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Guida P, Martínez-Fernández R, Máñez-Miró JU, Del Álamo M, Foffani G, Fernández-Rodríguez B, Monje MHG, Obeso I, Obeso JA, Gasca-Salas C. Social Cognition in Parkinson's Disease after Focused Ultrasound Subthalamotomy: A Controlled Study. Mov Disord 2024. [PMID: 39140267 DOI: 10.1002/mds.29945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 07/02/2024] [Accepted: 07/10/2024] [Indexed: 08/15/2024] Open
Abstract
Social cognition (SC) encompasses a set of cognitive functions that enable individuals to understand and respond appropriately to social interactions. Although focused ultrasound subthalamotomy (FUS-STN) effectively treats Parkinson's disease (PD) clinical motor features, its impact and safety on cognitive-behavioral interactions/interpersonal awareness are unknown. This study investigated the effects of unilateral FUS-STN on facial emotion recognition (FER) and affective and cognitive theory of mind (ToM) in PD patients from a randomized sham-controlled trial (NCT03454425). Subjects performed SC evaluation before and 4 months after the procedure while still under blind assessment conditions. The SC assessment included the Karolinska Directed Emotional Faces task for FER, the Reading the Mind in the Eyes (RME) test for affective ToM, and The Theory of Mind Picture Stories Task (ToM PST) (order, questions, and total score) for cognitive ToM. The active treatment group showed anecdotal-to-moderate evidence of no worsening in SC after FUS-STN. Anecdotal evidence for an improvement was recognized in the SC score changes, from baseline to post-treatment, for the active treatment group compared with sham for the RME, ToM PST order, ToM PST total, FER total, and recognition of fear, disgust, and anger. This study provides the first evidence that unilateral FUS-STN does not impair social cognitive abilities, indicating that it can be considered a safe treatment approach for this domain in PD patients. Furthermore, the results suggest FUS-STN may even lead to some improvement in social cognitive outcomes, which should be considered as a preliminary finding requiring further investigation with larger samples sizes. © 2024 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Pasqualina Guida
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
- Instituto de Investigación Sanitaria HM Hospitales, Madrid, Spain
- PhD Program in Neuroscience, Autónoma de Madrid University-Cajal Institute, Madrid, Spain
| | - Raúl Martínez-Fernández
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
- Instituto de Investigación Sanitaria HM Hospitales, Madrid, Spain
- Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain
| | - Jorge U Máñez-Miró
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
| | - Marta Del Álamo
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
- Instituto de Investigación Sanitaria HM Hospitales, Madrid, Spain
| | - Guglielmo Foffani
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
- Instituto de Investigación Sanitaria HM Hospitales, Madrid, Spain
- Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain
- Hospital Nacional de Parapléjicos, SESCAM, Toledo, Spain
| | - Beatriz Fernández-Rodríguez
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
| | - Mariana H G Monje
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
| | - Ignacio Obeso
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
- Instituto de Investigación Sanitaria HM Hospitales, Madrid, Spain
| | - José A Obeso
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
- Instituto de Investigación Sanitaria HM Hospitales, Madrid, Spain
- Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain
- School of Medicine, University CEU-San Pablo, Madrid, Spain
| | - Carmen Gasca-Salas
- HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
- Instituto de Investigación Sanitaria HM Hospitales, Madrid, Spain
- Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain
- School of Medicine, University CEU-San Pablo, Madrid, Spain
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Zhang Y, Li Y, Lai C, Wang X, Luo F, Niu Y, Qin Y, Zhang Y, Zhang H. Interocular asymmetry of retinal change in Parkinson's disease. Parkinsonism Relat Disord 2024; 125:107037. [PMID: 38878445 DOI: 10.1016/j.parkreldis.2024.107037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 06/08/2024] [Accepted: 06/10/2024] [Indexed: 07/29/2024]
Abstract
