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DeGutis J, Aul C, Barthelemy OJ, Davis BL, Alshuaib S, Marin A, Kinger SB, Ellis TD, Cronin-Golomb A. Side of motor symptom onset predicts sustained attention deficits and motor improvements after attention training in Parkinson's disease. Neuropsychologia 2023; 190:108698. [PMID: 37806442 DOI: 10.1016/j.neuropsychologia.2023.108698] [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: 03/08/2023] [Revised: 08/28/2023] [Accepted: 10/05/2023] [Indexed: 10/10/2023]
Abstract
OBJECTIVE Parkinson's disease (PD) side of motor symptom onset has been associated with distinct cognitive deficits; individuals with left-side onset (LPD) show more visuospatial impairments, whereas those with right-side onset (RPD) show more verbal impairments. Non-spatial attention is a critical cognitive ability associated with motor functioning that is right hemisphere lateralized but has not been characterized with regard to PD side of onset. We compared individuals with LPD and RPD on non-spatial attention tasks and examined differential responses to a 4-week sustained attention training program. METHOD Participants included 9 with LPD and 12 with RPD, who performed both brief and extended go/no-go continuous performance tasks and an attentional blink task. Participants also engaged in an at-home sustained attention training program, Tonic and Phasic Alertness Training (TAPAT), 5 days/week for 4 weeks. We assessed cognitive and motor symptoms before and after training, and after a 4-week no-contact period. RESULTS At baseline, participants with LPD exhibited worse performance than those with RPD on the extended continuous performance task, indicating specific deficits in sustaining attention. Poorer attention was associated with worse clinical motor scores. Notably, side of onset had a significant effect on clinical motor changes after sustained attention training, with only LPD participants improving after training, and 4/9 showing clinically meaningful improvements. CONCLUSIONS Compared to RPD, participants with LPD had poorer sustained attention pre-training and were more likely to improve on clinical motor functioning after sustained attention training. These findings support mechanistic differences between LPD and RPD and suggest potential differential treatment approaches.
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Affiliation(s)
- Joseph DeGutis
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA; Boston Attention and Learning Laboratory (BALLAB), VA Boston Healthcare System, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Courtney Aul
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA; Boston Attention and Learning Laboratory (BALLAB), VA Boston Healthcare System, Boston, MA, USA
| | - Olivier J Barthelemy
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Breanna L Davis
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Shaikhah Alshuaib
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Anna Marin
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Shraddha B Kinger
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Terry D Ellis
- Department of Physical Therapy, Boston University College of Health and Rehabilitation Sciences: Sargent College, Boston, MA, USA
| | - Alice Cronin-Golomb
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA.
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Levy M, Zurawel M, d’Hardemare V, Moran A, Andelman F, Manor Y, Cohen J, Meshulam M, Balash Y, Gurevich T, Fried I, Bergman H. Subthalamic nucleus physiology is correlated with deep brain stimulation motor and non-motor outcomes. Brain Commun 2023; 5:fcad268. [PMID: 38025270 PMCID: PMC10664412 DOI: 10.1093/braincomms/fcad268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 04/24/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
Subthalamic nucleus deep brain stimulation is commonly indicated for symptomatic relief of idiopathic Parkinson's disease. Despite the known improvement in motor scores, affective, cognitive, voice and speech functions might deteriorate following this procedure. Recent studies have correlated motor outcomes with intraoperative microelectrode recordings. However, there are no microelectrode recording-based tools with predictive values relating to long-term outcomes of integrative motor and non-motor symptoms. We conducted a retrospective analysis of the outcomes of patients with idiopathic Parkinson's disease who had subthalamic nucleus deep brain stimulation at Tel Aviv Sourasky Medical Centre (Tel Aviv, Israel) during 2015-2016. Forty-eight patients (19 women, 29 men; mean age, 58 ± 8 years) who were implanted with a subthalamic nucleus deep brain stimulation device underwent pre- and postsurgical assessments of motor, neuropsychological, voice and speech symptoms. Significant improvements in all motor symptoms (except axial signs) and levodopa equivalent daily dose were noted in all patients. Mild improvements were observed in more posterior-related neuropsychological functions (verbal memory, visual memory and organization) while mild deterioration was observed in frontal functions (personality changes, executive functioning and verbal fluency). The concomitant decline in speech intelligibility was mild and only partial, probably in accordance with the neuropsychological verbal fluency results. Acoustic characteristics were the least affected and remained within normal values. Dimensionality reduction of motor, neuropsychological and voice scores rendered six principal components that reflect the main clinical aspects: the tremor-dominant versus the rigidity-bradykinesia-dominant motor symptoms, frontal