maps of pallidal functional territories, the highest value of percentage overlap was noticed between PPN maps and the associative territory. Conclusions: We successfully reconstructed the anatomical course of the pallidotegmental pathways and comprehensively characterized their topographical arrangement within both pallidal segments. PPM maps were localized in the ventromedial aspect of the GPi, while they occupied the anterior pole and the most ventral portion of the GPe. A better understanding of the spatial and topographical arrangement of the pallidotegmental pathways may have pathophysiological and therapeutic implications in movement disorders.
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Affiliation(s)
- Salvatore Bertino
- Brain Mapping Lab, Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, 98125 Messina, Italy; (G.A.B.); (G.A.); (D.M.)
- Correspondence: (S.B.); (A.C.); Tel.: +39-090-2217143 (S.B. & A.C.)
| | - Gianpaolo Antonio Basile
- Brain Mapping Lab, Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, 98125 Messina, Italy; (G.A.B.); (G.A.); (D.M.)
| | - Giuseppe Anastasi
- Brain Mapping Lab, Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, 98125 Messina, Italy; (G.A.B.); (G.A.); (D.M.)
| | - Alessia Bramanti
- IRCCS Centro Neurolesi “Bonino Pulejo”, 98124 Messina, Italy; (A.B.); (B.F.)
| | - Bartolo Fonti
- IRCCS Centro Neurolesi “Bonino Pulejo”, 98124 Messina, Italy; (A.B.); (B.F.)
| | - Filippo Cavallaro
- Physical Rehabilitation Medicine and Sport Medicine Unit, University Hospital Policlinico “G. Martino”, 98124 Messina, Italy; (F.C.); (D.B.)
| | - Daniele Bruschetta
- Physical Rehabilitation Medicine and Sport Medicine Unit, University Hospital Policlinico “G. Martino”, 98124 Messina, Italy; (F.C.); (D.B.)
| | - Demetrio Milardi
- Brain Mapping Lab, Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, 98125 Messina, Italy; (G.A.B.); (G.A.); (D.M.)
- Physical Rehabilitation Medicine and Sport Medicine Unit, University Hospital Policlinico “G. Martino”, 98124 Messina, Italy; (F.C.); (D.B.)
| | - Alberto Cacciola
- Brain Mapping Lab, Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, 98125 Messina, Italy; (G.A.B.); (G.A.); (D.M.)
- Correspondence: (S.B.); (A.C.); Tel.: +39-090-2217143 (S.B. & A.C.)
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21
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Li HQ, Spitzer NC. Exercise enhances motor skill learning by neurotransmitter switching in the adult midbrain. Nat Commun 2020; 11:2195. [PMID: 32366867 PMCID: PMC7198516 DOI: 10.1038/s41467-020-16053-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 04/07/2020] [Indexed: 02/07/2023] Open
Abstract
Physical exercise promotes motor skill learning in normal individuals and those with neurological disorders but its mechanism of action is unclear. We find that one week of voluntary wheel running enhances the acquisition of motor skills in normal adult mice. One week of running also induces switching from ACh to GABA expression in neurons in the caudal pedunculopontine nucleus (cPPN). Consistent with regulation of motor skills, we show that the switching neurons make projections to the substantia nigra (SN), ventral tegmental area (VTA) and ventrolateral-ventromedial nuclei of the thalamus (VL-VM). Use of viral vectors to override transmitter switching blocks the beneficial effect of running on motor skill learning. We suggest that neurotransmitter switching provides the basis by which sustained running benefits motor skill learning, presenting a target for clinical treatment of movement disorders.
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Affiliation(s)
- Hui-Quan Li
- Neurobiology Section, Division of Biological Sciences and Center for Neural Circuits and Behavior, La Jolla, CA, 92093-0357, USA.
- Kavli Institute for Brain and Mind, University of California San Diego, La Jolla, CA, 92093-0357, USA.
| | - Nicholas C Spitzer
- Neurobiology Section, Division of Biological Sciences and Center for Neural Circuits and Behavior, La Jolla, CA, 92093-0357, USA.
- Kavli Institute for Brain and Mind, University of California San Diego, La Jolla, CA, 92093-0357, USA.
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22
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Neuronal oscillations of the pedunculopontine nucleus in progressive supranuclear palsy: Influence of levodopa and movement. Clin Neurophysiol 2020; 131:414-419. [DOI: 10.1016/j.clinph.2019.11.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 11/06/2019] [Accepted: 11/15/2019] [Indexed: 11/13/2022]
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23
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Gay M, Belaid H, Rogers A, Pérez-García F, Roustan M, Bardinet E, François C, Karachi C. Anatomo-Functional Mapping of the Primate Mesencephalic Locomotor Region Using Stereotactic Lesions. Mov Disord 2020; 35:789-799. [PMID: 31922282 DOI: 10.1002/mds.27983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 12/24/2019] [Accepted: 12/27/2019] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Dysfunction of the mesencephalic locomotor region has been implicated in gait disorders. However, the role of its 2 components, the pedunculopontine and the cuneiform nuclei, in locomotion is poorly understood in primates. OBJECTIVES To analyze the effect of cuneiform lesions on gait and balance in 2 monkeys and to compare them with those obtained after cholinergic pedunculopontine lesions in 4 monkeys and after lesions in both the cuneiform and pedunculopontine nuclei in 1 monkey. METHODS After each stereotactic lesion, we performed a neurological examination and gait and balance assessments with kinematic measures during a locomotor task. The 3-dimensional location of each lesion was analyzed on a common brainstem space. RESULTS After each cuneiform lesion, we observed a contralateral cervical dystonia including an increased tone in the proximal forelimb and an increase in knee angle, back curvature and walking speed. Conversely, cholinergic pedunculopontine lesions increased tail rigidity and back curvature and an imbalance of the muscle tone between the ipsi- and contralateral hindlimb with decreased knee angles. The walking speed was decreased. Moreover, pedunculopontine lesions often resulted in a longer time to waking postsurgery. CONCLUSIONS The location of the lesions and their behavioral effects revealed a somatotopic organization of muscle tone control, with the neck and forelimb represented within the cuneiform nucleus and hindlimb and tail represented within the pedunculopontine nucleus. Cuneiform lesions increased speed, whereas pedunculopontine lesions decreased it. These findings confirm the complex and specific role of the cuneiform and pedunculopontine nuclei in locomotion and suggest the role of the pedunculopontine in sleep control. © 2020 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Marion Gay
- Sorbonne University, Univ. Pierre & Marie Curie Paris 06, CNRS, INSERM, APHP GH Pitié-Salpêtrière, Institut du cerveau et de la moelle épinière, Paris, France
| | - Hayat Belaid
- Sorbonne University, Univ. Pierre & Marie Curie Paris 06, CNRS, INSERM, APHP GH Pitié-Salpêtrière, Institut du cerveau et de la moelle épinière, Paris, France.,Department of Neurosurgery, Rothschild Foundation, Paris, France
| | - Alister Rogers
- Sorbonne University, Univ. Pierre & Marie Curie Paris 06, CNRS, INSERM, APHP GH Pitié-Salpêtrière, Institut du cerveau et de la moelle épinière, Paris, France.,Department of Neurosurgery, Rothschild Foundation, Paris, France
| | - Fernando Pérez-García
- Sorbonne University, Univ. Pierre & Marie Curie Paris 06, CNRS, INSERM, APHP GH Pitié-Salpêtrière, Institut du cerveau et de la moelle épinière, Paris, France.,Center of NeuroImaging Research-CENIR, Paris, France
| | - Maxime Roustan
- Sorbonne University, Univ. Pierre & Marie Curie Paris 06, CNRS, INSERM, APHP GH Pitié-Salpêtrière, Institut du cerveau et de la moelle épinière, Paris, France
| | - Eric Bardinet
- Sorbonne University, Univ. Pierre & Marie Curie Paris 06, CNRS, INSERM, APHP GH Pitié-Salpêtrière, Institut du cerveau et de la moelle épinière, Paris, France.,Center of NeuroImaging Research-CENIR, Paris, France
| | - Chantal François
- Sorbonne University, Univ. Pierre & Marie Curie Paris 06, CNRS, INSERM, APHP GH Pitié-Salpêtrière, Institut du cerveau et de la moelle épinière, Paris, France
| | - Carine Karachi
- Sorbonne University, Univ. Pierre & Marie Curie Paris 06, CNRS, INSERM, APHP GH Pitié-Salpêtrière, Institut du cerveau et de la moelle épinière, Paris, France.,AP-HP, Department of Neurosurgery, La Pitié-Salpêtrière University Hospital, Paris, France
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24
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Pal B. Response to "Concerns regarding Baksa et al., Cell Molec. Life Sci., 2019." by Edgar Garcia-Rill and Francisco J. Urbano (CMLS-D-18-0156R1). Cell Mol Life Sci 2019; 76:4583-4587. [PMID: 31691836 PMCID: PMC11105466 DOI: 10.1007/s00018-019-03308-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 09/16/2019] [Accepted: 09/18/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Balazs Pal
- Department of Physiology, University of Debrecen, Faculty of Medicine, Debrecen, Hungary.
