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Grobe-Einsler M, Lupa A, Weller J, Kaut O. RTMS of the Cerebellum Using an Accelerated Stimulation Protocol Improved Gait in Parkinson's Disease. Neurorehabil Neural Repair 2024; 38:539-550. [PMID: 38804539 DOI: 10.1177/15459683241257518] [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] [Indexed: 05/29/2024]
Abstract
BACKGROUND Repetitive transcranial magnetic stimulation (rTMS) is a nonpharmacological and noninvasive brain stimulation technique that has been proven to be effective in Parkinson's disease (PD). The combination of rTMS and treadmill training improved gait function in PD greater than treadmill training alone. OBJECTIVE The aim of our study was to evaluate the combination of a novel high-intensity, short intervention rTMS treatment and a multimodal treatment protocol including of physiotherapy, occupational therapy and language therapy, the so-called Parkinson's Disease Multimodal Complex Treatment (PD-MCT), to improve motor function. METHODS In this randomized double-blind sham-controlled trial rTMS with 48 Hz or sham was applied over the cerebellum 3 times a day for 5 consecutive days. Patients were assessed at baseline (V0), after 5 days of treatment (V1), and 4 weeks later (V2). The primary clinical outcome measure was the motor sum-score of the Unified PD Rating Scale (UPDRSIII), secondary clinical outcomes were quantitative motor tasks. RESULTS A total of 36 PD patients were randomly allocated either to rTMS (n = 20) or sham (n = 16), both combined with PD-MCT. rTMS improved the UDPRSIII score comparing baseline and V1 in the treatment group by -8.2 points (P = .004). The 8MW and dynamic posturography remained unchanged in both groups after intervention. Conclusion. Compressing weeks of canonical rTMS protocols into 5 days was effective and well tolerated. rTMS may serve as an add-on therapy for augmenting the multimodal complex treatment of motor symptoms, but seems to be ineffective to treat postural instability.
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Affiliation(s)
- Marcus Grobe-Einsler
- Department of Neurology, University Hospital Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Annemarie Lupa
- Department of Neurology, University Hospital Bonn, Bonn, Germany
| | - Johannes Weller
- Department of Neurology, University Hospital Bonn, Bonn, Germany
| | - Oliver Kaut
- SRH Gesundheitszentrum Bad Wimpfen GmbH, Bad Wimpfen, Bonn, Nordrhein-Westfalen, Germany
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Mattson MP, Leak RK. The hormesis principle of neuroplasticity and neuroprotection. Cell Metab 2024; 36:315-337. [PMID: 38211591 DOI: 10.1016/j.cmet.2023.12.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 11/06/2023] [Accepted: 12/18/2023] [Indexed: 01/13/2024]
Abstract
Animals live in habitats fraught with a range of environmental challenges to their bodies and brains. Accordingly, cells and organ systems have evolved stress-responsive signaling pathways that enable them to not only withstand environmental challenges but also to prepare for future challenges and function more efficiently. These phylogenetically conserved processes are the foundation of the hormesis principle, in which single or repeated exposures to low levels of environmental challenges improve cellular and organismal fitness and raise the probability of survival. Hormetic principles have been most intensively studied in physical exercise but apply to numerous other challenges known to improve human health (e.g., intermittent fasting, cognitive stimulation, and dietary phytochemicals). Here we review the physiological mechanisms underlying hormesis-based neuroplasticity and neuroprotection. Approaching natural resilience from the lens of hormesis may reveal novel methods for optimizing brain function and lowering the burden of neurological disorders.
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Affiliation(s)
- Mark P Mattson
- Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Rehana K Leak
- Graduate School of Pharmaceutical Sciences, Duquesne University, Pittsburgh, PA, USA
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Gronlier E, Volle J, Coizet V, Paccard A, Habermacher C, Roche Y, Roucard C, Duveau V, David O. Evoked responses to single pulse electrical stimulation reveal impaired striatal excitability in a rat model of Parkinson's disease. Neurobiol Dis 2023; 185:106266. [PMID: 37604316 PMCID: PMC10480488 DOI: 10.1016/j.nbd.2023.106266] [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: 06/02/2023] [Revised: 08/02/2023] [Accepted: 08/18/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Sensorimotor beta oscillations are increased in Parkinson's disease (PD) due to the alteration of dopaminergic transmission. This electrophysiological read-out is reported both in patients and in animal models such as the 6-OHDA rat model obtained with unilateral nigral injection of 6-hydroxydopamine (6-OHDA). Current treatments, based on dopaminergic replacement, transiently normalize this pathological beta activity and improve patients' quality of life. OBJECTIVES We wanted to assess in vivo whether the abnormal beta oscillations can be correlated with impaired striatal or cortical excitability of the sensorimotor system and modulated by the pharmacological manipulation of the dopaminergic system. METHODS In the unilateral 6-OHDA rat model and control animals, we used intra-striatal and intra-cortical single-pulse electrical stimulation (SPES) and concurrent local field potentials (LFP) recordings. In the two groups, we quantified basal cortico-striatal excitability from time-resolved spectral analyses of LFP evoked responses induced remotely by intracerebral stimulations. The temporal dependance of cortico-striatal excitability to dopaminergic transmission was further tested using electrophysiological recordings combined with levodopa injection. RESULTS LFP evoked responses after striatal stimulation showed a transient reduction of power in a large time-frequency domain in the 6-OHDA group compared to the sham group. This result was specific to the striatum, as no significant difference was observed in cortical LFP evoked responses between the two groups. This impaired striatal excitability in the 6-OHDA group was observed in the striatum at least during the first 3 months after the initial lesion. In addition, the striatum responses to SPES during a levodopa challenge showed a transient potentiation of the decrease of responsiveness in frequencies below 40 Hz. CONCLUSION The spectral properties of striatal responses to SPES show high sensitivity to dopaminergic transmission in the unilateral 6-OHDA rat model. We thus propose that this approach could be used in preclinical models as a time-resolved biomarker of impaired dopaminergic transmission capable of monitoring progressive neurodegeneration and/or challenges to drug intake.
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Affiliation(s)
- Eloïse Gronlier
- SynapCell SAS, Saint-Ismier, France; Univ. Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France.
| | | | - Véronique Coizet
- Univ. Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France
| | - Antoine Paccard
- Univ. Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France
| | | | | | | | | | - Olivier David
- Univ. Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France; Aix Marseille Université, INSERM, INS, Institut de Neurosciences des Systèmes, Marseille, France
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Su D, Zhang Z, Zhang Z, Gan Y, Zhang Y, Liu X, Bi J, Ma L, Zhao H, Wang X, Wang Z, Ma H, Sifat S, Zhou J, Li W, Wu T, Jing J, Feng T. Microstructural and functional impairment of the basal ganglia in Wilson's disease: a multimodal neuroimaging study. Front Neurosci 2023; 17:1146644. [PMID: 37152597 PMCID: PMC10157043 DOI: 10.3389/fnins.2023.1146644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 03/27/2023] [Indexed: 05/09/2023] Open
Abstract
Objectives Magnetic susceptibility changes in brain MRI of Wilson's disease (WD) patients have been described in subcortical nuclei especially the basal ganglia. The objectives of this study were to investigate its relationship with other microstructural and functional alterations of the subcortical nuclei and the diagnostic utility of these MRI-related metrics. Methods A total of 22 WD patients and 20 healthy controls (HCs) underwent 3.0T multimodal MRI scanning. Susceptibility, volume, diffusion microstructural indices and whole-brain functional connectivity of the putamen (PU), globus pallidus (GP), caudate nucleus (CN), and thalamus (TH) were analyzed. Receiver operating curve (ROC) was applied to evaluate the diagnostic value of the imaging data. Correlation analysis was performed to explore the connection between susceptibility change and microstructure and functional impairment of WD and screen for neuroimaging biomarkers of disease severity. Results Wilson's disease patients demonstrated increased susceptibility in the PU, GP, and TH, and widespread atrophy and microstructural impairments in the PU, GP, CN, and TH. Functional connectivity decreased within the basal ganglia and increased between the PU and cortex. The ROC model showed higher diagnostic value of isotropic volume fraction (ISOVF, in the neurite orientation dispersion and density imaging model) compared with susceptibility. Severity of neurological symptoms was correlated with volume and ISOVF. Susceptibility was positively correlated with ISOVF in GP. Conclusion Microstructural impairment of the basal ganglia is related to excessive metal accumulation in WD. Brain atrophy and microstructural impairments are useful neuroimaging biomarkers for the neurological impairment of WD.
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Affiliation(s)
- Dongning Su
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhijin Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhe Zhang
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Tiantan Neuroimaging Center of Excellence, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yawen Gan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yingkui Zhang
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Tiantan Neuroimaging Center of Excellence, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xinyao Liu
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Tiantan Neuroimaging Center of Excellence, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jingfeng Bi
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Tiantan Neuroimaging Center of Excellence, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Lingyan Ma
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Huiqing Zhao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xuemei Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhan Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Huizi Ma
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Shairy Sifat
- Djavad Mowafaghian Centre for Brain Health, Pacific Parkinson’s Research Centre, University of British Columbia and Vancouver Coastal Health, Vancouver, BC, Canada
| | - Junhong Zhou
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Roslindale, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Wei Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Tao Wu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Jing Jing
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Tiantan Neuroimaging Center of Excellence, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- *Correspondence: Jing Jing,
| | - Tao Feng
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Tao Feng,
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Cristini J, Parwanta Z, De las Heras B, Medina-Rincon A, Paquette C, Doyon J, Dagher A, Steib S, Roig M. Motor Memory Consolidation Deficits in Parkinson's Disease: A Systematic Review with Meta-Analysis. JOURNAL OF PARKINSON'S DISEASE 2023; 13:865-892. [PMID: 37458048 PMCID: PMC10578244 DOI: 10.3233/jpd-230038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/21/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND The ability to encode and consolidate motor memories is essential for persons with Parkinson's disease (PD), who usually experience a progressive loss of motor function. Deficits in memory encoding, usually expressed as poorer rates of skill improvement during motor practice, have been reported in these patients. Whether motor memory consolidation (i.e., motor skill retention) is also impaired is unknown. OBJECTIVE To determine whether motor memory consolidation is impaired in PD compared to neurologically intact individuals. METHODS We conducted a pre-registered systematic review (PROSPERO: CRD42020222433) following PRISMA guidelines that included 46 studies. RESULTS Meta-analyses revealed that persons with PD have deficits in retaining motor skills (SMD = -0.17; 95% CI = -0.32, -0.02; p = 0.0225). However, these deficits are task-specific, affecting sensory motor (SMD = -0.31; 95% CI -0.47, -0.15; p = 0.0002) and visuomotor adaptation (SMD = -1.55; 95% CI = -2.32, -0.79; p = 0.0001) tasks, but not sequential fine motor (SMD = 0.17; 95% CI = -0.05, 0.39; p = 0.1292) and gross motor tasks (SMD = 0.04; 95% CI = -0.25, 0.33; p = 0.7771). Importantly, deficits became non-significant when augmented feedback during practice was provided, and additional motor practice sessions reduced deficits in sensory motor tasks. Meta-regression analyses confirmed that deficits were independent of performance during encoding, as well as disease duration and severity. CONCLUSION Our results align with the neurodegenerative models of PD progression and motor learning frameworks and emphasize the importance of developing targeted interventions to enhance motor memory consolidation in PD.