versus posterior neuropsychological deficits and acoustic characteristics versus speech intelligibility abnormalities. Microelectrode recordings of subthalamic nucleus spiking activity were analysed off-line and correlated with the original scores and with the principal component results. Based on 198 microelectrode recording trajectories, we suggest an intraoperative subthalamic nucleus deep brain stimulation score, which is a simple sum of three microelectrode recording properties: normalized neuronal activity, the subthalamic nucleus width and the relative proportion of the subthalamic nucleus dorsolateral oscillatory region. A threshold subthalamic nucleus deep brain stimulation score >2.5 (preferentially composed of normalized root mean square >1.5, subthalamic nucleus width >3 mm and a dorsolateral oscillatory region/subthalamic nucleus width ratio >1/3) predicts better motor and non-motor long-term outcomes. The algorithm presented here optimizes intraoperative decision-making of deep brain stimulation contact localization based on microelectrode recording with the aim of improving long-term (>1 year) motor, neuropsychological and voice symptoms.
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Affiliation(s)
- Mikael Levy
- Movement Disorders Unit, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel
- Department of Neurosurgery, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel
- School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel
- The Edmond and Lily Safra Center for Brain Sciences, The Hebrew University of Jerusalem, Jerusalem 9190401, Israel
| | - Mika Zurawel
- Movement Disorders Unit, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel
- School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Vincent d’Hardemare
- Department of Neurosurgery, Hospital Foundation Rothschild, Paris 75019, France
| | - Anan Moran
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel
- School of Neurobiology, Biochemistry & Biophysics, George S. Wise Faculty of Life Science, Tel-Aviv University, Tel Aviv 6423906, Israel
| | - Fani Andelman
- Movement Disorders Unit, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel
- School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Yael Manor
- Movement Disorders Unit, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel
- School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Jacob Cohen
- Department of Otolaryngology Head and Neck Surgery, Rambam Health Care Campus, Haifa 3525408, Israel
| | - Moshe Meshulam
- Movement Disorders Unit, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel
- School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Yacov Balash
- Movement Disorders Unit, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel
- School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Tanya Gurevich
- Movement Disorders Unit, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel
- School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Itzhak Fried
- Movement Disorders Unit, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel
- Department of Neurosurgery, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel
- School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Hagai Bergman
- The Edmond and Lily Safra Center for Brain Sciences, The Hebrew University of Jerusalem, Jerusalem 9190401, Israel
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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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Borghammer P. The α-Synuclein Origin and Connectome Model (SOC Model) of Parkinson's Disease: Explaining Motor Asymmetry, Non-Motor Phenotypes, and Cognitive Decline. JOURNAL OF PARKINSON'S DISEASE 2021; 11:455-474. [PMID: 33682732 PMCID: PMC8150555 DOI: 10.3233/jpd-202481] [Citation(s) in RCA: 74] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/10/2021] [Indexed: 12/12/2022]
Abstract
A new model of Parkinson's disease (PD) pathogenesis is proposed, the α-Synuclein Origin site and Connectome (SOC) model, incorporating two aspects of α-synuclein pathobiology that impact the disease course for each patient: the anatomical location of the initial α-synuclein inclusion, and α-synuclein propagation dependent on the ipsilateral connections that dominate connectivity of the human brain. In some patients, initial α-synuclein pathology occurs within the CNS, leading to a brain-first subtype of PD. In others, pathology begins in the peripheral autonomic nervous system, leading to a body-first subtype. In brain-first cases, it is proposed that the first pathology appears unilaterally, often in the amygdala. If α-synuclein propagation depends on connection strength, a unilateral focus of pathology will disseminate more to the ipsilateral hemisphere. Thus, α-synuclein spreads mainly to ipsilateral structures including the substantia nigra. The asymmetric distribution of pathology leads to asymmetric dopaminergic degeneration and motor asymmetry. In body-first cases, the α-synuclein pathology ascends via the vagus to both the left and right dorsal motor nuclei of the vagus owing to the overlapping parasympathetic innervation of the gut. Consequently, the initial α-synuclein pathology inside the CNS is more symmetric, which promotes more symmetric propagation in the brainstem, leading to more symmetric dopaminergic degeneration and less motor asymmetry. At diagnosis, body-first patients already have a larger, more symmetric burden of α-synuclein pathology, which in turn promotes faster disease progression and accelerated cognitive decline. The SOC model is supported by a considerable body of existing evidence and may have improved explanatory power.
