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Aiello EN, Mameli F, Ruggiero F, Zirone E, Zago S, Piacentini S, Poletti B, Reitano MR, Santangelo G, Ticozzi N, Silani V, Priori A, Ferrucci R. Psychometrics and diagnostics of the Italian version of the Alternate Verbal Fluency Battery (AVFB) in non-demented Parkinson's disease patients. Neurol Sci 2024; 45:3767-3774. [PMID: 38467953 PMCID: PMC11255082 DOI: 10.1007/s10072-024-07436-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 02/29/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND Verbal fluency (VF) tasks are known as suitable for detecting cognitive impairment (CI) in Parkinson's disease (PD). This study thus aimed to evaluate the psychometrics and diagnostics of the Alternate Verbal Fluency Battery (AVFB) by Costa et al. (2014) in an Italian cohort of non-demented PD patients, as well as to derive disease-specific cut-offs for it. METHODS N = 192 non-demented PD patients were screened with the Montreal Cognitive Assessment (MoCA) and underwent the AVFB-which includes phonemic, semantic and alternate VF tests (PVF; SVF; AVF), as well as a Composite Shifting Index (CSI) reflecting the "cost" of shifting from a single- to a double-cued VF task. Construct validity and diagnostics were assessed for each AVFB measure against the MoCA. Internal reliability and factorial validity were also tested. RESULTS The MoCA proved to be strongly associated with PVF, SVF and AVF scores, whilst moderately with the CSI. The AVFB was internally consistent and underpinned by a single component; however, an improvement in both internal reliability and fit to its factorial structure was observed when dropping the CSI. Demographically adjusted scores on PVF, SVF and AVF tests were diagnostically sound in detecting MoCA-defined cognitive impairment, whilst this was not true for the CSI. Disease-specific cut-offs for PVF, SVF and AVF tests were derived. DISCUSSION In conclusion, PVF, SVF and AVF tests are reliable, valid and diagnostically sound instruments to detect cognitive impairment in non-demented PD patients and are therefore recommended for use in clinical practice and research.
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Affiliation(s)
- Edoardo Nicolò Aiello
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Francesca Mameli
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Fabiana Ruggiero
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Eleonora Zirone
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefano Zago
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Barbara Poletti
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Oncology and Hemato-Oncology, Università Degli Studi Di Milano, Via Santa Sofia 9, 20122, Milan, Italy
| | | | - Gabriella Santangelo
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Nicola Ticozzi
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Pathophysiology and Transplantation, "Dino Ferrari" Center, Università degli Studi di Milano, Milan, Italy
| | - Vincenzo Silani
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Pathophysiology and Transplantation, "Dino Ferrari" Center, Università degli Studi di Milano, Milan, Italy
| | - Alberto Priori
- ASST Santi Paolo e Carlo, San Paolo University Hospital, Milan, Italy
- "Aldo Ravelli" Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, University of Milan, Milan, Italy
| | - Roberta Ferrucci
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
- Department of Oncology and Hemato-Oncology, Università Degli Studi Di Milano, Via Santa Sofia 9, 20122, Milan, Italy.
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Beheshti I, Perron J, Ko JH. Neuroanatomical Signature of the Transition from Normal Cognition to MCI in Parkinson's Disease. Aging Dis 2024:AD.2024.0323. [PMID: 38913040 DOI: 10.14336/ad.2024.0323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 03/23/2024] [Indexed: 06/25/2024] Open
Abstract
The progression of Parkinson's disease (PD) is often accompanied by cognitive decline. We had previously developed a brain age estimation program utilizing structural MRI data of 949 healthy individuals from publicly available sources. Structural MRI data of 244 PD patients who were cognitively normal at baseline was acquired from the Parkinson Progression Markers Initiative (PPMI). 192 of these showed stable normal cognitive function from baseline out to 5 years (PD-SNC), and the remaining 52 had unstable normal cognition and developed mild cognitive impairment within 5 years (PD-UNC). 105 healthy controls were also included in the analysis as a reference. First, we examined if there were any baseline differences in regional brain structure between PD-UNC and PD-SNC cohorts utilizing the three most widely used atrophy estimation pipelines, i.e., voxel-based morphometry (VBM), deformation-based morphometry and cortical thickness analyses. We then investigated if accelerated brain age estimation with our multivariate regressive machine learning algorithm was different across these groups (HC, PD-SNC, and PD-UNC). As per the VBM analysis, PD-UNC patients demonstrated a noticeable increase in GM volume in the posterior and anterior lobes of the cerebellum, sub-lobar, extra-nuclear, thalamus, and pulvinar regions when compared to PD-SNC at baseline. PD-UNC patients were observed to have significantly older brain age compared to both PD-SNC patients (p=0.009) and healthy controls (p<0.009). The increase in GM volume in the PD-UNC group could potentially indicate an inflammatory or neuronal hypertrophy response, which could serve as a biomarker for future cognitive decline among this population.