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Affiliation(s)
- Jacopo Cristini
- Memory and Motor Rehabilitation Laboratory (MEMORY-LAB), Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Montreal Center for Interdisciplinary Research in Rehabilitation (CRIR), Laval, QC, Canada
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Zohra Parwanta
- Memory and Motor Rehabilitation Laboratory (MEMORY-LAB), Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Montreal Center for Interdisciplinary Research in Rehabilitation (CRIR), Laval, QC, Canada
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Bernat De las Heras
- Memory and Motor Rehabilitation Laboratory (MEMORY-LAB), Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Montreal Center for Interdisciplinary Research in Rehabilitation (CRIR), Laval, QC, Canada
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Almudena Medina-Rincon
- Memory and Motor Rehabilitation Laboratory (MEMORY-LAB), Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Montreal Center for Interdisciplinary Research in Rehabilitation (CRIR), Laval, QC, Canada
- Grupo de investigación iPhysio, San Jorge University, Zaragoza, Aragón, Spain
- Department of Physiotherapy, San Jorge University, Zaragoza, Aragón, Spain
| | - Caroline Paquette
- Department of Kinesiology & Physical Education, McGill University, Montreal, QC,Canada
- Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Montreal Center for Interdisciplinary Research in Rehabilitation (CRIR), Laval, QC, Canada
| | - Julien Doyon
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
| | - Alain Dagher
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
| | - Simon Steib
- Department of Human Movement, Training and Active Aging, Institute of Sports and Sports Sciences, Heidelberg University, Heidelberg, Germany
| | - Marc Roig
- Memory and Motor Rehabilitation Laboratory (MEMORY-LAB), Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Montreal Center for Interdisciplinary Research in Rehabilitation (CRIR), Laval, QC, Canada
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, QC, Canada
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Lahlou S, Gabitov E, Owen L, Shohamy D, Sharp M. Preserved motor memory in Parkinson's disease. Neuropsychologia 2022; 167:108161. [PMID: 35041839 DOI: 10.1016/j.neuropsychologia.2022.108161] [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: 05/12/2021] [Revised: 01/02/2022] [Accepted: 01/13/2022] [Indexed: 11/28/2022]
Abstract
Patients with Parkinson's disease, who lose the dopaminergic projections to the striatum, are impaired in certain aspects of motor learning. Recent evidence suggests that, in addition to its role in motor performance, the striatum plays a key role in the memory of motor learning. Whether Parkinson's patients have impaired motor memory and whether motor memory is modulated by dopamine at the time of initial learning is unknown. To address these questions, we measured memory of a learned motor sequence in Parkinson's patients who were either On or Off their dopaminergic medications at the time of initial learning. We compared them to a group of older and younger controls. Contrary to our predictions, motor memory was not impaired in patients compared to older controls, and was not influenced by dopamine state at the time of initial learning. To probe post-learning consolidation processes, we also tested whether learning a new sequence shortly after learning the initial sequence would interfere with later memory. We found that, in contrast to younger adults, neither older adults nor patients were susceptible to this interference. These findings suggest that motor memory is preserved in Parkinson's patients and raise the possibility that motor memory in patients is supported by compensatory non-dopamine sensitive mechanisms. Furthermore, given the similar performance characteristics observed in the patients and older adults and the absence of an effect of dopamine, these results raise the possibility that aging and Parkinson's disease affect motor memory in similar ways.
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Affiliation(s)
- Soraya Lahlou
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Canada
| | - Ella Gabitov
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Canada
| | - Lucy Owen
- Department of Psychological and Brain Sciences, Dartmouth College, USA
| | - Daphna Shohamy
- Department of Psychology, Columbia University, USA; Zuckerman Mind Brain Behavior Institute and Kavli Institute for Brain Science, Columbia University, USA
| | - Madeleine Sharp
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Canada.
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Dopamine transporter silencing in the rat: systems-level alterations in striato-cerebellar and prefrontal-midbrain circuits. Mol Psychiatry 2022; 27:2329-2339. [PMID: 35246636 PMCID: PMC9126810 DOI: 10.1038/s41380-022-01471-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 01/15/2022] [Accepted: 02/02/2022] [Indexed: 12/12/2022]
Abstract
Silencing of dopamine transporter (DAT), a main controlling factor of dopaminergic signaling, results in biochemical and behavioral features characteristic for neuropsychiatric diseases with presumed hyperdopaminergia including schizophrenia, attention deficit hyperactivity disorder (ADHD), bipolar disorder, and obsessive-compulsive disorder (OCD). Investigation of DAT silencing thus provides a transdiagnostic approach towards a systems-level understanding of common underlying pathways. Using a high-field multimodal imaging approach and a highly sensitive cryogenic coil, we integrated structural, functional and metabolic investigations in tandem with behavioral assessments on a newly developed preclinical rat model, comparing DAT homozygous knockout (DAT-KO, N = 14), heterozygous knockout (N = 8) and wild-type male rats (N = 14). We identified spatially distributed structural and functional brain alterations encompassing motor, limbic and associative loops that demonstrated strong behavioral relevance and were highly consistent across imaging modalities. DAT-KO rats manifested pronounced volume loss in the dorsal striatum, negatively correlating with cerebellar volume increase. These alterations were associated with hyperlocomotion, repetitive behavior and loss of efficient functional small-world organization. Further, prefrontal and midbrain regions manifested opposite changes in functional connectivity and local network topology. These prefrontal disturbances were corroborated by elevated myo-inositol levels and increased volume. To conclude, our imaging genetics approach provides multimodal evidence for prefrontal-midbrain decoupling and striato-cerebellar neuroplastic compensation as two key features of constitutive DAT blockade, proposing them as transdiagnostic mechanisms of hyperdopaminergia. Thus, our study connects developmental DAT blockade to systems-level brain changes, underlying impaired action inhibition control and resulting in motor hyperactivity and compulsive-like features relevant for ADHD, schizophrenia and OCD.
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Kazemi A, Mirian MS, Lee S, McKeown MJ. Galvanic Vestibular Stimulation Effects on EEG Biomarkers of Motor Vigor in Parkinson's Disease. Front Neurol 2021; 12:759149. [PMID: 34803892 PMCID: PMC8599939 DOI: 10.3389/fneur.2021.759149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 10/05/2021] [Indexed: 01/18/2023] Open
Abstract
Background: Impaired motor vigor (MV) is a critical aspect of Parkinson's disease (PD) pathophysiology. While MV is predominantly encoded in the basal ganglia, deriving (cortical) EEG measures of MV may provide valuable targets for modulation via galvanic vestibular stimulation (GVS). Objective: To find EEG features predictive of MV and examine the effects of high-frequency GVS. Methods: Data were collected from 20 healthy control (HC) and 18 PD adults performing 30 trials total of a squeeze bulb task with sham or multi-sine (50-100 Hz "GVS1" or 100-150 Hz "GVS2") stimuli. For each trial, we determined the time to reach maximum force after a "Go" signal, defined MV as the inverse of this time, and used the EEG data 1-sec prior to this time for prediction. We utilized 53 standard EEG features, including relative spectral power, harmonic parameters, and amplitude and phase of bispectrum corresponding to standard EEG bands from each of 27 EEG channels. We then used LASSO regression to select a sparse set of features to predict MV. The regression weights were examined, and separate band-specific models were developed by including only band-specific features (Delta, Theta, Alpha-low, Alpha-high, Beta, Gamma). The correlation between MV prediction and measured MV was used to assess model performance. Results: Models utilizing broadband EEG features were capable of accurately predicting MV (controls: 75%, PD: 81% of the variance). In controls, all EEG bands performed roughly equally in predicting MV, while in the PD group, the model using only beta band features did not predict MV well compared to other bands. Despite having minimal effects on the EEG feature values themselves, both GVS stimuli had significant effects on MV and profound effects on MV predictability via the EEG. With the GVS1 stimulus, beta-band activity in PD subjects became more closely associated with MV compared to the sham condition. With GVS2 stimulus, MV could no longer be accurately predicted from the EEG. Conclusions: EEG features can be a proxy for MV. However, GVS stimuli have profound effects on the relationship between EEG and MV, possibly via direct vestibulo-basal ganglia connections not measurable by the EEG.
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Affiliation(s)
- Alireza Kazemi
- Center for Mind and Brain, Department of Psychology, University of California, Davis, Davis, CA, United States
| | - Maryam S. Mirian
- Pacific Parkinson's Research Centre, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
| | - Soojin Lee
- Pacific Parkinson's Research Centre, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
- Wellcome Centre for Integrative Neuroimaging (FMRIB), University of Oxford, Oxford, United Kingdom
| | - Martin J. McKeown
- Pacific Parkinson's Research Centre, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
- Faculty of Medicine (Neurology), University of British Columbia, Vancouver, BC, Canada
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Pasman EP, McKeown MJ, Garg S, Cleworth TW, Bloem BR, Inglis JT, Carpenter MG. Brain connectivity during simulated balance in older adults with and without Parkinson's disease. Neuroimage Clin 2021; 30:102676. [PMID: 34215147 PMCID: PMC8102637 DOI: 10.1016/j.nicl.2021.102676] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 04/02/2021] [Accepted: 04/10/2021] [Indexed: 11/07/2022]
Abstract
Individuals with Parkinson's disease often experience postural instability, a debilitating and largely treatment-resistant symptom. A better understanding of the neural substrates contributing to postural instability could lead to more effective treatments. Constraints of current functional neuroimaging techniques, such as the horizontal orientation of most MRI scanners (forcing participants to lie supine), complicates investigating cortical and subcortical activation patterns and connectivity networks involved in healthy and parkinsonian balance control. In this cross-sectional study, we utilized a newly-validated MRI-compatible balance simulator (based on an inverted pendulum) that enabled participants to perform balance-relevant tasks while supine in the scanner. We utilized functional MRI to explore effective connectivity underlying static and dynamic balance control in healthy older adults (n = 17) and individuals with Parkinson's disease while on medication (n = 17). Participants performed four tasks within the scanner with eyes closed: resting, proprioceptive tracking of passive ankle movement, static balancing of the simulator, and dynamic responses to random perturbations of the simulator. All analyses were done in the participant's native space without spatial transformation to a common template. Effective connectivity between 57 regions of interest was computed using a Bayesian Network learning approach with false discovery rate set to 5%. The first 12 principal components of the connection weights, binomial logistic regression, and cross-validation were used to create 4 separate models: contrasting static balancing vs {rest, proprioception} and dynamic balancing vs {rest, proprioception} for both controls and individuals with Parkinson's disease. In order to directly compare relevant connections between controls and individuals with Parkinson's disease, we used connections relevant for predicting a task in either controls or individuals with Parkinson's disease in logistic regression with Least Absolute Shrinkage and Selection Operator regularization. During dynamic balancing, we observed decreased connectivity between different motor areas and increased connectivity from the brainstem to several cortical and subcortical areas in controls, while individuals with Parkinson's disease showed increased connectivity associated with motor and parietal areas, and decreased connectivity from brainstem to other subcortical areas. No significant models were found for static balancing in either group. Our results support the notion that dynamic balance control in individuals with Parkinson's disease relies more on cortical motor areas compared to healthy older adults, who show a preference of subcortical control during dynamic balancing.
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Affiliation(s)
- Elizabeth P Pasman
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
| | | | - Saurabh Garg
- Pacific Parkinson's Research Centre, Vancouver, BC, Canada
| | - Taylor W Cleworth
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
| | - Bastiaan R Bloem
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Center of Expertise for Parkinson & Movement Disorders, Nijmegen, The Netherlands
| | - J Timothy Inglis
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada; International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, BC, Canada
| | - Mark G Carpenter
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada; International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, BC, Canada.
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Piras F, Vecchio D, Assogna F, Pellicano C, Ciullo V, Banaj N, Edden RAE, Pontieri FE, Piras F, Spalletta G. Cerebellar GABA Levels and Cognitive Interference in Parkinson's disease and Healthy Comparators. J Pers Med 2020; 11:jpm11010016. [PMID: 33379134 PMCID: PMC7823866 DOI: 10.3390/jpm11010016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 12/14/2020] [Accepted: 12/24/2020] [Indexed: 01/30/2023] Open
Abstract
The neuroanatomical and molecular substrates for cognitive impairment in Parkinson Disease (PD) are far from clear. Evidence suggests a non-dopaminergic basis, and a crucial role for cerebellum in cognitive control in PD. We investigated whether a PD cognitive marker (response inhibition) was differently controlled by g-amino butyric acid (GABA) and/or by glutamate-glutamine (Glx) levels in the cerebellum of idiopathic PD patients, and healthy comparators (HC). Magnetic resonance spectroscopy of GABA/Glx (MEGA-PRESS acquisition sequence) was performed at 3 Tesla, and response inhibition assessed by the Stroop Word-Color Test (SWCT) and the Wisconsin Card Sorting Test (WCST). Linear correlations between cerebellar GABA/Glx levels, SWCT time/error interference effects and WCST perseverative errors were performed to test differences between correlation coefficients in PD and HC. Results showed that higher levels of mean cerebellar GABA were associated to SWCT increased time and error interference effects in PD, and the contrary in HC. Such effect dissociated by hemisphere, while correlation coefficients differences were significant in both right and left cerebellum. We conclude that MRS measured levels of cerebellar GABA are related in PD patients with decreased efficiency in filtering task-irrelevant information. This is crucial for developing pharmacological treatments for PD to potentially preserve cognitive functioning.