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Affiliation(s)
- Per Borghammer
- Department of Nuclear Medicine & PET, Aarhus University Hospital, Aarhus, Denmark
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The Characteristics of Cognitive Impairment in ALS Patients Depend on the Lateralization of Motor Damage. Brain Sci 2020; 10:brainsci10090650. [PMID: 32961718 PMCID: PMC7563934 DOI: 10.3390/brainsci10090650] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 09/15/2020] [Accepted: 09/17/2020] [Indexed: 01/30/2023] Open
Abstract
(1) Background: Cognitive features of patients with amyotrophic lateral sclerosis (ALS) have never been specifically analyzed according to the lateralization of motor impairment. In the present study we investigated the cognitive performances of ALS patients to describe the relationship between motor and cognitive dysfunction, according to site and side of disease onset. (2) Methods: Six-hundred and nine ALS patients underwent a comprehensive neuropsychological evaluation at diagnosis in Turin ALS Centre Tests included—mini-mental state examination (MMSE), frontal assessment battery (FAB), trail-making test A/B (TMT A-B), digit span forward and backward (digit span FW/digit span BW), letter fluency test (FAS), category fluency test (CAT), Rey auditory verbal learning test (RAVLT), Babcock story recall test (BSRT), Rey-Osterrieth complex figure test (ROCFT), Wisconsin card sorting test (WCST), Raven’s coloured progressive matrices (CPM47). Cognitive performances of patients, grouped by side and site of onset, were statistically compared using z-scores, as appropriate. (3) Results: Bulbar patients and bilateral spinal onset patients (Sbil) were generally characterized by lower cognitive performances in most neuropsychological tests, when compared to patients with lateralized onset (right-side spinal onset, Sri and left-side spinal onset, Sle). Digit span backward and visual memory task (ROCFT) median z-scores were significantly higher, reflecting a better cognitive performance, in Sri patients when compared to bulbar/Sbil patients, while verbal memory tasks (RAVLT and BRST) resulted in significantly higher scores in Sle patients. Our results are in keeping with hemispheric functional lateralization of language and visuospatial abilities. (4) Conclusions: In ALS patients, as in other neurodegenerative diseases, we found a direct relationship between lateralized motor and cognitive features.
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Cholerton B, Weiner MW, Nosheny RL, Poston KL, Mackin RS, Tian L, Ashford JW, Montine TJ. Cognitive Performance in Parkinson's Disease in the Brain Health Registry. J Alzheimers Dis 2020; 68:1029-1038. [PMID: 30909225 DOI: 10.3233/jad-181009] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The study of cognition in Parkinson's disease (PD) traditionally requires exhaustive recruitment strategies. The current study examines data collected by the Brain Health Registry (BHR) to determine whether ongoing efforts to improve the recruitment base for therapeutic trials in Alzheimer's disease may be similarly effective for PD research, and whether online cognitive measurements can discriminate between participants who do and do not report a PD diagnosis. Participants enrolled in the BHR (age ≥50) with self-reported PD data and online cognitive testing available were included (n = 11,813). Associations between baseline cognitive variables and diagnostic group were analyzed using logistic regression. Linear mixed effects models were used to analyze longitudinal data. A total of 634 participants reported PD diagnosis at baseline with no self-reported cognitive impairment and completed cognitive testing. Measures of visual learning and memory, processing speed, attention, and working memory discriminated between self-reported PD and non-PD participants after correcting for multiple comparisons (p values < 0.006). Scores on all cognitive tests improved over time in PD and controls with the exception of processing speed, which remained stable in participants with PD while improving in those without. We demonstrate that a novel online approach to recruitment and longitudinal follow-up of study participants is effective for those with self-reported PD, and that significant differences exist between those with and without a reported diagnosis of PD on computerized cognitive measures. These results have important implications for recruitment of participants with PD into targeted therapeutic trials or large-scale genetic and cognitive studies.
