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Ordás CM, Alonso-Frech F. The neural basis of somatosensory temporal discrimination threshold as a paradigm for time processing in the sub-second range: An updated review. Neurosci Biobehav Rev 2024; 156:105486. [PMID: 38040074 DOI: 10.1016/j.neubiorev.2023.105486] [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: 07/13/2023] [Revised: 11/20/2023] [Accepted: 11/27/2023] [Indexed: 12/03/2023]
Abstract
BACKGROUND AND OBJECTIVE The temporal aspect of somesthesia is a feature of any somatosensory process and a pre-requisite for the elaboration of proper behavior. Time processing in the milliseconds range is crucial for most of behaviors in everyday life. The somatosensory temporal discrimination threshold (STDT) is the ability to perceive two successive stimuli as separate in time, and deals with time processing in this temporal range. Herein, we focus on the physiology of STDT, on a background of the anatomophysiology of somesthesia and the neurobiological substrates of timing. METHODS A review of the literature through PubMed & Cochrane databases until March 2023 was performed with inclusion and exclusion criteria following PRISMA recommendations. RESULTS 1151 abstracts were identified. 4 duplicate records were discarded before screening. 957 abstracts were excluded because of redundancy, less relevant content or not English-written. 4 were added after revision. Eventually, 194 articles were included. CONCLUSIONS STDT encoding relies on intracortical inhibitory S1 function and is modulated by the basal ganglia-thalamic-cortical interplay through circuits involving the nigrostriatal dopaminergic pathway and probably the superior colliculus.
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Affiliation(s)
- Carlos M Ordás
- Universidad Rey Juan Carlos, Móstoles, Madrid, Spain; Department of Neurology, Hospital Rey Juan Carlos, Móstoles, Madrid, Spain.
| | - Fernando Alonso-Frech
- Department of Neurology, Hospital Clínico San Carlos, Universidad Complutense de Madrid, Spain
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2
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Heß T, Themann P, Oehlwein C, Milani TL. Does Impaired Plantar Cutaneous Vibration Perception Contribute to Axial Motor Symptoms in Parkinson's Disease? Effects of Medication and Subthalamic Nucleus Deep Brain Stimulation. Brain Sci 2023; 13:1681. [PMID: 38137129 PMCID: PMC10742284 DOI: 10.3390/brainsci13121681] [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: 11/08/2023] [Revised: 11/28/2023] [Accepted: 12/03/2023] [Indexed: 12/24/2023] Open
Abstract
OBJECTIVE To investigate whether impaired plantar cutaneous vibration perception contributes to axial motor symptoms in Parkinson's disease (PD) and whether anti-parkinsonian medication and subthalamic nucleus deep brain stimulation (STN-DBS) show different effects. METHODS Three groups were evaluated: PD patients in the medication "on" state (PD-MED), PD patients in the medication "on" state and additionally "on" STN-DBS (PD-MED-DBS), as well as healthy subjects (HS) as reference. Motor performance was analyzed using a pressure distribution platform. Plantar cutaneous vibration perception thresholds (VPT) were investigated using a customized vibration exciter at 30 Hz. RESULTS Motor performance of PD-MED and PD-MED-DBS was characterized by greater postural sway, smaller limits of stability ranges, and slower gait due to shorter strides, fewer steps per minute, and broader stride widths compared to HS. Comparing patient groups, PD-MED-DBS showed better overall motor performance than PD-MED, particularly for the functional limits of stability and gait. VPTs were significantly higher for PD-MED compared to those of HS, which suggests impaired plantar cutaneous vibration perception in PD. However, PD-MED-DBS showed less impaired cutaneous vibration perception than PD-MED. CONCLUSIONS PD patients suffer from poor motor performance compared to healthy subjects. Anti-parkinsonian medication in tandem with STN-DBS seems to be superior for normalizing axial motor symptoms compared to medication alone. Plantar cutaneous vibration perception is impaired in PD patients, whereas anti-parkinsonian medication together with STN-DBS is superior for normalizing tactile cutaneous perception compared to medication alone. Consequently, based on our results and the findings of the literature, impaired plantar cutaneous vibration perception might contribute to axial motor symptoms in PD.
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Affiliation(s)
- Tobias Heß
- Department of Human Locomotion, Chemnitz University of Technology, 09126 Chemnitz, Germany
| | - Peter Themann
- Department of Neurology and Parkinson, Clinic at Tharandter Forest, 09633 Halsbruecke, Germany
| | - Christian Oehlwein
- Neurological Outpatient Clinic for Parkinson Disease and Deep Brain Stimulation, 07551 Gera, Germany
| | - Thomas L. Milani
- Department of Human Locomotion, Chemnitz University of Technology, 09126 Chemnitz, Germany
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3
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Permezel F, Alty J, Harding IH, Thyagarajan D. Brain Networks Involved in Sensory Perception in Parkinson's Disease: A Scoping Review. Brain Sci 2023; 13:1552. [PMID: 38002513 PMCID: PMC10669548 DOI: 10.3390/brainsci13111552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 10/26/2023] [Accepted: 10/31/2023] [Indexed: 11/26/2023] Open
Abstract
Parkinson's Disease (PD) has historically been considered a disorder of motor dysfunction. However, a growing number of studies have demonstrated sensory abnormalities in PD across the modalities of proprioceptive, tactile, visual, auditory and temporal perception. A better understanding of these may inform future drug and neuromodulation therapy. We analysed these studies using a scoping review. In total, 101 studies comprising 2853 human participants (88 studies) and 125 animals (13 studies), published between 1982 and 2022, were included. These highlighted the importance of the basal ganglia in sensory perception across all modalities, with an additional role for the integration of multiple simultaneous sensation types. Numerous studies concluded that sensory abnormalities in PD result from increased noise in the basal ganglia and increased neuronal receptive field size. There is evidence that sensory changes in PD and impaired sensorimotor integration may contribute to motor abnormalities.
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Affiliation(s)
- Fiona Permezel
- Department of Neuroscience, Monash University, Melbourne 3004, Australia; (F.P.); (I.H.H.)
- Department of Neurology, Mayo Clinic, Rochester, MN 55901, USA
| | - Jane Alty
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart 7001, Australia;
| | - Ian H. Harding
- Department of Neuroscience, Monash University, Melbourne 3004, Australia; (F.P.); (I.H.H.)
| | - Dominic Thyagarajan
- Department of Neuroscience, Monash University, Melbourne 3004, Australia; (F.P.); (I.H.H.)
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4
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Miyawaki EK. Review: Subjective Time Perception, Dopamine Signaling, and Parkinsonian Slowness. Front Neurol 2022; 13:927160. [PMID: 35899266 PMCID: PMC9311331 DOI: 10.3389/fneur.2022.927160] [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: 04/23/2022] [Accepted: 06/16/2022] [Indexed: 11/25/2022] Open
Abstract
The association between idiopathic Parkinson's disease, a paradigmatic dopamine-deficiency syndrome, and problems in the estimation of time has been studied experimentally for decades. I review that literature, which raises a question about whether and if dopamine deficiency relates not only to the motor slowness that is an objective and cardinal parkinsonian sign, but also to a compromised neural substrate for time perception. Why does a clinically (motorically) significant deficiency in dopamine play a role in the subjective perception of time's passage? After a discussion of a classical conception of basal ganglionic control of movement under the influence of dopamine, I describe recent work in healthy mice using optogenetics; the methodology visualizes dopaminergic neuronal firing in very short time intervals, then allows for correlation with motor behaviors in trained tasks. Moment-to-moment neuronal activity is both highly dynamic and variable, as assessed by photometry of genetically defined dopaminergic neurons. I use those animal data as context to review a large experimental experience in humans, spanning decades, that has examined subjective time perception mainly in Parkinson's disease, but also in other movement disorders. Although the human data are mixed in their findings, I argue that loss of dynamic variability in dopaminergic neuronal activity over very short intervals may be a fundamental sensory aspect in the pathophysiology of parkinsonism. An important implication is that therapeutic response in Parkinson's disease needs to be understood in terms of short-term alterations in dynamic neuronal firing, as has already been examined in novel ways—for example, in the study of real-time changes in neuronal network oscillations across very short time intervals. A finer analysis of a treatment's network effects might aid in any effort to augment clinical response to either medications or functional neurosurgical interventions in Parkinson's disease.
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Affiliation(s)
- Edison K. Miyawaki
- Department of Neurology, Mass General Brigham, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
- *Correspondence: Edison K. Miyawaki
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5
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Korsun O, Renvall H, Nurminen J, Mäkelä JP, Pekkonen E. Modulation of sensory cortical activity by deep brain stimulation in advanced Parkinson's Disease. Eur J Neurosci 2022; 56:3979-3990. [PMID: 35560964 PMCID: PMC9544049 DOI: 10.1111/ejn.15692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 04/28/2022] [Accepted: 05/10/2022] [Indexed: 11/28/2022]
Abstract
Despite optimal oral drug treatment, about 90% of patients with Parkinson's disease develop motor fluctuation and dyskinesia within 5-10 years from the diagnosis. Moreover, the patients show non-motor symptoms in different sensory domains. Bilateral deep brain stimulation applied to the subthalamic nucleus is considered the most effective treatment in advanced Parkinson's disease and it has been suggested to affect sensorimotor modulation and relate to motor improvement in patients. However, observations on the relationship between sensorimotor activity and clinical improvement have remained sparse. Here we studied the somatosensory evoked magnetic fields in thirteen right-handed patients with advanced Parkinson's disease before and 7 months after stimulator implantation. Somatosensory processing was addressed with magnetoencephalography during alternated median nerve stimulation at both wrists. The strengths and the latencies of the ~60-ms responses at the contralateral primary somatosensory cortices were highly variable but detectable and reliably localized in all patients. The response strengths did not differ between preoperative and postoperative DBSON measurements. The change in the response strength between pre- and postoperative condition in the dominant left hemisphere of our right-handed patients correlated with the alleviation of their motor symptoms (p = 0.04). However, the result did not survive correction for multiple comparisons. Magnetoencephalography appears an effective tool to explore non-motor effects in patients with Parkinson's disease, and it may help in understanding the neurophysiological basis of deep brain stimulation. However, the high interindividual variability in the somatosensory responses and poor tolerability of DBSOFF condition warrants larger patient groups and measurements also in non-medicated patients.
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Affiliation(s)
- Olesia Korsun
- Biomag Laboratory, HUS Medical Imaging Center, Helsinki University Hospital, Helsinki University, and Aalto University School of Science, Helsinki, Finland.,Department of Neuroscience and Biomedical Engineering, Aalto University, School of Science, Espoo, Finland
| | - Hanna Renvall
- Biomag Laboratory, HUS Medical Imaging Center, Helsinki University Hospital, Helsinki University, and Aalto University School of Science, Helsinki, Finland.,Department of Neuroscience and Biomedical Engineering, Aalto University, School of Science, Espoo, Finland
| | - Jussi Nurminen
- Biomag Laboratory, HUS Medical Imaging Center, Helsinki University Hospital, Helsinki University, and Aalto University School of Science, Helsinki, Finland.,Motion Analysis Laboratory, Children's Hospital, Helsinki University Hospital and Helsinki University, Helsinki, Finland
| | - Jyrki P Mäkelä
- Biomag Laboratory, HUS Medical Imaging Center, Helsinki University Hospital, Helsinki University, and Aalto University School of Science, Helsinki, Finland
| | - Eero Pekkonen
- Department of Neurology, Helsinki University Hospital and Department of Clinical Neurosciences (Neurology), University of Helsinki, Helsinki, Finland
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6
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The distorted body: The perception of the relative proportions of the body is preserved in Parkinson's disease. Psychon Bull Rev 2022; 29:1317-1326. [PMID: 35445288 PMCID: PMC9020551 DOI: 10.3758/s13423-022-02099-9] [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] [Accepted: 03/29/2022] [Indexed: 11/08/2022]
Abstract
Given humans' ubiquitous visual experience of their own body, one reasonable assumption is that one's perceptions of the lengths of their body parts should be accurate. However, recent research has shown that large systematic distortions of the length of body parts are present in healthy younger adults. These distortions appear to be linked to tactile sensitivity such that individuals overestimate the length of body parts of low tactile sensitivity to a greater extent than body parts of high tactile sensitivity. There are certain conditions featuring reduced tactile sensitivity, such as Parkinson's disease (PD) and healthy older ageing. However, the effect of these circumstances on individuals' perceptions of the lengths of their body parts remains unknown. In this study, participants visually estimated the length of their body parts using their hand as a metric. We show that despite the reductions in tactile sensitivity, and potential alterations in the cortical presentation of body parts that may occur in PD and healthy older ageing, individuals with mild-moderate PD and older adults of comparable age experience body size distortions comparable to healthy younger controls. These findings demonstrate that the ability to perceive the length of one's body parts is well preserved in mild-moderate PD.