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25
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Olfactory Stimulation with Japanese Soy Sauce Improves Upper Limb Performance. Occup Ther Int 2019; 2019:2748721. [PMID: 31656454 PMCID: PMC6791263 DOI: 10.1155/2019/2748721] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 09/01/2019] [Indexed: 11/30/2022] Open
Abstract
Background We have observed changes in body reactions during cooking, which is one of the treatment modalities used in occupational therapy. The perception of food-related odors during cooking may have behavioral effects on human activities through the activation of appetitive motivation. Objectives We investigated whether odor components contained in seasonings could facilitate the human motor system and the specificity of this effect. Methods The subjects were 72 healthy adults, randomly assigned to a water exposure group, a phenylethyl alcohol (PEA, pleasant rose-like odor) exposure group, and a Japanese soy sauce (Koikuchi Shoyu) exposure group (n = 24 each). The subjects' olfactory sense was stimulated by their sniffing of three different test tubes containing 5 ml of water, PEA, or Japanese soy sauce for 20 sec while they were seated. The modified Functional Reach Test (mFRT), which mimics a functional activity that is required in daily living and assesses a reliable measure of sitting balance, was performed prior to and immediately after the sniffing. Results Sniffing the soy sauce increased the subjects' mFRT scores. This facilitation effect was odorant-specific and was absent when the subjects were presented with water or PEA. Conclusions Cooking interventions are aimed at improving tool-handling skills such as using knives and chopsticks. The results indicate that treatment interventions using odors of seasonings would be effective for improving subjects' physical functions.
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26
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Abstract
Parkinson's disease (PD) and other synucleinopathies, namely dementia with Lewy bodies (DLB) and multiple system atrophy (MSA), are common degenerative neurological disorders that share synuclein pathology. Although certain cardinal features of parkinsonism, including bradykinesia and rigidity, respond well to levodopa, axial features, such as gait and balance impairment, are less reliably responsive to dopaminergic therapy and surgical interventions. Consequently, falls are common in PD and other synucleinopathies and are a major contributor toward injury and loss of independence. This underscores the need for appropriate fall risk assessment and implementation of preventative measures in all patients with parkinsonism. The aim of this review is therefore to explore modifiable and non-modifiable risk factors for falls in synucleinopathies. We next review and evaluate the evidence for pharmacological, nonpharmacological, and surgical approaches for fall prevention, and emphasize individualized and multifaceted approaches.
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27
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Heilbronn M, Scholten M, Schlenstedt C, Mancini M, Schöllmann A, Cebi I, Pötter-Nerger M, Gharabaghi A, Weiss D. Anticipatory postural adjustments are modulated by substantia nigra stimulation in people with Parkinson's disease and freezing of gait. Parkinsonism Relat Disord 2019; 66:34-39. [DOI: 10.1016/j.parkreldis.2019.06.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 06/17/2019] [Accepted: 06/26/2019] [Indexed: 01/17/2023]
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28
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Vitale F, Capozzo A, Mazzone P, Scarnati E. Neurophysiology of the pedunculopontine tegmental nucleus. Neurobiol Dis 2019. [DOI: 10.1016/j.nbd.2018.03.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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29
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Nowacki A, Galati S, Ai-Schlaeppi J, Bassetti C, Kaelin A, Pollo C. Pedunculopontine nucleus: An integrative view with implications on Deep Brain Stimulation. Neurobiol Dis 2019; 128:75-85. [DOI: 10.1016/j.nbd.2018.08.015] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 06/22/2018] [Accepted: 08/24/2018] [Indexed: 12/21/2022] Open
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30
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Perera T, Tan JL, Cole MH, Yohanandan SAC, Silberstein P, Cook R, Peppard R, Aziz T, Coyne T, Brown P, Silburn PA, Thevathasan W. Balance control systems in Parkinson's disease and the impact of pedunculopontine area stimulation. Brain 2019; 141:3009-3022. [PMID: 30165427 PMCID: PMC6158752 DOI: 10.1093/brain/awy216] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 06/26/2018] [Indexed: 11/23/2022] Open
Abstract
Impaired balance is a major contributor to falls and diminished quality of life in Parkinson’s disease, yet the pathophysiology is poorly understood. Here, we assessed if patients with Parkinson’s disease and severe clinical balance impairment have deficits in the intermittent and continuous control systems proposed to maintain upright stance, and furthermore, whether such deficits are potentially reversible, with the experimental therapy of pedunculopontine nucleus deep brain stimulation. Two subject groups were assessed: (i) 13 patients with Parkinson’s disease and severe clinical balance impairment, implanted with pedunculopontine nucleus deep brain stimulators; and (ii) 13 healthy control subjects. Patients were assessed in the OFF medication state and blinded to two conditions; off and on pedunculopontine nucleus stimulation. Postural sway data (deviations in centre of pressure) were collected during quiet stance using posturography. Intermittent control of sway was assessed by calculating the frequency of intermittent switching behaviour (discontinuities), derived using a wavelet-based transformation of the sway time series. Continuous control of sway was assessed with a proportional–integral–derivative (PID) controller model using ballistic reaction time as a measure of feedback delay. Clinical balance impairment was assessed using the ‘pull test’ to rate postural reflexes and by rating attempts to arise from sitting to standing. Patients with Parkinson’s disease demonstrated reduced intermittent switching of postural sway compared with healthy controls. Patients also had abnormal feedback gains in postural sway according to the PID model. Pedunculopontine nucleus stimulation improved intermittent switching of postural sway, feedback gains in the PID model and clinical balance impairment. Clinical balance impairment correlated with intermittent switching of postural sway (rho = − 0.705, P < 0.001) and feedback gains in the PID model (rho = 0.619, P = 0.011). These results suggest that dysfunctional intermittent and continuous control systems may contribute to the pathophysiology of clinical balance impairment in Parkinson’s disease. Clinical balance impairment and their related control system deficits are potentially reversible, as demonstrated by their improvement with pedunculopontine nucleus deep brain stimulation.