PURPOSE To investigate interocular asymmetry (IA) of retinal structure and vessel density in patients with Parkinson's disease (PD) and normal controls (NC). METHODS Seventy-eight subjects including 40 PD patients and 38 NC had completed optical coherence tomography angiography (OCTA) and neurological examinations for three rating scales (UPDRS-III, MMSE and MoCA). The IA was calculated by the absolute value of difference in right and left eyes. The IA of thickness in macular ganglion cell inner-plexiform layer (GCIPL), peripapillary retinal nerve fiber layer (pRNFL), and vessel density of superficial capillary plexus (SCP), deep capillary plexus (DCP), radial peripapillary capillary (RPC) were obtained from OCTA. RESULTS The motor-symptom-onset side of eyes showed lower vessel density in parafovea of SCP (51.09 ± 3.46 vs 49.81 ± 4.16, P = 0.03) and superior hemi of perifovea DCP (49.55 ± 5.81 vs 47.33 ± 5.71, = 0.04). The PD patients showed larger IA in thickness of superior half of pRNFL (5.27 [2.67, 10.87] vs 3.08 [1.62, 5.61], P = 0.02) and parafovea GCIPL (2.40[1.25, 6.35] vs 1.40[0.50, 2.45], P = 0.02). No significant interocular asymmetry was found in vessel density between PD and NC. A higher UPDRS-III scale was associated with larger IA in GCIPL (β = 0.093, P = 0.001) and smaller IA in DCP (β = -0.065, P = 0.037). CONCLUSION The motor-symptom-onset side of eyes showed more severe loss of macular vessel density than the other side of eyes. The PD patients showed asymmetrical structural change in GCIPL and pRNFL, which showed the potential as the diagnostic biomarker for PD.
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Affiliation(s)
- Yuqiao Zhang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yan Li
- Department of Neurology, Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Chunxin Lai
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital. Guangzhou, China; Shantou University Medical College, Shantou, China
| | - Xinhao Wang
- Department of Neurology, Maoming People's Hospital, Maoming, China
| | - Fulong Luo
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital. Guangzhou, China; The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Yongyi Niu
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital. Guangzhou, China
| | - Yongjie Qin
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital. Guangzhou, China
| | - Yuhu Zhang
- Department of Neurology, Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
| | - Hongyang Zhang
- Department of Ophthalmology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
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Tröster AI. Developments in the prediction of cognitive changes following deep brain stimulation in persons with Parkinson's disease. Expert Rev Neurother 2024; 24:643-659. [PMID: 38814926 DOI: 10.1080/14737175.2024.2360121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 05/22/2024] [Indexed: 06/01/2024]
Abstract
INTRODUCTION Deep brain stimulation (DBS) is an effective treatment for Parkinson's disease (PD) motor symptoms that improves function and quality of life in appropriately selected patients. Because mild to moderate cognitive declines can follow DBS and impact quality of life in a minority of patients, an important consideration involves the cognitive deficit and its prediction. AREAS COVERED The author briefly summarizes cognitive outcomes from DBS and reviews in more detail the risks/predictors of post-DBS cognitive dysfunction by mainly focusing on work published between 2018 and 2024 and using comprehensive neuropsychological (NP) evaluations. Most publications concern bilateral subthalamic nucleus (STN) DBS. Comment is offered on challenges and potential avenues forward. EXPERT OPINION STN DBS is relatively safe cognitively but declines occur especially in verbal fluency and executive function/working memory. Numerous predictors and risk factors for cognitive outcomes have been identified (age and pre-operative neuropsychological status appear the most robust) but precise risk estimates cannot yet be confidently offered. Future studies should employ study center consortia, follow uniform reporting criteria (to be developed), capitalize on advances in stimulation, biomarkers, and artificial intelligence, and address DBS in diverse groups. Advances offer an avenue to investigate the amelioration of cognitive deficits in PD using neuromodulation.