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Affiliation(s)
- Iman Beheshti
- Department of Human Anatomy and Cell Science, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- PrairieNeuro Research Centre, Kleysen Institute for Advanced Medicine, Health Science Centre, Winnipeg, MB, Canada
| | - Jarrad Perron
- PrairieNeuro Research Centre, Kleysen Institute for Advanced Medicine, Health Science Centre, Winnipeg, MB, Canada
- Graduate Program in Biomedical Engineering, Price Faculty of Engineering, University of Manitoba, Winnipeg, MB, Canada
| | - Ji Hyun Ko
- Department of Human Anatomy and Cell Science, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- PrairieNeuro Research Centre, Kleysen Institute for Advanced Medicine, Health Science Centre, Winnipeg, MB, Canada
- Graduate Program in Biomedical Engineering, Price Faculty of Engineering, University of Manitoba, Winnipeg, MB, Canada
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Liu H, Zhong Y, Liu G, Su H, Liu Z, Wei J, Mo L, Tan C, Liu X, Chen L. Corpus callosum and cerebellum participate in semantic dysfunction of Parkinson's disease: a diffusion tensor imaging-based cross-sectional study. Neuroreport 2024; 35:366-373. [PMID: 38526949 DOI: 10.1097/wnr.0000000000002015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
Language dysfunction is common in Parkinson's disease (PD) patients, among which, the decline of semantic fluency is usually observed. This study aims to explore the relationship between white matter (WM) alterations and semantic fluency changes in PD patients. 127 PD patients from the Parkinson's Progression Markers Initiative cohort who received diffusion tensor imaging scanning, clinical assessment and semantic fluency test (SFT) were included. Tract-based special statistics, automated fiber quantification, graph-theoretical and network-based analyses were performed to analyze the correlation between WM structural changes, brain network features and semantic fluency in PD patients. Fractional anisotropy of corpus callosum, anterior thalamic radiation, inferior front-occipital fasciculus, and uncinate fasciculus, were positively correlated with SFT scores, while a negative correlation was identified between radial diffusion of the corpus callosum, inferior longitudinal fasciculus, and SFT scores. Automatic fiber quantification identified similar alterations with more details in these WM tracts. Brain network analysis positively correlated SFT scores with nodal efficiency of cerebellar lobule VIII, and nodal local efficiency of cerebellar lobule X. WM integrity and myelin integrity in the corpus callosum and several other language-related WM tracts may influence the semantic function in PD patients. Damage to the cerebellum lobule VIII and lobule X may also be involved in semantic dysfunction in PD patients.
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Affiliation(s)
- Hang Liu
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Rodriguez‐Porcel F, Schwen Blackett D, Hickok G, Bonilha L, Turner TH. Bridging the Gap: Association between Objective and Subjective Outcomes of Communication Performance in People with Parkinson's Disease Evaluated for Deep Brain Stimulation. Mov Disord Clin Pract 2023; 10:1795-1799. [PMID: 38094653 PMCID: PMC10715351 DOI: 10.1002/mdc3.13921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 09/28/2023] [Accepted: 10/29/2023] [Indexed: 02/01/2024] Open
Abstract
Background Decrements in verbal fluency following deep brain stimulation (DBS) in people with Parkinson's disease (PwP) are common. As such, verbal fluency tasks are used in assessing DBS candidacy and target selection. However, the correspondence between testing performance and the patient's perception of communication abilities is not well-established. Methods The Communication Participation Item Bank (CPIB) was administered to 85 PwP during pre-DBS neuropsychological evaluations. Central tendencies for CPIB responses and correlations between CPIB total scores, clinical and demographic factors, and language-based tasks were examined. Results Most PwP indicated some degree of communication interference on the CPIB. Worse scores on semantic fluency and greater motor impairment were associated with more communication interference. Conclusions Our findings suggest an incomplete correspondence between commonly used language-based tests and patient-reported outcomes of communication abilities. The need for a functional communication instrument that reflects the different aspects of communication abilities in functional contexts is emphasized.
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Affiliation(s)
| | - Deena Schwen Blackett
- Department of OtolaryngologyMedical University of South CarolinaCharlestonSCUSA
- Division of Speech‐Language Pathology, Department of Rehabilitation SciencesMedical University of South CarolinaCharlestonSCUSA
| | - Gregory Hickok
- Department of Language ScienceUniversity of California, IrvineIrvineCAUSA
| | | | - Travis H. Turner
- Department of NeurologyMedical University of South CarolinaCharlestonSCUSA
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5
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Kerestes R, Laansma MA, Owens-Walton C, Perry A, van Heese EM, Al-Bachari S, Anderson TJ, Assogna F, Aventurato ÍK, van Balkom TD, Berendse HW, van den Berg KR, Mphys RB, Brioschi R, Carr J, Cendes F, Clark LR, Dalrymple-Alford JC, Dirkx MF, Druzgal J, Durrant H, Emsley HC, Garraux G, Haroon HA, Helmich RC, van den Heuvel OA, João RB, Johansson ME, Khachatryan S, Lochner C, McMillan CT, Melzer TR, Mosley P, Newman B, Opriessnig P, Parkes LM, Pellicano C, Piras F, Pitcher TL, Poston KL, Rango M, Roos A, Rummel C, Schmidt R, Schwingenschuh P, Silva LS, Smith V, Squarcina L, Stein DJ, Tavadyan Z, Tsai CC, Vecchio D, Vriend C, Wang JJ, Wiest R, Yasuda CL, Young CB, Jahanshad N, Thompson PM, van der Werf YD, Harding IH. Cerebellar Volume and Disease Staging in Parkinson's Disease: An ENIGMA-PD Study. Mov Disord 2023; 38:2269-2281. [PMID: 37964373 PMCID: PMC10754393 DOI: 10.1002/mds.29611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 08/14/2023] [Accepted: 