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Korucu ZT, Onurlu İ, Korucu A, Günendi Z. The effect of supervised dynamic exercise program on somatosensory temporal discrimination in patients with fibromyalgia syndrome. Arch Rheumatol 2021; 36:409-418. [PMID: 34870173 PMCID: PMC8612498 DOI: 10.46497/archrheumatol.2021.8412] [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: 08/26/2020] [Accepted: 12/22/2020] [Indexed: 11/04/2022] Open
Abstract
Objectives
This study aims to investigate the effect of a supervised dynamic exercise program on somatosensory temporal discrimination (STD) which indicates the central sensory processing ability. Patients and methods
Forty-eight patients (mean age: 43 years; range, 19 to 64 years) with fibromyalgia syndrome (FMS) were included in this prospective, randomized study between April 2018 and October 2018. Demographics and clinical measurements were recorded. The STD threshold was measured by a researcher blinded to the treatment groups. After baseline assessments, the patients were randomized into two groups: the supervised exercise group (SEG) and the home exercise group (HEG) as the control group. The SEG performed submaximal aerobic exercise and low-medium resistant isotonic exercises under the supervision of a physiotherapist, 1-h per day, three days in a week for four weeks. The HEG was given a home-based exercise program consisting of low-to-medium resistance isotonic exercises and aerobic exercises 1-h per day, three days in a week for four weeks. After exercise program, clinical assessments and STD threshold measurement were repeated. Results
Clinical and STD threshold measures improved significantly after four-week exercise program in both groups. The improvements in clinical measures were significantly higher in the SEG. However, there was no difference in the STD threshold improvement between the groups. No correlation was found between the STD threshold measure and clinical features in any patients. Conclusion
Although a significant improvement was achieved in impaired STD threshold with SEG, it was not found to be superior to the amelioration observed with HEG.
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Affiliation(s)
- Zübeyde Tuğçe Korucu
- Department of Physical Medicine and Rehabilitation, Ankara City Hospital, Ankara, Turkey
| | - İlknur Onurlu
- Department of Physical Medicine and Rehabilitation, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Alperen Korucu
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Turkey
| | - Zafer Günendi
- Department of Physical Medicine and Rehabilitation, Gazi University Faculty of Medicine, Ankara, Turkey
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8
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Pfeifer KJ, Cook AJ, Yankulova JK, Mortimer BJP, Erickson-DiRenzo E, Dhall R, Montaser-Kouhsari L, Tass PA. Clinical Efficacy and Dosing of Vibrotactile Coordinated Reset Stimulation in Motor and Non-motor Symptoms of Parkinson's Disease: A Study Protocol. Front Neurol 2021; 12:758481. [PMID: 34867742 PMCID: PMC8636796 DOI: 10.3389/fneur.2021.758481] [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: 08/14/2021] [Accepted: 10/12/2021] [Indexed: 11/13/2022] Open
Abstract
Enhanced neuronal synchronization of the subthalamic nucleus (STN) is commonly found in PD patients and corresponds to decreased motor ability. Coordinated reset (CR) was developed to decouple synchronized states causing long lasting desynchronization of neural networks. Vibrotactile CR stimulation (vCR) was developed as non-invasive therapeutic that delivers gentle vibrations to the fingertips. A previous study has shown that vCR can desynchronize abnormal brain rhythms within the sensorimotor cortex of PD patients, corresponding to sustained motor relief after 3 months of daily treatment. To further develop vCR, we created a protocol that has two phases. Study 1, a double blinded randomized sham-controlled study, is designed to address motor and non-motor symptoms, sensorimotor integration, and potential calibration methods. Study 2 examines dosing effects of vCR using a remote study design. In Study 1, we will perform a 7-month double-blind sham-controlled study including 30 PD patients randomly placed into an active vCR or inactive (sham) vCR condition. Patients will receive stimulation for 4 h a day in 2-h blocks for 6 months followed by a 1-month pause in stimulation to assess long lasting effects. Our primary outcome measure is the Movement Disorders Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) part III off medication after 6 months of treatment. Secondary measures include a freezing of gait (FOG) questionnaire, objective motor evaluations, sensorimotor electroencephalography (EEG) results, a vibratory temporal discrimination task (VTDT), non-motor symptom evaluations/tests such as sleep, smell, speech, quality of life measurements and Levodopa Equivalent Daily Dose (LEDD). Patients will be evaluated at baseline, 3, 6, and 7 months. In the second, unblinded study phase (Study 2), all patients will be given the option to receive active vCR stimulation at a reduced dose for an additional 6 months remotely. The remote MDS-UPDRS part III off medication will be our primary outcome measure. Secondary measures include sleep, quality of life, objective motor evaluations, FOG and LEDD. Patients will be evaluated in the same time periods as the first study. Results from this study will provide clinical efficacy of vCR and help validate our investigational vibrotactile device for the purpose of obtaining FDA clearance. Clinical Trial Registration: ClinicalTrials.gov, identifier: NCT04877015.
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Affiliation(s)
- Kristina J. Pfeifer
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, United States
| | - Alex J. Cook
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, United States
| | - Jessica K. Yankulova
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, United States
| | | | - Elizabeth Erickson-DiRenzo
- Department of Otolarygology Head and Neck Surgery/Laryngology Division, Stanford University School of Medicine, Stanford, CA, United States
| | - Rohit Dhall
- Department of Neurology, Center for Neurodegenerative Disorders, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Leila Montaser-Kouhsari
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - Peter A. Tass
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, United States
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9
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Topkan TA, Altin E, Kocer B, Cengiz B. Cortical plasticity causes useless hand syndrome in multiple sclerosis: a neurophysiological study in a rare case. Somatosens Mot Res 2021; 39:18-20. [PMID: 34632929 DOI: 10.1080/08990220.2021.1986384] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Useless Hand Syndrome (UHS) is a rare clinical manifestation of an upper cervical cord lesion, which is most commonly associated with multiple sclerosis (MS). The pathophysiological mechanism underlying UHS remains unclear. CASE We report a 25-year-old woman, who described numbness in her left upper extremity. Cervical magnetic resonance imaging revealed a posterior upper cervical cord lesion. There was no cortical lesion that could explain the clinical findings. We measured (1) short-latency afferent inhibition (SAI) by obtaining motor evoked potentials as an indicator of sensorimotor integration and (2) somatosensorial temporal discrimination threshold (STDT) to display central somatosensory pathway function. In the right cerebral hemisphere, we found an excessive increase in STDT and no inhibition in the SAI paradigm. CONCLUSIONS These findings indicate that impairment of sensorimotor integration and central processing of sensory stimuli cause useless hand syndrome.
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Affiliation(s)
| | - Emine Altin
- Department of Neurology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Belgin Kocer
- Department of Neurology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Bülent Cengiz
- Department of Neurology, Faculty of Medicine, Gazi University, Ankara, Turkey
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10
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Buyuktaskin D, Iseri E, Guney E, Gunendi Z, Cengiz B. Somatosensory Temporal Discrimination in Autism Spectrum Disorder. Autism Res 2021; 14:656-667. [PMID: 33522138 DOI: 10.1002/aur.2479] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 12/15/2020] [Accepted: 12/20/2020] [Indexed: 12/14/2022]
Abstract
Sensory differences are common in Autism Spectrum Disorder (ASD). While there is no well-accepted method to measure sensory differences objectively, there is accumulating evidence from recent years concerning sensory perception, including data concerning temporal discrimination thresholds of individuals with ASD as measured by different measures. The somatosensory temporal discrimination (STD) test measures the threshold at which an individual can temporally discriminate multiple tactile stimuli delivered in succession. We aimed to investigate tactile perception in ASD and hypothesized that children with ASD have impaired STD related to their subjective sensory symptoms and daily difficulties. Thirty adolescents with ASD and 30 typically developed subjects were recruited. The Childhood Autism Rating Scale, Strengths and Difficulties Questionnaire, and Adolescent/Adult Sensory Profile were implemented before STD evaluation. Average somatosensory detection (1.48 ± 0.42) and discrimination thresholds (112.70 ± 43.45) of the children with ASD were significantly higher (P = 0.010, P = 0.001, respectively) than those of the controls (1.18 ± 0.42, 79.95 ± 31.60, respectively). Sensory seeking scores of the ASD group (40.8 ± 7.60) were significantly lower (P = 0.024) than those of the control group (45.83 ± 9.17). However, the psychophsycal thresholds did not have any statistically significant relationships with subjective sensory symptoms or daily difficulties. This study demonstrates impaired sensory processing in ASD evaluated by STD and its lack of relationship with subjective sensory symptoms and daily difficulties. This psychophysical evidence of increased STD thresholds and decreased sensory seeking profile supports the disturbances in the regulation of sensory processing in ASD. LAY SUMMARY: Sensory differences are common in autism; however, there is no well-accepted method to measure them objectively. This study aims to investigate somatosensory differences and their relation with sensory and emotional/behavioral difficulties of children with autism. We show that autistic children have higher tactile discrimination thresholds and fewer sensory seeking behaviors. This supports the presence of impairments in sensory processing in autism. Measuring the sensory differences may help understanding clinical symptoms and neurobiological underpinings of autism. Autism Res 2021, 14: 656-667. © 2021 International Society for Autism Research and Wiley Periodicals LLC.
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Affiliation(s)
- Dicle Buyuktaskin
- Department of Child and Adolescent Psychiatry, Cizre Dr. Selahattin Cizrelioglu State Hospital, Sirnak, Turkey.,Department of Child and Adolescent Psychiatry, Gazi University, Ankara, Turkey
| | - Elvan Iseri
- Department of Child and Adolescent Psychiatry, Gazi University, Ankara, Turkey
| | - Esra Guney
- Department of Child and Adolescent Psychiatry, Gazi University, Ankara, Turkey
| | - Zafer Gunendi
- Department of Physical Therapy and Rehabilitation, Gazi University, Ankara, Turkey
| | - Bulent Cengiz
- Department of Neurology, Gazi University, Ankara, Turkey
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11
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Yoshida N, Suzuki T, Ogahara K, Higashi T, Sugawara K. Somatosensory temporal discrimination threshold changes during motor learning. Somatosens Mot Res 2020; 37:313-319. [PMID: 33064045 DOI: 10.1080/08990220.2020.1830755] [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] [Indexed: 01/25/2023]
Abstract
PURPOSE Mechanisms underlying the somatosensory temporal discrimination threshold and its relationship with motor control have been reported; however, little is known regarding the change in temporal processing of tactile information during motor learning. We investigated the somatosensory temporal discrimination threshold changes during motor learning in a feedback-control task. MATERIALS AND METHODS We included 15 healthy individuals. The somatosensory temporal discrimination threshold was measured on the index finger. A 10-session coin rotation task was performed, with 2 min' training per session. The coin rotation scores were determined through tests (continuous coin rotation at 180° at maximum speed for 10 s). The coin rotation test score and the somatosensory temporal discrimination threshold were determined at baseline and after 5 and 10 sets of training, as follows: pre-test; training5set (1 set × 5); post-test5block; training5set (1 set × 5); and post-test10block. The coin rotation score and the somatosensory temporal discrimination threshold were compared between the tests. The latter was also compared between the right (the within-subject control) and left fingers. RESULTS The coin rotation score showed significant differences among all tests. In the somatosensory temporal discrimination threshold, there was a significant difference between the pre-test and post-test5block values, pre-test and post-test10block values of the left side and between the right and left sides in the post-test5block and the post-test10block values. CONCLUSIONS The somatosensory temporal discrimination threshold decreased along with task-performance progress following motor learning during a feedback-control task.