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Affiliation(s)
- Alexander I Tröster
- Department of Clinical Neuropsychology and Center for Neuromodulation, Barrow Neurological Institute, Phoenix, Arizona, USA
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Kähkölä J, Katisko J, Lahtinen M. Deep Brain Stimulation of Subthalamic Nucleus Improves Quality of Life in General and Mental Health Domains in Parkinson's Disease to the Level of the General Population. Neuromodulation 2024; 27:520-527. [PMID: 37086220 DOI: 10.1016/j.neurom.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 02/24/2023] [Accepted: 03/16/2023] [Indexed: 04/23/2023]
Abstract
OBJECTIVES Parkinson's disease (PD) leads to significant impairment in quality of life (QoL) across various domains. Deep brain stimulation of the subthalamic nucleus (STN-DBS) is known to improve motor and nonmotor symptoms in PD. The aim was to study whether STN-DBS could improve the QoL of patients with PD to the level of the general population, and to determine factors predicting better motor outcomes. MATERIALS AND METHODS The retrospective analysis included 43 patients who underwent either primary or revision STN-DBS. Patients filled out a general QoL questionnaire (RAND 36-item health survey) before and 12 months after surgery, and scores were compared with age- and sex-adjusted national population values. In addition, motor scores were calculated using Unified Parkinson Disease Rating Scale part 3 (UPDRS 3) with the best PD medication. Levodopa equivalent daily dose (LEDD) was also collected. Changes in the QoL were compared with operation age, disease duration, and preoperative QoL. RESULTS Preoperatively, patients had significantly impaired QoL in all subsections compared with that of the general population. The mean postoperative UPDRS 3 improvement was 50.0%, and reduction in LEDD was 69.0%. Statistically significant QoL improvements were found in Physical Function, Mental Health, Social Function, Vitality, and Role Physical 12 months postoperatively compared with baseline. The mean differences compared with a healthy population were not statistically significant in General Health, Mental Health, Vitality, and Role Emotional. Furthermore, disease duration was found to be negatively correlated with improvements in UPDRS 3 score, and worse preoperative QoL positively correlated with changes in Physical Function. CONCLUSIONS Patients experienced significant QoL improvements after STN-DBS. The General Health and Mental Health of patients were postoperatively most comparable with age- and sex-adjusted population values. Moreover, earlier stimulation predicted better motor improvements, which emphasizes the importance of earlier timing of STN-DBS surgery and minimizing loss of function at a critical disease stage.
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Affiliation(s)
- Johannes Kähkölä
- Oulu Research Group of Advanced Surgical Technologies and Physics, Medical Research Center, Oulu University Hospital, University of Oulu, Oulu, Finland; Research Unit of Clinical Medicine, University of Oulu, Oulu, Finland
| | - Jani Katisko
- Oulu Research Group of Advanced Surgical Technologies and Physics, Medical Research Center, Oulu University Hospital, University of Oulu, Oulu, Finland; Neurocenter, Oulu University Hospital, University of Oulu, Oulu, Finland; Research Unit of Clinical Medicine, University of Oulu, Oulu, Finland
| | - Maija Lahtinen
- Oulu Research Group of Advanced Surgical Technologies and Physics, Medical Research Center, Oulu University Hospital, University of Oulu, Oulu, Finland; Neurocenter, Oulu University Hospital, University of Oulu, Oulu, Finland; Research Unit of Clinical Medicine, University of Oulu, Oulu, Finland.
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Béreau M, Castrioto A, Servant M, Lhommée E, Desmarets M, Bichon A, Pélissier P, Schmitt E, Klinger H, Longato N, Phillipps C, Wirth T, Fraix V, Benatru I, Durif F, Azulay JP, Moro E, Broussolle E, Thobois S, Tranchant C, Krack P, Anheim M. Imbalanced motivated behaviors according to motor sign asymmetry in drug-naïve Parkinson's disease. Sci Rep 2023; 13:21234. [PMID: 38040775 PMCID: PMC10692157 DOI: 10.1038/s41598-023-48188-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 11/23/2023] [Indexed: 12/03/2023] Open
Abstract
Few studies have considered the influence of motor sign asymmetry on motivated behaviors in de novo drug-naïve Parkinson's disease (PD). We tested whether motor sign asymmetry could be associated with different motivated behavior patterns in de novo drug-naïve PD. We performed a cross-sectional study in 128 de novo drug-naïve PD patients and used the Ardouin Scale of Behavior in Parkinson's disease (ASBPD) to assess a set of motivated behaviors. We assessed motor asymmetry based on (i) side of motor onset and (ii) MDS-UPDRS motor score, then we compared right hemibody Parkinson's disease to left hemibody Parkinson's disease. According to the MDS-UPDRS motor score, patients with de novo right hemibody PD had significantly lower frequency of approach behaviors (p = 0.031), including nocturnal hyperactivity (p = 0.040), eating behavior (p = 0.040), creativity (p = 0.040), and excess of motivation (p = 0.017) than patients with de novo left hemibody PD. Patients with de novo left hemibody PD did not significantly differ from those with de novo right hemibody PD regarding avoidance behaviors including apathy, anxiety and depression. Our findings suggest that motor sign asymmetry may be associated with an imbalance between motivated behaviors in de novo drug-naïve Parkinson's disease.