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Affiliation(s)
- Federica Piras
- Neuropsychiatry Laboratory, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Via Ardeatina 306/354, 00179 Rome, Italy; (F.P.); (D.V.); (F.A.); (C.P.); (V.C.); (N.B.); (F.P.)
| | - Daniela Vecchio
- Neuropsychiatry Laboratory, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Via Ardeatina 306/354, 00179 Rome, Italy; (F.P.); (D.V.); (F.A.); (C.P.); (V.C.); (N.B.); (F.P.)
| | - Francesca Assogna
- Neuropsychiatry Laboratory, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Via Ardeatina 306/354, 00179 Rome, Italy; (F.P.); (D.V.); (F.A.); (C.P.); (V.C.); (N.B.); (F.P.)
| | - Clelia Pellicano
- Neuropsychiatry Laboratory, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Via Ardeatina 306/354, 00179 Rome, Italy; (F.P.); (D.V.); (F.A.); (C.P.); (V.C.); (N.B.); (F.P.)
| | - Valentina Ciullo
- Neuropsychiatry Laboratory, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Via Ardeatina 306/354, 00179 Rome, Italy; (F.P.); (D.V.); (F.A.); (C.P.); (V.C.); (N.B.); (F.P.)
| | - Nerisa Banaj
- Neuropsychiatry Laboratory, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Via Ardeatina 306/354, 00179 Rome, Italy; (F.P.); (D.V.); (F.A.); (C.P.); (V.C.); (N.B.); (F.P.)
| | - Richard A. E. Edden
- Department of Radiology, Kennedy Krieger Institute 707 North Broadway, Johns Hopkins University, Baltimore, MD 21205, USA;
| | - Francesco E. Pontieri
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), “Sant’Andrea” University Hospital, via di Grottarossa 1035-1037, 00189 Rome, Italy;
| | - Fabrizio Piras
- Neuropsychiatry Laboratory, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Via Ardeatina 306/354, 00179 Rome, Italy; (F.P.); (D.V.); (F.A.); (C.P.); (V.C.); (N.B.); (F.P.)
| | - Gianfranco Spalletta
- Neuropsychiatry Laboratory, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Via Ardeatina 306/354, 00179 Rome, Italy; (F.P.); (D.V.); (F.A.); (C.P.); (V.C.); (N.B.); (F.P.)
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1977 Butler Blvd., Houston, TX 77030, USA
- Correspondence: ; Tel.: +39-06-51501575
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11
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Zhou C, Gao T, Guo T, Wu J, Guan X, Zhou W, Huang P, Xuan M, Gu Q, Xu X, Xia S, Kong D, Wu J, Zhang M. Structural Covariance Network Disruption and Functional Compensation in Parkinson's Disease. Front Aging Neurosci 2020; 12:199. [PMID: 32714179 PMCID: PMC7351504 DOI: 10.3389/fnagi.2020.00199] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 06/08/2020] [Indexed: 12/27/2022] Open
Abstract
Purpose: To investigate the structural covariance network disruption in Parkinson’s disease (PD), and explore the functional alterations of disrupted structural covariance network. Methods: A cohort of 100 PD patients and 70 healthy participants underwent structural and functional magnetic resonance scanning. Independent component analysis (ICA) was applied separately to both deformation-based morphometry (DBM) maps and functional maps with the same calculating parameters (both decomposed into 20 independent components (ICs) and computed 20 times the Infomax algorithm in ICASSO). Disrupted structural covariance network in PD patients was identified, and then, we performed goodness of fit analysis to obtain the functional network that showed the highest spatial overlap with it. We investigated the relationship between structural covariance network and functional network alterations. Finally, to further understand the structural and functional alterations over time, we performed a longitudinal subgroup analysis (51 patients were followed up for 2 years) with the same procedures. Results: In a cross-sectional analysis, PD patients showed decreased structural covariance between anterior and posterior cingulate subnetworks. The functional components showed best overlap with anterior and posterior cingulate structural subnetworks were selected as anterior and posterior cingulate functional subnetworks. The functional connectivity between them was significantly increased [assessed by Functional Network Connectivity (FNC) toolbox]; and the increased functional connectivity was negatively correlated with cingulate structural covariance network integrity. Longitudinal subgroup analysis showed cingulate structural covariance network disruption was worse at follow-up, while the functional connectivity between anterior and posterior cingulate network was increased at baseline and decreased at follow-up. Conclusion: This study indicated that the cingulate structural covariance network displayed a high susceptibility in PD patients. This study indicated that the cingulate structural covariance network displayed a high susceptibility in PD patients. Considering that disrupted structural covariance network coexisted with enhanced/remained functional activity during disease development, enhanced functional activity underlying the disrupted cingulate structural covariance network might represent a temporal compensation for maintaining clinical performance.
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Affiliation(s)
- Cheng Zhou
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ting Gao
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Tao Guo
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jingjing Wu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaojun Guan
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Weiwen Zhou
- Department of Radiation Oncology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Peiyu Huang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Min Xuan
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Quanquan Gu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaojun Xu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Shunren Xia
- Zhejiang University City College, Hangzhou, China
| | - Dexing Kong
- School of Mathematical Sciences, Zhejiang University, Hangzhou, China
| | - Jian Wu
- AdvanCed Computing aNd SysTem Laboratory, College of Computer Science and Technology, Zhejiang University, Hangzhou, China
| | - Minming Zhang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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12
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Transcranial magnetic stimulation and gait disturbances in Parkinson's disease: A systematic review. Neurophysiol Clin 2020; 50:213-225. [DOI: 10.1016/j.neucli.2020.05.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 05/14/2020] [Accepted: 05/14/2020] [Indexed: 12/11/2022] Open
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13
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Chen M, Li Y, Chen J, Gao L, Sun J, Gu Z, Wu T, Chan P. Structural and functional brain alterations in patients with idiopathic rapid eye movement sleep behavior disorder. J Neuroradiol 2020; 49:66-72. [DOI: 10.1016/j.neurad.2020.04.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 12/09/2019] [Accepted: 04/15/2020] [Indexed: 11/17/2022]
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14
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Galoppin M, Berroir P, Soucy JP, Suzuki Y, Lavigne GJ, Gagnon JF, Montplaisir JY, Stip E, Blanchet PJ. Chronic Neuroleptic-Induced Parkinsonism Examined With Positron Emission Tomography. Mov Disord 2020; 35:1189-1198. [PMID: 32353194 DOI: 10.1002/mds.28046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 03/11/2020] [Accepted: 03/16/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Neuroleptic drug-induced parkinsonism (NIP) is a leading cause of parkinsonism, particularly in aging. Based on abnormal dopamine transporter scan results, individuals displaying chronic NIP are often diagnosed with Lewy-body Parkinson's disease (PD), but this assumption needs further substantiation. OBJECTIVE To quantitate the profile of striatal dopaminergic nerve terminal density in NIP relative to PD. METHODS We used the positron emission tomography ligand [11 C](+)-dihydrotetrabenazine targeting vesicular monoamine transporter type 2 (VMAT2) binding sites and collected various clinical parameters (motor ratings, olfaction, polysomnography to document rapid eye movement sleep muscle activity, quantitative sensory testing for pain thresholds) possibly predicting binding results in patients older than age 50 living with schizophrenia spectrum disorders under long-term stable antipsychotic drug treatment, with (N = 11) or without (N = 11) chart documention of chronic NIP, and compared them to healthy volunteers (N = 11) and others medicated for PD (N = 12). RESULTS Striatal VMAT2 binding was dichotomous in the NIP group between those with spared (N = 5) or low (N = 6) PD-like values. Striatal binding reduction in the low VMAT2-NIP group was asymmetric without the gradient of maximal involvement in the posterior putamen typical of PD. Anosmia was the only nonmotor parameter measured matching the abnormal striatal VMAT2 binding status. CONCLUSION These preliminary observations suggest that striatal VMAT2 binding is abnormal in a fraction of chronic NIP cases and differs in spatial distribution from PD. The possibility of a drug-induced axonopathy and resultant synaptopathy, as well as the evolution of the binding deficit, warrant further longitudinal studies in a large cohort. © 2020 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Manon Galoppin
- Department of Medicine, University of Montreal Hospital Center, Montreal, Canada
| | | | - Jean-Paul Soucy
- Department of Medicine, University of Montreal Hospital Center, Montreal, Canada.,PERFORM Centre, Concordia University, Montreal, Canada.,McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Yoshitaka Suzuki
- Department of Stomatognathic Function and Occlusal Reconstruction, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Gilles J Lavigne
- Centre for Advanced Research in Sleep Medicine, Hopital du Sacre-Coeur de Montreal, Montreal, Canada.,Faculty of Dental Medicine, University of Montreal, Montreal, Canada
| | - Jean-François Gagnon
- Centre for Advanced Research in Sleep Medicine, Hopital du Sacre-Coeur de Montreal, Montreal, Canada
| | - Jacques Y Montplaisir
- Centre for Advanced Research in Sleep Medicine, Hopital du Sacre-Coeur de Montreal, Montreal, Canada
| | - Emmanuel Stip
- Department of Medicine, University of Montreal Hospital Center, Montreal, Canada.,Department of Psychiatry, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Pierre J Blanchet
- Department of Medicine, University of Montreal Hospital Center, Montreal, Canada.,Faculty of Dental Medicine, University of Montreal, Montreal, Canada.,Montreal Mental Health University Institute, Montreal, Canada
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15
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Lopez AM, Trujillo P, Hernandez AB, Lin YC, Kang H, Landman BA, Englot DJ, Dawant BM, Konrad PE, Claassen DO. Structural Correlates of the Sensorimotor Cerebellum in Parkinson's Disease and Essential Tremor. Mov Disord 2020; 35:1181-1188. [PMID: 32343870 DOI: 10.1002/mds.28044] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 12/15/2019] [Accepted: 02/28/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Parkinson's disease (PD) and essential tremor (ET) are commonly encountered movement disorders. Pathophysiologic processes that localize to the cerebellum are described in both. There are limited studies investigating cerebellar structural changes in these conditions, largely because of inherent challenges in the efficiency of segmentation. METHODS We applied a novel multiatlas cerebellar segmentation method to T1-weighted images in 282 PD and 111 essential tremor patients to define 26 cerebellar lobule volumes. The severity of postural and resting tremor in both populations and gait and postural instability in PD patients were defined using subscores of the UPDRS and Washington Heights-Inwood Genetic Study motor scales. These clinical measurements were related to lobule volume size. Multiple comparisons were controlled using a false discovery rate method. RESULTS Group differences were identified between ET and PD patients, with reductions in deep cerebellar nucleus volume in ET versus reduced lobule VI volume in PD. In ET patients, lobule VIII was negatively correlated with the severity of postural tremor. In PD patients, lobule IV was positively correlated with resting tremor and total tremor severity. We observed differences in cerebellar structure that localized to sensorimotor lobules of the cerebellum. Lobule volumes appeared to differentially relate to clinical symptoms, suggesting important clinicopathologic distinctions between these conditions. These results emphasize the role of the cerebellum in tremor symptoms and should foster future clinical and pathologic investigations of the sensorimotor lobules of the cerebellum. © 2020 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Alexander M Lopez
- Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Paula Trujillo
- Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Adreanna B Hernandez
- Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Ya-Chen Lin
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Hakmook Kang
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Bennett A Landman
- Department of Radiology/Biomedical Engineering, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Dario J Englot
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Benoit M Dawant
- Department of Radiology/Biomedical Engineering, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Peter E Konrad
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Daniel O Claassen
- Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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16
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Kaut O, Mielacher C, Hurlemann R, Wüllner U. Resting-state fMRI reveals increased functional connectivity in the cerebellum but decreased functional connectivity of the caudate nucleus in Parkinson’s disease. Neurol Res 2020; 42:62-67. [DOI: 10.1080/01616412.2019.1709141] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Oliver Kaut
- Department of Neurology, University Clinic Bonn, Bonn, Germany
| | - Clemens Mielacher
- Division of Medical Psychology, University Clinic Bonn, Bonn, Germany
| | - René Hurlemann
- Division of Medical Psychology, University Clinic Bonn, Bonn, Germany
| | - Ullrich Wüllner
- Department of Neurology, University Clinic Bonn, Bonn, Germany
- Department of Clinical Studies, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
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17
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Kolmancic K, Perellón-Alfonso R, Pirtosek Z, Rothwell JC, Bhatia K, Kojovic M. Sex differences in Parkinson's disease: A transcranial magnetic stimulation study. Mov Disord 2019; 34:1873-1881. [PMID: 31603570 DOI: 10.1002/mds.27870] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 08/25/2019] [Accepted: 08/29/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Demographic and clinical studies imply that female sex may be protective for PD, but pathophysiological evidence to support these observations is missing. In early PD, functional changes may be detected in primary motor cortex using transcranial magnetic stimulation. OBJECTIVE We hypothesised that if pathophysiology differs between sexes in PD, this will be reflected in differences of motor cortex measurements. METHODS Forty-one newly diagnosed PD patients (22 males, 19 females) were clinically assessed using MDS-UPDRS part III, and various measures of cortical excitability and sensorimotor cortex plasticity were measured over both hemispheres, corresponding to the less and more affected side, using transcranial magnetic stimulation. Twenty-three healthy (10 men, 13 women) participants were studied for comparison. RESULTS Among patients, no significant differences between sexes were found in age, age of diagnosis, symptom duration, and total or lateralized motor score. However, male patients had disturbed interhemispheric balance of motor thresholds, caused by decreased resting and active motor thresholds in the more affected hemisphere. Short interval intracortical inhibition was more effective in female compared to male patients in both hemispheres. Female patients had a preserved physiological focal response to sensorimotor plasticity protocol, whereas male patients showed an abnormal spread of the protocol effect. CONCLUSION The study provides one of the first neurophysiological evidences of sex differences in early PD. Female patients have a more favorable profile of transcranial magnetic stimulation measures, possibly reflecting a more successful cortical compensation or delayed maladaptive changes in the sensorimotor cortex. © 2019 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Kaja Kolmancic
- Institute of Pathophysiology, University of Ljubljana, Medical Faculty, Ljubljana, Slovenia.,Department of Neurology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | | | - Zvezdan Pirtosek
- Department of Neurology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - John C Rothwell
- UCL Queen's Square, Institute of Neurology, London, United Kingdom
| | - Kailash Bhatia
- UCL Queen's Square, Institute of Neurology, London, United Kingdom
| | - Maja Kojovic
- Department of Neurology, University Medical Centre Ljubljana, Ljubljana, Slovenia
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18
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Foffani G, Obeso JA. A Cortical Pathogenic Theory of Parkinson's Disease. Neuron 2019; 99:1116-1128. [PMID: 30236282 DOI: 10.1016/j.neuron.2018.07.028] [Citation(s) in RCA: 93] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 06/14/2018] [Accepted: 07/17/2018] [Indexed: 01/17/2023]
Abstract
In Parkinson's disease, the progressive neurodegeneration of nigrostriatal dopaminergic neurons in the substantia nigra pars compacta (SNc) is associated with classic motor features, which typically have a focal onset. Since a defined somatotopic arrangement in the SNc has not been recognized, this focal motor onset is unexplained and hardly justified by current pathogenic theories of bottom-up disease progression (Braak's hypothesis, prionopathy). Here we propose that corticostriatal activity may represent a critical somatotopic "stressor" for nigrostriatal terminals, ultimately driving retrograde nigrostriatal degeneration and leading to focal motor onset and progression of Parkinson's disease. As a pathogenic mechanism, corticostriatal activity may promote secretion of striatal extracellular alpha-synuclein, favoring its pathological aggregation at vulnerable dopaminergic synapses. A similar pathogenic process may occur at corticofugal projections to the medulla oblongata and other vulnerable structures, thereby contributing to the bottom-up progression of Lewy pathology. This cortical pathogenesis may co-exist with bottom-up mechanisms, adding an integrative top-down perspective to the quest for the factors that impinge upon the vulnerability of dopaminergic cells in the onset and progression of Parkinson's disease.