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Affiliation(s)
- Naoshin Yoshida
- Unit of Rehabilitation Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.,Department of Rehabilitation, Yokosuka Kyosai Hospital, Yokosuka, Japan
| | - Tomotaka Suzuki
- Faculty of Health and Social Work School of Rehabilitation, Kanagawa University of Human Services, Yokosuka, Japan
| | - Kakuya Ogahara
- Unit of Rehabilitation Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.,Faculty of Health and Social Work School of Rehabilitation, Kanagawa University of Human Services, Yokosuka, Japan
| | - Toshio Higashi
- Unit of Rehabilitation Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kenichi Sugawara
- Faculty of Health and Social Work School of Rehabilitation, Kanagawa University of Human Services, Yokosuka, Japan
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12
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Belvisi D, Fabbrini A, De Bartolo MI, Costanzo M, Manzo N, Fabbrini G, Defazio G, Conte A, Berardelli A. The Pathophysiological Correlates of Parkinson's Disease Clinical Subtypes. Mov Disord 2020; 36:370-379. [PMID: 33037859 DOI: 10.1002/mds.28321] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 09/07/2020] [Accepted: 09/10/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Possible pathophysiological mechanisms underlying Parkinson's disease (PD) clinical subtypes are unknown. The objective of this study was to identify pathophysiological substrate of PD subtypes using neurophysiological techniques. METHODS One hundred de novo PD patients participated. We collected patient demographic and clinical data, which were used to perform a hierarchical cluster analysis. The neurophysiological assessment tested primary motor cortex excitability and plasticity using transcranial magnetic stimulation. To evaluate motor performance, we performed a kinematic analysis of fast index finger abduction. To investigate sensory function and sensorimotor mechanisms, we measured the somatosensory temporal discrimination threshold at rest and during movement, respectively. RESULTS Hierarchical cluster analysis identified 2 clinical clusters. Cluster I ("mild motor-predominant") included patients who had milder motor and nonmotor symptoms severity than cluster II patients, who had a combination of severe motor and nonmotor manifestations (diffuse malignant). We observed that the diffuse malignant subtype had increased cortical excitability and reduced plasticity compared with the mild motor-predominant subtype. Kinematic analysis of motor performance demonstrated that the diffuse malignant subtype was significantly slower than the mild motor-predominant subtype. Conversely, we did not observe any significant differences in sensory function or sensorimotor integration between the two PD subtypes. CONCLUSIONS De novo PD subtypes showed different patterns of motor system dysfunction, whereas sensory function and sensorimotor integration mechanisms did not differ between subtypes. Our findings suggest that the subtyping of PD patients is not a mere clinical classification but reflects different pathophysiological mechanisms. Neurophysiological parameters may represent promising biomarkers to evaluate PD subtypes and their progression. © 2020 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Daniele Belvisi
- IRCCS Neuromed, Pozzilli, Italy.,Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | | | | | - Matteo Costanzo
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | | | - Giovanni Fabbrini
- IRCCS Neuromed, Pozzilli, Italy.,Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Giovanni Defazio
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato, Italy
| | - Antonella Conte
- IRCCS Neuromed, Pozzilli, Italy.,Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Alfredo Berardelli
- IRCCS Neuromed, Pozzilli, Italy.,Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
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D'Antonio F, De Bartolo MI, Ferrazzano G, Trebbastoni A, Amicarelli S, Campanelli A, de Lena C, Berardelli A, Conte A. Somatosensory Temporal Discrimination Threshold in Patients with Cognitive Disorders. J Alzheimers Dis 2020; 70:425-432. [PMID: 31177234 DOI: 10.3233/jad-190385] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND The temporal processing of sensory information can be evaluated by testing the somatosensory temporal discrimination threshold (STDT), which is defined as the shortest interstimulus interval needed to recognize two sequential sensory stimuli as separate in time. The STDT requires the functional integrity of the basal ganglia and of the somatosensory cortex (S1). Although there is evidence that time processing is impaired in patients with Alzheimer's disease (AD), no study has yet investigated STDT in patients with various degree of cognitive impairment. OBJECTIVE The aim of our study was to understand how cognition and attention deficits affect STDT values in patients with cognitive abnormalities. METHODS We enrolled 63 patients: 28 had mild-moderate AD, 16 had mild cognitive impairment (MCI), and the remaining 19 had subjective cognitive deficit (SCD). A group of 45 age-matched healthy subjects acted as controls. Paired tactile stimuli for STDT testing consisted of square-wave electrical pulses delivered with a constant current stimulator through surface electrodes over the distal phalanx of the index finger. RESULTS STDT values were higher in AD and MCI patients than in SCD subjects or healthy controls. Changes in the STDT in AD and MCI were similar in both conditions and did not correlate with disease severity. CONCLUSIONS STDT alterations in AD and MCI may reflect a dysfunction of the dopaminergic system, which signals salient events and includes the striatum and the mesocortical and mesolimbic circuits.
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Affiliation(s)
- Fabrizia D'Antonio
- Department of Human Neuroscience, Sapienza University of Rome, Rome Italy.,PhD Program in Behavioral Neuroscience, Sapienza University of Rome, Rome, Italy
| | | | | | | | - Sara Amicarelli
- Department of Human Neuroscience, Sapienza University of Rome, Rome Italy
| | | | - Carlo de Lena
- Department of Human Neuroscience, Sapienza University of Rome, Rome Italy
| | - Alfredo Berardelli
- Department of Human Neuroscience, Sapienza University of Rome, Rome Italy.,IRCCS Neuromed, Pozzilli (IS), Italy
| | - Antonella Conte
- Department of Human Neuroscience, Sapienza University of Rome, Rome Italy.,IRCCS Neuromed, Pozzilli (IS), Italy
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De Bartolo MI, Manzo N, Ferrazzano G, Baione V, Belvisi D, Fabbrini G, Berardelli A, Conte A. Botulinum Toxin Effects on Sensorimotor Integration in Focal Dystonias. Toxins (Basel) 2020; 12:toxins12050277. [PMID: 32344856 PMCID: PMC7290883 DOI: 10.3390/toxins12050277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 04/22/2020] [Accepted: 04/23/2020] [Indexed: 12/04/2022] Open
Abstract
(1) Background: In dystonia, the somatosensory temporal discrimination threshold (STDT) is abnormally increased at rest and higher and longer-lasting during movement execution in comparison with healthy subjects (HS), suggesting an abnormal sensorimotor integration. These abnormalities are thought to depend on abnormal proprioceptive input coming from dystonic muscles. Since Botulinum toxin-A (BT-A) reduces proprioceptive input in the injected muscles, our study investigated the effects of BT-A on STDT tested at rest and during voluntary movement execution in patients with focal dystonia. (2) Methods: We enrolled 35 patients with focal dystonia: 14 patients with cervical dystonia (CD), 11 patients with blepharospasm (BSP), and 10 patients with focal hand dystonia (FHD); and 12 age-matched HS. STDT tested by delivering paired stimuli was measured in all subjects at rest and during index finger abductions. (3) Results: Patients with dystonia had higher STDT values at rest and during movement execution than HS. While BT-A did not modify STDT at rest, it reduced the abnormal values of STDT during movement in CD and FHD patients, but not in BSP patients. (4) Conclusions: BT-A improved abnormal sensorimotor integration in CD and FHD, most likely by decreasing the overflow of proprioceptive signaling from muscle dystonic activity to the thalamus.
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Affiliation(s)
- Maria Ilenia De Bartolo
- IRCCS NEUROMED, Via Atinense, 18, 86077 Pozzilli (IS), Italy; (M.I.D.B.); (N.M.); (D.B.); (G.F.); (A.C.)
| | - Nicoletta Manzo
- IRCCS NEUROMED, Via Atinense, 18, 86077 Pozzilli (IS), Italy; (M.I.D.B.); (N.M.); (D.B.); (G.F.); (A.C.)
| | - Gina Ferrazzano
- Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy; (G.F.); (V.B.)
| | - Viola Baione
- Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy; (G.F.); (V.B.)
| | - Daniele Belvisi
- IRCCS NEUROMED, Via Atinense, 18, 86077 Pozzilli (IS), Italy; (M.I.D.B.); (N.M.); (D.B.); (G.F.); (A.C.)
| | - Giovanni Fabbrini
- IRCCS NEUROMED, Via Atinense, 18, 86077 Pozzilli (IS), Italy; (M.I.D.B.); (N.M.); (D.B.); (G.F.); (A.C.)
- Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy; (G.F.); (V.B.)
| | - Alfredo Berardelli
- IRCCS NEUROMED, Via Atinense, 18, 86077 Pozzilli (IS), Italy; (M.I.D.B.); (N.M.); (D.B.); (G.F.); (A.C.)
- Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy; (G.F.); (V.B.)
- Correspondence:
| | - Antonella Conte
- IRCCS NEUROMED, Via Atinense, 18, 86077 Pozzilli (IS), Italy; (M.I.D.B.); (N.M.); (D.B.); (G.F.); (A.C.)
- Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy; (G.F.); (V.B.)
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15
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Bologna M, Paparella G, Fasano A, Hallett M, Berardelli A. Evolving concepts on bradykinesia. Brain 2020; 143:727-750. [PMID: 31834375 PMCID: PMC8205506 DOI: 10.1093/brain/awz344] [Citation(s) in RCA: 108] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 09/02/2019] [Accepted: 09/06/2019] [Indexed: 12/20/2022] Open
Abstract
Bradykinesia is one of the cardinal motor symptoms of Parkinson's disease and other parkinsonisms. The various clinical aspects related to bradykinesia and the pathophysiological mechanisms underlying bradykinesia are, however, still unclear. In this article, we review clinical and experimental studies on bradykinesia performed in patients with Parkinson's disease and atypical parkinsonism. We also review studies on animal experiments dealing with pathophysiological aspects of the parkinsonian state. In Parkinson's disease, bradykinesia is characterized by slowness, the reduced amplitude of movement, and sequence effect. These features are also present in atypical parkinsonisms, but the sequence effect is not common. Levodopa therapy improves bradykinesia, but treatment variably affects the bradykinesia features and does not significantly modify the sequence effect. Findings from animal and patients demonstrate the role of the basal ganglia and other interconnected structures, such as the primary motor cortex and cerebellum, as well as the contribution of abnormal sensorimotor processing. Bradykinesia should be interpreted as arising from network dysfunction. A better understanding of bradykinesia pathophysiology will serve as the new starting point for clinical and experimental purposes.