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Affiliation(s)
- Matthieu Béreau
- Neurology Department, University Hospital of Besançon, CHRU de Besançon, 3 Bd Alexandre Fleming, 25030, Besançon Cedex, France.
- Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive - UR LINC, Université Bourgogne Franche-Comté, Besançon, France.
| | - Anna Castrioto
- Inserm, U1216, Grenoble Institut Neurosciences, CHU Grenoble Alpes, University Grenoble Alpes, 38000, Grenoble, France
| | - Mathieu Servant
- Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive - UR LINC, Université Bourgogne Franche-Comté, Besançon, France
| | - Eugénie Lhommée
- Inserm, U1216, Grenoble Institut Neurosciences, CHU Grenoble Alpes, University Grenoble Alpes, 38000, Grenoble, France
| | - Maxime Desmarets
- Unité de Méthodologie, CIC INSERM 1431, CHU de Besançon, Besançon, France
| | - Amélie Bichon
- Inserm, U1216, Grenoble Institut Neurosciences, CHU Grenoble Alpes, University Grenoble Alpes, 38000, Grenoble, France
| | - Pierre Pélissier
- Inserm, U1216, Grenoble Institut Neurosciences, CHU Grenoble Alpes, University Grenoble Alpes, 38000, Grenoble, France
| | - Emmanuelle Schmitt
- Inserm, U1216, Grenoble Institut Neurosciences, CHU Grenoble Alpes, University Grenoble Alpes, 38000, Grenoble, France
| | - Hélène Klinger
- Movement Disorders Unit, Neurology Department, Hospices Civils de Lyon, Lyon, France
- Faculté de Médecine Lyon Sud, Université Claude Bernard Lyon 1, University of Lyon, Lyon, France
- CNRS, Institut des Sciences Cognitives Marc Jeannerod, UMR 5229, Bron, France
| | - Nadine Longato
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Clélie Phillipps
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Thomas Wirth
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104, Université de Strasbourg, Illkirch, France
- Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France
| | - Valérie Fraix
- Inserm, U1216, Grenoble Institut Neurosciences, CHU Grenoble Alpes, University Grenoble Alpes, 38000, Grenoble, France
| | - Isabelle Benatru
- Neurology Department, University Hospital of Poitiers, Poitiers, France
- INSERM, CHU de Poitiers, Centre d'Investigation Clinique CIC1402, University of Poitiers, Poitiers, France
| | - Franck Durif
- EA7280 NPsy-Sydo, Université Clermont Auvergne, Clermont-Ferrand, France
- Neurology Department, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Jean-Philippe Azulay
- Movement Disorders Unit, Neurology Department, University Hospital of Marseille, Marseille, France
| | - Elena Moro
- Inserm, U1216, Grenoble Institut Neurosciences, CHU Grenoble Alpes, University Grenoble Alpes, 38000, Grenoble, France
| | - Emmanuel Broussolle
- Movement Disorders Unit, Neurology Department, Hospices Civils de Lyon, Lyon, France
- Faculté de Médecine Lyon Sud, Université Claude Bernard Lyon 1, University of Lyon, Lyon, France
- CNRS, Institut des Sciences Cognitives Marc Jeannerod, UMR 5229, Bron, France
| | - Stéphane Thobois
- Movement Disorders Unit, Neurology Department, Hospices Civils de Lyon, Lyon, France
- Faculté de Médecine Lyon Sud, Université Claude Bernard Lyon 1, University of Lyon, Lyon, France
- CNRS, Institut des Sciences Cognitives Marc Jeannerod, UMR 5229, Bron, France
| | - Christine Tranchant
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Paul Krack
- Department of Neurology, Movement Disorders Center, University Hospital of Bern, Bern, Switzerland
| | - Mathieu Anheim
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104, Université de Strasbourg, Illkirch, France
- Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France
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Zhu Y, Li S, Da X, Lai H, Tan C, Liu X, Deng F, Chen L. Study of the relationship between onset lateralization and hemispheric white matter asymmetry in Parkinson's disease. J Neurol 2023; 270:5004-5016. [PMID: 37382631 DOI: 10.1007/s00415-023-11849-1] [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: 04/22/2023] [Revised: 06/23/2023] [Accepted: 06/24/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND Parkinson's disease (PD) is characterized by a lateralized onset, but its cause and mechanism are still unclear. METHODS Obtaining diffusion tensor imaging (DTI) data from the Parkinson's Progression Markers Initiative (PPMI). Tract-based spatial statistics analysis and region-of-interest-based analysis were performed to evaluate the white matter (WM) asymmetry using original DTI parameters, Z Score normalized parameters, or