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Affiliation(s)
- Guglielmo Foffani
- CINAC, Hospital Universitario HM Puerta del Sur, Móstoles, Universidad CEU-San Pablo, Madrid, Spain; Hospital Nacional de Parapléjicos, Toledo, Spain.
| | - José A Obeso
- CINAC, Hospital Universitario HM Puerta del Sur, Móstoles, Universidad CEU-San Pablo, Madrid, Spain; CIBERNED, Instituto de Salud Carlos III, Madrid, Spain.
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19
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Mei S, Li J, Middlebrooks EH, Almeida L, Hu W, Zhang Y, Ramirez-Zamora A, Chan P. New Onset On-Medication Freezing of Gait After STN-DBS in Parkinson's Disease. Front Neurol 2019; 10:659. [PMID: 31275238 PMCID: PMC6593871 DOI: 10.3389/fneur.2019.00659] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 06/05/2019] [Indexed: 12/18/2022] Open
Abstract
Freezing of gait (FoG) is commonly observed in advanced Parkinson's disease (PD) and it is associated with reduced mobility, recurrent falls, injuries, and loss of independence. This phenomenon typically occurs as the effect of dopaminergic medications wears off (“off” FoG) but on rare occasions, it can also be observed during peak medication effect (“on” FoG). In this report, we present the case of a 65-year-old female with a 13-year history of akinetic-rigid idiopathic PD who developed recurrent episodes of “on” FoG after bilateral subthalamic nucleus deep brain stimulation (STN-DBS). She underwent STN-DBS for management of motor fluctuations, which resulted in a marked improvement in her motor symptoms. Within the next 6 months and after several programming sessions, the patient reported “on” FoG occurring regularly 1 h after taking levodopa and lasting a few hours. Accordingly, a repeated levodopa challenge showed that FoG resolved with either levodopa administration or STN stimulation alone, but the combination of both therapies induced recurrence of FoG in our patient. Subsequent management was complex requiring adjustments in levodopa dose and formulation along with advanced DBS programming.
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Affiliation(s)
- Shanshan Mei
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Jiping Li
- Department of Functional Neurosurgery, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Erik H Middlebrooks
- Department of Radiology, Mayo Clinic, Jacksonville, FL, United States.,Department of Neurologic Surgery, Mayo Clinic, Jacksonville, FL, United States
| | - Leonardo Almeida
- Department of Neurology, Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, United States
| | - Wei Hu
- Department of Neurology, Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, United States
| | - Yuqing Zhang
- Department of Functional Neurosurgery, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Adolfo Ramirez-Zamora
- Department of Neurology, Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, United States
| | - Piu Chan
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
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20
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Hu S, Wu H, Xu C, Wang A, Wang Y, Shen T, Huang F, Kan H, Li C. Aberrant Coupling Between Resting-State Cerebral Blood Flow and Functional Connectivity in Wilson's Disease. Front Neural Circuits 2019; 13:25. [PMID: 31057370 PMCID: PMC6482267 DOI: 10.3389/fncir.2019.00025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Accepted: 03/25/2019] [Indexed: 12/17/2022] Open
Abstract
Both abnormalities of resting-state cerebral blood flow (CBF) and functional connectivity in Wilson’s disease (WD) have been identified by several studies. Whether the coupling of CBF and functional connectivity is imbalanced in WD remains largely unknown. To assess this possibility, 27 patients with WD and 27 sex- and age-matched healthy controls were recruited to acquire functional MRI and arterial spin labeling imaging data. Functional connectivity strength (FCS) and CBF were calculated based on standard gray mask. Compared to healthy controls, the CBF–FCS correlations of patients with WD were significantly decreased in the basal ganglia and the cerebellum and slightly increased in the prefrontal cortex and thalamus. In contrast, decreased CBF of patients with WD occurred predominately in subcortical and cognitive- and emotion-related brain regions, including the basal ganglia, thalamus, insular, and inferior prefrontal cortex, whereas increased CBF occurred primarily in the temporal cortex. The FCS decrease in WD patients was predominately in the basal ganglia and thalamus, and the increase was primarily in the prefrontal cortex. These findings suggest that aberrant neurovascular coupling in the brain may be a possible neuropathological mechanism underlying WD.
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Affiliation(s)
- Sheng Hu
- Medical Information Engineering, Anhui University of Chinese Medicine, Hefei, China
| | - Hongli Wu
- Medical Information Engineering, Anhui University of Chinese Medicine, Hefei, China
| | - ChunSheng Xu
- Laboratory of Digital Medical Imaging, Medical Imaging Center, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, China
| | - Anqin Wang
- Laboratory of Digital Medical Imaging, Medical Imaging Center, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, China
| | - Yi Wang
- Medical Information Engineering, Anhui University of Chinese Medicine, Hefei, China
| | - Tongping Shen
- Medical Information Engineering, Anhui University of Chinese Medicine, Hefei, China
| | - Fangliang Huang
- Medical Information Engineering, Anhui University of Chinese Medicine, Hefei, China
| | - Hongxing Kan
- Medical Information Engineering, Anhui University of Chinese Medicine, Hefei, China
| | - Chuanfu Li
- Laboratory of Digital Medical Imaging, Medical Imaging Center, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, China
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21
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Filippi M, Preziosa P, Rocca MA. Brain mapping in multiple sclerosis: Lessons learned about the human brain. Neuroimage 2019; 190:32-45. [DOI: 10.1016/j.neuroimage.2017.09.021] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 09/07/2017] [Accepted: 09/09/2017] [Indexed: 02/07/2023] Open
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22
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Philippens IHCHM, Wubben JA, Franke SK, Hofman S, Langermans JAM. Involvement of the Red Nucleus in the Compensation of Parkinsonism may Explain why Primates can develop Stable Parkinson's Disease. Sci Rep 2019; 9:880. [PMID: 30696912 PMCID: PMC6351580 DOI: 10.1038/s41598-018-37381-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 12/05/2018] [Indexed: 01/14/2023] Open
Abstract
Neurological compensatory mechanisms help our brain to adjust to neurodegeneration as in Parkinson's disease. It is suggested that the compensation of the damaged striato-thalamo-cortical circuit is focused on the intact thalamo-rubro-cerebellar pathway as seen during presymptomatic Parkinson, paradoxical movement and sensorimotor rhythm (SMR). Indeed, the size of the red nucleus, connecting the cerebellum with the cerebral cortex, is larger in Parkinson's disease patients suggesting an increased activation of this brain area. Therefore, the red nucleus was examined in MPTP-induced parkinsonian marmoset monkeys during the presymptomatic stage and after SMR activation by neurofeedback training. We found a reverse significant correlation between the early expression of parkinsonian signs and the size of the parvocellular part of the red nucleus, which is predominantly present in human and non-human primates. In quadrupedal animals it consists mainly of the magnocellular part. Furthermore, SMR activation, that mitigated parkinsonian signs, further increased the size of the red nucleus in the marmoset monkey. This plasticity of the brain helps to compensate for dysfunctional movement control and can be a promising target for compensatory treatment with neurofeedback technology, vibrotactile stimulation or DBS in order to improve the quality of life for Parkinson's disease patients.
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Affiliation(s)
- Ingrid H C H M Philippens
- Animal Science Department, Biomedical Primate Research Centre (BPRC), P.O. Box 3306, 2280 GH, Rijswijk, The Netherlands.
| | - Jacqueline A Wubben
- Department of Immunobiology, Biomedical Primate Research Centre (BPRC), P.O. Box 3306, 2280 GH, Rijswijk, The Netherlands
| | - Sigrid K Franke
- Department of Immunobiology, Biomedical Primate Research Centre (BPRC), P.O. Box 3306, 2280 GH, Rijswijk, The Netherlands.,Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, Neuroscience Campus Amsterdam, VU University, Amsterdam, The Netherlands
| | - Sam Hofman
- Department of Immunobiology, Biomedical Primate Research Centre (BPRC), P.O. Box 3306, 2280 GH, Rijswijk, The Netherlands
| | - Jan A M Langermans
- Animal Science Department, Biomedical Primate Research Centre (BPRC), P.O. Box 3306, 2280 GH, Rijswijk, The Netherlands
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Grandi LC, Di Giovanni G, Galati S. Reprint of “Animal models of early-stage Parkinson's disease and acute dopamine deficiency to study compensatory neurodegenerative mechanisms”. J Neurosci Methods 2018; 310:75-88. [DOI: 10.1016/j.jneumeth.2018.10.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 08/06/2018] [Accepted: 08/09/2018] [Indexed: 12/19/2022]
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Israeli-Korn SD, Barliya A, Paquette C, Franzén E, Inzelberg R, Horak FB, Flash T. Intersegmental coordination patterns are differently affected in Parkinson's disease and cerebellar ataxia. J Neurophysiol 2018; 121:672-689. [PMID: 30461364 DOI: 10.1152/jn.00788.2017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The law of intersegmental coordination (Borghese et al. 1996) may be altered in pathological conditions. Here we investigated the contribution of the basal ganglia (BG) and the cerebellum to lower limb intersegmental coordination by inspecting the plane's orientation and other parameters pertinent to this law in patients with idiopathic Parkinson's disease (PD) or cerebellar ataxia (CA). We also applied a mathematical model that successfully accounts for the intersegmental law of coordination observed in control subjects (Barliya et al. 2009). In the present study, we compared the planarity index (PI), covariation plane (CVP) orientation, and CVP orientation predicted by the model in 11 PD patients, 8 CA patients, and two groups of healthy subjects matched for age, height, weight, and gender to each patient group (Ctrl_PD and Ctrl_CA). Controls were instructed to alter their gait speed to match those of their respective patient group. PD patients were examined after overnight withdrawal of anti-parkinsonian medications (PD-off-med) and then on medication (PD-on-med). PI was above 96% in all gait conditions in all groups suggesting that the law of intersegmental coordination is preserved in both BG and cerebellar pathology. However, the measured and predicted CVP orientations rotated in PD-on-med and PD-off-med compared with Ctrl_PD and in CA vs. Ctrl_CA. These rotations caused by PD and CA were in opposite directions suggesting differences in the roles of the BG and cerebellum in intersegmental coordination during human locomotion. NEW & NOTEWORTHY Kinematic and muscular synergies may have a role in overcoming motor redundancies, which may be reflected in intersegmental covariation. Basal ganglia and cerebellar networks were suggested to be involved in crafting and modulating synergies. We thus compared intersegmental coordination in Parkinson's disease and cerebellar disease patients and found opposite effects in some aspects. Further research integrating muscle activities as well as biomechanical and neural control modeling are needed to account for these findings.