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Affiliation(s)
- Matteo Bologna
- Department of Human Neurosciences, Sapienza University of Rome, Italy
- IRCCS Neuromed, Pozzilli (IS), Italy
| | | | - Alfonso Fasano
- Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Toronto, Ontario, Canada
- Division of Neurology, University of Toronto, Toronto, Ontario, Canada
- Krembil Brain Institute, Toronto, Ontario, Canada
- Center for Advancing Neurotechnological Innovation to Application (CRANIA), Toronto, ON, Canada
| | - Mark Hallett
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD, USA
| | - Alfredo Berardelli
- Department of Human Neurosciences, Sapienza University of Rome, Italy
- IRCCS Neuromed, Pozzilli (IS), Italy
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16
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Dogru Huzmeli E, Yilmaz A, Okuyucu E. Analysis of the effects of subthalamic nucleus deep brain stimulation on somatosensation in Parkinson's disease patients. Neurol Sci 2019; 41:925-931. [PMID: 31845044 DOI: 10.1007/s10072-019-04168-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 11/20/2019] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Despite the subthalamic nucleus (STN) deep brain stimulation (DBS) is a treatment commonly used to ameliorate the motor symptoms of Parkinson's disease (PD), its effects on somatosensation is unclear. The purpose of this study was to investigate the potential effects of DBS on temperature, proprioceptive, tactile, exteroceptive, pain and cortical sensations, and odor identification in PD patients. METHODS The study included 14 patients (with a mean age of 59.78 ± 11.03 years; range, 44-70 years) with idiopathic PD who underwent DBS surgery for movement disorders caused by PD at the same Neurosurgery Department. All patients were tested while DBS was turned on (DBS-ON) and off (DBS-OFF). To clearly observe the effect of removing stimulation off, DBS devices were turned off by experimental clinical personnel for a minimum duration of 30 min prior to examination. Temperature, proprioceptive, tactile, exteroceptive, pain and cortical sensations, and odor identification were examined. RESULTS We found that two-point discrimination was significantly lower during DBS-ON than DBS-OFF (p = 0.031). Tactile sensation and kinesthesia deviation degree were lower during DBS-ON than DBS-OFF, but were non-significant (p > 0.05). The number of correct answers on an assessment of graphesthesia was higher during DBS-ON, but was non-significant as well (p > 0.05). Odor identification was better during DBS-OFF. CONCLUSIONS DBS may have an effective role to improve somatosensation and DBS-related benefits may not be explained by improvements in motor function alone, but rather by enhanced somatosensory processing. Further studies with larger study groups are needed.
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Affiliation(s)
- Esra Dogru Huzmeli
- Physiotherapy and Rehabilitation Department, Health Science Faculty, Hatay Mustafa Kemal University, Antakya, Hatay, Turkey.
| | - Atilla Yilmaz
- Department of Neurosurgery, Istanbul Okan University Hospital, Istanbul, Turkey
| | - Esra Okuyucu
- Department of Neurology, Tayfur Sokmen Medicine Faculty, Hatay Mustafa Kemal University, Antakya, Hatay, Turkey
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17
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Odorfer TM, Wind T, Zeller D. Temporal Discrimination Thresholds and Proprioceptive Performance: Impact of Age and Nerve Conduction. Front Neurosci 2019; 13:1241. [PMID: 31803012 PMCID: PMC6877661 DOI: 10.3389/fnins.2019.01241] [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: 08/19/2019] [Accepted: 11/04/2019] [Indexed: 11/25/2022] Open
Abstract
Background Increasing attention is payed to the contribution of somatosensory processing in motor control. In particular, temporal somatosensory discrimination has been found to be altered differentially in common movement disorders. To date, there have only been speculations as to how impaired temporal discrimination and clinical motor signs may relate to each other. Prior to disentangling this relationship, potential confounders of temporal discrimination, in particular age and peripheral nerve conduction, should be assessed, and a quantifiable measure of proprioceptive performance should be established. Objective To assess the influence of age and polyneuropathy (PNP) on somatosensory temporal discrimination threshold (STDT), temporal discrimination movement threshold (TDMT), and behavioral measures of proprioception of upper and lower limbs. Methods STDT and TDMT were assessed in 79 subjects (54 healthy, 25 with PNP; age 30–79 years). STDT was tested with surface electrodes over the thenar or dorsal foot region. TDMT was probed with needle electrodes in flexor carpi radialis (FCR) and tibialis anterior (TA) muscle. Goniometer-based devices were used to assess limb proprioception during (i) active pointing to LED markers, (ii) active movements in response to variable visual cues, and (iii) estimation of limb position following passive movements. Pointing (or estimation) error was taken as a measure of proprioceptive performance. Results In healthy subjects, higher age was associated with higher STDT and TDMT at upper and lower extremities, while age did not correlate with proprioceptive performance. Patients with PNP showed higher STDT and TDMT values and decreased proprioceptive performance in active pointing tasks compared to matched healthy subjects. As an additional finding, there was a significant correlation between performance in active pointing tasks and temporal discrimination thresholds. Conclusion Given their notable impact on measures of temporal discrimination, age and peripheral nerve conduction need to be accounted for if STDT and TDMT are applied in patients with movement disorders. As a side observation, the correlation between measures of proprioception and temporal discrimination may prompt further studies on the presumptive link between these two domains.
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Affiliation(s)
| | - Teresa Wind
- Department of Neurology, University of Würzburg, Würzburg, Germany
| | - Daniel Zeller
- Department of Neurology, University of Würzburg, Würzburg, Germany
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18
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19
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Gunendi Z, Polat M, Vuralli D, Cengiz B. Somatosensory temporal discrimination is impaired in fibromyalgia. J Clin Neurosci 2018; 60:44-48. [PMID: 30528354 DOI: 10.1016/j.jocn.2018.10.067] [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: 05/25/2018] [Accepted: 10/15/2018] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Fibromyalgia is the prototypical central sensitivity syndrome which is associated with increased sensitivity to pain and other stimuli. In this study, we aimed to evaluate whether somatosensory temporal discrimination ability, which provides information about central processing of sensory stimuli, was impaired in patients with fibromyalgia. METHODS Fifteen patients with fibromyalgia and 15 healthy subjects participated in the study. Demographic characteristics of participants and severity for fatigue, sleep quality, cognitive symptoms, somatic symptoms and health-related quality of life in fibromyalgia patients were recorded. Somatosensory temporal discrimination thresholds were measured from the dorsum of the dominant hands of the participants by using a constant current stimulator (Medtronic, Keypoint). RESULTS Patients with fibromyalgia had higher somatosensory temporal discrimination thresholds than healthy subjects (p < 0.001). There were significant correlations between STDTs and pain intensity, FIQ scores and symptom severity scale scores in fibromyalgia group (p = 0.006, r = 0.68; p = 0.037, r = 0.54; p = 0.017, r = 0.61 respectively). CONCLUSION Somatosensory temporal discrimination ability is impaired in fibromyalgia patients compared to healthy subjects. Disrupted somatosensory temporal discrimination ability correlates with increased widespread pain and severity of other symptoms including fatigue, sleep quality, cognitive symptoms, somatic symptoms and decreased functional status. The impaired somatosensory temporal discrimination ability indicates an alteration in higher cognitive sensory processing in fibromyalgia patients.
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Affiliation(s)
- Zafer Gunendi
- Gazi University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Besevler, 06510 Ankara, Turkey
| | - Musa Polat
- Gazi University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Besevler, 06510 Ankara, Turkey
| | - Doga Vuralli
- Gazi University, Faculty of Medicine, Department of Neurology and Algology, Besevler, 06510 Ankara, Turkey.
| | - Bulent Cengiz
- Gazi University, Faculty of Medicine, Department of Neurology, Motor Control Laboratory, Besevler, 06510 Ankara, Turkey
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20
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Conte A, Belvisi D, De Bartolo MI, Manzo N, Cortese FN, Tartaglia M, Ferrazzano G, Fabbrini G, Berardelli A. Abnormal sensory gating in patients with different types of focal dystonias. Mov Disord 2018; 33:1910-1917. [DOI: 10.1002/mds.27530] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 08/08/2018] [Accepted: 08/23/2018] [Indexed: 02/06/2023] Open
Affiliation(s)
- Antonella Conte
- Department of Human Neurosciences; Sapienza, University of Rome; Rome Italy
- IRCCS NEUROMED; Pozzilli IS Italy
| | | | | | - Nicoletta Manzo
- Department of Human Neurosciences; Sapienza, University of Rome; Rome Italy
| | | | - Matteo Tartaglia
- Department of Human Neurosciences; Sapienza, University of Rome; Rome Italy
| | | | - Giovanni Fabbrini
- Department of Human Neurosciences; Sapienza, University of Rome; Rome Italy
- IRCCS NEUROMED; Pozzilli IS Italy
| | - Alfredo Berardelli
- Department of Human Neurosciences; Sapienza, University of Rome; Rome Italy
- IRCCS NEUROMED; Pozzilli IS Italy
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21
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Belvisi D, Conte A, Cortese FN, Tartaglia M, Manzo N, Li Voti P, Suppa A, Berardelli A. Voluntary Movement Takes Shape: The Link Between Movement Focusing and Sensory Input Gating. Front Hum Neurosci 2018; 12:330. [PMID: 30174597 PMCID: PMC6108059 DOI: 10.3389/fnhum.2018.00330] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 07/26/2018] [Indexed: 11/13/2022] Open
Abstract
The aim of the study was to investigate the relationship between motor surround inhibition (mSI) and the modulation of somatosensory temporal discrimination threshold (STDT) induced by voluntary movement. Seventeen healthy volunteers participated in the study. To assess mSI, we delivered transcranial magnetic stimulation (TMS) single pulses to record motor evoked potentials (MEPs) from the right abductor digiti minimi (ADM; “surround muscle”) during brief right little finger flexion. mSI was expressed as the ratio of ADM MEP amplitude during movement to MEP amplitude at rest. We preliminarily measured STDT values by assessing the shortest interval at which subjects were able to recognize a pair of electric stimuli, delivered over the volar surface of the right little finger, as separate in time. We then evaluated the STDT by using the same motor task used for mSI. mSI and STDT modulation were evaluated at the same time points during movement. mSI and STDT modulation displayed similar time-dependent changes during index finger movement. In both cases, the modulation was maximally present at the onset of the movement and gradually vanished over about 200 ms. Our study provides the first neurophysiological evidence about the relationship between mSI and tactile-motor integration during movement execution.
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Affiliation(s)
| | - Antonella Conte
- IRCCS Neuromed, Pozzilli, Italy.,Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | | | - Matteo Tartaglia
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Nicoletta Manzo
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | | | - Antonio Suppa
- IRCCS Neuromed, Pozzilli, Italy.,Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Alfredo Berardelli
- IRCCS Neuromed, Pozzilli, Italy.,Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
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Somatosensory temporal discrimination in Parkinson’s disease, dystonia and essential tremor: Pathophysiological and clinical implications. Clin Neurophysiol 2018; 129:1849-1853. [DOI: 10.1016/j.clinph.2018.05.024] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 04/23/2018] [Accepted: 05/15/2018] [Indexed: 12/18/2022]
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23
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Fiorio M, Emadi Andani M, Recchia S, Tinazzi M. The somatosensory temporal discrimination threshold changes after a placebo procedure. Exp Brain Res 2018; 236:2983-2990. [DOI: 10.1007/s00221-018-5357-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 08/10/2018] [Indexed: 10/28/2022]
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Nelson AJ, Hoque T, Gunraj C, Chen R. Altered somatosensory processing in Parkinson's disease and modulation by dopaminergic medications. Parkinsonism Relat Disord 2018; 53:76-81. [DOI: 10.1016/j.parkreldis.2018.05.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 04/30/2018] [Accepted: 05/05/2018] [Indexed: 12/18/2022]
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25
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Avanzino L, Fiorio M, Conte A. Actual and Illusory Perception in Parkinson's Disease and Dystonia: A Narrative Review. Front Neurol 2018; 9:584. [PMID: 30079051 PMCID: PMC6062595 DOI: 10.3389/fneur.2018.00584] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 06/28/2018] [Indexed: 12/12/2022] Open
Abstract
Sensory information is continuously processed so as to allow behavior to be adjusted according to environmental changes. Before sensory information reaches the cortex, a number of subcortical neural structures select the relevant information to send to be consciously processed. In recent decades, several studies have shown that the pathophysiological mechanisms underlying movement disorders such as Parkinson's disease (PD) and dystonia involve sensory processing abnormalities related to proprioceptive and tactile information. These abnormalities emerge from psychophysical testing, mainly temporal discrimination, as well as from experimental paradigms based on bodily illusions. Although the link between proprioception and movement may be unequivocal, how temporal tactile information abnormalities and bodily illusions relate to motor disturbances in PD and dystonia is still a matter of debate. This review considers the role of altered sensory processing in the pathophysiology of movement disorders, focusing on how sensory alteration patterns differ between PD and dystonia. We also discuss the evidence available and the potential for developing new therapeutic strategies based on the manipulation of multi-sensory information and bodily illusions in patients with these movement disorders.