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Affiliation(s)
- Thushara Perera
- The Bionics Institute, East Melbourne, Victoria, Australia.,Department of Medical Bionics, The University of Melbourne, Parkville, Victoria, Australia
| | - Joy L Tan
- The Bionics Institute, East Melbourne, Victoria, Australia.,Department of Medical Bionics, The University of Melbourne, Parkville, Victoria, Australia
| | - Michael H Cole
- School of Exercise Science, Australian Catholic University, Brisbane, Queensland, Australia
| | | | - Paul Silberstein
- Royal North Shore and North Shore Private Hospitals, Sydney, New South Wales, Australia
| | - Raymond Cook
- Royal North Shore and North Shore Private Hospitals, Sydney, New South Wales, Australia
| | - Richard Peppard
- The Bionics Institute, East Melbourne, Victoria, Australia.,Clinical Neurosciences, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - Tipu Aziz
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford OX1 3TH, UK
| | - Terry Coyne
- Asia-Pacific Centre for Neuromodulation, Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Peter Brown
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford OX1 3TH, UK.,Medical Research Council Brain Network Dynamics Unit, University of Oxford, Oxford OX1 3TH, UK
| | - Peter A Silburn
- Asia-Pacific Centre for Neuromodulation, Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Wesley Thevathasan
- The Bionics Institute, East Melbourne, Victoria, Australia.,Departments of Neurology, The Royal Melbourne and Austin Hospitals, Victoria, Australia.,Department of Medicine, The University of Melbourne, Parkville, Victoria, Australia
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31
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Gao S, Proekt A, Renier N, Calderon DP, Pfaff DW. Activating an anterior nucleus gigantocellularis subpopulation triggers emergence from pharmacologically-induced coma in rodents. Nat Commun 2019; 10:2897. [PMID: 31263107 PMCID: PMC6603023 DOI: 10.1038/s41467-019-10797-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 06/01/2019] [Indexed: 02/08/2023] Open
Abstract
Multiple areas within the reticular activating system (RAS) can hasten awakening from sleep or light planes of anesthesia. However, stimulation in individual sites has shown limited recovery from deep global suppression of brain activity, such as coma. Here we identify a subset of RAS neurons within the anterior portion of nucleus gigantocellularis (aNGC) capable of producing a high degree of awakening represented by a broad high frequency cortical reactivation associated with organized movements and behavioral reactivity to the environment from two different models of deep pharmacologically-induced coma (PIC): isoflurane (1.25%-1.5%) and induced hypoglycemic coma. Activating aNGC neurons triggered awakening by recruiting cholinergic, noradrenergic, and glutamatergic arousal pathways. In summary, we identify an evolutionarily conserved population of RAS neurons, which broadly restore cerebral cortical activation and motor behavior in rodents through the coordinated activation of multiple arousal-promoting circuits.
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Affiliation(s)
- S Gao
- Department of Anesthesiology, Weill Cornell Medical College, New York, NY, 10065, USA
| | - A Proekt
- Department of Anesthesiology, Weill Cornell Medical College, New York, NY, 10065, USA
- Laboratory of Neurobiology and Behavior, the Rockefeller University, New York, NY, 10065, USA
| | - N Renier
- ICM, Brain and Spine Institute, Hopital de la Pitie-Salpetriere, Sorbonne Universite, Inserm, CNRS, Paris, 75013, France
| | - D P Calderon
- Department of Anesthesiology, Weill Cornell Medical College, New York, NY, 10065, USA.
- Laboratory of Neurobiology and Behavior, the Rockefeller University, New York, NY, 10065, USA.
| | - D W Pfaff
- Laboratory of Neurobiology and Behavior, the Rockefeller University, New York, NY, 10065, USA
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32
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Baksa B, Kovács A, Bayasgalan T, Szentesi P, Kőszeghy Á, Szücs P, Pál B. Characterization of functional subgroups among genetically identified cholinergic neurons in the pedunculopontine nucleus. Cell Mol Life Sci 2019; 76:2799-2815. [PMID: 30734834 PMCID: PMC6588655 DOI: 10.1007/s00018-019-03025-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 12/21/2018] [Accepted: 01/23/2019] [Indexed: 12/19/2022]
Abstract
The pedunculopontine nucleus (PPN) is a part of the reticular activating system which is composed of cholinergic, glutamatergic and GABAergic neurons. Early electrophysiological studies characterized and grouped PPN neurons based on certain functional properties (i.e., the presence or absence of the A-current, spike latency, and low threshold spikes). Although other electrophysiological characteristics of these neurons were also described (as high threshold membrane potential oscillations, great differences in spontaneous firing rate and the presence or absence of the M-current), systematic assessment of these properties and correlation of them with morphological markers are still missing. In this work, we conducted electrophysiological experiments on brain slices of genetically identified cholinergic neurons in the PPN. Electrophysiological properties were compared with rostrocaudal location of the neuronal soma and selected morphometric features obtained with post hoc reconstruction. We found that functional subgroups had different proportions in the rostral and caudal subregions of the nucleus. Neurons with A-current can be divided to early-firing and late-firing neurons, where the latter type was found exclusively in the caudal subregion. Similar to this, different parameters of high threshold membrane potential oscillations also showed characteristic rostrocaudal distribution. Furthermore, based on our data, we propose that high threshold oscillations rather emerge from neuronal somata and not from the proximal dendrites. In summary, we demonstrated the existence and spatial distribution of functional subgroups of genetically identified PPN cholinergic neurons, which are in accordance with differences found in projection and in vivo functional findings of the subregions. Being aware of functional differences of PPN subregions will help the design and analysis of experiments using genetically encoded opto- and chemogenetic markers for in vivo experiments.
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Affiliation(s)
- B Baksa
- Department of Physiology, University of Debrecen, Faculty of Medicine, Nagyerdei krt 98, Debrecen, 4012, Hungary
| | - A Kovács
- Department of Physiology, University of Debrecen, Faculty of Medicine, Nagyerdei krt 98, Debrecen, 4012, Hungary
| | - T Bayasgalan
- Department of Physiology, University of Debrecen, Faculty of Medicine, Nagyerdei krt 98, Debrecen, 4012, Hungary
| | - P Szentesi
- Department of Physiology, University of Debrecen, Faculty of Medicine, Nagyerdei krt 98, Debrecen, 4012, Hungary
| | - Á Kőszeghy
- Department of Physiology, University of Debrecen, Faculty of Medicine, Nagyerdei krt 98, Debrecen, 4012, Hungary
- Division of Cognitive Neurobiology, Center for Brain Research, Medical University of Vienna, Vienna, Austria
| | - P Szücs
- Department of Anatomy, Histology and Embriology, University of Debrecen, Faculty of Medicine, Debrecen, Hungary
| | - Balázs Pál
- Department of Physiology, University of Debrecen, Faculty of Medicine, Nagyerdei krt 98, Debrecen, 4012, Hungary.