the asymmetry index (AI). Hierarchical cluster analysis and least absolute shrinkage and selection operator regression were performed to construct predictive models for predicting the PD onset side. DTI data from The Second Affiliated Hospital of Chongqing Medical University were obtained for external validation of the prediction model. RESULTS 118 PD patients and 69 healthy controls (HC) from PPMI were included. Right-onset PD patients presented more asymmetric areas than left-onset PD patients. The inferior cerebellar peduncle (ICP), superior cerebellar peduncle (SCP), external capsule (EC), cingulate gyrus (CG), superior fronto-occipital fasciculus (SFO), uncinate fasciculus (UNC), and tapetum (TAP) showed significant asymmetry in left-onset and right-onset PD patients. An onset-side-specific pattern of WM alterations exists in PD patients, and a prediction model was constructed. The predicting models based on AI and ΔZ Score presented favorable efficacy in predicting PD onset side by external validation in 26 PD patients and 16 HCs from our hospital. CONCLUSIONS Right-onset PD patients may have more severe WM damage than left-onset PD patients. WM asymmetry in ICP, SCP, EC, CG, SFO, UNC, and TAP may predict PD onset side. Imbalances in the WM network may underlie the mechanism of lateralized onset in PD.
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Affiliation(s)
- Yuxia Zhu
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, 74 Linjiang Road, Yuzhong District, Chongqing, 400010, China
| | - Sichen Li
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, 74 Linjiang Road, Yuzhong District, Chongqing, 400010, China
| | - Xiaohui Da
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, 74 Linjiang Road, Yuzhong District, Chongqing, 400010, China
| | - Hongyu Lai
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, 74 Linjiang Road, Yuzhong District, Chongqing, 400010, China
| | - Changhong Tan
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, 74 Linjiang Road, Yuzhong District, Chongqing, 400010, China
| | - Xi Liu
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, 74 Linjiang Road, Yuzhong District, Chongqing, 400010, China.
| | - Fen Deng
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, 74 Linjiang Road, Yuzhong District, Chongqing, 400010, China.
| | - Lifen Chen
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, 74 Linjiang Road, Yuzhong District, Chongqing, 400010, China
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Voruz P, Haegelen C, Assal F, Drapier S, Drapier D, Sauleau P, Vérin M, Péron JA. Motor Symptom Asymmetry Predicts Cognitive and Neuropsychiatric Profile Following Deep Brain Stimulation of the Subthalamic Nucleus in Parkinson's Disease: a 5-Year Longitudinal Study. Arch Clin Neuropsychol 2023; 38:904-912. [PMID: 36796803 PMCID: PMC10456213 DOI: 10.1093/arclin/acad013] [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] [Accepted: 01/12/2023] [Indexed: 02/18/2023] Open
Abstract
INTRODUCTION Risk factors (e.g., motor symptom asymmetry) for short- and long-term cognitive and neuropsychiatric symptoms following deep brain stimulation (DBS) of the subthalamic nucleus (STN) in patients with Parkinson's disease have yet to be fully identified. The objectives of the present study were to determine whether motor symptom asymmetry in Parkinson's disease is one such risk factor and to identify predictors of subnormal cognitive decline. METHODS A total of 26 patients receiving STN-DBS (13 with left-sided motor symptoms and 13 with right-sided ones) underwent follow-up neuropsychological, depression and apathy assessments over a 5-year period. Nonparametric intergroup comparisons were performed on raw scores, as well as Cox regression analyses on standardized Mattis Dementia Rating Scale scores. RESULTS Compared with patients who had predominantly left-sided symptoms, right-sided patients scored higher on both apathy (at 3 months and 36 months) and depressive symptoms (at 6 months and 12 months) and scored lower on global cognitive efficiency (at 36 months and 60 months). Survival analyses revealed that only right-sided patients had subnormal standardized dementia scores, which were negatively associated with the number of perseverations in the Wisconsin Card Scoring Test. CONCLUSION Right-sided motor symptoms are a risk factor for more severe short- and long-term cognitive and neuropsychiatric symptoms following STN-DBS, confirming literature findings on left hemispheric vulnerability.