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Affiliation(s)
- Laura Avanzino
- Section of Human Physiology, Department of Experimental Medicine, University of Genoa, Genoa, Italy
| | - Mirta Fiorio
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Antonella Conte
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- IRCCS Neuromed, Pozzilli, Italy
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Gating of Sensory Input at Subcortical and Cortical Levels during Grasping in Humans. J Neurosci 2018; 38:7237-7247. [PMID: 29976624 DOI: 10.1523/jneurosci.0545-18.2018] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 05/09/2018] [Accepted: 06/22/2018] [Indexed: 01/27/2023] Open
Abstract
Afferent input from the periphery to the cortex contributes to the control of grasping. How sensory input is gated along the ascending sensory pathway and its functional role during gross and fine grasping in humans remain largely unknown. To address this question, we assessed somatosensory-evoked potential components reflecting activation at subcortical and cortical levels and psychophysical tests at rest, during index finger abduction, precision, and power grip. We found that sensory gating at subcortical level and in the primary somatosensory cortex (S1), as well as intracortical inhibition in the S1, increased during power grip compared with the other tasks. To probe the functional relevance of gating in the S1, we examined somatosensory temporal discrimination threshold by measuring the shortest time interval to perceive a pair of electrical stimuli. Somatosensory temporal discrimination threshold increased during power grip, and higher threshold was associated with increased intracortical inhibition in the S1. These novel findings indicate that humans gate sensory input at subcortical level and in the S1 largely during gross compared with fine grasping. Inhibitory processes in the S1 may increase discrimination threshold to allow better performance during power grip.SIGNIFICANCE STATEMENT Most of our daily life actions involve grasping. Here, we demonstrate that gating of afferent input increases at subcortical level and in the primary somatosensory cortex (S1) during gross compared with fine grasping in intact humans. The precise timing of sensory information is critical for human perception and behavior. Notably, we found that the ability to perceive a pair of electrical stimuli, as measured by the somatosensory temporal discrimination threshold, increased during power grip compared with the other tasks. We propose that reduced afferent input to the S1 during gross grasping behaviors diminishes temporal discrimination of sensory processes related, at least in part, to increased inhibitory processes within the S1.
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Electroencephalographic read-outs of the modulation of cortical network activity by deep brain stimulation. Bioelectron Med 2018; 4:2. [PMID: 32232078 PMCID: PMC7098231 DOI: 10.1186/s42234-018-0003-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 02/15/2018] [Indexed: 12/24/2022] Open
Abstract
Deep brain stimulation (DBS), a reversible and adjustable treatment for neurological and psychiatric refractory disorders, consists in delivering electrical currents to neuronal populations located in subcortical structures. The targets of DBS are spatially restricted, but connect to many parts of the brain, including the cortex, which might explain the observed clinical benefits in terms of symptomatology. The DBS mechanisms of action at a large scale are however poorly understood, which has motivated several groups to recently conduct many research programs to monitor cortical responses to DBS. Here we review the knowledge gathered from the use of electroencephalography (EEG) in patients treated by DBS. We first focus on the methodology to record and process EEG signals concurrently to DBS. In the second part of the review, we address the clinical and scientific benefits brought by EEG/DBS studies so far.
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28
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Lee MS, Lee MJ, Conte A, Berardelli A. Abnormal somatosensory temporal discrimination in Parkinson’s disease: Pathophysiological correlates and role in motor control deficits. Clin Neurophysiol 2018; 129:442-447. [DOI: 10.1016/j.clinph.2017.11.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Revised: 11/13/2017] [Accepted: 11/21/2017] [Indexed: 12/14/2022]
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29
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Conte A, McGovern EM, Narasimham S, Beck R, Killian O, O'Riordan S, Reilly RB, Hutchinson M. Temporal Discrimination: Mechanisms and Relevance to Adult-Onset Dystonia. Front Neurol 2017; 8:625. [PMID: 29234300 PMCID: PMC5712317 DOI: 10.3389/fneur.2017.00625] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 11/07/2017] [Indexed: 12/05/2022] Open
Abstract
Temporal discrimination is the ability to determine that two sequential sensory stimuli are separated in time. For any individual, the temporal discrimination threshold (TDT) is the minimum interval at which paired sequential stimuli are perceived as being asynchronous; this can be assessed, with high test–retest and inter-rater reliability, using a simple psychophysical test. Temporal discrimination is disordered in a number of basal ganglia diseases including adult-onset dystonia, of which the two most common phenotypes are cervical dystonia and blepharospasm. The causes of adult-onset focal dystonia are unknown; genetic, epigenetic, and environmental factors are relevant. Abnormal TDTs in adult-onset dystonia are associated with structural and neurophysiological changes considered to reflect defective inhibitory interneuronal processing within a network which includes the superior colliculus, basal ganglia, and primary somatosensory cortex. It is hypothesized that abnormal temporal discrimination is a mediational endophenotype and, when present in unaffected relatives of patients with adult-onset dystonia, indicates non-manifesting gene carriage. Using the mediational endophenotype concept, etiological factors in adult-onset dystonia may be examined including (i) the role of environmental exposures in disease penetrance and expression; (ii) sexual dimorphism in sex ratios at age of onset; (iii) the pathogenesis of non-motor symptoms of adult-onset dystonia; and (iv) subcortical mechanisms in disease pathogenesis.
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Affiliation(s)
- Antonella Conte
- Department of Neurology and Psychiatry, Sapienza, University of Rome, Rome, Italy.,IRCCS Neuromed, Pozzilli, Isernia, Italy
| | - Eavan M McGovern
- Department of Neurology, St Vincent's University Hospital Dublin, Dublin, Ireland.,School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| | - Shruti Narasimham
- Trinity Centre for Bioengineering, Trinity College, The University of Dublin, Dublin, Ireland.,School of Medicine, Trinity College, The University of Dublin, Dublin, Ireland.,School of Engineering, Trinity College, The University of Dublin, Dublin, Ireland
| | - Rebecca Beck
- Trinity Centre for Bioengineering, Trinity College, The University of Dublin, Dublin, Ireland.,School of Medicine, Trinity College, The University of Dublin, Dublin, Ireland.,School of Engineering, Trinity College, The University of Dublin, Dublin, Ireland
| | - Owen Killian
- Trinity Centre for Bioengineering, Trinity College, The University of Dublin, Dublin, Ireland.,School of Medicine, Trinity College, The University of Dublin, Dublin, Ireland.,School of Engineering, Trinity College, The University of Dublin, Dublin, Ireland
| | - Sean O'Riordan
- Department of Neurology, St Vincent's University Hospital Dublin, Dublin, Ireland.,School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| | - Richard B Reilly
- Trinity Centre for Bioengineering, Trinity College, The University of Dublin, Dublin, Ireland.,School of Medicine, Trinity College, The University of Dublin, Dublin, Ireland.,School of Engineering, Trinity College, The University of Dublin, Dublin, Ireland
| | - Michael Hutchinson
- Department of Neurology, St Vincent's University Hospital Dublin, Dublin, Ireland.,School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
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Conte A, Belvisi D, Manzo N, Bologna M, Barone F, Tartaglia M, Upadhyay N, Berardelli A. Understanding the link between somatosensory temporal discrimination and movement execution in healthy subjects. Physiol Rep 2017; 4:4/18/e12899. [PMID: 27650249 PMCID: PMC5037912 DOI: 10.14814/phy2.12899] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Accepted: 07/25/2016] [Indexed: 01/28/2023] Open
Abstract
The somatosensory temporal discrimination threshold (STDT) is the shortest interval at which an individual recognizes paired stimuli as separate in time. We investigated whether and how voluntary movement modulates STDT in healthy subjects. In 17 healthy participants, we tested STDT during voluntary index‐finger abductions at several time‐points after movement onset and during motor preparation. We then tested whether voluntary movement‐induced STDT changes were specific for the body segment moved, depended on movement kinematics, on the type of movement or on the intensity for delivering paired electrical stimuli for STDT. To understand the mechanisms underlying STDT modulation, we also tested STDT during motor imagery and after delivering repetitive transcranial magnetic stimulation to elicit excitability changes in the primary somatosensory cortex (S1). When tested on the moving hand at movement onset and up to 200 msec thereafter, STDT values increased from baseline, but during motor preparation remained unchanged. STDT values changed significantly during fast and slow index‐finger movements and also, though less, during passive index‐finger abductions, whereas during tonic index‐finger abductions they remained unchanged. STDT also remained unchanged when tested in body parts other than those engaged in movement and during imagined movement. Nor did testing STDT at increased intensity influence movement‐induced STDT changes. The cTBS‐induced S1 cortical changes left movement‐induced STDT changes unaffected. Our findings suggest that movement execution in healthy subjects may alter STDT processing.
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Affiliation(s)
| | | | - Nicoletta Manzo
- Department of Neurology and Psychiatry, Sapienza University Rome, Rome, Italy
| | | | - Francesca Barone
- Department of Neurology and Psychiatry, Sapienza University Rome, Rome, Italy
| | - Matteo Tartaglia
- Department of Neurology and Psychiatry, Sapienza University Rome, Rome, Italy
| | - Neeraj Upadhyay
- Department of Neurology and Psychiatry, Sapienza University Rome, Rome, Italy
| | - Alfredo Berardelli
- IRCCS Neuromed, Pozzilli (IS), Italy Department of Neurology and Psychiatry, Sapienza University Rome, Rome, Italy
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Leodori G, Formica A, Zhu X, Conte A, Belvisi D, Cruccu G, Hallett M, Berardelli A. The third-stimulus temporal discrimination threshold: focusing on the temporal processing of sensory input within primary somatosensory cortex. J Neurophysiol 2017; 118:2311-2317. [PMID: 28747470 DOI: 10.1152/jn.00947.2016] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Revised: 07/21/2017] [Accepted: 07/21/2017] [Indexed: 11/22/2022] Open
Abstract
The somatosensory temporal discrimination threshold (STDT) has been used in recent years to investigate time processing of sensory information, but little is known about the physiological correlates of somatosensory temporal discrimination. The objective of this study was to investigate whether the time interval required to discriminate between two stimuli varies according to the number of stimuli in the task. We used the third-stimulus temporal discrimination threshold (ThirdDT), defined as the shortest time interval at which an individual distinguishes a third stimulus following a pair of stimuli delivered at the STDT. The STDT and ThirdDT were assessed in 31 healthy subjects. In a subgroup of 10 subjects, we evaluated the effects of the stimuli intensity on the ThirdDT. In a subgroup of 16 subjects, we evaluated the effects of S1 continuous theta-burst stimulation (S1-cTBS) on the STDT and ThirdDT. Results show that ThirdDT is shorter than STDT. We found a positive correlation between STDT and ThirdDT values. As long as the stimulus intensity was within the perceivable and painless range, it did not affect ThirdDT values. S1-cTBS significantly affected both STDT and ThirdDT, although the latter was affected to a greater extent and for a longer period of time. We conclude that the interval needed to discriminate between time-separated tactile stimuli is related to the number of stimuli used in the task. STDT and ThirdDT are encoded in S1, probably by a shared tactile temporal encoding mechanism whose performance rapidly changes during the perception process. ThirdDT is a new method to measure somatosensory temporal discrimination.NEW & NOTEWORTHY To investigate whether the time interval required to discriminate between stimuli varies according to changes in the stimulation pattern, we used the third-stimulus temporal discrimination threshold (ThirdDT). We found that the somatosensory temporal discrimination acuity varies according to the number of stimuli in the task. The ThirdDT is a new method to measure somatosensory temporal discrimination and a possible index of inhibitory activity at the S1 level.