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33
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Wichmann T. Changing views of the pathophysiology of Parkinsonism. Mov Disord 2019; 34:1130-1143. [PMID: 31216379 DOI: 10.1002/mds.27741] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 05/15/2019] [Accepted: 05/20/2019] [Indexed: 12/11/2022] Open
Abstract
Studies of the pathophysiology of parkinsonism (specifically akinesia and bradykinesia) have a long history and primarily model the consequences of dopamine loss in the basal ganglia on the function of the basal ganglia/thalamocortical circuit(s). Changes of firing rates of individual nodes within these circuits were originally considered central to parkinsonism. However, this view has now given way to the belief that changes in firing patterns within the basal ganglia and related nuclei are more important, including the emergence of burst discharges, greater synchrony of firing between neighboring neurons, oscillatory activity patterns, and the excessive coupling of oscillatory activities at different frequencies. Primarily focusing on studies obtained in nonhuman primates and human patients with Parkinson's disease, this review summarizes the current state of this field and highlights several emerging areas of research, including studies of the impact of the heterogeneity of external pallidal neurons on parkinsonism, the importance of extrastriatal dopamine loss, parkinsonism-associated synaptic and morphologic plasticity, and the potential role(s) of the cerebellum and brainstem in the motor dysfunction of Parkinson's disease. © 2019 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Thomas Wichmann
- Department of Neurology/School of Medicine and Yerkes National Primate Research Center, Emory University, Atlanta, Georgia, USA
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34
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Garcia-Rill E, Saper CB, Rye DB, Kofler M, Nonnekes J, Lozano A, Valls-Solé J, Hallett M. Focus on the pedunculopontine nucleus. Consensus review from the May 2018 brainstem society meeting in Washington, DC, USA. Clin Neurophysiol 2019; 130:925-940. [PMID: 30981899 PMCID: PMC7365492 DOI: 10.1016/j.clinph.2019.03.008] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 03/15/2019] [Accepted: 03/22/2019] [Indexed: 12/12/2022]
Abstract
The pedunculopontine nucleus (PPN) is located in the mesopontine tegmentum and is best delimited by a group of large cholinergic neurons adjacent to the decussation of the superior cerebellar peduncle. This part of the brain, populated by many other neuronal groups, is a crossroads for many important functions. Good evidence relates the PPN to control of reflex reactions, sleep-wake cycles, posture and gait. However, the precise role of the PPN in all these functions has been controversial and there still are uncertainties in the functional anatomy and physiology of the nucleus. It is difficult to grasp the extent of the influence of the PPN, not only because of its varied functions and projections, but also because of the controversies arising from them. One controversy is its relationship to the mesencephalic locomotor region (MLR). In this regard, the PPN has become a new target for deep brain stimulation (DBS) for the treatment of parkinsonian gait disorders, including freezing of gait. This review is intended to indicate what is currently known, shed some light on the controversies that have arisen, and to provide a framework for future research.
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Affiliation(s)
- E Garcia-Rill
- Center for Translational Neuroscience, Department of Neurobiology and Developmental Sciences, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
| | - C B Saper
- Department of Neurology, Division of Sleep Medicine and Program in Neuroscience, Harvard Medical School, Boston, MA, USA
| | - David B Rye
- Department of Neurology, Division of Sleep Medicine and Program in Neuroscience, Harvard Medical School, Boston, MA, USA
| | - M Kofler
- Department of Neurology, Hochzirl Hospital, Zirl, Austria
| | - J Nonnekes
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Rehabilitation, Nijmegen, the Netherlands
| | - A Lozano
- Division of Neurosurgery, University of Toronto and Krembil Neuroscience Centre, University Health Network, Toronto, Canada
| | - J Valls-Solé
- Neurology Department, Hospital Clínic, University of Barcelona, IDIBAPS (Institut d'Investigació Biomèdica August Pi i Sunyer), Barcelona, Spain
| | - M Hallett
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
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Blumen HM, Brown LL, Habeck C, Allali G, Ayers E, Beauchet O, Callisaya M, Lipton RB, Mathuranath PS, Phan TG, Pradeep Kumar VG, Srikanth V, Verghese J. Gray matter volume covariance patterns associated with gait speed in older adults: a multi-cohort MRI study. Brain Imaging Behav 2019; 13:446-460. [PMID: 29629501 PMCID: PMC6177326 DOI: 10.1007/s11682-018-9871-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Accelerated gait decline in aging is associated with many adverse outcomes, including an increased risk for falls, cognitive decline, and dementia. Yet, the brain structures associated with gait speed, and how they relate to specific cognitive domains, are not well-understood. We examined structural brain correlates of gait speed, and how they relate to processing speed, executive function, and episodic memory in three non-demented and community-dwelling older adult cohorts (Overall N = 352), using voxel-based morphometry and multivariate covariance-based statistics. In all three cohorts, we identified gray matter volume covariance patterns associated with gait speed that included brain stem, precuneus, fusiform, motor, supplementary motor, and prefrontal (particularly ventrolateral prefrontal) cortex regions. Greater expression of these gray matter volume covariance patterns linked to gait speed were associated with better processing speed in all three cohorts, and with better executive function in one cohort. These gray matter covariance patterns linked to gait speed were not associated with episodic memory in any of the cohorts. These findings suggest that gait speed, processing speed (and to some extent executive functions) rely on shared neural systems that are subject to age-related and dementia-related change. The implications of these findings are discussed within the context of the development of interventions to compensate for age-related gait and cognitive decline.
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Affiliation(s)
- Helena M Blumen
- Department of Medicine, Albert Einstein College of Medicine, 1225 Morris Park Avenue, Van Etten Building, Room 313B, Bronx, NY, 10461, USA.
- Department of Neurology, Albert Einstein College of Medicine, 1225 Morris Park Avenue, Van Etten Building, Room 313B, Bronx, NY, 10461, USA.
