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Anjum MF, Espinoza AI, Cole RC, Singh A, May P, Uc EY, Dasgupta S, Narayanan NS. Resting-state EEG measures cognitive impairment in Parkinson's disease. NPJ Parkinsons Dis 2024; 10:6. [PMID: 38172519 PMCID: PMC10764756 DOI: 10.1038/s41531-023-00602-0] [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: 03/07/2023] [Accepted: 11/14/2023] [Indexed: 01/05/2024] Open
Abstract
Cognitive dysfunction is common in Parkinson's disease (PD). We developed and evaluated an EEG-based biomarker to index cognitive functions in PD from a few minutes of resting-state EEG. We hypothesized that synchronous changes in EEG across the power spectrum can measure cognition. We optimized a data-driven algorithm to efficiently capture these changes and index cognitive function in 100 PD and 49 control participants. We compared our EEG-based cognitive index with the Montreal cognitive assessment (MoCA) and cognitive tests across different domains from National Institutes of Health (NIH) Toolbox using cross-validations, regression models, and randomization tests. Finally, we externally validated our approach on 32 PD participants. We observed cognition-related changes in EEG over multiple spectral rhythms. Utilizing only 8 best-performing electrodes, our proposed index strongly correlated with cognition (MoCA: rho = 0.68, p value < 0.001; NIH-Toolbox cognitive tests: rho ≥ 0.56, p value < 0.001) outperforming traditional spectral markers (rho = -0.30-0.37). The index showed a strong fit in regression models (R2 = 0.46) with MoCA, yielded 80% accuracy in detecting cognitive impairment, and was effective in both PD and control participants. Notably, our approach was equally effective (rho = 0.68, p value < 0.001; MoCA) in out-of-sample testing. In summary, we introduced a computationally efficient data-driven approach for cross-domain cognition indexing using fewer than 10 EEG electrodes, potentially compatible with dynamic therapies like closed-loop neurostimulation. These results will inform next-generation neurophysiological biomarkers for monitoring cognition in PD and other neurological diseases.
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Affiliation(s)
- Md Fahim Anjum
- Department of Neurology, University of California San Francisco, San Francisco, CA, 94143, USA.
| | - Arturo I Espinoza
- Department of Neurology, The University of Iowa, Iowa city, IA, 52240, USA
| | - Rachel C Cole
- Department of Neurology, The University of Iowa, Iowa city, IA, 52240, USA
| | - Arun Singh
- Division of Basic Biomedical Sciences, Sanford School of Medicine, University of South Dakota, South Dakota, SD, 57069, USA
| | - Patrick May
- Department of Electrical and Computer Engineering, The University of Iowa, Iowa city, IA, 52240, USA
| | - Ergun Y Uc
- Department of Neurology, The University of Iowa, Iowa city, IA, 52240, USA
- Neurology Service, Iowa City VA Medical Center, Iowa city, IA, 52240, USA
| | - Soura Dasgupta
- Department of Electrical and Computer Engineering, The University of Iowa, Iowa city, IA, 52240, USA
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Yeager BE, Twedt HP, Bruss J, Schultz J, Narayanan NS. Salience network and cognitive impairment in Parkinson's disease. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.10.13.23296825. [PMID: 37873396 PMCID: PMC10593050 DOI: 10.1101/2023.10.13.23296825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
Parkinson's disease (PD) is a neurodegenerative disease with cognitive as well as motor impairments. While much is known about the brain networks leading to motor impairments in PD, less is known about the brain networks contributing to cognitive impairments. Here, we leveraged resting-state functional magnetic resonance imaging (rs-fMRI) data from the Parkinson's Progression Marker Initiative (PPMI) to examine network dysfunction in PD patients with cognitive impairment. We tested the hypothesis that cognitive impairments in PD involve altered connectivity of the salience network (SN), a key cortical network that detects and integrates responses to salient stimuli. We used the Montreal Cognitive Assessment (MoCA) as a continuous index of coarse cognitive function in PD. We report two major results. First, in 82 PD patients we found significant relationships between lower intra-network connectivity of the frontoparietal network (FPN; comprising the dorsolateral prefrontal and posterior parietal cortices bilaterally) with lower MoCA scores. Second, we found significant relationships between lower inter-network connectivity between the SN and the basal ganglia network (BGN) and the default mode network (DMN) with lower MoCA scores. These data support our hypothesis about the SN and provide new insights into the brain networks contributing to cognitive impairments in PD.