09/11/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Increasing evidence points to a pathophysiological role for the cerebellum in Parkinson's disease (PD). However, regional cerebellar changes associated with motor and non-motor functioning remain to be elucidated. OBJECTIVE To quantify cross-sectional regional cerebellar lobule volumes using three dimensional T1-weighted anatomical brain magnetic resonance imaging from the global ENIGMA-PD working group. METHODS Cerebellar parcellation was performed using a deep learning-based approach from 2487 people with PD and 1212 age and sex-matched controls across 22 sites. Linear mixed effects models compared total and regional cerebellar volume in people with PD at each Hoehn and Yahr (HY) disease stage, to an age- and sex- matched control group. Associations with motor symptom severity and Montreal Cognitive Assessment scores were investigated. RESULTS Overall, people with PD had a regionally smaller posterior lobe (dmax = -0.15). HY stage-specific analyses revealed a larger anterior lobule V bilaterally (dmax = 0.28) in people with PD in HY stage 1 compared to controls. In contrast, smaller bilateral lobule VII volume in the posterior lobe was observed in HY stages 3, 4, and 5 (dmax = -0.76), which was incrementally lower with higher disease stage. Within PD, cognitively impaired individuals had lower total cerebellar volume compared to cognitively normal individuals (d = -0.17). CONCLUSIONS We provide evidence of a dissociation between anterior "motor" lobe and posterior "non-motor" lobe cerebellar regions in PD. Whereas less severe stages of the disease are associated with larger motor lobe regions, more severe stages of the disease are marked by smaller non-motor regions. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Rebecca Kerestes
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Max A. Laansma
- Amsterdam UMC, Dept. Anatomy and Neurosciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
| | - Conor Owens-Walton
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Andrew Perry
- Monash Bioinformatics Platform, Monash University, Melbourne, VIC, Australia
| | - Eva M. van Heese
- Amsterdam UMC, Dept. Anatomy and Neurosciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
| | - Sarah Al-Bachari
- Faculty of Health and Medicine, The University of Lancaster, Lancaster, UK
| | - Tim J. Anderson
- Department of Medicine, University of Otago, Christchurch, Christchurch, New Zealand
- New Zealand Brain Research Institute, Christchurch, New Zealand
- Neurology Department, Te Wahtu Ora - Health New Zealand Waitaha Canterbury, Christchurch, New Zew Zealand
| | - Francesca Assogna
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Ítalo K. Aventurato
- Department of Neurology, University of Campinas - UNICAMP, Campinas, Brazil
- Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
| | - Tim D. van Balkom
- Amsterdam UMC, Dept. Anatomy and Neurosciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
- Amsterdam UMC, Dept. Psychiatry, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Henk W. Berendse
- Amsterdam UMC, Dept. Neurology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Kevin R.E. van den Berg
- Department of Neurology and Center of Expertise for Parkinson & Movement Disorders, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
- Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Rebecca Betts Mphys
- School of Physics and Astronomy, Faculty of Science and Engineering, The University of Manchester, Manchester, UK
| | - Ricardo Brioschi
- Department of Neurology, University of Campinas - UNICAMP, Campinas, Brazil
| | - Jonathan Carr
- Division of Neurology, Tygerberg Hospital and Stellenbosch University, Cape Town, South Africa
| | - Fernando Cendes
- Department of Neurology, University of Campinas - UNICAMP, Campinas, Brazil
- Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
| | - Lyles R. Clark
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - John C. Dalrymple-Alford
- New Zealand Brain Research Institute, Christchurch, New Zealand
- School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
| | - Michiel F. Dirkx
- Department of Neurology and Center of Expertise for Parkinson & Movement Disorders, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Jason Druzgal
- Department of Radiology and Medical Imaging, University of Virginia, USA
| | - Helena Durrant
- School of Physics and Astronomy, Faculty of Science and Engineering, The University of Manchester, Manchester, UK
| | - Hedley C.A. Emsley
- Lancaster Medical School, Lancaster University, Lancaster, UK
- Division of Neuroscience and Experimental Psychology, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Gaëtan Garraux
- GIGA-CRC in vivo imaging, University of Liège, Belgium
- Department of Neurology, CHU Liège, Liège, Belgium
| | - Hamied A. Haroon
- Division of Psychology, Communication & Human Neuroscience, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Rick C. Helmich
- Department of Neurology and Center of Expertise for Parkinson & Movement Disorders, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
- Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Odile A. van den Heuvel
- Amsterdam UMC, Dept. Anatomy and Neurosciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
- Amsterdam UMC, Dept. Psychiatry, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Rafael B. João
- Department of Neurology, University of Campinas - UNICAMP, Campinas, Brazil
- Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
| | - Martin E. Johansson
- Department of Neurology and Center of Expertise for Parkinson & Movement Disorders, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Samson Khachatryan
- Department of Neurology and Neurosurgery, National Institute of Health, Yerevan, Armenia
- Centers for Sleep and Movement Disorders, Somnus Neurology Clinic, Yerevan, Armenia
| | - Christine Lochner
- SA MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - Corey T. McMillan
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Tracy R. Melzer
- Department of Medicine, University of Otago, Christchurch, Christchurch, New Zealand
- New Zealand Brain Research Institute, Christchurch, New Zealand