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Affiliation(s)
- Philippe Voruz
- Clinical and Experimental Neuropsychology Laboratory, Faculty of Psychology, Geneva, Switzerland
- Neurology Department, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Claire Haegelen
- Neurosurgery Department, Pontchaillou University Hospital, Rennes, France
- MediCIS, INSERM-University of Rennes 1, Rennes, France
| | - Frédéric Assal
- Neurology Department, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Sophie Drapier
- ‘Behavior and Basal Ganglia’ Research Unit, University of Rennes 1, Rennes, France
- Neurology Department, Pontchaillou University Hospital, Rennes, France
| | - Dominique Drapier
- ‘Behavior and Basal Ganglia’ Research Unit, University of Rennes 1, Rennes, France
- Adult Psychiatry Department, Guillaume Régnier Hospital, Rennes, France
| | - Paul Sauleau
- ‘Behavior and Basal Ganglia’ Research Unit, University of Rennes 1, Rennes, France
- Physiology Department, Pontchaillou University Hospital, Rennes, France
| | - Marc Vérin
- ‘Behavior and Basal Ganglia’ Research Unit, University of Rennes 1, Rennes, France
- Neurology Department, Pontchaillou University Hospital, Rennes, France
| | - Julie A Péron
- Clinical and Experimental Neuropsychology Laboratory, Faculty of Psychology, Geneva, Switzerland
- Neurology Department, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
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Constantin IM, Voruz P, Péron JA. Moderating effects of uric acid and sex on cognition and psychiatric symptoms in asymmetric Parkinson's disease. Biol Sex Differ 2023; 14:26. [PMID: 37143121 PMCID: PMC10157998 DOI: 10.1186/s13293-023-00510-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 04/17/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND Non-motor symptoms are an important early feature of Parkinson's disease (PD), encompassing a variety of cognitive and psychiatric symptoms that seem to manifest differently depending on motor symptom asymmetry. Different factors, such as uric acid (UA) and sex, seem to influence cognitive and psychiatric expression in PD, however their interplay remains to be better understood. METHODS Participants taking part in the Parkinson's Progression Marker Initiative were studied based on the side of motor symptom asymmetry and sex. Three-way interaction modeling was used to examine the moderating effects of sex and UA on cognitive functions and psychiatric symptoms. RESULTS Significant three-way interactions were highlighted at 1-year follow-up between motor symptom asymmetry, UA and sex for immediate and long-term memory in female patients exhibiting predominantly left-sided motor symptoms, and for processing speed and sleepiness in female patients exhibiting predominantly right-sided motor symptoms. No significant interactions were observed for male patients. Moreover, female patients exhibiting predominantly right-sided motor symptoms demonstrated lower serum UA concentrations and had overall better outcomes, while male patients with predominantly right-sided motor symptoms demonstrated particularly poor outcomes. CONCLUSIONS These findings suggest that in the earliest stages of the disease, UA and sex moderate cognitive functions and psychiatric symptoms differently depending on motor asymmetry, holding important clinical implications for symptom management in patients.
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Affiliation(s)
- Ioana Medeleine Constantin
- Clinical and Experimental Neuropsychology Laboratory, Faculty of Psychology and Educational Sciences, University of Geneva, 40 Bd du Pont d'Arve, 1205, Geneva, Switzerland
| | - Philippe Voruz
- Clinical and Experimental Neuropsychology Laboratory, Faculty of Psychology and Educational Sciences, University of Geneva, 40 Bd du Pont d'Arve, 1205, Geneva, Switzerland
- Neurology Department, Geneva University Hospitals, 4 Rue Gabrielle-Perret-Gentil, 1205, Geneva, Switzerland
| | - Julie Anne Péron
- Clinical and Experimental Neuropsychology Laboratory, Faculty of Psychology and Educational Sciences, University of Geneva, 40 Bd du Pont d'Arve, 1205, Geneva, Switzerland.