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Affiliation(s)
- Simon D Israeli-Korn
- Department of Computer Science and Applied Mathematics, Weizmann Institute of Science , Rehovot , Israel.,Movement Disorders Institute, Department of Neurology, Chaim Sheba Medical Center, Tel-Hashomer, Ramat Gan , Israel
| | - Avi Barliya
- Department of Computer Science and Applied Mathematics, Weizmann Institute of Science , Rehovot , Israel
| | - Caroline Paquette
- Balance Disorders Laboratory, Department of Neurology, Oregon Health and Science University , Portland, Oregon.,Department of Kinesiology and Physical Education, McGill University and Centre for Interdisciplinary Research in Rehabilitation , Montreal, Quebec , Canada
| | - Erika Franzén
- Balance Disorders Laboratory, Department of Neurology, Oregon Health and Science University , Portland, Oregon.,Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden.,Allied Health Professionals Function, Karolinska University Hospital , Stockholm , Sweden
| | - Rivka Inzelberg
- Department of Computer Science and Applied Mathematics, Weizmann Institute of Science , Rehovot , Israel.,Department of Neurology and Neurosurgery, Sackler Faculty of Medicine and the Sagol School of Neuroscience, Tel Aviv University , Israel
| | - Fay B Horak
- Balance Disorders Laboratory, Department of Neurology, Oregon Health and Science University , Portland, Oregon
| | - Tamar Flash
- Department of Computer Science and Applied Mathematics, Weizmann Institute of Science , Rehovot , Israel
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Ballarini T, Růžička F, Bezdicek O, Růžička E, Roth J, Villringer A, Vymazal J, Mueller K, Schroeter ML, Jech R. Unraveling connectivity changes due to dopaminergic therapy in chronically treated Parkinson's disease patients. Sci Rep 2018; 8:14328. [PMID: 30254336 PMCID: PMC6156510 DOI: 10.1038/s41598-018-31988-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 08/30/2018] [Indexed: 11/14/2022] Open
Abstract
The effects of dopaminergic therapy for Parkinson’s disease (PD) on the brain functional architecture are still unclear. We investigated this topic in 31 PD patients (disease duration: 11.2 ± (SD) 3.6 years) who underwent clinical and MRI assessments under chronic dopaminergic treatment (duration: 8.3 ± (SD) 4.4 years) and after its withdrawal. Thirty healthy controls were also included. Functional and morphological changes were studied, respectively, with eigenvector centrality mapping and seed-based connectivity, and voxel-based morphometry. Patients off medication, compared to controls, showed increased connectivity in cortical sensorimotor areas extending to the cerebello-thalamo-cortical pathway and parietal and frontal brain structures. Dopaminergic therapy normalized this increased connectivity. Notably, patients showed decreased interconnectedness in the medicated compared to the unmedicated condition, encompassing putamen, precuneus, supplementary motor and sensorimotor areas bilaterally. Similarly, lower connectivity was found comparing medicated patients to controls, overlapping with the within-group comparison in the putamen. Seed-based analyses revealed that dopaminergic therapy reduced connectivity in motor and default mode networks. Lower connectivity in the putamen correlated with longer disease duration, medication dose, and motor symptom improvement. Notably, atrophy and connectivity changes were topographically dissociated. After chronic treatment, dopaminergic therapy decreases connectivity of key motor and default mode network structures that are abnormally elevated in PD off condition.
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Affiliation(s)
- Tommaso Ballarini
- Max-Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Filip Růžička
- Department of Neurology, Charles University in Prague, First Faculty of Medicine, Prague, Czech Republic
| | - Ondrej Bezdicek
- Department of Neurology, Charles University in Prague, First Faculty of Medicine, Prague, Czech Republic
| | - Evžen Růžička
- Department of Neurology, Charles University in Prague, First Faculty of Medicine, Prague, Czech Republic
| | - Jan Roth
- Department of Neurology, Charles University in Prague, First Faculty of Medicine, Prague, Czech Republic
| | - Arno Villringer
- Max-Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Clinic for Cognitive Neurology, University Clinic, Leipzig, Germany
| | - Josef Vymazal
- Department of Radiology, Na Homolce Hospital, Prague, Czech Republic
| | - Karsten Mueller
- Max-Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Matthias L Schroeter
- Max-Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Clinic for Cognitive Neurology, University Clinic, Leipzig, Germany.,FTLD Consortium, Ulm, Germany
| | - Robert Jech
- Department of Neurology, Charles University in Prague, First Faculty of Medicine, Prague, Czech Republic.
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26
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Grandi LC, Di Giovanni G, Galati S. Animal models of early-stage Parkinson's disease and acute dopamine deficiency to study compensatory neurodegenerative mechanisms. J Neurosci Methods 2018; 308:205-218. [PMID: 30107207 DOI: 10.1016/j.jneumeth.2018.08.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 08/06/2018] [Accepted: 08/09/2018] [Indexed: 12/21/2022]
Abstract
Parkinson's disease is a common neurodegenerative disease characterized by a widely variety of motor and non-motor symptoms. While the motor deficits are only visible following a severe dopamine depletion, neurodegenerative process and some non-motor symptoms are manifested years before the motor deficits. Importantly, chronic degeneration of dopaminergic neurons leads to the development of compensatory mechanisms that play roles in the progression of the disease and the response to anti-parkinsonian therapies. The identification of these mechanisms will be of great importance for improving our understanding of factors with important contributions to the disease course and the underlying adaptive process. To date, most of the data obtained from animal models reflect the late, chronic, dopamine-depleted states, when compensatory mechanisms have already been established. Thus, adequate animal models with which researchers are able to dissect early- and late-phase mechanisms are necessary. Here, we reviewed the literature related to animal models of early-stage PD and pharmacological treatments capable of inducing acute dopamine impairments and/or depletion, such as reserpine, haloperidol and tetrodotoxin. We highlighted the advantages, limitations and the future prospective uses of these models, as well as their applications in the identification of novel agents for treating this neurological disorder.
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Affiliation(s)
- Laura Clara Grandi
- Laboratory for Biomedical Neurosciences, Neurocenter of Southern Switzerland, Switzerland
| | - Giuseppe Di Giovanni
- Department of Physiology and Biochemistry, Faculty of Medicine and Surgery, University of Malta, Malta; Neuroscience Division, School of Biosciences, Cardiff University, Cardiff, UK.
| | - Salvatore Galati
- Laboratory for Biomedical Neurosciences, Neurocenter of Southern Switzerland, Switzerland.
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27
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28
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Leak RK, Calabrese EJ, Kozumbo WJ, Gidday JM, Johnson TE, Mitchell JR, Ozaki CK, Wetzker R, Bast A, Belz RG, Bøtker HE, Koch S, Mattson MP, Simon RP, Jirtle RL, Andersen ME. Enhancing and Extending Biological Performance and Resilience. Dose Response 2018; 16:1559325818784501. [PMID: 30140178 PMCID: PMC6096685 DOI: 10.1177/1559325818784501] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 05/15/2018] [Indexed: 12/17/2022] Open
Abstract
Human performance, endurance, and resilience have biological limits that are genetically and epigenetically predetermined but perhaps not yet optimized. There are few systematic, rigorous studies on how to raise these limits and reach the true maxima. Achieving this goal might accelerate translation of the theoretical concepts of conditioning, hormesis, and stress adaptation into technological advancements. In 2017, an Air Force-sponsored conference was held at the University of Massachusetts for discipline experts to display data showing that the amplitude and duration of biological performance might be magnified and to discuss whether there might be harmful consequences of exceeding typical maxima. The charge of the workshop was "to examine and discuss and, if possible, recommend approaches to control and exploit endogenous defense mechanisms to enhance the structure and function of biological tissues." The goal of this white paper is to fulfill and extend this workshop charge. First, a few of the established methods to exploit endogenous defense mechanisms are described, based on workshop presentations. Next, the white paper accomplishes the following goals to provide: (1) synthesis and critical analysis of concepts across some of the published work on endogenous defenses, (2) generation of new ideas on augmenting biological performance and resilience, and (3) specific recommendations for researchers to not only examine a wider range of stimulus doses but to also systematically modify the temporal dimension in stimulus inputs (timing, number, frequency, and duration of exposures) and in measurement outputs (interval until assay end point, and lifespan). Thus, a path forward is proposed for researchers hoping to optimize protocols that support human health and longevity, whether in civilians, soldiers, athletes, or the elderly patients. The long-term goal of these specific recommendations is to accelerate the discovery of practical methods to conquer what were once considered intractable constraints on performance maxima.
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Affiliation(s)
- Rehana K. Leak
- Graduate School of Pharmaceutical Sciences, Duquesne University, Pittsburgh, PA, USA
| | - Edward J. Calabrese
- School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA
| | | | - Jeffrey M. Gidday
- Departments of Ophthalmology, Neuroscience, and Physiology, Louisiana State University School of Medicine, New Orleans, LA, USA
| | - Thomas E. Johnson
- Department of Integrative Physiology, University of Colorado, Boulder, CO, USA
| | - James R. Mitchell
- Department of Genetics and Complex Diseases, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - C. Keith Ozaki
- Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Reinhard Wetzker
- Institute for Molecular Cell Biology, University of Jena, Jena, Germany
| | - Aalt Bast
- Department of Pharmacology and Toxicology, Maastricht University, Maastricht, The Netherlands
| | - Regina G. Belz
- Hans-Ruthenberg-Institute, Agroecology Unit, University of Hohenheim, Stuttgart, Germany
| | - Hans E. Bøtker
- Department of Clinical Medicine, Aarhus University Hospital Skejby, Aarhus, Denmark
| | - Sebastian Koch
- Department of Neurology, University of Miami, Miller School of Medicine, FL, USA
| | - Mark P. Mattson
- Laboratory of Neurosciences, National Institute on Aging Intramural Research Program, Baltimore, MD, USA
| | - Roger P. Simon
- Departments of Medicine and Neurobiology, Morehouse School of Medicine, Atlanta, GA, USA
| | - Randy L. Jirtle
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA
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29
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Compensatory dopaminergic-cholinergic interactions in conflict processing: Evidence from patients with Parkinson's disease. Neuroimage 2018; 190:94-106. [PMID: 29337277 DOI: 10.1016/j.neuroimage.2018.01.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 12/29/2017] [Accepted: 01/07/2018] [Indexed: 01/21/2023] Open
Abstract
Executive functions are complex both in the cognitive operations involved and in the neural structures and functions that support those operations. This complexity makes executive function highly vulnerable to the detrimental effects of aging, brain injury, and disease, but may also open paths to compensation. Neural compensation is often used to explain findings of additional or altered patterns of brain activations by older adults or patient populations compared to young adults or healthy controls, especially when associated with relatively preserved performance. Here we test the hypothesis of an alternative form of compensation, between different neuromodulator systems. 135 patients with Parkinson's Disease (PD) completed vesicular monoamine transporter type2 (VMAT2) and acetylcholinesterase PET scanning to assess the integrity of nigrostriatal dopaminergic, thalamic cholinergic, and cortical cholinergic pathways, and a behavioral test (Stroop + task-switching) that puts high demands on conflict processing, an important aspect of executive control. Supporting the compensatory hypothesis, regression models controlling for age and other covariates revealed an interaction between caudate dopamine and cortical cholinergic integrity: Cortical cholinergic integrity was a stronger predictor of conflict processing in patients with relatively low caudate dopaminergic function. These results suggest that although frontostriatal dopaminergic function plays a central role in executive control, cholinergic systems may also make an important contribution. The present results suggest potential pathways for remediation, and that the appropriate interventions for each patient may depend on their particular profile of decline. Furthermore, they help to elucidate the brain systems that underlie executive control, which may be important for understanding other disorders as well as executive function in healthy adults.