- School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
| | - Philip Mosley
- Clinical Brain Networks Group, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
- The Australian eHealth Research Centre, CSIRO Health and Biosecurity, Brisbane, Queensland, Australia
| | - Benjamin Newman
- Department of Radiology and Medical Imaging, University of Virginia, USA
| | - Peter Opriessnig
- Department of Neurology, Clinical Division of Neurogeriatrics, Medical University Graz, Graz, Austria
| | - Laura M. Parkes
- Division of Psychology, Communication and Human Neuroscience, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre, Northern Care Alliance & University of Manchester, Manchester, UK
| | - Clelia Pellicano
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Fabrizio Piras
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Toni L. Pitcher
- Department of Medicine, University of Otago, Christchurch, Christchurch, New Zealand
- New Zealand Brain Research Institute, Christchurch, New Zealand
| | - Kathleen L. Poston
- Department of Neurology & Neurological Sciences, Stanford University, Palo Alto, CA, USA
| | - Mario Rango
- Excellence Center for Advanced MR Techniques and Parkinson’s Disease Center, Neurology unit, Fondazione IRCCS Cà Granda Maggiore Policlinico Hospital, University of Milan, Milan, Italy
- Dept of Neurosciences, Neurology Unit, Fondazione Ca’ Granda, IRCCS, Ospedale Policlinico, Univeristy of Milan, Milano, Italy
| | - Annerine Roos
- SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Christian Rummel
- Support Center for Advanced Neuroimaging, (SCAN) University Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Reinhold Schmidt
- Department of Neurology, Medical University of Graz, Graz, Austria
| | | | - Lucas S. Silva
- Department of Neurology, University of Campinas - UNICAMP, Campinas, Brazil
- Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
| | - Viktorija Smith
- Department of Neurology & Neurological Sciences, Stanford University, Palo Alto, CA, USA
| | - Letizia Squarcina
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Dan J. Stein
- SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Zaruhi Tavadyan
- Department of Neurology and Neurosurgery, National Institute of Health, Yerevan, Armenia
- Centers for Sleep and Movement Disorders, Somnus Neurology Clinic, Yerevan, Armenia
| | - Chih-Chien Tsai
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
| | - Daniela Vecchio
- Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Chris Vriend
- Amsterdam UMC, Dept. Anatomy and Neurosciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam UMC, Dept. Psychiatry, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Brain imaging, Amsterdam, the Netherlands
| | - Jiun-Jie Wang
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan City, Taiwan
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Keelung Branch Keelung City, Taiwan
- Healthy Ageing Research Center, ChangGung University, Taiwan
- Department of Chemical Engineering, Ming-Chi University of Technology, New Taipei City, Taiwan
| | - Roland Wiest
- Support Center for Advanced Neuroimaging, (SCAN) University Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Clarissa L. Yasuda
- Department of Neurology, University of Campinas - UNICAMP, Campinas, Brazil
- Brazilian Institute of Neuroscience and Neurotechnology, Campinas, Brazil
| | - Christina B. Young
- Department of Neurology & Neurological Sciences, Stanford University, Palo Alto, CA, USA
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Paul M. Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Ysbrand D. van der Werf
- Amsterdam UMC, Dept. Anatomy and Neurosciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
| | - Ian H. Harding
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Monash Biomedical Imaging, Monash University, Melbourne, VIC, Australia
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Zengaffinen F, Stahnke A, Furger S, Wiest R, Dierks T, Strik W, Morishima Y. Computational analysis on verbal fluency reveals heterogeneity in subjective language interests and brain structure. NEUROIMAGE. REPORTS 2023; 3:100159. [PMID: 38606311 PMCID: PMC7615821 DOI: 10.1016/j.ynirp.2023.100159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
Language is an essential higher cognitive function in humans and is often affected by psychiatric and neurological disorders. Objective measures like the verbal fluency test are often used to determine language dysfunction. Recent applications of computational approaches broaden insights into language-related functions. In addition, individuals diagnosed with a psychiatric or neurological disorder also often report subjective difficulties in language-related functions. Therefore, we investigated the association between objective and subjective measures of language functioning, on the one hand, and inter-individual structural variations in language-related brain areas, on the other hand. We performed a Latent Semantic analysis (LSA) on a semantic verbal fluency task in 101 healthy adult participants. To investigate if these objective measures are associated with a subjective one, we examined assessed subjective natural tendency of interest in language-related activity with a study-specific questionnaire. Lastly, a voxel-based brain morphometry (VBM) was conducted to reveal associations between objective (LSA) measures and structural changes in language-related brain areas. We found a positive correlation between the LSA measure cosine similarity and the subjective interest in language. Furthermore, we found that higher cosine similarity corresponds to higher gray matter volume in the right cerebellum. The results suggest that people with higher interests in language access semantic knowledge in a more organized way exhibited by higher cosine similarity and have larger grey matter volume in the right cerebellum, when compared to people with lower interests. In conclusion, we demonstrate that there is inter-individual diverseness of accessing the semantic knowledge space and that it is associated with subjective language interests as well as structural differences in the right cerebellum.