- Neurology Department, Geneva University Hospitals, 4 Rue Gabrielle-Perret-Gentil, 1205, Geneva, Switzerland.
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Biomarkers and non-motor symptoms as a function of motor symptom asymmetry in early Parkinson's disease. Neuropsychologia 2022; 177:108419. [PMID: 36375651 DOI: 10.1016/j.neuropsychologia.2022.108419] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 10/19/2022] [Accepted: 11/06/2022] [Indexed: 11/13/2022]
Abstract
INTRODUCTION The longitudinal trajectories of cognitive-neuropsychiatric symptoms from the early stages of Parkinson's disease, as a function of motor symptom asymmetry at the onset of the disease, remain to be fully explored. Moreover, the relationship to biomarkers warrants further investigation. METHODOLOGY Non-motor and biospecimen data from 413 patients with Parkinson's disease, dissociating predominantly left-sided motor symptoms patients (n = 179), predominantly right-sided motor symptoms patients (n = 234), and matched healthy controls (n = 196), were extracted from the Parkinson's Progression Marker Initiative database during a 3-Year follow-up. Non-parametric and conservative corrections for multivariate comparisons were carried out on neuropsychiatric and biomarker data. RESULTS A decline for global cognitive efficiency scores in predominantly right-sided motor symptoms patients was observed, whereas depressive and anxiety symptoms were greater overtime for predominantly left-sided motor symptoms patients. Biomarker analysis revealed that predominantly right-sided patients expressed decreased levels of total-tau and phospho-tau over time, while left-sided patients didn't differ from healthy controls. CONCLUSION From the early course of the disease, the existence of different clinical phenotypes is proposed, associated to emerging evidences of distinct pathological pathways and a left-hemispheric vulnerability for cognitive decline.
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10
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Bove F, Cavallieri F, Castrioto A, Meoni S, Schmitt E, Bichon A, Lhommée E, Pélissier P, Kistner A, Chevrier E, Seigneuret E, Chabardès S, Valzania F, Fraix V, Moro E. Does Motor Symptoms Asymmetry Predict Motor Outcome of Subthalamic Deep Brain Stimulation in Parkinson's Disease Patients? Front Hum Neurosci 2022; 16:931858. [PMID: 35799771 PMCID: PMC9253299 DOI: 10.3389/fnhum.2022.931858] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 05/23/2022] [Indexed: 12/02/2022] Open
Abstract
Background In Parkinson's disease (PD), the side of motor symptoms onset may influence disease progression, with a faster motor symptom progression in patients with left side lateralization. Moreover, worse neuropsychological outcomes after subthalamic nucleus deep brain stimulation (STN-DBS) have been described in patients with predominantly left-sided motor symptoms. The objective of this study was to evaluate if the body side of motor symptoms onset may predict motor outcome of bilateral STN-DBS. Methods This retrospective study included all consecutive PD patients treated with bilateral STN-DBS at Grenoble University Hospital from 1993 to 2015. Demographic, clinical and neuroimaging data were collected before (baseline condition) and 1 year after surgery (follow-up condition). The predictive factors of motor outcome at one-year follow-up, measured by the percentage change in the MDS-UPDRS-III score, were evaluated through univariate and multivariate linear regression analysis. Results A total of 233 patients were included with one-year follow-up after surgery [143 males (61.40%); 121 (51.90 %) right body onset; 112 (48.10%) left body onset; mean age at surgery, 55.31 ± 8.44 years; mean disease duration, 11.61 ± 3.87]. Multivariate linear regression analysis showed that the left side of motor symptoms onset did not predict motor outcome (β = 0.093, 95% CI = −1.967 to 11.497, p = 0.164). Conclusions In this retrospective study, the body side of motor symptoms onset did not significantly influence the one-year motor outcome in a large cohort of PD patients treated with bilateral STN-DBS.