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Affiliation(s)
- Giorgio Leodori
- Department of Neurology and Psychiatry, "Sapienza" University of Rome, Rome, Italy.,Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
| | | | - Xiaoying Zhu
- Department of Neurology and Psychiatry, "Sapienza" University of Rome, Rome, Italy.,Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China; and
| | - Antonella Conte
- Department of Neurology and Psychiatry, "Sapienza" University of Rome, Rome, Italy.,IRCCS Neuromed, Pozzilli (IS), Italy
| | | | - Giorgio Cruccu
- Department of Neurology and Psychiatry, "Sapienza" University of Rome, Rome, Italy
| | - Mark Hallett
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
| | - Alfredo Berardelli
- Department of Neurology and Psychiatry, "Sapienza" University of Rome, Rome, Italy; .,IRCCS Neuromed, Pozzilli (IS), Italy
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Conte A, Belvisi D, Tartaglia M, Cortese FN, Baione V, Battista E, Zhu XY, Fabbrini G, Berardelli A. Abnormal Temporal Coupling of Tactile Perception and Motor Action in Parkinson's Disease. Front Neurol 2017. [PMID: 28634466 PMCID: PMC5459880 DOI: 10.3389/fneur.2017.00249] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Evidence shows altered somatosensory temporal discrimination threshold (STDT) in Parkinson’s disease in comparison to normal subjects. In healthy subjects, movement execution modulates STDT values through mechanisms of sensory gating. We investigated whether STDT modulation during movement execution in patients with Parkinson’s disease differs from that in healthy subjects. In 24 patients with Parkinson’s disease and 20 healthy subjects, we tested STDT at baseline and during index finger abductions (at movement onset “0”, 100, and 200 ms thereafter). We also recorded kinematic features of index finger abductions. Fifteen out of the 24 patients were also tested ON medication. In healthy subjects, STDT increased significantly at 0, 100, and 200 ms after movement onset, whereas in patients with Parkinson’s disease in OFF therapy, it increased significantly at 0 and 100 ms but returned to baseline values at 200 ms. When patients were tested ON therapy, STDT during index finger abductions increased significantly, with a time course similar to that of healthy subjects. Differently from healthy subjects, in patients with Parkinson’s disease, the mean velocity of the finger abductions decreased according to the time lapse between movement onset and the delivery of the paired electrical stimuli for testing somatosensory temporal discrimination. In conclusion, patients with Parkinson’s disease show abnormalities in the temporal coupling between tactile information and motor outflow. Our study provides first evidence that altered temporal processing of sensory information play a role in the pathophysiology of motor symptoms in Parkinson’s disease.
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Affiliation(s)
- Antonella Conte
- Department of Neurology and Psychiatry, Sapienza University Rome, Rome, Italy.,IRCCS Neuromed, Pozzilli, Italy
| | | | - Matteo Tartaglia
- Department of Neurology and Psychiatry, Sapienza University Rome, Rome, Italy
| | | | - Viola Baione
- Department of Neurology and Psychiatry, Sapienza University Rome, Rome, Italy
| | - Emanuele Battista
- Department of Neurology and Psychiatry, Sapienza University Rome, Rome, Italy
| | - Xiao Y Zhu
- Department of Neurology and Psychiatry, Sapienza University Rome, Rome, Italy.,Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Giovanni Fabbrini
- Department of Neurology and Psychiatry, Sapienza University Rome, Rome, Italy.,IRCCS Neuromed, Pozzilli, Italy
| | - Alfredo Berardelli
- Department of Neurology and Psychiatry, Sapienza University Rome, Rome, Italy.,IRCCS Neuromed, Pozzilli, Italy
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Sridharan KS, Højlund A, Johnsen EL, Sunde NA, Johansen LG, Beniczky S, Østergaard K. Differentiated effects of deep brain stimulation and medication on somatosensory processing in Parkinson's disease. Clin Neurophysiol 2017; 128:1327-1336. [PMID: 28570866 DOI: 10.1016/j.clinph.2017.04.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 03/14/2017] [Accepted: 04/19/2017] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Deep brain stimulation (DBS) and dopaminergic medication effectively alleviate the motor symptoms in Parkinson's disease (PD) patients, but their effects on the sensory symptoms of PD are still not well understood. To explore early somatosensory processing in PD, we recorded magnetoencephalography (MEG) from thirteen DBS-treated PD patients and ten healthy controls during median nerve stimulation. METHODS PD patients were measured during DBS-treated, untreated and dopaminergic-medicated states. We focused on early cortical somatosensory processing as indexed by N20m, induced gamma augmentation (31-45Hz and 55-100Hz) and induced beta suppression (13-30Hz). PD patients' motor symptoms were assessed by UPDRS-III. RESULTS Using Bayesian statistics, we found positive evidence for differentiated effects of treatments on the induced gamma augmentation (31-45Hz) with highest gamma in the dopaminergic-medicated state and lowest in the DBS-treated and untreated states. In contrast, UPDRS-III scores showed beneficial effects of both DBS and dopaminergic medication on the patients' motor symptoms. Furthermore, treatments did not affect the amplitude of N20m. CONCLUSIONS Our results suggest differentiated effects of DBS and dopaminergic medication on cortical somatosensory processing in PD patients despite consistent ameliorating effects of both treatments on PD motor symptoms. SIGNIFICANCE The differentiated effect suggests differences in the effect mechanisms of the two treatments.
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Affiliation(s)
- Kousik Sarathy Sridharan
- Department of Neurology, Aarhus University Hospital, Nørrebrogade 44, 8000 Aarhus, Denmark; Center of Functionally Integrative Neuroscience (CFIN), Aarhus University, Nørrebrogade 44, 8000 Aarhus, Denmark.
| | - Andreas Højlund
- Department of Neurology, Aarhus University Hospital, Nørrebrogade 44, 8000 Aarhus, Denmark; Center of Functionally Integrative Neuroscience (CFIN), Aarhus University, Nørrebrogade 44, 8000 Aarhus, Denmark
| | - Erik Lisbjerg Johnsen
- Department of Neurology, Aarhus University Hospital, Nørrebrogade 44, 8000 Aarhus, Denmark
| | - Niels Aagaard Sunde
- Department of Neurosurgery, Aarhus University Hospital, Nørrebrogade 44, 8000 Aarhus, Denmark
| | | | - Sándor Beniczky
- Department of Clinical Neurophysiology, Aarhus University Hospital, Nørrebrogade 44, 8000 Aarhus, Denmark; Department of Clinical Neurophysiology, Danish Epilepsy Center, Kolonivej 1, 4293 Dianalund, Denmark
| | - Karen Østergaard
- Department of Neurology, Aarhus University Hospital, Nørrebrogade 44, 8000 Aarhus, Denmark; Center of Functionally Integrative Neuroscience (CFIN), Aarhus University, Nørrebrogade 44, 8000 Aarhus, Denmark
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The Effect of L-Dopa/Carbidopa Intestinal Gel in Parkinson Disease Assessed Using Neurophysiologic Techniques. Clin Neuropharmacol 2017; 39:302-305. [PMID: 27755134 DOI: 10.1097/wnf.0000000000000184] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND By providing a stable and smooth L-dopa plasmatic level, L-dopa/carbidopa intestinal gel reproduces the physiological continuous dopaminergic receptor stimulation in patients with Parkinson disease (PD), and it therefore represents a suitable tool to investigate the role of the altered dopaminergic neurotransmission in the pathophysiology of motor and sensory abnormalities in this condition. METHODS We studied 11 patients with advanced PD being treated with L-Dopa/carbidopa intestinal gel (LCIG) and 11 age-matched healthy subjects. Bradykinesia was measured by kinematic recording of repetitive finger movements (finger tapping), whereas sensory abnormalities were evaluated using the somatosensory tactile discrimination threshold. All the patients were studied off and on medication, in 2 different experimental sessions. RESULTS Parkinson disease patients were very slow and hypokinetic during finger tapping, with no progressive reduction in amplitude or speed being observed during movement repetition. Somatosensory temporal discrimination threshold values were higher in PD patients than in healthy subjects. The neurophysiologic assessment of the effects of LCIG in advanced PD patients demonstrates an improvement, although not normalization, of motor and sensory abnormalities. CONCLUSIONS The study provides an objective evaluation of the effects of LCIG on motor and sensory abnormalities in PD. The results suggest that besides dopaminergic mechanisms motor and sensory abnormalities in PD reflect a varying combination of pathophysiologic mechanisms.
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35
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Mc Govern EM, Butler JS, Beiser I, Williams L, Quinlivan B, Narasiham S, Beck R, O'Riordan S, Reilly RB, Hutchinson M. A comparison of stimulus presentation methods in temporal discrimination testing. Physiol Meas 2017; 38:N57-N64. [PMID: 28099169 DOI: 10.1088/1361-6579/38/2/n57] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The temporal discrimination threshold (TDT) is the shortest time interval at which an individual detects two stimuli to be asynchronous (normal = 30-50 ms). It has been shown to be abnormal in patients with disorders affecting the basal ganglia including adult onset idiopathic focal dystonia (AOIFD). Up to 97% of patients have an abnormal TDT with age- and sex-related penetrance in unaffected relatives, demonstrating an autosomal dominant inheritance pattern. These findings support the use of the TDT as a pre-clinical biomarker for AOIFD. The usual stimulus presentation method involves the presentation of progressively asynchronous stimuli; when three sequential stimuli are reported asynchronous is taken as a participant's TDT. To investigate the robustness of the 'staircase' method of presentation, we introduced a method of randomised presentation order to explore any potential 'learning effect' that may be associated with this existing method. The aim of this study was to investigate differences in temporal discrimination using two methods of stimulus presentation. Thirty healthy volunteers were recruited to the study (mean age 33.73 ± 3.4 years). Visual and tactile TDT testing using a staircase and randomised method of presentation order was carried out in a single session. There was a strong relationship between the staircase and random method for TDT values. This observed consistency between testing methods suggests that the existing experimental approach is a robust method of recording an individual's TDT. In addition, our newly devised randomised paradigm is a reproducible and more efficient method for data acquisition in the clinic setting. However, the two presentation methods yield different absolute TDT results and either of the two methods should be used uniformly in all participants in any one particular study.