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Affiliation(s)
- Brenna Cholerton
- Department of Pathology, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Michael W Weiner
- Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, CA, USA.,Department of Medicine, University of California San Francisco, San Francisco, CA, USA.,Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA.,Department of Radiology, University of California San Francisco, San Francisco, CA, USA
| | - Rachel L Nosheny
- Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, CA, USA.,Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
| | - Kathleen L Poston
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Palo Alto, CA, USA
| | - R Scott Mackin
- Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, CA, USA.,Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
| | - Lu Tian
- Department of Health Research and Policy, Stanford University, Palo Alto, CA, USA
| | - J Wesson Ashford
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA.,War Related Illness and Injury Study Center (WRIISC), Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Thomas J Montine
- Department of Pathology, Stanford University School of Medicine, Palo Alto, CA, USA
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Li P, Ensink E, Lang S, Marshall L, Schilthuis M, Lamp J, Vega I, Labrie V. Hemispheric asymmetry in the human brain and in Parkinson's disease is linked to divergent epigenetic patterns in neurons. Genome Biol 2020; 21:61. [PMID: 32151270 PMCID: PMC7063821 DOI: 10.1186/s13059-020-01960-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 02/13/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Hemispheric asymmetry in neuronal processes is a fundamental feature of the human brain and drives symptom lateralization in Parkinson's disease (PD), but its molecular determinants are unknown. Here, we identify divergent epigenetic patterns involved in hemispheric asymmetry by profiling DNA methylation in isolated prefrontal cortex neurons from control and PD brain hemispheres. DNA methylation is fine-mapped at enhancers and promoters, genome-wide, by targeted bisulfite sequencing in two independent sample cohorts. RESULTS We find that neurons of the human prefrontal cortex exhibit hemispheric differences in DNA methylation. Hemispheric asymmetry in neuronal DNA methylation patterns is largely mediated by differential CpH methylation, and chromatin conformation analysis finds that it targets thousands of genes. With aging, there is a loss of hemispheric asymmetry in neuronal epigenomes, such that hemispheres epigenetically converge in late life. In neurons of PD patients, hemispheric asymmetry in DNA methylation is greater than in controls and involves many PD risk genes. Epigenetic, transcriptomic, and proteomic differences between PD hemispheres correspond to the lateralization of PD symptoms, with abnormalities being most prevalent in the hemisphere matched to side of symptom predominance. Hemispheric asymmetry and symptom lateralization in PD is linked to genes affecting neurodevelopment, immune activation, and synaptic transmission. PD patients with a long disease course have greater hemispheric asymmetry in neuronal epigenomes than those with a short disease course. CONCLUSIONS Hemispheric differences in DNA methylation patterns are prevalent in neurons and may affect the progression and symptoms of PD.