| | - Lucy L Brown
- Department of Neurology, Albert Einstein College of Medicine, 1225 Morris Park Avenue, Van Etten Building, Room 313B, Bronx, NY, 10461, USA
| | - Christian Habeck
- Cognitive Neuroscience Division, Department of Neurology and Taub Institute for Research on Alzheimer's disease and the Aging Brain, Columbia University, New York, NY, USA
| | - Gilles Allali
- Department of Clinical Neurosciences, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Emmeline Ayers
- Department of Medicine, Albert Einstein College of Medicine, 1225 Morris Park Avenue, Van Etten Building, Room 313B, Bronx, NY, 10461, USA
| | - Olivier Beauchet
- Joseph Kaufmann Chair in Geriatric Medicine, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Michele Callisaya
- Stroke and Ageing Research Group, Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia
- Menzies Institute for Medical Research, University of Tasmania (M.L.C.), Hobart, TAS, Australia
| | - Richard B Lipton
- Department of Neurology, Albert Einstein College of Medicine, 1225 Morris Park Avenue, Van Etten Building, Room 313B, Bronx, NY, 10461, USA
| | - P S Mathuranath
- Department of Neurology, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India
| | - Thanh G Phan
- Stroke and Ageing Research Group, Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia
| | - V G Pradeep Kumar
- Department of Neurology, Baby Memorial Hospital, Kozhikode, Kerala, India
| | - Velandai Srikanth
- Stroke and Ageing Research Group, Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia
- Menzies Institute for Medical Research, University of Tasmania (M.L.C.), Hobart, TAS, Australia
| | - Joe Verghese
- Department of Medicine, Albert Einstein College of Medicine, 1225 Morris Park Avenue, Van Etten Building, Room 313B, Bronx, NY, 10461, USA
- Department of Neurology, Albert Einstein College of Medicine, 1225 Morris Park Avenue, Van Etten Building, Room 313B, Bronx, NY, 10461, USA
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Geng X, Wang X, He F, Zhang X, Xie J, Gao G, Han H, Yao X, Zhang H, Gao Y, Wang Y, Wang M. Spike and Local Field Synchronization Between the Pedunculopontine Nucleus and Primary Motor Cortex in a Rat Model of Parkinson's Disease. Neuroscience 2019; 404:470-483. [DOI: 10.1016/j.neuroscience.2019.01.044] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 10/16/2018] [Accepted: 01/23/2019] [Indexed: 02/06/2023]
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Structure and function of the mesencephalic locomotor region in normal and parkinsonian primates. CURRENT OPINION IN PHYSIOLOGY 2019. [DOI: 10.1016/j.cophys.2019.01.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Garcia-Rill E. Neuroepigenetics of arousal: Gamma oscillations in the pedunculopontine nucleus. J Neurosci Res 2019; 97:1515-1520. [PMID: 30916810 DOI: 10.1002/jnr.24417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 03/06/2019] [Indexed: 01/20/2023]
Abstract
Four major discoveries on the function of the pedunculopontine nucleus (PPN) have significantly advanced our understanding of the role of arousal in neurodegenerative disorders. The first was the finding that stimulation of the PPN-induced controlled locomotion on a treadmill in decerebrate animals, the second was the revelation of electrical coupling in the PPN and other arousal and sleep-wake control regions, the third was the determination of intrinsic gamma band oscillations in PPN neurons, and the last was the discovery of gene transcription resulting from the manifestation of gamma activity in the PPN. These discoveries have led to novel therapies such as PPN deep brain stimulation (DBS) for Parkinson's disease (PD), identified the mechanism of action of the stimulant modafinil, determined the presence of separate mechanisms underlying gamma activity during waking versus REM sleep, and revealed the presence of gene transcription during the manifestation of gamma band oscillations. These discoveries set the stage for additional major advances in the treatment of a number of disorders.
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Affiliation(s)
- Edgar Garcia-Rill
- Center for Translational Neuroscience (CTN), University of Arkansas for Medical Sciences, Little Rock, Arkansas
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Local and Relayed Effects of Deep Brain Stimulation of the Pedunculopontine Nucleus. Brain Sci 2019; 9:brainsci9030064. [PMID: 30889866 PMCID: PMC6468768 DOI: 10.3390/brainsci9030064] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 03/12/2019] [Accepted: 03/13/2019] [Indexed: 12/18/2022] Open
Abstract
Our discovery of low-threshold stimulation-induced locomotion in the pedunculopontine nucleus (PPN) led to the clinical use of deep brain stimulation (DBS) for the treatment of disorders such as Parkinson's disease (PD) that manifest gait and postural disorders. Three additional major discoveries on the properties of PPN neurons have opened new areas of research for the treatment of motor and arousal disorders. The description of (a) electrical coupling, (b) intrinsic gamma oscillations, and (c) gene regulation in the PPN has identified a number of novel therapeutic targets and methods for the treatment of a number of neurological and psychiatric disorders. We first delve into the circuit, cellular, intracellular, and molecular organization of the PPN, and then consider the clinical results to date on PPN DBS. This comprehensive review will provide valuable information to explain the network effects of PPN DBS, point to new directions for treatment, and highlight a number of issues related to PPN DBS.
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40
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The pedunclopontine nucleus and Parkinson's disease. Neurobiol Dis 2018; 128:3-8. [PMID: 30171892 DOI: 10.1016/j.nbd.2018.08.017] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 06/22/2018] [Accepted: 08/26/2018] [Indexed: 01/08/2023] Open
Abstract
In the last decade, scientific and clinical interest in the pedunculopontine nucleus (PPN) has grown dramatically. This growth is largely a consequence of experimental work demonstrating its connection to the control of gait and of clinical work implicating PPN pathology in levodopa-insensitive gait symptoms of Parkinson's disease (PD). In addition, the development of optogenetic and chemogenetic approaches has made experimental analysis of PPN circuitry and function more tractable. In this brief review, recent findings in the field linking PPN to the basal ganglia and PD are summarized; in addition, an attempt is made to identify key gaps in our understanding and challenges this field faces in moving forward.
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Parmentier É, De Pasqua V, D'Ostilio K, Depierreux F, Garraux G, Maertens de Noordhout A. Correlation between deep brain stimulation effects on freezing of gait and audio-spinal reflex. Clin Neurophysiol 2018; 129:2083-2088. [PMID: 30077869 DOI: 10.1016/j.clinph.2018.07.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 07/09/2018] [Accepted: 07/12/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVE A network of cortical, subcortical and brainstem structures might be involved in freezing of gait (FOG). Subthalamic nucleus (STN) deep brain stimulation (DBS) could modulate this network. The audio-spinal reflex (ASR), reduced in PD, but increased by treatment, can be used to further investigate that locomotor network. The aim of this study is to find whether a correlation exists between ASR and FOG in PD patients under DBS. METHODS In 14 PD patients with STN DBS and previous FOG, ASR was recorded, with DBS switched on and off. We also assessed FOG Questionnaire (FOGQ) and Unified Parkinson's Disease Rating Scale (UPDRS) Part III. RESULTS Switching "on" DBS increased ASR amplitude (+ 33.2% with DBS ON, p = 0.048). We also found a significant inverse correlation between FOGQ and modulation of ASR by DBS (r = -0.59, r2 = 0.35, p < 0.05). CONCLUSIONS This study shows that the incremental effect of DBS on ASR is greater in PD patients with less severe FOG. SIGNIFICANCE This study shows a link between electrophysiological and clinical data about gait control. It might contribute to better understand why some DBS patients report heavy FOG and others do not. ASR might be used to evaluate or maybe predict the effect of stimulation parameters changes on FOG.