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Affiliation(s)
- Francilia Zengaffinen
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Antje Stahnke
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Stephan Furger
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Roland Wiest
- University Institute of Diagnostic and Interventional Neuroradiology, Inselspital, University of Bern, Bern, Switzerland
| | - Thomas Dierks
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Werner Strik
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Yosuke Morishima
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
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7
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Pagonabarraga J, Pérez-González R, Bejr-Kasem H, Marín-Lahoz J, Horta-Barba A, Martinez-Horta S, Aracil-Bolaños I, Sampedro F, Campolongo A, Rivas E, Puig-Davi A, Ruiz-Barrios I, Pérez-Pérez J, Pascual-Sedano B, Kulisevsky J. Dissociable contribution of plasma NfL and p-tau181 to cognitive impairment in Parkinson's disease. Parkinsonism Relat Disord 2022; 105:132-138. [PMID: 35752549 DOI: 10.1016/j.parkreldis.2022.05.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 04/13/2022] [Accepted: 05/24/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND Cognitive dysfunction is a disabling complication in Parkinson's disease (PD). Accuracy of diagnosis of mild cognitive impairment in PD (PD-MCI) depends on the tests performed, which limits results generalization. Blood-based biomarkers could provide additional objective information for PD-MCI diagnosis and progression. Blood neurofilament light chain (NfL), a marker of neuronal injury, has shown good performance for PD disease stratification and progression. While NfL is not disease-specific, phosphorylated-tau at threonine-181 (p-tau181) in blood is a highly specific marker of concomitant brain amyloid-β and tau pathology. METHODS We investigated the potential of plasma NfL and p-tau181 levels as markers of cognitive impairment in a prospective cohort of 109 PD patients with and without PD-MCI (age 68.1 ± 7 years, education 12.2± 5 years), and 40 comparable healthy controls. After a follow-up of 4 years, we evaluated their predictive value for progression to dementia. RESULTS Although NfL and p-tau181 levels were significantly increased in PD compared with healthy controls, only NfL levels were significantly higher in PD-MCI compared with PD with normal cognition (PD-NC) at baseline. After a follow-up of 4 years, only NfL predicted progression to dementia (HR 1.23, 95% CI 1.02-1.53; p = 0.038). Significant correlations between fluid biomarkers and neuropsychological examination were only found with NfL levels. CONCLUSIONS Plasma NfL levels objectively differentiates PD-MCI from PD-NC patients, and may serve as a plasma biomarker for predicting progression to dementia in PD. Plasma levels of p-tau181 does not seem to help in differentiating PD-MCI or to predict future cognitive deterioration.
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Affiliation(s)
- Javier Pagonabarraga
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Department of Medicine, Barcelona, Spain; Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain; Centro de Investigación en Red - Enfermedades Neurodegenerativas (CIBERNED), Spain.
| | - Rocío Pérez-González
- Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain; Centro de Investigación en Red - Enfermedades Neurodegenerativas (CIBERNED), Spain.
| | - Helena Bejr-Kasem
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Department of Medicine, Barcelona, Spain; Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain; Centro de Investigación en Red - Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Juan Marín-Lahoz
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Department of Medicine, Barcelona, Spain; Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain; Centro de Investigación en Red - Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Andrea Horta-Barba
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Department of Medicine, Barcelona, Spain; Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
| | - Saul Martinez-Horta
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Department of Medicine, Barcelona, Spain; Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain; Centro de Investigación en Red - Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Ignacio Aracil-Bolaños
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Department of Medicine, Barcelona, Spain; Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
| | - Frederic Sampedro
- Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain; Centro de Investigación en Red - Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Antonia Campolongo
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Department of Medicine, Barcelona, Spain; Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain; Centro de Investigación en Red - Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Elisa Rivas
- Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain; Centro de Investigación en Red - Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Arnau Puig-Davi
- Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
| | - I Ruiz-Barrios
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Department of Medicine, Barcelona, Spain
| | - Jesús Pérez-Pérez
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Department of Medicine, Barcelona, Spain; Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
| | - Berta Pascual-Sedano
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Department of Medicine, Barcelona, Spain; Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain; Centro de Investigación en Red - Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Jaime Kulisevsky
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Department of Medicine, Barcelona, Spain; Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain; Centro de Investigación en Red - Enfermedades Neurodegenerativas (CIBERNED), Spain
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8
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Sohtorik İlkmen Y, Soncu Büyükişcan E. Verbal Fluency Tests: Normative Data Stratified by Age and Education in an Istanbul Sample. TURKISH JOURNAL OF NEUROLOGY 2022. [DOI: 10.4274/tnd.2022.36824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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9
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Luo B, Dong W, Chang L, Qiu C, Lu Y, Liu D, Xue C, Zhang L, Liu W, Zhang W, Yan J. Altered Interhemispheric Functional Connectivity Associated With Early Verbal Fluency Decline After Deep Brain Stimulation in Parkinson’s Disease. Front Aging Neurosci 2022; 14:799545. [PMID: 35431904 PMCID: PMC9011328 DOI: 10.3389/fnagi.2022.799545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 02/08/2022] [Indexed: 11/25/2022] Open
Abstract
Background Patients with Parkinson’s disease (PD) experience a decline in verbal fluency (VF) immediately after undergoing deep brain stimulation (DBS) of the subthalamic nucleus (STN). This phenomenon is thought to be related to surgical microlesions. Purpose We investigated the alterations in interhemispheric functional connectivity after STN-DBS in PD patients. We also evaluated the correlation between these changes and decreased VF scores. Method Overall, 30 patients with PD were enrolled in the study. Resting-state functional magnetic resonance imaging scans were performed twice, once before and once after DBS, in PD patients. Voxel-mirrored homotopic connectivity (VMHC) was applied in order to evaluate the synchronicity of functional connectivity between the hemispheres. Result After undergoing STN-DBS, PD patients demonstrated reduced VMHC value in the posterior cerebellum lobe, angular gyrus, precuneus/posterior cingulate gyrus (PCC), supramarginal gyrus, superior frontal gyrus (SFG) (medial and dorsolateral) and middle frontal gyrus (MFG). In addition, we observed a significant positive correlation between the altered VMHC value in the SFG and MFG and the change of phonemic VF scores. Conclusion PD patients demonstrated an interhemispheric coordination disorder in the prefrontal cortex, cerebellum, supramarginal gyrus and DMN after undergoing STN-DBS. The positive correlation between reduced VMHC value in the SFG and MFG and the changes of VF scores provides a novel understanding with regard to the decline of VF after DBS.