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Beck EN, Intzandt BN, Almeida QJ. Can Dual Task Walking Improve in Parkinson's Disease After External Focus of Attention Exercise? A Single Blind Randomized Controlled Trial. Neurorehabil Neural Repair 2017; 32:18-33. [PMID: 29262749 DOI: 10.1177/1545968317746782] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND It may be possible to use attention-based exercise to decrease demands associated with walking in Parkinson's disease (PD), and thus improve dual task walking ability. For example, an external focus of attention (focusing on the effect of an action on the environment) may recruit automatic control processes degenerated in PD, whereas an internal focus (limb movement) may recruit conscious (nonautomatic) control processes. Thus, we aimed to investigate how externally and internally focused exercise influences dual task walking and symptom severity in PD. METHODS Forty-seven participants with PD were randomized to either an Externally (n = 24) or Internally (n = 23) focused group and completed 33 one-hour attention-based exercise sessions over 11 weeks. In addition, 16 participants were part of a control group. Before, after, and 8 weeks following the program (pre/post/washout), gait patterns were measured during single and dual task walking (digit-monitoring task, ie, walking while counting numbers announced by an audio-track), and symptom severity (UPDRS-III) was assessed ON and OFF dopamine replacement. Pairwise comparisons (95% confidence intervals [CIs]) and repeated-measures analyses of variance were conducted. RESULTS Pre to post: Dual task step time decreased in the external group (Δ = 0.02 seconds, CI 0.01-0.04). Dual task step length (Δ = 2.3 cm, CI 0.86-3.75) and velocity (Δ = 4.5 cm/s, CI 0.59-8.48) decreased (became worse) in the internal group. UPDRS-III scores (ON and OFF) decreased (improved) in only the External group. Pre to washout: Dual task step time ( P = .005) and percentage in double support ( P = .014) significantly decreased (improved) in both exercise groups, although only the internal group increased error on the secondary counting task (ie, more errors monitoring numbers). UPDRS-III scores in both exercise groups significantly decreased ( P = .001). CONCLUSIONS Since dual task walking improvements were found immediately, and 8 weeks after the cessation of an externally focused exercise program, we conclude that externally focused exercise may improve on functioning of automatic control networks in PD. Internally focused exercise hindered dual tasking ability. Overall, externally focused exercise led to greater rehabilitation benefits in dual tasking and motor symptoms compared with internally focused exercise.
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Affiliation(s)
- Eric N Beck
- 1 Wilfrid Laurier University, Waterloo, Ontario, Canada
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31
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Kordys E, Apetz N, Schneider K, Duncan E, Büschbell B, Rohleder C, Sué M, Drzezga A, Neumaier B, Timmermann L, Endepols H. Motor impairment and compensation in a hemiparkinsonian rat model: correlation between dopamine depletion severity, cerebral metabolism and gait patterns. EJNMMI Res 2017; 7:68. [PMID: 28831764 PMCID: PMC5567589 DOI: 10.1186/s13550-017-0317-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 08/16/2017] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND In Parkinson's disease (PD), cerebral dopamine depletion is associated with PD subtype-specific metabolic patterns of hypo- and hypermetabolism. It has been hypothesised that hypometabolism reflects impairment, while hypermetabolism may indicate compensatory activity. In order to associate metabolic patterns with pathophysiological and compensatory mechanisms, we combined resting state [18F]FDG-PET (to demonstrate brain metabolism in awake animals), [18F]FDOPA-PET (dopamine depletion severity) and gait analysis in a unilateral 6-hydroxydopamine rat model. RESULTS We found unilateral nigro-striatal dopaminergic loss to decrease swing speed of the contralesional forelimb and stride length of all paws in association with depletion severity. Depletion severity was found to correlate with compensatory changes such as increased stance time of the other three paws and diagonal weight shift to the ipsilesional hind paw. [18F]FDG-PET revealed ipsilesional hypo- and contralesional hypermetabolism; metabolic deactivation of the ipsilesional network needed for sensorimotor integration (hippocampus/retrosplenial cortex/lateral posterior thalamus) was solely associated with bradykinesia, but hypometabolism of the ipsilesional rostral forelimb area was related to both pathological and compensatory gait changes. Mixed effects were also found for hypermetabolism of the contralesional midbrain locomotor region, while contralesional striatal hyperactivation was linked to motor impairments rather than compensation. CONCLUSIONS Our results indicate that ipsilesional hypo- and contralesional hypermetabolism contribute to both motor impairment and compensation. This is the first time when energy metabolism, dopamine depletion and gait analysis were combined in a hemiparkinsonian model. By experimentally increasing or decreasing compensational brain activity, its potential and limits can be further investigated.
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Affiliation(s)
- Elena Kordys
- Institute of Radiochemistry and Experimental Molecular Imaging, University Hospital of Cologne, Kerpener Str. 62, 50937, Köln, Germany
| | - Nadine Apetz
- Institute of Radiochemistry and Experimental Molecular Imaging, University Hospital of Cologne, Kerpener Str. 62, 50937, Köln, Germany.,Department of Neurology, University Hospital of Cologne, Kerpener Str. 62, 50937, Köln, Germany
| | - Katharina Schneider
- Institute of Radiochemistry and Experimental Molecular Imaging, University Hospital of Cologne, Kerpener Str. 62, 50937, Köln, Germany
| | - Eilidh Duncan
- Institute of Radiochemistry and Experimental Molecular Imaging, University Hospital of Cologne, Kerpener Str. 62, 50937, Köln, Germany
| | - Beatriz Büschbell
- Institute of Radiochemistry and Experimental Molecular Imaging, University Hospital of Cologne, Kerpener Str. 62, 50937, Köln, Germany
| | - Cathrin Rohleder
- Institute of Radiochemistry and Experimental Molecular Imaging, University Hospital of Cologne, Kerpener Str. 62, 50937, Köln, Germany.,Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, J5, 68159, Mannheim, Germany
| | - Michael Sué
- Max-Planck Institute of Metabolism Research, Gleueler Str. 50, 50931, Köln, Germany
| | - Alexander Drzezga
- Department of Nuclear Medicine, University Hospital of Cologne, Kerpener Str. 62, 50937, Köln, Germany
| | - Bernd Neumaier
- Institute of Radiochemistry and Experimental Molecular Imaging, University Hospital of Cologne, Kerpener Str. 62, 50937, Köln, Germany.,Forschungszentrum Jülich GmbH, Institute for Neuroscience and Medicine, INM-5: Nuclear Chemistry, 52425, Jülich, Germany
| | - Lars Timmermann
- Department of Neurology, University Hospital of Cologne, Kerpener Str. 62, 50937, Köln, Germany
| | - Heike Endepols
- Institute of Radiochemistry and Experimental Molecular Imaging, University Hospital of Cologne, Kerpener Str. 62, 50937, Köln, Germany. .,Department of Nuclear Medicine, University Hospital of Cologne, Kerpener Str. 62, 50937, Köln, Germany.
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32
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Philippens IHCHM, Wubben JA, Vanwersch RAP, Estevao DL, Tass PA. Sensorimotor rhythm neurofeedback as adjunct therapy for Parkinson's disease. Ann Clin Transl Neurol 2017; 4:585-590. [PMID: 28812048 PMCID: PMC5553225 DOI: 10.1002/acn3.434] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 05/31/2017] [Accepted: 06/07/2017] [Indexed: 11/18/2022] Open
Abstract
Neurofeedback may enhance compensatory brain mechanisms. EEG‐based sensorimotor rhythm neurofeedback training was suggested to be beneficial in Parkinson's disease. In a placebo‐controlled study in parkinsonian nonhuman primates we here show that sensorimotor rhythm neurofeedback training reduces MPTP‐induced parkinsonian symptoms and both ON and OFF scores during classical L‐DOPA treatment. Our findings encourage further development of sensorimotor rhythm neurofeedback training as adjunct therapy for Parkinson's disease which might help reduce L‐DOPA‐induced side effects.
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Affiliation(s)
- Ingrid H C H M Philippens
- Animal Science Department Biomedical Primate Research Centre (BPRC) P.O. Box 3306 Rijswijk 2280 GH the Netherlands.,Department of Immunobiology Biomedical Primate Research Centre (BPRC) P.O. Box 3306 Rijswijk 2280 GH the Netherlands
| | - Jacqueline A Wubben
- Department of Immunobiology Biomedical Primate Research Centre (BPRC) P.O. Box 3306 Rijswijk 2280 GH the Netherlands
| | - Raymond A P Vanwersch
- Animal Science Department Biomedical Primate Research Centre (BPRC) P.O. Box 3306 Rijswijk 2280 GH the Netherlands
| | - Dave L Estevao
- Department of Immunobiology Biomedical Primate Research Centre (BPRC) P.O. Box 3306 Rijswijk 2280 GH the Netherlands
| | - Peter A Tass
- Department of Neurosurgery Stanford University Stanford California USA
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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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Cerebellar theta burst stimulation does not improve freezing of gait in patients with Parkinson's disease. J Neurol 2017; 264:963-972. [PMID: 28382420 PMCID: PMC5413528 DOI: 10.1007/s00415-017-8479-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Revised: 03/28/2017] [Accepted: 03/29/2017] [Indexed: 11/09/2022]
Abstract
Freezing of gait (FOG) in Parkinson’s disease (PD) likely results from dysfunction within a complex neural gait circuitry involving multiple brain regions. Herein, cerebellar activity is increased in patients compared to healthy subjects. This cerebellar involvement has been proposed to be compensatory. We hypothesized that patients with FOG would have a reduced ability to recruit the cerebellum to compensate for dysfunction in other brain areas. In this study cerebellar activity was modified unilaterally by either excitatory or inhibitory theta burst stimulation (TBS), applied during two separate sessions. The ipsilateral cerebellar hemisphere, corresponding to the body side most affected by PD, was stimulated. Seventeen patients with PD showing ‘off’ state FOG participated. The presence of FOG was verified objectively upon inclusion. We monitored gait and bimanual rhythmic upper limb movements before and directly after TBS. Gait was evaluated with a FOG-provoking protocol, including rapid 360° turns and a 10-m walking test with small fast steps. Upper limb movement performance was evaluated with a repetitive finger flexion–extension task. TBS did not affect the amount of freezing during walking or finger tapping. However, TBS did increase gait speed when walking with small steps, and decreased gait speed when walking as fast as possible with a normal step size. The changes in gait speed were not accompanied by changes in corticospinal excitability of M1. Unilateral cerebellar TBS did not improve FOG. However, changes in gait speed were found which suggests a role of the cerebellum in PD.
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35
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Gao L, Zhang J, Hou Y, Hallett M, Chan P, Wu T. The cerebellum in dual-task performance in Parkinson's disease. Sci Rep 2017; 7:45662. [PMID: 28358358 PMCID: PMC5372469 DOI: 10.1038/srep45662] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 03/02/2017] [Indexed: 12/03/2022] Open
Abstract
Parkinson’s disease (PD) patients have difficulty in performing a dual-task. It has been suggested that the cerebellum is important in dual-tasking. We used functional MRI to investigate the role of the cerebellum in performing a dual motor and cognitive task in PD patients. We have examined whether there are any areas additionally activated for dual-task performance, and compared the neural activity and functional connectivity pattern in the cerebellum between PD patients and healthy controls. We found that the right cerebellar vermis and left lobule V of cerebellar anterior lobe were additionally activated for dual-task performance in healthy controls and for motor task in PD patients. We didn’t find any cerebellar regions additionally activated while performing dual-task in PD patients. In addition, the right cerebellar vermis had enhanced connectivity with motor and cognitive associated networks in PD patients. PD patients have limited cerebellar resources that are already utilized for single tasks and, for dual tasks, cannot augment as necessary in order to integrate motor and cognitive networks.
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Affiliation(s)
- Linlin Gao
- Department of Neurobiology, Key Laboratory on Neurodegenerative Disorders of Ministry of Education, Beijing Institute of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory on Parkinson's Disease, Parkinson Disease Center of Beijing Institute for Brain Disorders, Beijing, China
| | - Jiarong Zhang
- Department of Neurobiology, Key Laboratory on Neurodegenerative Disorders of Ministry of Education, Beijing Institute of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory on Parkinson's Disease, Parkinson Disease Center of Beijing Institute for Brain Disorders, Beijing, China
| | - Yanan Hou
- Department of Neurobiology, Key Laboratory on Neurodegenerative Disorders of Ministry of Education, Beijing Institute of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory on Parkinson's Disease, Parkinson Disease Center of Beijing Institute for Brain Disorders, Beijing, China
| | - Mark Hallett
- Human Motor Control Section, Medical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Piu Chan
- Department of Neurobiology, Key Laboratory on Neurodegenerative Disorders of Ministry of Education, Beijing Institute of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory on Parkinson's Disease, Parkinson Disease Center of Beijing Institute for Brain Disorders, Beijing, China
| | - Tao Wu
- Department of Neurobiology, Key Laboratory on Neurodegenerative Disorders of Ministry of Education, Beijing Institute of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory on Parkinson's Disease, Parkinson Disease Center of Beijing Institute for Brain Disorders, Beijing, China
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Gao LL, Zhang JR, Chan P, Wu T. Levodopa Effect on Basal Ganglia Motor Circuit in Parkinson's Disease. CNS Neurosci Ther 2016; 23:76-86. [PMID: 27663605 DOI: 10.1111/cns.12634] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 08/22/2016] [Accepted: 08/27/2016] [Indexed: 12/16/2022] Open
Abstract
AIMS To investigate the effects of levodopa on the basal ganglia motor circuit (BGMC) in Parkinson's disease (PD). METHODS Thirty PD patients with asymmetrical bradykinesia and 30 control subjects were scanned using resting-state functional MRI. Functional connectivity of the BGMC was measured and compared before and after levodopa administration in patients with PD. The correlation between improvements in bradykinesia and changes in BGMC connectivity was examined. RESULTS In the PD-off state (before medication), the posterior putamen and internal globus pallidus (GPi) had decreased connectivity while the subthalamic nucleus (STN) had enhanced connectivity within the BGMC relative to control subjects. Levodopa administration increased the connectivity of posterior putamen- and GPi-related networks but decreased the connectivity of STN-related networks. Improvements in bradykinesia were correlated with enhanced connectivity of the posterior putamen-cortical motor pathway and with decreased connectivity of the STN-thalamo-cortical motor pathway. CONCLUSION In PD patients with asymmetrical bradykinesia, levodopa can partially normalize the connectivity of the BGMC with a larger effect on the more severely affected side. Moreover, the beneficial effect of levodopa on bradykinesia is associated with normalization of the striato-thalamo-cortical motor and STN-cortical motor pathways. Our findings inform the neural mechanism of levodopa treatment in PD.