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Affiliation(s)
- Peipei Li
- Center for Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI 49503 USA
| | - Elizabeth Ensink
- Center for Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI 49503 USA
| | - Sean Lang
- Center for Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI 49503 USA
| | - Lee Marshall
- Center for Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI 49503 USA
| | - Meghan Schilthuis
- Center for Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI 49503 USA
| | - Jared Lamp
- Department of Translational Neuroscience, College of Human Medicine, Michigan State University, Grand Rapids, MI 49503 USA
- Integrated Mass Spectrometry Unit, College of Human Medicine, Michigan State University, Grand Rapids, MI 49503 USA
| | - Irving Vega
- Department of Translational Neuroscience, College of Human Medicine, Michigan State University, Grand Rapids, MI 49503 USA
- Integrated Mass Spectrometry Unit, College of Human Medicine, Michigan State University, Grand Rapids, MI 49503 USA
| | - Viviane Labrie
- Center for Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI 49503 USA
- Division of Psychiatry and Behavioral Medicine, College of Human Medicine, Michigan State University, Grand Rapids, MI 49503 USA
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8
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Di Caprio V, Modugno N, Mancini C, Olivola E, Mirabella G. Early‐Stage Parkinson's Patients Show Selective Impairment in Reactive But Not Proactive Inhibition. Mov Disord 2019; 35:409-418. [DOI: 10.1002/mds.27920] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 09/27/2019] [Accepted: 10/23/2019] [Indexed: 11/08/2022] Open
Affiliation(s)
- Veronica Di Caprio
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Neuromed, Pozzilli (IS) Italy
| | - Nicola Modugno
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Neuromed, Pozzilli (IS) Italy
| | - Christian Mancini
- Department of Anatomy, Histology, Forensic Medicine & OrthopedicsSapienza University Rome Italy
| | - Enrica Olivola
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Neuromed, Pozzilli (IS) Italy
| | - Giovanni Mirabella
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Neuromed, Pozzilli (IS) Italy
- Department of Anatomy, Histology, Forensic Medicine & OrthopedicsSapienza University Rome Italy
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9
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Schintu S, Freedberg M, Alam ZM, Shomstein S, Wassermann EM. Left-shifting prism adaptation boosts reward-based learning. Cortex 2018; 109:279-286. [PMID: 30399479 PMCID: PMC7327780 DOI: 10.1016/j.cortex.2018.09.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 08/08/2018] [Accepted: 09/21/2018] [Indexed: 01/08/2023]
Abstract
Visuospatial cognition has an inherent lateralized bias. Individual differences in the direction and magnitude of this bias are associated with asymmetrical D2/3 dopamine binding and dopamine system genotypes. Dopamine level affects feedback-based learning and dopamine signaling asymmetry is related to differential learning from reward and punishment. High D2 binding in the left hemisphere is associated with preference for reward. Prism adaptation (PA) is a simple sensorimotor technique, which modulates visuospatial bias according to the direction of the deviation. Left-deviating prism adaptation (LPA) induces rightward bias in healthy subjects. It is therefore possible that the right side of space increases in saliency along with left hemisphere dopaminergic activity. Right-deviating prism adaptation (RPA) has been used mainly as a control condition because it does not modulate behavior in healthy individuals. Since LPA induces a rightward visuospatial bias as a result of left hemisphere modulation, and higher dopaminergic activity in the left hemisphere is associated with preference for rewarding events we hypothesized that LPA would increase the preference for learning with reward. Healthy volunteers performed a computer-based probabilistic classification task before and after LPA or RPA. Consistent with our predictions, PA altered the preference for rewarded versus punished learning, with the LPA group exhibiting increased learning from reward. These results suggest that PA modulates dopaminergic activity in a lateralized fashion.
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Affiliation(s)
- Selene Schintu
- Behavioral Neurology Unit, National Institute for Neurological Disorders and Stroke, Bethesda, USA; Department of Psychology, George Washington University, Washington, USA.