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Affiliation(s)
- Francesco Bove
- Neurology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Francesco Cavallieri
- Neurology Unit, Department of Neuromotor and Rehabilitation, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
- *Correspondence: Francesco Cavallieri
| | - Anna Castrioto
- Division of Neurology, Grenoble Institute of Neurosciences, Inserm U1216, CHU of Grenoble, Grenoble Alpes University, Grenoble, France
| | - Sara Meoni
- Division of Neurology, Grenoble Institute of Neurosciences, Inserm U1216, CHU of Grenoble, Grenoble Alpes University, Grenoble, France
| | - Emmanuelle Schmitt
- Division of Neurology, Grenoble Institute of Neurosciences, Inserm U1216, CHU of Grenoble, Grenoble Alpes University, Grenoble, France
| | - Amélie Bichon
- Division of Neurology, Grenoble Institute of Neurosciences, Inserm U1216, CHU of Grenoble, Grenoble Alpes University, Grenoble, France
| | - Eugénie Lhommée
- Division of Neurology, Grenoble Institute of Neurosciences, Inserm U1216, CHU of Grenoble, Grenoble Alpes University, Grenoble, France
| | - Pierre Pélissier
- Division of Neurology, Grenoble Institute of Neurosciences, Inserm U1216, CHU of Grenoble, Grenoble Alpes University, Grenoble, France
| | - Andrea Kistner
- Division of Neurology, Grenoble Institute of Neurosciences, Inserm U1216, CHU of Grenoble, Grenoble Alpes University, Grenoble, France
| | - Eric Chevrier
- Division of Neurology, Grenoble Institute of Neurosciences, Inserm U1216, CHU of Grenoble, Grenoble Alpes University, Grenoble, France
| | - Eric Seigneuret
- Division of Neurosurgery, CHU of Grenoble, Grenoble Alpes University, Grenoble, France
| | - Stephan Chabardès
- Division of Neurosurgery, CHU of Grenoble, Grenoble Alpes University, Grenoble, France
| | - Franco Valzania
- Neurology Unit, Department of Neuromotor and Rehabilitation, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Valerie Fraix
- Division of Neurology, Grenoble Institute of Neurosciences, Inserm U1216, CHU of Grenoble, Grenoble Alpes University, Grenoble, France
| | - Elena Moro
- Division of Neurology, Grenoble Institute of Neurosciences, Inserm U1216, CHU of Grenoble, Grenoble Alpes University, Grenoble, France
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11
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Xie C, Power J, Prasad AA. Bidirectional Optogenetic Modulation of the Subthalamic Nucleus in a Rodent Model of Parkinson's Disease. Front Neurosci 2022; 16:848821. [PMID: 35655750 PMCID: PMC9152094 DOI: 10.3389/fnins.2022.848821] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 03/31/2022] [Indexed: 11/17/2022] Open
Abstract
Parkinson's disease (PD) is a neurodegenerative disorder characterized by a range of motor symptoms. Treatments are focused on dopamine replacement therapy or deep brain stimulation (DBS). The subthalamic nucleus (STN) is a common target for DBS treatment of PD. However, the function of the STN in normal conditions and pathology is poorly understood. Here, we show in rats that optogenetic modulation of STN neuronal activity exerts bidirectional control of motor function, where inhibition of the STN increases movement and STN activation decreases movement. We also examined the effect of bidirectional optogenetic manipulation STN neuronal activity under dopamine depleted condition using the bilateral rodent 6-hydroxydopamine (6-OHDA) model of Parkinson's disease. Optogenetic inhibition of the STN in the absence of dopamine had no impact on motor control yet STN excitation led to pronounced abnormal involuntary movement. Administration of levodopa rescued the abnormal involuntary movements induced by STN excitation. Although dopamine and STN dysfunction are well established in PD pathology, here we demonstrate simultaneous STN over activity and loss of dopamine lead to motor deficits. Moreover, we show the dysfunction of the STN is dependent on dopamine. This study provides evidence that the loss of dopamine and the over activity of the STN are key features of PD motor deficits. These results provide insight into the STN pathology in PD and therapeutic mechanism of targeting the STN for the treatment for PD.
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Affiliation(s)
- Caroline Xie
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - John Power
- Department of Physiology and Translational Neuroscience Facility, School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Asheeta A. Prasad
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
- Faculty of Medicine and Health, School of Medical Sciences, University of Sydney, Sydney, NSW, Australia
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