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Affiliation(s)
- Lin-Lin Gao
- Department of Neurobiology, Key Laboratory on Neurodegenerative Disorders of Ministry of Education, Beijing Institute of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory on Parkinson's Disease, Parkinson Disease Center of Beijing Institute for Brain Disorders, Beijing, China
| | - Jia-Rong Zhang
- Department of Neurobiology, Key Laboratory on Neurodegenerative Disorders of Ministry of Education, Beijing Institute of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory on Parkinson's Disease, Parkinson Disease Center of Beijing Institute for Brain Disorders, Beijing, China
| | - Piu Chan
- Department of Neurobiology, Key Laboratory on Neurodegenerative Disorders of Ministry of Education, Beijing Institute of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory on Parkinson's Disease, Parkinson Disease Center of Beijing Institute for Brain Disorders, Beijing, China
| | - Tao Wu
- Department of Neurobiology, Key Laboratory on Neurodegenerative Disorders of Ministry of Education, Beijing Institute of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory on Parkinson's Disease, Parkinson Disease Center of Beijing Institute for Brain Disorders, Beijing, China
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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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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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Default mode network differences between rigidity- and tremor-predominant Parkinson's disease. Cortex 2016; 81:239-50. [PMID: 27266635 DOI: 10.1016/j.cortex.2016.04.021] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 09/08/2015] [Accepted: 04/22/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND Parkinson's disease (PD) traditionally is characterized by tremor, rigidity, and bradykinesia, although cognitive impairment also is a common symptom. The clinical presentation of PD is heterogeneous and associated with different risk factors for developing cognitive impairment. PD patients with primary akinetic/rigidity (PDAR) are more likely to develop cognitive deficits compared to those with tremor-predominant symptoms (PDT). Because cognitive impairment in PD appears to be related to changes in the default mode network (DMN), this study tested the hypothesis that DMN integrity is different between PDAR and PDT subtypes. METHOD Resting state fMRI (rs-fMRI) and whole brain volumetric data were obtained from 17 PDAR, 15 PDT and 24 healthy controls (HCs) using a 3T scanner. PD patients were matched closely to HCs for demographic and cognitive variables, and showed no symptoms of dementia. Voxel-based morphometry (VBM) was used to examine brain gray matter (GM) volume changes between groups. Independent component analysis (ICA) interrogated differences in the DMN among PDAR, PDT, and HC. RESULTS There was decreased activity in the left inferior parietal cortex (IPC) and the left posterior cingulate cortex (PCC) within the DMN between PDAR and both HC and PDT subjects, even after controlling for multiple comparisons, but not between PDT and HC. GM volume differences between groups were detected at a lower threshold (p < 0.001, uncorrected). Resting state activity in IPC and PCC were correlated with some measures of cognitive performance in PD but not in HC. CONCLUSION This is the first study to demonstrate DMN differences between cognitively comparable PDAR and PDT subtypes. The DMN differences between PD and HC appear to be driven by the PDAR subtype. Further studies are warranted to understand the underlying neural mechanisms and their relevance to clinical and cognitive outcomes in PDAR and PDT subtypes.
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Hou Y, Luo C, Yang J, Ou R, Song W, Wei Q, Cao B, Zhao B, Wu Y, Shang HF, Gong Q. Prediction of individual clinical scores in patients with Parkinson's disease using resting-state functional magnetic resonance imaging. J Neurol Sci 2016; 366:27-32. [PMID: 27288771 DOI: 10.1016/j.jns.2016.04.030] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Revised: 03/27/2016] [Accepted: 04/16/2016] [Indexed: 02/05/2023]
Abstract
Neuroimaging holds the promise that it may one day aid the clinical assessment. However, the vast majority of studies using resting-state functional magnetic resonance imaging (fMRI) have reported average differences between Parkinson's disease (PD) patients and healthy controls, which do not permit inferences at the level of individuals. This study was to develop a model for the prediction of PD illness severity ratings from individual fMRI brain scan. The resting-state fMRI scans were obtained from 84 patients with PD and the Unified Parkinson's Disease Rating Scale-III (UPDRS-III) scores were obtained before scanning. The RVR method was used to predict clinical scores (UPDRS-III) from fMRI scans. The application of RVR to whole-brain resting-state fMRI data allowed prediction of UPDRS-III scores with statistically significant accuracy (correlation=0.35, P-value=0.001; mean sum of squares=222.17, P-value=0.002). This prediction was informed strongly by negative weight areas including prefrontal lobe and medial occipital lobe, and positive weight areas including medial parietal lobe. It was suggested that fMRI scans contained sufficient information about neurobiological change in patients with PD to permit accurate prediction about illness severity, on an individual subject basis. Our results provided preliminary evidence, as proof-of-concept, to support that fMRI might be possible to be a clinically useful quantitative assessment aid in PD at individual level. This may enable clinicians to target those uncooperative patients and machines to replace human for a more efficient use of health care resources.
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Affiliation(s)
- YanBing Hou
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - ChunYan Luo
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jing Yang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - RuWei Ou
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Wei Song
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - QianQian Wei
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Bei Cao
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Bi Zhao
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ying Wu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hui-Fang Shang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - QiYong Gong
- Huaxi MR Research Center, Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
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Park J, Chang WH, Cho JW, Youn J, Kim YK, Kim SW, Kim YH. Usefulness of Transcranial Magnetic Stimulation to Assess Motor Function in Patients With Parkinsonism. Ann Rehabil Med 2016; 40:81-7. [PMID: 26949673 PMCID: PMC4775762 DOI: 10.5535/arm.2016.40.1.81] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 08/07/2015] [Indexed: 12/11/2022] Open
Abstract
Objective To investigate the clinical significance of upper and lower extremity transcranial magnetic stimulation (TMS)-induced motor evoked potentials (MEPs) in patients with parkinsonism. Methods Twenty patients (14 men, 6 women; mean age 70.5±9.1 years) suffering from parkinsonism were included in this study. All participants underwent single-pulse TMS session to assess the corticospinal excitability of the upper and lower extremity motor cortex. The resting motor threshold (RMT) was defined as the lowest stimulus intensity able to evoke MEPs of an at least 50 µV peak-to-peak amplitude in 5 of 10 consecutive trials. Five sweeps of MEPs at 120% of the RMT were performed, and the mean amplitude and latency of the MEPs were calculated. Patients were also assessed using the Unified Parkinson's Disease Rating Scale part III (UPDRS-III) and the 5-meter Timed Up and Go (5m-TUG) test. Results There was a significant positive correlation between the RMTs of MEPs in the upper and lower extremities (r=0.612, p=0.004) and between the amplitude of MEPs in the upper and lower extremities (r=0.579, p=0.007). The RMT of upper extremity MEPs showed a significant negative relationship with the UPDRS-III score (r=–0.516, p=0.020). In addition, RMTs of lower extremity MEPs exhibited a negative relationship with the UPDRS-III score, but the association was not statistically significant (r=–406, p=0.075). Conclusion These results indicated that the RMT of MEPs reflect the severity of motor dysfunction in patients with parkinsonism. MEP is a potential quantitative, electrodiagnostic method to assess motor function in patients with parkinsonism.
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Affiliation(s)
- Jaechan Park
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Won Hyuk Chang
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jin Whan Cho
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jinyoung Youn
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yun Kwan Kim
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sun Woong Kim
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yun-Hee Kim
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.; Department of Health Science and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea.; Department of Medical Device Management & Research, SAIHST, Sungkyunkwan University, Seoul, Korea
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Fifel K, Piggins H, Deboer T. Modeling sleep alterations in Parkinson's disease: How close are we to valid translational animal models? Sleep Med Rev 2016; 25:95-111. [DOI: 10.1016/j.smrv.2015.02.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 02/18/2015] [Accepted: 02/18/2015] [Indexed: 10/23/2022]
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Abstract
The difficulty to understand, diagnose, and treat neurological disorders stems from the great complexity of the central nervous system on different levels of physiological granularity. The individual components, their interactions, and dynamics involved in brain development and function can be represented as molecular, cellular, or functional networks, where diseases are perturbations of networks. These networks can become a useful research tool in investigating neurological disorders if they are properly tailored to reflect corresponding mechanisms. Here, we review approaches to construct networks specific for neurological disorders describing disease-related pathology on different scales: the molecular, cellular, and brain level. We also briefly discuss cross-scale network analysis as a necessary integrator of these scales.
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Hanganu A, Provost JS, Monchi O. Neuroimaging studies of striatum in cognition part II: Parkinson's disease. Front Syst Neurosci 2015; 9:138. [PMID: 26500512 PMCID: PMC4596940 DOI: 10.3389/fnsys.2015.00138] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 09/22/2015] [Indexed: 11/27/2022] Open
Abstract
In recent years a gradual shift in the definition of Parkinson's disease (PD) has been established, from a classical akinetic-rigid movement disorder to a multi-system neurodegenerative disease. While the pathophysiology of PD is complex and goes much beyond the nigro-striatal degeneration, the striatum has been shown to be responsible for many cognitive functions. Patients with PD develop impairments in multiple cognitive domains and the PD model is probably the most extensively studied regarding striatum dysfunction and its influence on cognition. Up to 40% of PD patients present cognitive impairment even in the early stages of disease development. Thus, understanding the key patterns of striatum and connecting regions' influence on cognition will help develop more specific approaches to alleviate cognitive impairment and slow down its decline. This review focuses on the contribution of neuroimaging studies in understanding how striatum impairment affects cognition in PD.