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Affiliation(s)
- Bei Luo
- Department of Functional Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Wenwen Dong
- Department of Functional Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Lei Chang
- Department of Functional Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Chang Qiu
- Department of Functional Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yue Lu
- Department of Functional Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Dongming Liu
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Chen Xue
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Li Zhang
- Department of Geriatric Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Weiguo Liu
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Wenbin Zhang
- Department of Functional Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- *Correspondence: Wenbin Zhang,
| | - Jun Yan
- Department of Geriatric Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- Jun Yan,
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10
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Harrington DL, Shen Q, Sadeghi V, Huang M, Litvan I, Wei X, Lee RR. Semantic Recollection in Parkinson's Disease: Functional Reconfiguration and MAPT Variants. Front Aging Neurosci 2021; 13:727057. [PMID: 34616286 PMCID: PMC8489380 DOI: 10.3389/fnagi.2021.727057] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 08/18/2021] [Indexed: 01/16/2023] Open
Abstract
Decline in semantic cognition in early stages of Parkinson’s disease (PD) is a leading risk factor for future dementia, yet the underlying neural mechanisms are not understood. The present study addressed this gap by investigating the functional connectivity of regions involved in semantic recollection. We further examined whether microtubule-associated protein tau (MAPT) risk variants, which may accelerate cognitive decline, altered the strength of regional functional connections. Cognitively normal PD and healthy elder controls underwent fMRI while performing a fame-discrimination task, which activates the semantic network. Analyses focused on disturbances in fame-modulated functional connectivity in PD for regions that govern semantic recollection and interrelated processes. Group differences were found in multiple connectivity features, which were reduced into principal components that reflected the strength of fame-modulated regional couplings with other brain areas. Despite the absence of group differences in semantic cognition, two aberrant connectivity patterns were uncovered in PD. One pattern was related to a loss in frontal, parietal, and temporal connection topologies that governed semantic recollection in older controls. Another pattern was characterized by functional reconfiguration, wherein frontal, parietal, temporal and caudate couplings were strengthened with areas that were not recruited by controls. Correlations between principal component scores and cognitive measures suggested that reconfigured frontal coupling topologies in PD supported compensatory routes for accessing semantic content, whereas reconfigured parietal, temporal, and caudate connection topologies were detrimental or unrelated to cognition. Increased tau transcription diminished recruitment of compensatory frontal topologies but amplified recruitment of parietal topologies that were unfavorable for cognition. Collectively, the findings provide a new understanding of early vulnerabilities in the functional architecture of regional connectivity during semantic recollection in cognitively normal PD. The findings also have implications for tracking cognitive progression and selecting patients who stand to benefit from therapeutic interventions.
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Affiliation(s)
- Deborah L Harrington
- Research and Radiology Services, VA San Diego Healthcare System, San Diego, CA, United States.,Department of Radiology, University of California, San Diego, La Jolla, CA, United States
| | - Qian Shen
- Research and Radiology Services, VA San Diego Healthcare System, San Diego, CA, United States.,Department of Radiology, University of California, San Diego, La Jolla, CA, United States
| | - Vida Sadeghi
- Research and Radiology Services, VA San Diego Healthcare System, San Diego, CA, United States
| | - Mingxiong Huang
- Research and Radiology Services, VA San Diego Healthcare System, San Diego, CA, United States.,Department of Radiology, University of California, San Diego, La Jolla, CA, United States
| | - Irene Litvan
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, United States
| | - Xiangyu Wei
- Research and Radiology Services, VA San Diego Healthcare System, San Diego, CA, United States
| | - Roland R Lee
- Research and Radiology Services, VA San Diego Healthcare System, San Diego, CA, United States.,Department of Radiology, University of California, San Diego, La Jolla, CA, United States
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11
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Cholerton BA, Poston KL, Yang L, Rosenthal LS, Dawson TM, Pantelyat A, Edwards KL, Tian L, Quinn JF, Chung KA, Hiller AL, Hu SC, Montine TJ, Zabetian CP. Semantic fluency and processing speed are reduced in non-cognitively impaired participants with Parkinson's disease. J Clin Exp Neuropsychol 2021; 43:469-480. [PMID: 34355669 DOI: 10.1080/13803395.2021.1927995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Introduction: Parkinson's disease (PD) is associated with a range of cognitive deficits. Few studies have carefully examined the subtle impacts of PD on cognition among patients who do not meet formal criteria for MCI or dementia. The aim of the current study was thus to describe the impact of PD on cognition in those without cognitive impairment in a well-characterized cohort.Methods: Non-cognitively impaired participants (122 with PD, 122 age- and sex-matched healthy volunteers) underwent extensive cognitive testing. Linear regression analyses compared diagnostic group performance across cognitive measures. For cognitive tasks that were significantly different between groups, additional analyses examined group differences restricting the group inclusion to PD participants with mild motor symptoms or disease duration less than 10 years.Results: Processing speed and semantic verbal fluency were significantly lower in the PD group (B = -3.77, 95% CIs [-5.76 to -1.77], p < .001, and B = -2.02, 95% CIs [-3.12, -0.92], p < .001, respectively), even after excluding those with moderate to severe motor symptoms (B = -2.73, 95% CIs [-4.94 to -0.53], p = .015 and B = -2.11, 95% CIs [-3.32 to -0.91], p < .001, respectively) or longer disease duration (B = -3.89, 95% CIs [-6.14 to -1.63], p < .001 and B = -1.58, 95% CIs [-2.78 to -0.37], p = .010, respectively). Semantic verbal fluency remained significantly negatively associated with PD diagnosis after controlling for processing speed (B = -1.66, 95% CIs [-2.79 to -0.53], p = .004).Conclusions: Subtle decline in specific cognitive domains may be present among people diagnosed with PD but without evidence to support a formal cognitive diagnosis. These results suggest the importance of early awareness of the potential for diminishing aspects of cognition in PD even among those without mild cognitive impairment or dementia.