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Affiliation(s)
- Éric Parmentier
- Neurology Department, Centre Hospitalier Universitaire, Liège, Belgium; Cyclotron Research Centre, University of Liège, Belgium.
| | - Victor De Pasqua
- Neurology Department, Centre Hospitalier Régional de la Citadelle, Liège, Belgium
| | - Kévin D'Ostilio
- Neurology Department, Centre Hospitalier Régional de la Citadelle, Liège, Belgium
| | - Frédérique Depierreux
- Neurology Department, Centre Hospitalier Universitaire, Liège, Belgium; Cyclotron Research Centre, University of Liège, Belgium
| | - Gaëtan Garraux
- Neurology Department, Centre Hospitalier Universitaire, Liège, Belgium; Cyclotron Research Centre, University of Liège, Belgium
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Pallidal Stimulation Modulates Pedunculopontine Nuclei in Parkinson's Disease. Brain Sci 2018; 8:brainsci8070117. [PMID: 29941788 PMCID: PMC6071240 DOI: 10.3390/brainsci8070117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 06/18/2018] [Accepted: 06/22/2018] [Indexed: 11/30/2022] Open
Abstract
Background: In advanced Parkinson’s disease, the pedunculopontine nucleus region is thought to be abnormally inhibited by gamma-aminobutyric acid (GABA) ergic inputs from the over-active globus pallidus internus. Recent attempts to boost pedunculopontine nucleus function through deep brain stimulation are promising, but suffer from the incomplete understanding of the physiology of the pedunculopontine nucleus region. Methods: Local field potentials of the pedunculopontine nucleus region and the globus pallidus internus were recorded and quantitatively analyzed in a patient with Parkinson’s disease. In particular, we compared the local field potentials from the pedunculopontine nucleus region at rest and during deep brain stimulation of the globus pallidus internus. Results: At rest, the spectrum of local field potentials in the globus pallidus internus was mainly characterized by delta-theta and beta frequency activity whereas the spectrum of the pedunculopontine nucleus region was dominated by activity only in the delta and theta band. High-frequency deep brain stimulation of the globus pallidus internus led to increased theta activity in the pedunculopontine nucleus region and enabled information exchange between the left and right pedunculopontine nuclei. Therefore, Conclusions: When applying deep brain stimulation in the globus pallidus internus, its modulatory effect on pedunculopontine nucleus physiology should be taken into account.
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Thevathasan W, Moro E. What is the therapeutic mechanism of pedunculopontine nucleus stimulation in Parkinson's disease? Neurobiol Dis 2018; 128:67-74. [PMID: 29933055 DOI: 10.1016/j.nbd.2018.06.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 06/08/2018] [Accepted: 06/15/2018] [Indexed: 10/28/2022] Open
Abstract
Pedunculopontine nucleus (PPN) deep brain stimulation (DBS) is an experimental treatment for Parkinson's disease (PD) which offers a fairly circumscribed benefit for gait freezing and perhaps balance impairment. The benefit on gait freezing is variable and typically incomplete, which may reflect that the clinical application is yet to be optimised or reflect a fundamental limitation of the therapeutic mechanism. Thus, a better understanding of the therapeutic mechanism of PPN DBS may guide the further development of this therapy. The available evidence supports that the PPN is underactive in PD due to a combination of both degeneration and excessive inhibition. Low frequency PPN DBS could enhance PPN network activity, perhaps via disinhibition. A clinical implication is that in some PD patients, the PPN may be too degenerate for PPN DBS to work. Reaction time studies report that PPN DBS mediates a very specific benefit on pre-programmed movement. This seems relevant to the pathophysiology of gait freezing, which can be argued to reflect impaired release of pre-programmed adjustments to locomotion. Thus, the benefit of PPN DBS on gait freezing could be akin to that mediated by external cues. Alpha band activity is a prominent finding in local field potential recordings from PPN electrodes in PD patients. Alpha band activity is implicated in the suppression of task irrelevant processes and thus the effective allocation of attention (processing resources). Attentional deficits are prominent in patients with PD and gait freezing and PPN alpha activity has been observed to drop out prior to gait freezing episodes and to increase with levodopa. This raises the hypothesis that PPN DBS could support or emulate PPN alpha activity and consequently enhance the allocation of attention. Although PPN DBS has not been convincingly shown to increase general alertness or attention, it remains possible that PPN DBS may enhance the allocation of processing resources within the motor system, or "motor attention". For example, this could facilitate the 'switching' of motor state between continuation of pattern generated locomotion towards the intervention of pre-programmed adjustments. However, if the downstream consequence of PPN DBS on movement is limited to a circumscribed unblocking of pre-programmed movement, then this may have a similarly circumscribed degree of benefit for gait. If this is the case, then it may be possible to identify patients who may benefit most from PPN DBS. For example, those in whom pre-programmed deficits are the major contributors to gait freezing.
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Affiliation(s)
- Wesley Thevathasan
- Departments of Neurology, Royal Melbourne Hospital and Austin Hospitals, University of Melbourne, Australia and the Bionics Institute of Australia, Melbourne, Australia
| | - Elena Moro
- Movement Disorders Center, Division of Neurology, CHU Grenoble, Grenoble Alpes University, INSERM U1214, Grenoble, France.
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Goetz L, Bhattacharjee M, Ferraye MU, Fraix V, Maineri C, Nosko D, Fenoy AJ, Piallat B, Torres N, Krainik A, Seigneuret E, David O, Parent M, Parent A, Pollak P, Benabid AL, Debu B, Chabardès S. Deep Brain Stimulation of the Pedunculopontine Nucleus Area in Parkinson Disease: MRI-Based Anatomoclinical Correlations and Optimal Target. Neurosurgery 2018; 84:506-518. [DOI: 10.1093/neuros/nyy151] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 03/27/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- Laurent Goetz
- Grenoble Institute of Neurosciences, INSERM U1216 CEA-UJF-CHUGA, Grenoble, France
- University Grenoble Alpes, Grenoble, France
- CERVO Brain Research Center, Institut Universitaire en Santé Mentale de Québec, Department of Psychiatry and Neuroscience, Université Laval, Québec City, Canada
| | - Manik Bhattacharjee
- Grenoble Institute of Neurosciences, INSERM U1216 CEA-UJF-CHUGA, Grenoble, France
- University Grenoble Alpes, Grenoble, France
| | - Murielle U Ferraye
- Grenoble Institute of Neurosciences, INSERM U1216 CEA-UJF-CHUGA, Grenoble, France
- University Grenoble Alpes, Grenoble, France
| | - Valérie Fraix
- Grenoble Institute of Neurosciences, INSERM U1216 CEA-UJF-CHUGA, Grenoble, France
- University Grenoble Alpes, Grenoble, France
- Department of Neurology, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Carina Maineri
- Department of Neurosurgery, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
- Department of Pediatric Neurosurgery, Italian Hospital of Buenos Aires, Buenos Aires, Argentina
| | - Daniela Nosko
- Grenoble Institute of Neurosciences, INSERM U1216 CEA-UJF-CHUGA, Grenoble, France
- University Grenoble Alpes, Grenoble, France
- Pediatric department, Örebro University Hospital, Örebro, Sweden
| | - Albert J Fenoy
- Department of Neurosurgery, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