| | - Michael Freedberg
- Behavioral Neurology Unit, National Institute for Neurological Disorders and Stroke, Bethesda, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, USA
| | - Zaynah M Alam
- Behavioral Neurology Unit, National Institute for Neurological Disorders and Stroke, Bethesda, USA
| | - Sarah Shomstein
- Department of Psychology, George Washington University, Washington, USA
| | - Eric M Wassermann
- Behavioral Neurology Unit, National Institute for Neurological Disorders and Stroke, Bethesda, USA
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10
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Comparing Sensitivity and Specificity of Addenbrooke's Cognitive Examination-I, III and Mini-Addenbrooke's Cognitive Examination in Parkinson's Disease. Behav Neurol 2018; 2018:5932028. [PMID: 30369997 PMCID: PMC6189663 DOI: 10.1155/2018/5932028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 08/01/2018] [Accepted: 08/19/2018] [Indexed: 12/29/2022] Open
Abstract
Background Parkinson's disease (PD) is the second most common neurodegenerative disorder characterized by numerous motor and nonmotor symptoms. Neurocognitive disorders (NCD) are one of the most troublesome problems and their diagnosis is often challenging. Methods We compared the sensitivity and specificity of several versions of Addenbrooke Cognitive Examination (ACE, ACE-III, and Mini-ACE) on 552 subjects with PD. Normal cognition, mild and major NCD were judged in accordance with the respective criteria of the Diagnostic and Statistical Manual of Mental Disorders 5th edition. Subsequently, we applied the receiver operation characteristic (ROC) analysis in comparison of different education levels. Results For subjects with education level 0–8 and 9–12 years, the ACE-III had the best discriminating capabilities for mild NCD (cut-off scores: 83.5 and 85.5 points, respectively), while Mini-ACE was the best for subjects having education > 12 years (cut-off score: 25.5 points). For detecting major NCD, ACE-III had the best diagnostic accuracy in all levels of education (cut-off scores: 70.5, 77.5, and 78.5 points for subjects having education level 0–8, 9–12, and >12 years, respectively). Conclusion ACE-III and its nested version, the Mini-ACE, had the best screening abilities for detecting mild and major NCD in PD.
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11
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Mirabella G, Fragola M, Giannini G, Modugno N, Lakens D. Inhibitory control is not lateralized in Parkinson's patients. Neuropsychologia 2017. [DOI: 10.1016/j.neuropsychologia.2017.06.025] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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12
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Correlation of Visuospatial Ability and EEG Slowing in Patients with Parkinson's Disease. PARKINSON'S DISEASE 2017; 2017:3659784. [PMID: 28348918 PMCID: PMC5350347 DOI: 10.1155/2017/3659784] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 02/05/2017] [Indexed: 01/22/2023]
Abstract
Background. Visuospatial dysfunction is among the first cognitive symptoms in Parkinson's disease (PD) and is often predictive for PD-dementia. Furthermore, cognitive status in PD-patients correlates with quantitative EEG. This cross-sectional study aimed to investigate the correlation between EEG slowing and visuospatial ability in nondemented PD-patients. Methods. Fifty-seven nondemented PD-patients (17 females/40 males) were evaluated with a comprehensive neuropsychological test battery and a high-resolution 256-channel EEG was recorded. A median split was performed for each cognitive test dividing the patients sample into either a normal or lower performance group. The electrodes were split into five areas: frontal, central, temporal, parietal, and occipital. A linear mixed effects model (LME) was used for correlational analyses and to control for confounding factors. Results. Subsequently, for the lower performance, LME analysis showed a significant positive correlation between ROCF score and parietal alpha/theta ratio (b = .59, p = .012) and occipital alpha/theta ratio (b = 0.50, p = .030). No correlations were found in the group of patients with normal visuospatial abilities. Conclusion. We conclude that a reduction of the parietal alpha/theta ratio is related to visuospatial impairments in PD-patients. These findings indicate that visuospatial impairment in PD-patients could be influenced by parietal dysfunction.
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Association of Gait Characteristics and Depression in Patients with Parkinson's Disease Assessed in Goal-Directed Locomotion Task. PARKINSONS DISEASE 2017; 2017:6434689. [PMID: 28293444 PMCID: PMC5331290 DOI: 10.1155/2017/6434689] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 11/14/2016] [Accepted: 12/22/2016] [Indexed: 12/16/2022]
Abstract
Introduction. In the genesis of Parkinson's disease (PD) clinical phenomenology the exact nature of the association between bradykinesia and affective variables is unclear. In the present study, we analyzed the gait characteristics and level of depression in PD and healthy volunteers. Methods. Patients with PD (n = 48) and healthy controls (n = 52) were recruited for the present study. Walking speed, stride length, and cadence were compared between groups while participants completed a goal-directed locomotion task under visually controlled (VC) and visually noncontrolled conditions (VnC). Results. Significantly higher depression scores were found in PD comparing to healthy control groups. In PD, depression was associated with gait components in the VC wherein the place of the target was visible. In contrast, in healthy subjects the depression was associated with gait components in VnC wherein the location and image of the target were memorized and recalled. In patients with PD and depression, the visually deprived multitask augments the rate of cadence and diminishes stride length, while velocity remains relatively unchanged. The depression associated with gait characteristics as a comorbid affective factor in PD, and that impairs the coherence of gait pattern. Conclusion. The relationship between depression and gait parameters appears to indicate that PD not only is a neurological disease but also incorporates affective disturbances that associate with the regulation of gait characteristics.