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Affiliation(s)
- Brooke E Yeager
- Department of Neurology, Carver College of Medicine, University of Iowa, Iowa City, 52242, USA
| | - Hunter P Twedt
- Department of Neurology, Carver College of Medicine, University of Iowa, Iowa City, 52242, USA
| | - Joel Bruss
- Department of Neurology, Carver College of Medicine, University of Iowa, Iowa City, 52242, USA
- Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, 52242, USA
| | - Jordan Schultz
- Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa City, 52242, USA
| | - Nandakumar S Narayanan
- Department of Neurology, Carver College of Medicine, University of Iowa, Iowa City, 52242, USA
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Yavuz B, Rusen E, Duman T, Bas B. Developments of possible clinical diagnostic methods for parkinson's disease: event-related potentials. Neurocase 2023; 29:67-74. [PMID: 38678307 DOI: 10.1080/13554794.2024.2345404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 04/15/2024] [Indexed: 04/29/2024]
Abstract
In this study, Event-Related Potential (ERP) analyzes were performed to detect cognitive impairments in PD with Deep Brain Stimulation (DBS). A total of 85 volunteers underwent ERP analysis and neuropsychological testing (NPT) to determine cognitive level. In ERP analyses, prolonged latencies were observed in PD groups. However, patients implanted with DBS showed a decrease in latencies, a decrease in symptoms and statistical improvements in both cognitive and attention skills. Considering all these data, ERP results are promising as a noninvasive method that can be used in both disease status and diagnosis of PD.
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Affiliation(s)
- Burcak Yavuz
- Vocational School of Health Services/Istanbul, Altinbas University, Turkey
| | - Emir Rusen
- Faculty of Medicine, Department of Neurology/Istanbul, Altinbas University, Turkey
| | - Tugce Duman
- Department of Neuroscience/Istanbul, Uskudar University, Turkey
| | - Berra Bas
- Department of Psychology/Istanbul, Bahcelievler MedicalPark Hospital Turkey
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Nwogo RO, Kammermeier S, Singh A. Abnormal neural oscillations during gait and dual-task in Parkinson’s disease. Front Syst Neurosci 2022; 16:995375. [PMID: 36185822 PMCID: PMC9522469 DOI: 10.3389/fnsys.2022.995375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 08/23/2022] [Indexed: 12/03/2022] Open
Abstract
Gait dysfunctions are debilitating motor symptoms of Parkinson’s disease (PD) and may result in frequent falling with health complications. The contribution of the motor-cognitive network to gait disturbance can be studied more thoroughly by challenging motor-cognitive dual-task gait performances. Gait is a complex motor task that requires an appropriate contribution from motor and cognitive networks, reflected in frequency modulations among several cortical and subcortical networks. Electrophysiological recordings by scalp electroencephalography and implanted deep brain stimulation (DBS) electrodes have unveiled modulations of specific oscillatory patterns in the cortical-subcortical circuits in PD. In this review, we summarize oscillatory contributions of the cortical, basal ganglia, mesencephalic locomotor, and cerebellar regions during gait and dual-task activities in PD. We detail the involvement of the cognitive network in dual-task settings and compare how abnormal oscillations in the specific frequency bands in the cortical and subcortical regions correlate with gait deficits in PD, particularly freezing of gait (FOG). We suggest that altered neural oscillations in different frequencies can cause derangements in broader brain networks, so neuromodulation and pharmacological therapies should be considered to normalize those network oscillations to improve challenged gait and dual-task motor functions in PD. Specifically, the theta and beta bands in premotor cortical areas, subthalamic nucleus, as well as alpha band activity in the brainstem prepontine nucleus, modulate under clinically effective levodopa and DBS therapies, improving gait and dual-task performance in PD with FOG, compared to PD without FOG and age-matched healthy control groups.
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Affiliation(s)
- Rachel O. Nwogo
- Division of Basic Biomedical Sciences, Sanford School of Medicine, University of South Dakota, Vermillion, SD, United States
| | | | - Arun Singh
- Division of Basic Biomedical Sciences, Sanford School of Medicine, University of South Dakota, Vermillion, SD, United States
- *Correspondence: Arun Singh,
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