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Affiliation(s)
- Eavan M Mc Govern
- Department of Neurology, St. Vincent's University Hospital, Dublin, Ireland. School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland. Trinity Centre for Bioengineering, Dublin, Ireland
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36
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Vuralli D, Evren Boran H, Cengiz B, Coskun O, Bolay H. Chronic Migraine Is Associated With Sustained Elevation of Somatosensory Temporal Discrimination Thresholds. Headache 2016; 56:1439-1447. [DOI: 10.1111/head.12947] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 05/20/2016] [Accepted: 06/27/2016] [Indexed: 01/21/2023]
Affiliation(s)
- Doga Vuralli
- Department of Neurology and Algology; Gazi University Faculty of Medicine; Besevler Ankara 06510 Turkey
- Neuropsychiatry Center, Gazi University Faculty of Medicine; Besevler 06510 Ankara Turkey
| | - H. Evren Boran
- Department of Neurology and Algology; Gazi University Faculty of Medicine; Besevler Ankara 06510 Turkey
- Neuropsychiatry Center, Gazi University Faculty of Medicine; Besevler 06510 Ankara Turkey
| | - Bulent Cengiz
- Department of Neurology, Motor Control Laboratory; Gazi University Faculty of Medicine; Besevler Ankara 06510 Turkey
| | - Ozlem Coskun
- Department of Neurology and Algology; Gazi University Faculty of Medicine; Besevler Ankara 06510 Turkey
| | - Hayrunnisa Bolay
- Department of Neurology and Algology; Gazi University Faculty of Medicine; Besevler Ankara 06510 Turkey
- Neuropsychiatry Center, Gazi University Faculty of Medicine; Besevler 06510 Ankara Turkey
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Somatosensory temporal discrimination threshold in Parkinson’s disease parallels disease severity and duration. Clin Neurophysiol 2016; 127:2985-2989. [DOI: 10.1016/j.clinph.2016.06.026] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 04/18/2016] [Accepted: 06/29/2016] [Indexed: 11/22/2022]
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38
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Subthalamic deep brain stimulation modulates conscious perception of sensory function in Parkinson's disease. Pain 2016; 157:2758-2765. [DOI: 10.1097/j.pain.0000000000000697] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Suppa A, Bologna M, Conte A, Berardelli A, Fabbrini G. The effect of L-dopa in Parkinson’s disease as revealed by neurophysiological studies of motor and sensory functions. Expert Rev Neurother 2016; 17:181-192. [DOI: 10.1080/14737175.2016.1219251] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Antonio Suppa
- Department of Neurology and Psychiatry, Sapienza University of Rome and Neuromed Institute IRCCS, Pozzilli, Italy
| | - Matteo Bologna
- Department of Neurology and Psychiatry, Sapienza University of Rome and Neuromed Institute IRCCS, Pozzilli, Italy
| | - Antonella Conte
- Department of Neurology and Psychiatry, Sapienza University of Rome and Neuromed Institute IRCCS, Pozzilli, Italy
| | - Alfredo Berardelli
- Department of Neurology and Psychiatry, Sapienza University of Rome and Neuromed Institute IRCCS, Pozzilli, Italy
| | - Giovanni Fabbrini
- Department of Neurology and Psychiatry, Sapienza University of Rome and Neuromed Institute IRCCS, Pozzilli, Italy
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Turgeon M, Lustig C, Meck WH. Cognitive Aging and Time Perception: Roles of Bayesian Optimization and Degeneracy. Front Aging Neurosci 2016; 8:102. [PMID: 27242513 PMCID: PMC4870863 DOI: 10.3389/fnagi.2016.00102] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2016] [Accepted: 04/20/2016] [Indexed: 12/14/2022] Open
Abstract
This review outlines the basic psychological and neurobiological processes associated with age-related distortions in timing and time perception in the hundredths of milliseconds-to-minutes range. The difficulty in separating indirect effects of impairments in attention and memory from direct effects on timing mechanisms is addressed. The main premise is that normal aging is commonly associated with increased noise and temporal uncertainty as a result of impairments in attention and memory as well as the possible reduction in the accuracy and precision of a central timing mechanism supported by dopamine-glutamate interactions in cortico-striatal circuits. Pertinent to these findings, potential interventions that may reduce the likelihood of observing age-related declines in timing are discussed. Bayesian optimization models are able to account for the adaptive changes observed in time perception by assuming that older adults are more likely to base their temporal judgments on statistical inferences derived from multiple trials than on a single trial's clock reading, which is more susceptible to distortion. We propose that the timing functions assigned to the age-sensitive fronto-striatal network can be subserved by other neural networks typically associated with finely-tuned perceptuo-motor adjustments, through degeneracy principles (different structures serving a common function).
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Affiliation(s)
- Martine Turgeon
- Douglas Mental Health University Institute, McGill UniversityMontreal, QC, Canada
| | - Cindy Lustig
- Department of Psychology, University of MichiganAnn Arbor, MI, USA
| | - Warren H. Meck
- Department of Psychology and Neuroscience, Duke UniversityDurham, NC, USA
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Somatosensory Temporal Discrimination Threshold Involves Inhibitory Mechanisms in the Primary Somatosensory Area. J Neurosci 2016; 36:325-35. [PMID: 26758826 DOI: 10.1523/jneurosci.2008-15.2016] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
UNLABELLED Somatosensory temporal discrimination threshold (STDT) is defined as the shortest time interval necessary for a pair of tactile stimuli to be perceived as separate. Although STDT is altered in several neurological disorders, its neural bases are not entirely clear. We used continuous theta burst stimulation (cTBS) to condition the excitability of the primary somatosensory cortex in healthy humans to examine its possible contribution to STDT. Excitability was assessed using the recovery cycle of the N20 component of somatosensory evoked potentials (SEP) and the area of high-frequency oscillations (HFO). cTBS increased STDT and reduced inhibition in the N20 recovery cycle at an interstimulus interval of 5 ms. It also reduced the amplitude of late HFO. All three effects were correlated. There was no effect of cTBS over the secondary somatosensory cortex on STDT, although it reduced the N120 component of the SEP. STDT is assessed conventionally with a simple ascending method. To increase insight into the effect of cTBS, we measured temporal discrimination with a psychophysical method. cTBS reduced the slope of the discrimination curve, consistent with a reduction of the quality of sensory information caused by an increase in noise. We hypothesize that cTBS reduces the effectiveness of inhibitory interactions normally used to sharpen temporal processing of sensory inputs. This reduction in discriminability of sensory input is equivalent to adding neural noise to the signal. SIGNIFICANCE STATEMENT Precise timing of sensory information is crucial for nearly every aspect of human perception and behavior. One way to assess the ability to analyze temporal information in the somatosensory domain is to measure the somatosensory temporal discrimination threshold (STDT), defined as the shortest time interval necessary for a pair of tactile stimuli to be perceived as separate. In this study, we found that STDT depends on inhibitory mechanisms within the primary somatosensory area (S1). This finding helps interpret the sensory processing deficits in neurological diseases, such as focal dystonia and Parkinson's disease, and possibly prompts future studies using neurostimulation techniques over S1 for therapeutic purposes in dystonic patients.
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Temporal discrimination threshold with healthy aging. Neurobiol Aging 2016; 43:174-9. [PMID: 27255827 DOI: 10.1016/j.neurobiolaging.2016.04.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 02/10/2016] [Accepted: 04/13/2016] [Indexed: 01/16/2023]
Abstract
The temporal discrimination threshold (TDT) is the shortest interstimulus interval at which a subject can perceive successive stimuli as separate. To investigate the effects of aging on TDT, we studied tactile TDT using the method of limits with 120% of sensory threshold in each hand for each of 100 healthy volunteers, equally divided among men and women, across 10 age groups, from 18 to 79 years. Linear regression analysis showed that age was significantly related to left-hand mean, right-hand mean, and mean of 2 hands with R-square equal to 0.08, 0.164, and 0.132, respectively. Reliability analysis indicated that the 3 measures had fair-to-good reliability (intraclass correlation coefficient: 0.4-0.8). We conclude that TDT is affected by age and has fair-to-good reproducibility using our technique.
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43
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Boran HE, Cengiz B, Bolay H. Somatosensory temporal discrimination is prolonged during migraine attacks. Headache 2015; 56:104-12. [DOI: 10.1111/head.12734] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2015] [Indexed: 12/12/2022]
Affiliation(s)
- H. Evren Boran
- Department of Neurology; Gazi University Faculty of Medicine; Besevler 06510 Ankara Turkey
- Motor Control Laboratory, Department of Neurology; Gazi University Faculty of Medicine; Besevler 06510 Ankara Turkey
| | - Bülent Cengiz
- Department of Neurology; Gazi University Faculty of Medicine; Besevler 06510 Ankara Turkey
- Motor Control Laboratory, Department of Neurology; Gazi University Faculty of Medicine; Besevler 06510 Ankara Turkey
| | - Hayrunnisa Bolay
- Department of Neurology; Gazi University Faculty of Medicine; Besevler 06510 Ankara Turkey
- Neuropsychiatry Centre, Gazi University; Besevler 06510 Ankara Turkey
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Alhourani A, McDowell MM, Randazzo MJ, Wozny TA, Kondylis ED, Lipski WJ, Beck S, Karp JF, Ghuman AS, Richardson RM. Network effects of deep brain stimulation. J Neurophysiol 2015; 114:2105-17. [PMID: 26269552 DOI: 10.1152/jn.00275.2015] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 08/10/2015] [Indexed: 11/22/2022] Open
Abstract
The ability to differentially alter specific brain functions via deep brain stimulation (DBS) represents a monumental advance in clinical neuroscience, as well as within medicine as a whole. Despite the efficacy of DBS in the treatment of movement disorders, for which it is often the gold-standard therapy when medical management becomes inadequate, the mechanisms through which DBS in various brain targets produces therapeutic effects is still not well understood. This limited knowledge is a barrier to improving efficacy and reducing side effects in clinical brain stimulation. A field of study related to assessing the network effects of DBS is gradually emerging that promises to reveal aspects of the underlying pathophysiology of various brain disorders and their response to DBS that will be critical to advancing the field. This review summarizes the nascent literature related to network effects of DBS measured by cerebral blood flow and metabolic imaging, functional imaging, and electrophysiology (scalp and intracranial electroencephalography and magnetoencephalography) in order to establish a framework for future studies.
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Affiliation(s)
- Ahmad Alhourani
- Department of Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Michael M McDowell
- Department of Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Michael J Randazzo
- Department of Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Thomas A Wozny
- Department of Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | | | - Witold J Lipski
- Department of Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Sarah Beck
- Department of Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jordan F Karp
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania; and
| | - Avniel S Ghuman
- Department of Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania; Center for the Neural Basis of Cognition, Pittsburgh, Pennsylvania
| | - R Mark Richardson
- Department of Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania; Center for the Neural Basis of Cognition, Pittsburgh, Pennsylvania
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Gee LE, Chen N, Ramirez-Zamora A, Shin DS, Pilitsis JG. The effects of subthalamic deep brain stimulation on mechanical and thermal thresholds in 6OHDA-lesioned rats. Eur J Neurosci 2015; 42:2061-9. [PMID: 26082992 DOI: 10.1111/ejn.12992] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 06/08/2015] [Accepted: 06/11/2015] [Indexed: 12/21/2022]
Abstract
Chronic pain is a major complaint for up to 85% of Parkinson's disease patients; however, it often not identified as a symptom of Parkinson's disease. Adequate treatment of motor symptoms often provides analgesic effects in Parkinson's patients but how this occurs remains unclear. Studies have shown both Parkinson's patients and 6-hydroxydopamine-lesioned rats exhibit decreased sensory thresholds. In humans, some show improvements in these deficits after subthalamic deep brain stimulation, while others report no change. Differing methods of testing and response criteria may explain these varying results. We examined this effect in 6-hydroxydopamine-lesioned rats. Sprague-Dawley rats were unilaterally implanted with subthalamic stimulating electrodes in the lesioned right hemisphere and sensory thresholds were tested using von Frey, tail-flick and hot-plate tests. Tests were done during and off subthalamic stimulation at 50 and 150 Hz to assess its effects on sensory thresholds. The 6-hydroxydopamine-lesioned animals exhibited lower mechanical (left paw, P < 0.01) and thermal thresholds than shams (hot plate, P < 0.05). Both 50 and 150 Hz increased mechanical (left paw; P < 0.01) and thermal thresholds in 6-hydroxydopamine-lesioned rats (hot-plate test: 150 Hz, P < 0.05, 50 Hz, P < 0.01). Interestingly, during von Frey testing, low-frequency stimulation provided a more robust improvement in some 6OHDA lesioned rats, while in others, the magnitude of improvement on high-frequency stimulation was greater. This study shows that subthalamic deep brain stimulation improves mechanical allodynia and thermal hyperalgesia in 6-hydroxydopamine-lesioned animals at both high and low frequencies. Furthermore, we suggest considering using low-frequency stimulation when treating Parkinson's patients where pain remains the predominant complaint.