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Affiliation(s)
- Brenna A Cholerton
- Department of Pathology, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Kathleen L Poston
- Department of Neurology and Neurological Sciences, Stanford School of Medicine, Palo Alto, CA, USA
| | - Laurice Yang
- Department of Neurology and Neurological Sciences, Stanford School of Medicine, Palo Alto, CA, USA
| | - Liana S Rosenthal
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ted M Dawson
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Neurodegeneration and Stem Cell Programs, Institute for Cell Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Alexander Pantelyat
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Karen L Edwards
- Department of Epidemiology, School of Medicine, University of California, Irvine, CA, USA
| | - Lu Tian
- Department of Biomedical Data Science, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Joseph F Quinn
- Parkinson's Disease Research, Education, and Clinical Center, Portland Veterans Affairs Health Care System, Portland, OR, USA.,Department of Neurology, Oregon Health and Science University, Portland, OR, USA
| | - Kathryn A Chung
- Parkinson's Disease Research, Education, and Clinical Center, Portland Veterans Affairs Health Care System, Portland, OR, USA.,Department of Neurology, Oregon Health and Science University, Portland, OR, USA
| | - Amie L Hiller
- Parkinson's Disease Research, Education, and Clinical Center, Portland Veterans Affairs Health Care System, Portland, OR, USA.,Department of Neurology, Oregon Health and Science University, Portland, OR, USA
| | - Shu-Ching Hu
- Geriatric Research Education, and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA.,Department of Neurology, University of Washington School of Medicine, Seattle, WA, USA
| | - Thomas J Montine
- Department of Pathology, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Cyrus P Zabetian
- Geriatric Research Education, and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA.,Department of Neurology, University of Washington School of Medicine, Seattle, WA, USA
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12
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Robinson GA, Campbell L, Ceslis A. A Goal Intervention Improves Language Fluency: Evidence from Parkinson's Disease and Healthy Aging. MEDICINES 2021; 8:medicines8030015. [PMID: 33810201 PMCID: PMC8004843 DOI: 10.3390/medicines8030015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/19/2021] [Accepted: 03/20/2021] [Indexed: 12/04/2022]
Abstract
Background: Parkinson’s disease [PD] is associated with reduced motor and cognitive initiation, and decreased goal-directed behavior including language generation. The current study investigated a novel goal intervention for language generation impairments in PD patients. Methods: Twenty-one PD patients and 22 healthy controls, matched for gender, age, and education, completed a cognitive baseline and language generation tasks (complex scene descriptions and phonemic/semantic word fluency) with standard and adapted instructions, which implements a target ‘goal’. In addition, participants completed self-report questionnaires for apathy and mood. Results: PD patients performed more poorly on two of three language generation tasks. The goal intervention was effective in increasing both the PD patient and healthy control groups’ language generation. However, there was no differential benefit of increased goal specificity and difficulty for PD patients. As a group, PD patients reported higher levels of apathy and depression than healthy controls. Specifically, PD patients with executive apathy were more likely to have language generation impairments than PD patients without executive apathy and controls. Apathy subscales and goal benefit were unrelated. Conclusions: The goal intervention was effective for PD patients and older adults, suggesting that enhanced goal specificity and difficulty may benefit individuals with PD or those aging naturally.
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Affiliation(s)
- Gail A. Robinson
- Queensland Brain Institute, The University of Queensland, Brisbane 4072, Australia
- Neuropsychology Research Unit, School of Psychology, The University of Queensland, Brisbane 4072, Australia; (L.C.); (A.C.)
- Correspondence: ; Tel.: +61-(0)7-3365-6401
| | - Lara Campbell
- Neuropsychology Research Unit, School of Psychology, The University of Queensland, Brisbane 4072, Australia; (L.C.); (A.C.)
| | - Amelia Ceslis
- Neuropsychology Research Unit, School of Psychology, The University of Queensland, Brisbane 4072, Australia; (L.C.); (A.C.)