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Weintraut R, Karádi K, Lucza T, Kovács M, Makkos A, Janszky J, Kovács N. Lille Apathy Rating Scale and MDS-UPDRS for Screening Apathy in Parkinson’s Disease. JOURNAL OF PARKINSONS DISEASE 2016; 6:257-65. [DOI: 10.3233/jpd-150726] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Rita Weintraut
- Institute of Behavioral Sciences, University of Pécs, Pécs, Hungary
| | - Kázmér Karádi
- Institute of Behavioral Sciences, University of Pécs, Pécs, Hungary
| | - Tivadar Lucza
- Institute of Behavioral Sciences, University of Pécs, Pécs, Hungary
| | - Márton Kovács
- Institute of Behavioral Sciences, University of Pécs, Pécs, Hungary
| | - Attila Makkos
- Institute of Behavioral Sciences, University of Pécs, Pécs, Hungary
| | - József Janszky
- Department of Neurology, University of Pécs, Pécs, Hungary
- MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary
| | - Norbert Kovács
- Department of Neurology, University of Pécs, Pécs, Hungary
- MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary
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Impaired neural processing of dynamic faces in left-onset Parkinson's disease. Neuropsychologia 2016; 82:123-133. [DOI: 10.1016/j.neuropsychologia.2016.01.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 12/22/2015] [Accepted: 01/15/2016] [Indexed: 11/19/2022]
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Stuart S, Lord S, Hill E, Rochester L. Gait in Parkinson's disease: A visuo-cognitive challenge. Neurosci Biobehav Rev 2016; 62:76-88. [PMID: 26773722 DOI: 10.1016/j.neubiorev.2016.01.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 12/15/2015] [Accepted: 01/05/2016] [Indexed: 12/18/2022]
Abstract
Vision and cognition have both been related to gait impairment in Parkinson's disease (PD) through separate strands of research. The cumulative and interactive effect of both (which we term visuo-cognition) has not been previously investigated and little is known about the influence of cognition on vision with respect to gait. Understanding the role of vision, cognition and visuo-cognition in gait in PD is critical for data interpretation and to infer and test underlying mechanisms. The purpose of this comprehensive narrative review was to examine the interdependent and interactive role of cognition and vision in gait in PD and older adults. Evidence from a broad range of research disciplines was reviewed and summarised. A key finding was that attention appears to play a pivotal role in mediating gait, cognition and vision, and should be considered emphatically in future research in this field.
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Affiliation(s)
- Samuel Stuart
- Institute of Neuroscience/Newcastle University Institute of Ageing, Clinical Ageing Research Unit, Campus for Ageing and Vitality Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Sue Lord
- Institute of Neuroscience/Newcastle University Institute of Ageing, Clinical Ageing Research Unit, Campus for Ageing and Vitality Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Elizabeth Hill
- Institute of Neuroscience/Newcastle University Institute of Ageing, Clinical Ageing Research Unit, Campus for Ageing and Vitality Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Lynn Rochester
- Institute of Neuroscience/Newcastle University Institute of Ageing, Clinical Ageing Research Unit, Campus for Ageing and Vitality Newcastle University, Newcastle upon Tyne, United Kingdom.