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Affiliation(s)
- Lucy E Gee
- Center for Neuroscience and Neuropharmacology, Albany Medical College, Albany, NY, USA.,Department of Neurosurgery, AMC Neurosurgery Group, Albany Medical Center, 47 New Scotland Ave, MC 10, Physicians Pavilion, 1st Floor, Albany, NY, 12208, USA
| | - Nita Chen
- Center for Neuroscience and Neuropharmacology, Albany Medical College, Albany, NY, USA
| | | | - Damian S Shin
- Center for Neuroscience and Neuropharmacology, Albany Medical College, Albany, NY, USA
| | - Julie G Pilitsis
- Center for Neuroscience and Neuropharmacology, Albany Medical College, Albany, NY, USA.,Department of Neurosurgery, AMC Neurosurgery Group, Albany Medical Center, 47 New Scotland Ave, MC 10, Physicians Pavilion, 1st Floor, Albany, NY, 12208, USA
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Does the cerebellum intervene in the abnormal somatosensory temporal discrimination in Parkinson's disease? Parkinsonism Relat Disord 2015; 21:789-92. [DOI: 10.1016/j.parkreldis.2015.04.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2014] [Revised: 04/06/2015] [Accepted: 04/07/2015] [Indexed: 11/24/2022]
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Nishikawa N, Shimo Y, Wada M, Hattori N, Kitazawa S. Effects of aging and idiopathic Parkinson's disease on tactile temporal order judgment. PLoS One 2015; 10:e0118331. [PMID: 25760621 PMCID: PMC4356579 DOI: 10.1371/journal.pone.0118331] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Accepted: 01/13/2015] [Indexed: 11/22/2022] Open
Abstract
It is generally accepted that the basal ganglia play an important role in interval timing that requires the measurement of temporal durations. By contrast, it remains controversial whether the basal ganglia play an essential role in temporal order judgment (TOJ) of successive stimuli, a behavior that does not necessarily require the measurement of durations in time. To address this issue, we compared the effects of idiopathic Parkinson’s disease (PD) on the TOJ of two successive taps delivered to each hand, with the arms uncrossed in one condition and crossed in another. In addition to age-matched elderly participants without PD (non-PD), we examined young healthy participants so that the effect of aging could serve as a control for evaluating the effects of PD. There was no significant difference between PD and non-PD participants in any parameter of TOJ under either arm posture, although reaction time was significantly longer in PD compared with non-PD participants. By contrast, the effect of aging was apparent in both conditions. With their arms uncrossed, the temporal resolution (the interstimulus interval that yielded 84% correct responses) in elderly participants was significantly worse compared with young participants. With their arms crossed, elderly participants made more errors at longer intervals (~1 s) than young participants, although both age groups showed similar judgment reversal at moderately short intervals (~200 ms). These results indicate that the basal ganglia and dopaminergic systems do not play essential roles in tactile TOJ involving both hands and that the effect of aging on TOJ is mostly independent of the dopaminergic systems.
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Affiliation(s)
- Natsuko Nishikawa
- Department of Neurology, Juntendo University School of Medicine, Tokyo, 113-8421, Japan
| | - Yasushi Shimo
- Department of Neurology, Juntendo University School of Medicine, Tokyo, 113-8421, Japan
| | - Makoto Wada
- Department of Neurophysiology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
- Developmental Disorders Section, Department of Rehabilitation for Brain Functions, Research Institute of National Rehabilitation Center for Persons with Disabilities, Tokorozawa, Japan
| | - Nobutaka Hattori
- Department of Neurology, Juntendo University School of Medicine, Tokyo, 113-8421, Japan
| | - Shigeru Kitazawa
- Department of Neurophysiology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
- Department of Brain Physiology, Graduate School of Medicine, Osaka University, Osaka, Japan
- Dynamic Brain Network Laboratory, Graduate School of Frontiers Bioscience, Osaka University, Osaka, Japan
- * E-mail:
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Conte A, Ferrazzano G, Manzo N, Leodori G, Fabbrini G, Fasano A, Tinazzi M, Berardelli A. Somatosensory temporal discrimination in essential tremor and isolated head and voice tremors. Mov Disord 2015; 30:822-7. [PMID: 25736856 DOI: 10.1002/mds.26163] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 01/09/2015] [Accepted: 01/15/2015] [Indexed: 02/05/2023] Open
Abstract
The aim of this study was to investigate the somatosensory temporal discrimination threshold in patients with essential tremor (sporadic and familial) and to evaluate whether somatosensory temporal discrimination threshold values differ depending on the body parts involved by tremor. We also investigated the somatosensory temporal discrimination in patients with isolated voice tremor. We enrolled 61 patients with tremor: 48 patients with essential tremor (31 patients with upper limb tremor alone, nine patients with head tremor alone, and eight patients with upper limb plus head tremor; 22 patients with familial vs. 26 sporadic essential tremor), 13 patients with isolated voice tremor, and 45 healthy subjects. Somatosensory temporal discrimination threshold values were normal in patients with familial essential tremor, whereas they were higher in patients with sporadic essential tremor. When we classified patients according to tremor distribution, somatosensory temporal discrimination threshold values were normal in patients with upper limb tremor and abnormal only in patients with isolated head tremor. Temporal discrimination threshold values were also abnormal in patients with isolated voice tremor. Somatosensory temporal discrimination processing is normal in patients with familial as well as in patients with sporadic essential tremor involving the upper limbs. By contrast, somatosensory temporal discrimination is altered in patients with isolated head tremor and voice tremor. This study with somatosensory temporal discrimination suggests that isolated head and voice tremors might possibly be considered as separate clinical entities from essential tremor.
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Affiliation(s)
- Antonella Conte
- Department of Neurology and Psychiatry, "Sapienza" University of Rome, Rome, Italy.,IRCCS Neuromed, Pozzilli (IS), Italy
| | - Gina Ferrazzano
- Department of Neurology and Psychiatry, "Sapienza" University of Rome, Rome, Italy
| | - Nicoletta Manzo
- Department of Neurology and Psychiatry, "Sapienza" University of Rome, Rome, Italy
| | - Giorgio Leodori
- Department of Neurology and Psychiatry, "Sapienza" University of Rome, Rome, Italy
| | - Giovanni Fabbrini
- Department of Neurology and Psychiatry, "Sapienza" University of Rome, Rome, Italy.,IRCCS Neuromed, Pozzilli (IS), Italy
| | - Alfonso Fasano
- Movement Disorders Center, TWH, UHN, Division of Neurology, Toronto Western Hospital and University of Toronto, Toronto, Ontario, Canada
| | - Michele Tinazzi
- Department of Neurological and Movement Sciences, University of Verona, Verona, Italy
| | - Alfredo Berardelli
- Department of Neurology and Psychiatry, "Sapienza" University of Rome, Rome, Italy.,IRCCS Neuromed, Pozzilli (IS), Italy
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Ferrazzano G, Conte A, Fabbrini G, Bologna M, Macerollo A, Defazio G, Hallett M, Berardelli A. Botulinum toxin and blink rate in patients with blepharospasm and increased blinking. J Neurol Neurosurg Psychiatry 2015; 86:336-40. [PMID: 24963123 DOI: 10.1136/jnnp-2014-307821] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE The aim of the study was to investigate the effect of botulinum toxin (BoNT) on blink rate (BR) in patients with blepharospasm (BSP) and increased blinking (IB). METHODS 37 patients with a clinical diagnosis of primary BSP (19 patients had tonic orbicularis oculi (OO) spasms and 18 patients had clonic OO spasms) and 8 patients with IB were included in this case-control study. All subjects underwent a standardised video protocol and clinical evaluation with a validated questionnaire designed to identify eye symptoms and Blepharospasm Disability Index (BSDI) before and 1 month after BoNT injection. BR was measured from the video recording before and after BoNT. BR in BSP and IB patients was compared with that from a group of healthy subjects and from a group of patients with hemifacial spasm (HFS). BR in HFS was also measured before and after BoNT. RESULTS BR was increased in patients with IB and in BSP patients with clonic spasms but not in BSP patients with tonic spasms. BoNT reduced BR in patients with IB and in patients with clonic spasms, but not in patients with tonic spasms. BoNT left BR in patients with HFS unchanged. Changes in BR after BoNT were also independent of the presence of ocular symptoms. Despite the differential response of BR, BoNT significantly reduced BSDI in patients with BSP and IB. CONCLUSIONS BoNT differentially modulates BR in patients with BSP and IB depending on the baseline BR. BoNT injection reduces BR only when the blink generator is overactive, possibly influencing tear film retention.
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Affiliation(s)
- Gina Ferrazzano
- Department of Neurology and Psychiatry, 'Sapienza' University of Rome, Rome, Italy
| | - Antonella Conte
- Department of Neurology and Psychiatry, 'Sapienza' University of Rome, Rome, Italy IRCCS Neuromed Institute, Pozzilli (IS), Italy
| | - Giovanni Fabbrini
- Department of Neurology and Psychiatry, 'Sapienza' University of Rome, Rome, Italy IRCCS Neuromed Institute, Pozzilli (IS), Italy
| | | | - Antonella Macerollo
- Department of Neurosciences and Sensory Organs, 'Aldo Moro' University of Bari, Bari, Italy
| | - Giovanni Defazio
- Department of Neurosciences and Sensory Organs, 'Aldo Moro' University of Bari, Bari, Italy
| | - Mark Hallett
- Human Motor Control Section, NINDS, NIH, Bethesda, Maryland, USA
| | - Alfredo Berardelli
- Department of Neurology and Psychiatry, 'Sapienza' University of Rome, Rome, Italy IRCCS Neuromed Institute, Pozzilli (IS), Italy
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Tinazzi M, Fasano A, Peretti A, Bove F, Conte A, Dall'Occhio C, Arbasino C, Defazio G, Fiorio M, Berardelli A. Tactile and proprioceptive temporal discrimination are impaired in functional tremor. PLoS One 2014; 9:e102328. [PMID: 25051180 PMCID: PMC4106827 DOI: 10.1371/journal.pone.0102328] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2014] [Accepted: 06/12/2014] [Indexed: 11/18/2022] Open
Abstract
Background and Methods In order to obtain further information on the pathophysiology of functional tremor, we assessed tactile discrimination threshold and proprioceptive temporal discrimination motor threshold values in 11 patients with functional tremor, 11 age- and sex-matched patients with essential tremor and 13 healthy controls. Results Tactile discrimination threshold in both the right and left side was significantly higher in patients with functional tremor than in the other groups. Proprioceptive temporal discrimination threshold for both right and left side was significantly higher in patients with functional and essential tremor than in healthy controls. No significant correlation between discrimination thresholds and duration or severity of tremor was found. Conclusions Temporal processing of tactile and proprioceptive stimuli is impaired in patients with functional tremor. The mechanisms underlying this impaired somatosensory processing and possible ways to apply these findings clinically merit further research.
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Affiliation(s)
- Michele Tinazzi
- Department of Neurological and Movement Sciences, University of Verona, Verona, Italy
| | - Alfonso Fasano
- Division of Neurology, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
- * E-mail:
| | - Alessia Peretti
- Department of Neurological and Movement Sciences, University of Verona, Verona, Italy
| | - Francesco Bove
- Department of Neurology, Università Cattolica, Rome, Italy
| | - Antonella Conte
- Department of Neurology and Psychiatry, Sapienza, University of Rome and IRCCS INM Neuromed, Pozzilli, Italy
| | | | - Carla Arbasino
- Division of Neurology, Ospedale di Voghera, Voghera, Italy
| | - Giovanni Defazio
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University of Bari, Bari, Italy
| | - Mirta Fiorio
- Department of Neurological and Movement Sciences, University of Verona, Verona, Italy
| | - Alfredo Berardelli
- Department of Neurology and Psychiatry, Sapienza, University of Rome and IRCCS INM Neuromed, Pozzilli, Italy
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