- Department of Neurosurgery, University of Texas Houston, Health Science Center, Houston, Texas
| | - Brigitte Piallat
- Grenoble Institute of Neurosciences, INSERM U1216 CEA-UJF-CHUGA, Grenoble, France
- University Grenoble Alpes, Grenoble, France
| | - Napoléon Torres
- University Grenoble Alpes, Grenoble, France
- Department of Neurosurgery, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
- CEA Clinatec-Minatec, Grenoble, France
| | - Alexandre Krainik
- Grenoble Institute of Neurosciences, INSERM U1216 CEA-UJF-CHUGA, Grenoble, France
- University Grenoble Alpes, Grenoble, France
- Department of Neuroradiology, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Eric Seigneuret
- Grenoble Institute of Neurosciences, INSERM U1216 CEA-UJF-CHUGA, Grenoble, France
- University Grenoble Alpes, Grenoble, France
- Department of Neurosurgery, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Olivier David
- Grenoble Institute of Neurosciences, INSERM U1216 CEA-UJF-CHUGA, Grenoble, France
- University Grenoble Alpes, Grenoble, France
| | - Martin Parent
- CERVO Brain Research Center, Institut Universitaire en Santé Mentale de Québec, Department of Psychiatry and Neuroscience, Université Laval, Québec City, Canada
| | - André Parent
- CERVO Brain Research Center, Institut Universitaire en Santé Mentale de Québec, Department of Psychiatry and Neuroscience, Université Laval, Québec City, Canada
| | - Pierre Pollak
- Grenoble Institute of Neurosciences, INSERM U1216 CEA-UJF-CHUGA, Grenoble, France
- University Grenoble Alpes, Grenoble, France
- Department of Neurology, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Alim -Louis Benabid
- University Grenoble Alpes, Grenoble, France
- Department of Neurosurgery, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
- CEA Clinatec-Minatec, Grenoble, France
| | - Bettina Debu
- Grenoble Institute of Neurosciences, INSERM U1216 CEA-UJF-CHUGA, Grenoble, France
- University Grenoble Alpes, Grenoble, France
| | - Stéphan Chabardès
- Grenoble Institute of Neurosciences, INSERM U1216 CEA-UJF-CHUGA, Grenoble, France
- University Grenoble Alpes, Grenoble, France
- Department of Neurosurgery, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
- CEA Clinatec-Minatec, Grenoble, France
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GABA A receptor in the Pedunculopontine tegmental (PPT) nucleus: Effects on cardiovascular system. Pharmacol Rep 2018; 70:1001-1009. [PMID: 32002952 DOI: 10.1016/j.pharep.2018.03.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 03/09/2018] [Accepted: 03/28/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND The pedunculopontine tegmental (PPT) nucleus is a heterogeneous nucleus with several functions including cardiovascular regulation. The presence of GABAA receptor has been shown in the PPT. Therefore, the cardiovascular effects of this receptor were examined. METHODS Rats were divided into: Control; Muscimol; Bicuculline (BMI); Hexamethonium (Hexa) + BMI and Atropine + BMI groups. The femoral vein and artery were cannulated for drug administration and recording of cardiovascular parameters, respectively. Muscimol (a GABAA agonist; 1.5 and 2.5 nmol), BMI (a GABAA antagonist; 0.1 and 0.2 nmol) were stereotaxically microinjected into the PPT. To evaluate the peripheral cardiovascular mechanisms of GABAA receptors, Hexa (a ganglionic blocker; 10 mg/kg) and atropine (a muscarinic receptor antagonist; 1 mg/kg) were intravenously (iv) injected before BMI (0.2 nmol). The average changes of mean arterial pressure (ΔMAP), systolic blood pressure (ΔSBP) and heart rate (ΔHR) in different intervals were calculated and compared both within and between case group and control group (repeated measures ANOVA). The peak changes in each group were also calculated and compared with those of the control group (independent sample t-test). RESULTS Both doses of BMI significantly increased ΔMAP, ΔSBP and ΔHR compared to control, while the only higher dose of muscimol significantly decreased ΔSBP. Iv injection of Hexa significantly attenuated ΔMAP, ΔSBP and ΔHR responses induced by BMI but atropine did not affect. CONCLUSIONS Our results demonstrate that GABAA receptor of the PPT has a tonic inhibitory effect on the cardiovascular system and its peripheral effect mostly is mediated by sympathetic system.
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Improving Dual-Task Control With a Posture-Second Strategy in Early-Stage Parkinson Disease. Arch Phys Med Rehabil 2018; 99:1540-1546.e2. [PMID: 29608901 DOI: 10.1016/j.apmr.2018.02.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 02/12/2018] [Accepted: 02/19/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To examine the task prioritization effects on postural-suprapostural dual-task performance in patients with early-stage Parkinson disease (PD) without clinically observed postural symptoms. DESIGN Cross-sectional study. Participants performed a force-matching task while standing on a mobile platform, and were instructed to focus their attention on either the postural task (posture-first strategy) or the force-matching task (posture-second strategy). SETTING University research laboratory. PARTICIPANTS Individuals (N=16) with early-stage PD who had no clinically observed postural symptoms. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Dual-task change (DTC; percent change between single-task and dual-task performance) of posture error, posture approximate entropy (ApEn), force error, and reaction time (RT). Positive DTC values indicate higher postural error, posture ApEn, force error, and force RT during dual-task conditions compared with single-task conditions. RESULTS Compared with the posture-first strategy, the posture-second strategy was associated with smaller DTC of posture error and force error, and greater DTC of posture ApEn. In contrast, greater DTC of force RT was observed under the posture-second strategy. CONCLUSIONS Contrary to typical recommendations, our results suggest that the posture-second strategy may be an effective dual-task strategy in patients with early-stage PD who have no clinically observed postural symptoms in order to reduce the negative effect of dual tasking on performance and facilitate postural automaticity.
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Liugan M, Zhang M, Cakmak YO. Neuroprosthetics for Auricular Muscles: Neural Networks and Clinical Aspects. Front Neurol 2018; 8:752. [PMID: 29387041 PMCID: PMC5775970 DOI: 10.3389/fneur.2017.00752] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Accepted: 12/28/2017] [Indexed: 11/13/2022] Open
Abstract
The mammalian external ear houses extrinsic and intrinsic auricular muscles. There are three extrinsic auricular muscles-the posterior, superior, and anterior auricular muscles-and six intrinsic muscles-the helicis major and minor, tragicus, anti-tragicus, transverse and oblique muscles. These muscles have been considered vestigial in humans. However, numerous therapeutic and diagnostic wearable devices are designed to monitor and alleviate the symptoms of neurological disorders, brainstem injuries, emotional states, and auditory functions, by making use of the neural networks of the auricular muscles and their locations, which are easily accessible for ergonomic wearable biomedical devices. They can also serve as a bio-controller of human neuroprosthetics. The functionality of these auricular muscles remains elusive and requires further experimentation for a more in-depth understanding of their anatomy. The aims of this review are (1) to provide a detailed account of the neural networks of the extrinsic and intrinsic auricular muscles, (2) to describe diagnostic and therapeutic functions of these muscles as demonstrated in the current literature, and (3) to outline existing and potential neuroprosthetic applications making use of the auricular muscles and their neural networks.