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The Cognition of Maximal Reach Distance in Parkinson’s Disease. PARKINSON'S DISEASE 2016; 2016:6827085. [PMID: 27597927 PMCID: PMC5002485 DOI: 10.1155/2016/6827085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 07/10/2016] [Accepted: 07/20/2016] [Indexed: 11/23/2022]
Abstract
This study aimed to investigate whether the cognition of spatial distance in reaching movements was decreased in patients with Parkinson's disease (PD) and whether this cognition was associated with various symptoms of PD. Estimated and actual maximal reaching distances were measured in three directions in PD patients and healthy elderly volunteers. Differences between estimated and actual measurements were compared within each group. In the PD patients, the associations between “error in cognition” of reaching distance and “clinical findings” were also examined. The results showed that no differences were observed in any values regardless of dominance of hand and severity of symptoms. The differences between the estimated and actual measurements were negatively deviated in the PD patients, indicating that they tended to underestimate reaching distance. “Error in cognition” of reaching distance correlated with the items of posture in the motor section of the Unified Parkinson's Disease Rating Scale. This suggests that, in PD patients, postural deviation and postural instability might affect the cognition of the distance from a target object.
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De Lucia N, Grossi D, Mauro A, Trojano L. Closing-in in Parkinson’s disease individuals with dementia: An experimental study. J Clin Exp Neuropsychol 2015; 37:946-55. [DOI: 10.1080/13803395.2015.1071339] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Kincses P, Kovács N, Karádi K, Kállai J. [Critical issues of the biopsychosocial treatment of Parkinson's disease]. Orv Hetil 2015; 156:472-8. [PMID: 25778854 DOI: 10.1556/oh.2015.30109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
This paper is a summary report on the basic questions of the biopsychosocial approach to Parkinson's disease. It deals with cognitive, affective and psychological health issues which significantly influence the outcome of the physical rehabilitation. In spite of the unchanged cognitive status, the psychological burden of the changes in the quality of life, the obstruction, the change in the affective tone, and the shrinking ability to fulfil social roles decrease the patient's quality of life. An interdisciplinary approach is best suited for mitigating these effects. Not only the patient but also his/her family and environment is seriously affected by the disease and its consequences. Treatment and rehabilitation options for increasing or maintaining the quality of life of the affected patients are diverse, and significantly depend on the features of the health care system. The authors believe that the following review emphasizing health psychological principles may contribute to the work of professionals working in clinical and rehabilitational fields and through them may increase the quality of life of patients and their family.
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Affiliation(s)
- Péter Kincses
- Pécsi Tudományegyetem, Általános Orvostudományi Kar Magatartástudományi Intézet Pécs
| | - Norbert Kovács
- Pécsi Tudományegyetem, Klinikai Központ Neurológiai Klinika Pécs Rét u. 2. 7623
| | - Kázmér Karádi
- Pécsi Tudományegyetem, Általános Orvostudományi Kar Magatartástudományi Intézet Pécs
| | - János Kállai
- Pécsi Tudományegyetem, Általános Orvostudományi Kar Magatartástudományi Intézet Pécs
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Schaefer SY. Preserved motor asymmetry in late adulthood: is measuring chronological age enough? Neuroscience 2015; 294:51-9. [PMID: 25772792 DOI: 10.1016/j.neuroscience.2015.03.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Revised: 03/03/2015] [Accepted: 03/05/2015] [Indexed: 02/01/2023]
Abstract
When comparing motor performance of the dominant and nondominant hands, older adults tend to be less asymmetric compared to young adults. This has suggested decreased motor lateralization and functional compensation within the aging brain. The current study further addressed this question by testing whether motor asymmetry was reduced in a sample of 44 healthy right-handed adults ages 65-89. We hypothesized that the older the age, the less the motor asymmetry, and that 'old old' participants (age 80+) would have less motor asymmetry than 'young old' participants (age 65-79). Using two naturalistic tasks that selectively biased the dominant or nondominant hands, we compared asymmetries in performance (measured as a ratio) across chronological age. Results showed preserved motor asymmetry across ages in both tasks, with no difference in asymmetry ratios in the 'old old' compared to the 'young old.' In the context of previous work, our findings suggest that the aging brain may also be characterized by additional measures besides chronological age.
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Affiliation(s)
- Sydney Y Schaefer
- Emma Eccles Jones College of Education and Human Services, Utah State University, 7000 Old Main Hill, Logan, UT 84322, USA; Department of Physical Therapy, University of Utah, 520 Wakara Way, Salt Lake City, UT 84108, USA; The Center on Aging, University of Utah, 30 North 1900 East, AB193 SOM, Salt Lake City, UT 84132, USA.
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