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Affiliation(s)
- Alexandru Hanganu
- Department of Clinical Neurosciences and Department of Radiology, Cumming School of Medicine, University of CalgaryCalgary, AB, Canada
- Hotchkiss Brain Institute, University of CalgaryCalgary, AB, Canada
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Université de MontréalMontréal, QC, Canada
| | - Jean-Sebastien Provost
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Université de MontréalMontréal, QC, Canada
- Department of Psychology, Faculty of Arts and Sciences, University of MontrealMontreal, QC, Canada
| | - Oury Monchi
- Department of Clinical Neurosciences and Department of Radiology, Cumming School of Medicine, University of CalgaryCalgary, AB, Canada
- Hotchkiss Brain Institute, University of CalgaryCalgary, AB, Canada
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Université de MontréalMontréal, QC, Canada
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Gesquière-Dando A, Guedj E, Loundou A, Carron R, Witjas T, Fluchère F, Delfini M, Mundler L, Regis J, Azulay JP, Eusebio A. A preoperative metabolic marker of parkinsonian apathy following subthalamic nucleus stimulation. Mov Disord 2015; 30:1767-76. [DOI: 10.1002/mds.26349] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Revised: 06/12/2015] [Accepted: 06/21/2015] [Indexed: 11/05/2022] Open
Affiliation(s)
- Aude Gesquière-Dando
- APHM; CHU Timone, Department of Neurology and Movement Disorders; Aix Marseille Université; Marseille France
- Institut de Neurosciences de la Timone UMR 7289; Aix Marseille Université; CNRS Marseille France
| | - Eric Guedj
- Institut de Neurosciences de la Timone UMR 7289; Aix Marseille Université; CNRS Marseille France
- APHM; CHU Timone, Service Central de Biophysique et Médecine Nucléaire; Aix Marseille Université; Marseille France
- CERIMED; Aix-Marseille Université; Marseille France
| | - Anderson Loundou
- APHM; CHU Timone, Unité d'Aide méthodologique à la Recherche Clinique et Epidémiologique; DRRC Marseille France
| | - Romain Carron
- APHM; CHU Timone, Department of Functional and Stereotactic Neurosurgery; Aix Marseille Université; Marseille France
| | - Tatiana Witjas
- APHM; CHU Timone, Department of Neurology and Movement Disorders; Aix Marseille Université; Marseille France
- Institut de Neurosciences de la Timone UMR 7289; Aix Marseille Université; CNRS Marseille France
| | - Frédérique Fluchère
- APHM; CHU Timone, Department of Neurology and Movement Disorders; Aix Marseille Université; Marseille France
| | - Marie Delfini
- APHM; CHU Timone, Department of Neurology and Movement Disorders; Aix Marseille Université; Marseille France
| | - Laura Mundler
- APHM; CHU Timone, Department of Neurology and Movement Disorders; Aix Marseille Université; Marseille France
| | - Jean Regis
- APHM; CHU Timone, Department of Functional and Stereotactic Neurosurgery; Aix Marseille Université; Marseille France
| | - Jean-Philippe Azulay
- APHM; CHU Timone, Department of Neurology and Movement Disorders; Aix Marseille Université; Marseille France
- Institut de Neurosciences de la Timone UMR 7289; Aix Marseille Université; CNRS Marseille France
| | - Alexandre Eusebio
- APHM; CHU Timone, Department of Neurology and Movement Disorders; Aix Marseille Université; Marseille France
- Institut de Neurosciences de la Timone UMR 7289; Aix Marseille Université; CNRS Marseille France
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Timmermann L, Asgharnejad M, Boroojerdi B, Dohin E, Woltering F, Elmer LW. Impact of 6-month earlier versus postponed initiation of rotigotine on long-term outcome: post hoc analysis of patients with early Parkinson's disease with mild symptom severity. Expert Opin Pharmacother 2015; 16:1423-33. [PMID: 25997442 DOI: 10.1517/14656566.2015.1049597] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Investigate impact of 6-month earlier versus postponed initiation of rotigotine in patients with early Parkinson's disease (PD) with mild symptom severity. BACKGROUND Long-term benefit of rotigotine in early-PD has been demonstrated: SP702 (NCT00594165) and SP716 (NCT00599196) were long-term, open-label extensions of double-blind, placebo-controlled studies of 6-month maintenance; rotigotine was well tolerated for up to 6 years, and demonstrated efficacy (Unified Parkinson's Disease Rating Scale [UPDRS] II + III below baseline) for ∼ 2 years (SP702) and ∼ 4 years (SP716). METHODS Post hoc analysis of patients at Hoehn and Yahr 1-2; groups defined by treatment received in 6-month double-blind studies: 'Rotigotine-Rotigotine' received rotigotine (n = 221), 'Placebo-Rotigotine' received placebo (n = 125). RESULTS At the start of open-label rotigotine maintenance, UPDRS II + III mean ± SD change from double-blind baseline was: -8.5 ± 10.6 'Rotigotine-Rotigotine', -7.7 ± 9.0 'Placebo-Rotigotine.' After this initial improvement scores gradually increased: It took ∼ 45 months for mean scores to cross baseline in 'Rotigotine-Rotigotine', and ∼ 21 months in 'Placebo-Rotigotine.' At the time mean UPDRS II + III had crossed baseline in 'Placebo-Rotigotine' (open-label week 84; ∼ 21 months), treatment difference (LS-mean) to 'Rotigotine-Rotigotine' change from baseline was -3.89 (95% CI -6.94, -0.84); p = 0.013. CONCLUSIONS In this post hoc analysis, 6-month earlier initiation of rotigotine resulted in slower return to baseline mean UPDRS II + III; initiation of rotigotine in patients with minimal/no functional disability or impairment may lead to an extended benefit.
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Affiliation(s)
- Lars Timmermann
- University Hospital Cologne, Department of Neurology , Cologne , Germany +49 221 478 7494 ; +49 221 478 87512 ;
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Affiliation(s)
- Martin J McKeown
- From the Departments of Medicine (Neurology) and Electrical and Computer Engineering (M.J.M.), University of British Columbia, Vancouver, Canada; and Department of Neurosciences (G.M.P.), University of California, San Diego.
| | - Guerry M Peavy
- From the Departments of Medicine (Neurology) and Electrical and Computer Engineering (M.J.M.), University of British Columbia, Vancouver, Canada; and Department of Neurosciences (G.M.P.), University of California, San Diego
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Kojovic M, Kassavetis P, Bologna M, Pareés I, Rubio-Agusti I, Berardelli A, Beraredelli A, Edwards MJ, Rothwell JC, Bhatia KP. Transcranial magnetic stimulation follow-up study in early Parkinson's disease: A decline in compensation with disease progression? Mov Disord 2015; 30:1098-106. [PMID: 25753906 DOI: 10.1002/mds.26167] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 12/08/2014] [Accepted: 01/12/2015] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND A number of neurophysiological abnormalities have been described in patients with Parkinson's disease, but very few longitudinal studies of how these change with disease progression have been reported. We describe measures of motor cortex inhibition and plasticity at 6 and 12 mo in 12 patients that we previously reported at initial diagnosis. Given the well-known interindividual variation in these measures, we were particularly concerned with the within-subject changes over time. METHODS Patients were assessed clinically, and transcranial magnetic stimulation (TMS) was used to measure motor cortical excitability, inhibition (short interval intracortical inhibition, cortical silent period), and plasticity (response to excitatory paired associative stimulation protocol) in both hemispheres. All measurements were performed 6 mo and 12 mo after the baseline experiments. RESULTS Asymmetry in clinical motor symptoms was reflected in asymmetry of plasticity and inhibition. In the group as a whole, little change was seen in any of the parameters over 12 mo. However, analysis of within-individual data showed clear correlations between changes in clinical asymmetry and asymmetry of response to paired associative stimulation protocol and cortical silent period. CONCLUSIONS Longitudinal changes in cortical silent period and response to paired associative stimulation protocol in Parkinson's disease reflect dynamic effects on motor cortex that are related to progression of motor signs. They are useful objective markers of early disease progression that could be used to detect effects of disease-modifying therapies. The decline in heightened plasticity that was present at disease onset may reflect failure of compensatory mechanisms that maintained function in the preclinical state.
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Affiliation(s)
- Maja Kojovic
- Sobell Department of Motor Neuroscience & Movement Disorders, UCL, Institute of Neurology, The National Hospital for Neurology & Neurosurgery, Queen Square, London, United Kingdom.,Department of Neurology, University of Ljubljana, Slovenia
| | - Panagiotis Kassavetis
- Sobell Department of Motor Neuroscience & Movement Disorders, UCL, Institute of Neurology, The National Hospital for Neurology & Neurosurgery, Queen Square, London, United Kingdom
| | - Matteo Bologna
- Department of Neurology and Psychiatry and Neuromed institute, "Sapienza" University of Rome, Italy
| | - Isabel Pareés
- Sobell Department of Motor Neuroscience & Movement Disorders, UCL, Institute of Neurology, The National Hospital for Neurology & Neurosurgery, Queen Square, London, United Kingdom
| | - Ignacio Rubio-Agusti
- Movement Disorders Unit, Neurology Department, Hospital Universitario La Fe, Valencia, Spain
| | - Alfredo Berardelli
- Department of Neurology and Psychiatry and Neuromed institute, "Sapienza" University of Rome, Italy
| | - Alfredo Beraredelli
- Department of Neurology and Psychiatry and Neuromed institute, "Sapienza" University of Rome, Italy
| | - Mark J Edwards
- Sobell Department of Motor Neuroscience & Movement Disorders, UCL, Institute of Neurology, The National Hospital for Neurology & Neurosurgery, Queen Square, London, United Kingdom
| | - John C Rothwell
- Sobell Department of Motor Neuroscience & Movement Disorders, UCL, Institute of Neurology, The National Hospital for Neurology & Neurosurgery, Queen Square, London, United Kingdom
| | - Kailash P Bhatia
- Sobell Department of Motor Neuroscience & Movement Disorders, UCL, Institute of Neurology, The National Hospital for Neurology & Neurosurgery, Queen Square, London, United Kingdom
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Greenbaum L, Lerer B. Pharmacogenetics of antipsychotic-induced movement disorders as a resource for better understanding Parkinson's disease modifier genes. Front Neurol 2015; 6:27. [PMID: 25750634 PMCID: PMC4335175 DOI: 10.3389/fneur.2015.00027] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Accepted: 01/30/2015] [Indexed: 12/05/2022] Open
Abstract
Antipsychotic-induced movement disorders are major side effects of antipsychotic drugs among schizophrenia patients, and include antipsychotic-induced parkinsonism (AIP) and tardive dyskinesia (TD). Substantial pharmacogenetic work has been done in this field, and several susceptibility variants have been suggested. In this paper, the genetics of antipsychotic-induced movement disorders is considered in a broader context. We hypothesize that genetic variants that are risk factors for AIP and TD may provide insights into the pathophysiology of motor symptoms in Parkinson’s disease (PD). Since loss of dopaminergic stimulation (albeit pharmacological in AIP and degenerative in PD) is shared by the two clinical entities, genes associated with susceptibility to AIP may be modifier genes that influence clinical expression of PD motor sub-phenotypes, such as age at onset, disease severity, or rate of progression. This is due to their possible functional influence on compensatory mechanisms for striatal dopamine loss. Better compensatory potential might be beneficial at the early and later stages of the PD course. AIP vulnerability variants could also be related to latent impairment in the nigrostriatal pathway, affecting its functionality, and leading to subclinical dopaminergic deficits in the striatum. Susceptibility of PD patients to early development of l-DOPA induced dyskinesia (LID) is an additional relevant sub-phenotype. LID might share a common genetic background with TD, with which it shares clinical features. Genetic risk variants may predispose to both phenotypes, exerting a pleiotropic effect. According to this hypothesis, elucidating the genetics of antipsychotic-induced movement disorders may advance our understanding of multiple aspects of PD and it clinical course, rendering this a potentially rewarding field of study.
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Affiliation(s)
- Lior Greenbaum
- Department of Neurology, Sheba Medical Center at Tel Hashomer , Ramat Gan , Israel ; The Joseph Sagol Neuroscience Center, Sheba Medical Center at Tel Hashomer , Ramat Gan , Israel
| | - Bernard Lerer
- Biological Psychiatry Laboratory, Department of Psychiatry, Hadassah - Hebrew University Medical Center , Jerusalem , Israel
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Zhang J, Bi W, Zhang Y, Zhu M, Zhang Y, Feng H, Wang J, Zhang Y, Jiang T. Abnormal functional connectivity density in Parkinson's disease. Behav Brain Res 2014; 280:113-8. [PMID: 25496782 DOI: 10.1016/j.bbr.2014.12.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 11/27/2014] [Accepted: 12/01/2014] [Indexed: 10/24/2022]
Abstract
The pathology of Parkinson's disease (PD) is not confined to the nigrostriatal pathway, but also involves widespread cerebral cortical areas. Using seed-based resting state functional connectivity, many previous studies have demonstrated that PD patients have abnormal functional integration. However, this technique strongly relies on a priori selection of the seed regions and may miss important unpredictable findings. Using an ultrafast voxel-wise functional connectivity density approach, this study performed a whole brain functional connectivity analysis to investigate the abnormal resting-state functional activities in PD patients. Compared with healthy controls, PD patients exhibited decreased short-range functional connectivity densities in regions that were mainly located in the ventral visual pathway and decreased long-range functional connectivity densities in the right middle and superior frontal gyrus, which have been speculated to be associated with visual hallucinations and cognitive dysfunction, respectively. PD patients also exhibited increased short- and long-range functional connectivity densities in the bilateral precuneus and posterior cingulate cortex, which may represent a compensatory process for maintaining normal brain function. The observed functional connectivity density alterations might be related to the disturbed structural connectivity of PD patients, leading to abnormal functional integration. Our results suggest that functional connectivity density mapping may provide a useful means to assess PD-related neurodegeneration and to study the pathophysiology of PD.
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Affiliation(s)
- Jiuquan Zhang
- Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing 400038, PR China
| | - Wenwei Bi
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, PR China
| | - Yuling Zhang
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, PR China
| | - Maohu Zhu
- Elementary Educational College, Jiangxi Normal University, Nanchang 330027, PR China
| | - Yanling Zhang
- Department of Neurology, Southwest Hospital, Third Military Medical University, Chongqing 400038, PR China
| | - Hua Feng
- Department of Neurosurgery, Southwest Hospital, Third Military Medical University, Chongqing 400038, PR China
| | - Jian Wang
- Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing 400038, PR China
| | - Yuanchao Zhang
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, PR China.
| | - Tianzi Jiang
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, PR China; National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, PR China.
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