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Affiliation(s)
- Mikee Liugan
- Department of Anatomy, University of Otago, Dunedin, New Zealand
| | - Ming Zhang
- Department of Anatomy, University of Otago, Dunedin, New Zealand
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Giorni A, Windels F, Stratton PG, Cook R, Silberstein P, Coyne T, Silburn PA, Sah P. Single-unit activity of the anterior Globus pallidus internus in Tourette patients and posterior Globus pallidus internus in dystonic patients. Clin Neurophysiol 2017; 128:2510-2518. [PMID: 29101846 DOI: 10.1016/j.clinph.2017.10.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 08/30/2017] [Accepted: 10/07/2017] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Our goal was to provide a detailed analysis of neurons' electrophysiological activity recorded in sub-territories of Globus pallidus internus (GPi) used as Deep Brain Stimulation (DBS) targets for these clinical conditions to potentially assist electrode targeting. METHODS We used intra-operative microelectrode recording during stereotactic neurosurgery to guide implantation of DBS lead. RESULTS Units in the medial anterior part of GPi of 7 Tourette's syndrome patients under general anesthesia were firing at mean and median rate of 32.1 and 21 Hz respectively (n = 101), with 45% of spikes fired during bursts and 21.3 bursts per minute. In the latero-posterior part of GPi of 7 dystonic patients under local anesthesia the mean and median activity were 46.1 and 30.6 Hz respectively (n = 27), and a mean of 21.7 bursts per minute was observed, with 30% of all spikes occurring during these bursts. CONCLUSION Units activity pattern - slow-regular, fast-irregular or fast-regular were present in different proportions between the two targets. SIGNIFICANCE The electrophysiological characteristics of the medial-anterior part of GPi and its latero-posterior portion can be used to assist DBS electrode targeting and also support the refinement of pathophysiological models of Tourette's syndrome and Dystonia.
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Affiliation(s)
- Andrea Giorni
- Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia; Asia Pacific Centre for Neuromodulation, Queensland Brain Institute, Brisbane, Queensland, Australia
| | - François Windels
- Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia; Asia Pacific Centre for Neuromodulation, Queensland Brain Institute, Brisbane, Queensland, Australia.
| | - Peter G Stratton
- Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia; Asia Pacific Centre for Neuromodulation, Queensland Brain Institute, Brisbane, Queensland, Australia
| | - Raymond Cook
- Royal North Shore and North Shore Private Hospitals, Sydney, New South Wales, Australia
| | - Paul Silberstein
- Royal North Shore and North Shore Private Hospitals, Sydney, New South Wales, Australia
| | - Terrence Coyne
- Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia; Asia Pacific Centre for Neuromodulation, Queensland Brain Institute, Brisbane, Queensland, Australia; St. Andrews War Memorial Hospital, Spring Hill, Queensland, Australia
| | - Peter A Silburn
- Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia; Asia Pacific Centre for Neuromodulation, Queensland Brain Institute, Brisbane, Queensland, Australia; St. Andrews War Memorial Hospital, Spring Hill, Queensland, Australia
| | - Pankaj Sah
- Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia; Asia Pacific Centre for Neuromodulation, Queensland Brain Institute, Brisbane, Queensland, Australia
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Thevathasan W, Debu B, Aziz T, Bloem BR, Blahak C, Butson C, Czernecki V, Foltynie T, Fraix V, Grabli D, Joint C, Lozano AM, Okun MS, Ostrem J, Pavese N, Schrader C, Tai CH, Krauss JK, Moro E. Pedunculopontine nucleus deep brain stimulation in Parkinson's disease: A clinical review. Mov Disord 2017; 33:10-20. [DOI: 10.1002/mds.27098] [Citation(s) in RCA: 122] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 06/08/2017] [Accepted: 06/14/2017] [Indexed: 12/21/2022] Open
Affiliation(s)
- Wesley Thevathasan
- Department of Medicine; Royal Melbourne Hospital, University of Melbourne, Australia and the Bionics Institute of Australia; Melbourne Australia
| | - Bettina Debu
- Movement Disorders Center; Division of Neurology, Centre Hospitalier Universitaire (CHU) Grenoble, Grenoble Alpes University; Grenoble France
| | - Tipu Aziz
- Department of Neurosurgery; John Radcliffe Hospital, University of Oxford; Oxford UK
| | - Bastiaan R. Bloem
- Department of Neurology; Donders Institute for Brain, Cognition and Behaviour, Radboud University; Nijmegen the Netherlands
| | - Christian Blahak
- Department of Neurology; Universitätsmedizin Mannheim, University of Heidelberg; Heidelberg Germany
| | - Christopher Butson
- Department of Bioengineering; Scientific Computing and Imaging Institute, University of Utah; Salt Lake City USA
| | - Virginie Czernecki
- Department of Neurology; Institut de Cerveau et de la Moelle épinière, Sorbonne Universités, University Pierre-and-Marie-Curie (UPMC) Université; Paris France
| | - Thomas Foltynie
- Sobell Department of Motor Neuroscience; University College London (UCL) Institute of Neurology; United Kingdom
| | - Valerie Fraix
- Movement Disorders Center; Division of Neurology, Centre Hospitalier Universitaire (CHU) Grenoble, Grenoble Alpes University; Grenoble France
| | - David Grabli
- Department of Neurology; Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtière University Hospital; Paris France
| | - Carole Joint
- Department of Neurosurgery; John Radcliffe Hospital, University of Oxford; Oxford UK
| | - Andres M. Lozano
- Department of Neurosurgery; Toronto Western Hospital, University of Toronto; Toronto Canada
| | - Michael S. Okun
- Departments of Neurology and Neurosurgery; University of Florida Center for Movement Disorders; Gainesville Florida USA
| | - Jill Ostrem
- Department of Neurology; UCSF Movement Disorder and Neuromodulation Center, University of California; San Francisco USA
| | - Nicola Pavese
- Institute of Neuroscience; Newcastle University; Newcastle upon Tyne UK
- Department of Clinical Medicine; Centre for Functionally Integrative Neuroscience, University of Aarhus; Aarhus Denmark
- Department of Neurology; Hannover Medical School; Hannover Germany
| | | | - Chun-Hwei Tai
- Department of Neurology; National Taiwan University Hospital, College of Medicine, National Taiwan University; Taipei Taiwan
| | - Joachim K. Krauss
- Department of Neurosurgery; Hannover Medical School; Hannover Germany
| | - Elena Moro
- Movement Disorders Center; Division of Neurology, Centre Hospitalier Universitaire (CHU) Grenoble, Grenoble Alpes University; Grenoble France
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Mena-Segovia J, Bolam JP. Rethinking the Pedunculopontine Nucleus: From Cellular Organization to Function. Neuron 2017; 94:7-18. [PMID: 28384477 DOI: 10.1016/j.neuron.2017.02.027] [Citation(s) in RCA: 147] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 02/03/2017] [Accepted: 02/15/2017] [Indexed: 12/21/2022]
Abstract
The pedunculopontine nucleus (PPN) has long been considered an interface between the basal ganglia and motor systems, and its ability to regulate arousal states puts the PPN in a key position to modulate behavior. Despite the large amount of data obtained over recent decades, a unified theory of its function is still incomplete. By putting together classical concepts and new evidence that dissects the influence of its different neuronal subtypes on their various targets, we propose that the PPN and, in particular, cholinergic neurons have a central role in updating the behavioral state as a result of changes in environmental contingencies. Such a function is accomplished by a combined mechanism that simultaneously restrains ongoing obsolete actions while it facilitates new contextual associations.
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Affiliation(s)
- Juan Mena-Segovia
- Center for Molecular and Behavioral Neuroscience, Rutgers University, Newark, NJ 07102, USA.
| | - J Paul Bolam
- MRC Brain Network Dynamics Unit, University of Oxford, Oxford OX1 3TH, UK
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