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13
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Megari K. Language impairment among patients with different types of cancer. Comparison with healthy adults. Breast Cancer Res Treat 2020; 184:779-782. [PMID: 32852707 DOI: 10.1007/s10549-020-05898-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Accepted: 08/18/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Language dysfunction is a crucial deficit in terms of cognitive functioning, quality of life and activities of daily living. Several studies have identified cognitive impairment in patients with cancer across several cognitive domains, including language. METHODS We investigated language functions among 182 patients with different types of cancer (not brain cancer) and compared them with the performance of Greek healthy adults with the same age and educational levels as the patients. The assessment included verbal fluency test, both semantic (animals) and phonological (X), and Boston Naming Test (BNT-60) among other neuropsychological measures. RESULTS Breast cancer patients performed worse compared to patients with prostate, colorectal and thyroid cancer in language tasks. In addition, breast cancer patients had a decreased performance compared with healthy adults, while patients with other types performed to the mean in two out of three language tasks. CONCLUSIONS Semantic and phonological fluency requirements of cognitive processes in the brain are discussed. IMPLICATIONS FOR CANCER SURVIVORS Language dysfunction is a crucial deficit in terms of cognitive functioning, quality of life and activities of daily living, especially in brain cancer patients, but it can be crucial for patients with other types of cancer as stated in the present study.
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Affiliation(s)
- Kalliopi Megari
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece.
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14
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Brandão PRP, Munhoz RP, Grippe TC, Cardoso FEC, de Almeida E Castro BM, Titze-de-Almeida R, Tomaz C, Tavares MCH. Cognitive impairment in Parkinson's disease: A clinical and pathophysiological overview. J Neurol Sci 2020; 419:117177. [PMID: 33068906 DOI: 10.1016/j.jns.2020.117177] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 09/16/2020] [Accepted: 10/08/2020] [Indexed: 11/29/2022]
Abstract
Cognitive dysfunction in Parkinson's disease (PD) has received increasing attention, and, together with other non-motor symptoms, exert a significant functional impact in the daily lives of patients. This article aims to compile and briefly summarize selected published data about clinical features, cognitive evaluation, biomarkers, and pathophysiology of PD-related dementia (PDD). The literature search included articles indexed in the MEDLINE/PubMed database, published in English, over the last two decades. Despite significant progress on clinical criteria and cohort studies for PD-mild cognitive impairment (PD-MCI) and PDD, there are still knowledge gaps about its exact molecular and pathological basis. Here we overview the scientific literature on the role of functional circuits, neurotransmitter systems (monoaminergic and cholinergic), basal forebrain, and brainstem nuclei dysfunction in PD-MCI. Correlations between neuroimaging and cerebrospinal fluid (CSF) biomarkers, clinical outcomes, and pathological results are described to aid in uncovering the neurodegeneration pattern in PD-MCI and PDD.
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Affiliation(s)
- Pedro Renato P Brandão
- Laboratory of Neuroscience and Behavior, Institute of Biological Sciences, Universidade de Brasília (UnB); Neurology Section, Medical Department, Chamber of Deputies of the Federal Republic of Brazil, Brasília, DF, Brazil.
| | - Renato Puppi Munhoz
- Toronto Western Hospital, Movement Disorders Centre, Toronto Western Hospital - UHN, Division of Neurology, University of Toronto, Toronto, Canada.
| | - Talyta Cortez Grippe
- Laboratory of Neuroscience and Behavior, Institute of Biological Sciences, Universidade de Brasília (UnB); Movement Disorders Group, Neurology Unit, Hospital de Base do Distrito Federal; School of Medicine, Centro Universitário de Brasília (UniCEUB), Brasília, DF, Brazil
| | - Francisco Eduardo Costa Cardoso
- Movement Disorders Unit, Internal Medicine Department, Neurology Service, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | | | - Ricardo Titze-de-Almeida
- Technology for Gene Therapy Laboratory, Central Institute of Sciences, University of Brasília/FAV, Brasília, DF, Brazil
| | - Carlos Tomaz
- Laboratory of Neuroscience and Behavior and Graduate Program in Environment, CEUMA University - UniCEUMA, São Luís, MA, Brazil.
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15
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Eyigoz E, Courson M, Sedeño L, Rogg K, Orozco-Arroyave JR, Nöth E, Skodda S, Trujillo N, Rodríguez M, Rusz J, Muñoz E, Cardona JF, Herrera E, Hesse E, Ibáñez A, Cecchi G, García AM. From discourse to pathology: Automatic identification of Parkinson's disease patients via morphological measures across three languages. Cortex 2020; 132:191-205. [PMID: 32992069 DOI: 10.1016/j.cortex.2020.08.020] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 06/02/2020] [Accepted: 08/25/2020] [Indexed: 01/11/2023]
Abstract
Embodied cognition research on Parkinson's disease (PD) points to disruptions of frontostriatal language functions as sensitive targets for clinical assessment. However, no existing approach has been tested for crosslinguistic validity, let alone by combining naturalistic tasks with machine-learning tools. To address these issues, we conducted the first classifier-based examination of morphological processing (a core frontostriatal function) in spontaneous monologues from PD patients across three typologically different languages. The study comprised 330 participants, encompassing speakers of Spanish (61 patients, 57 matched controls), German (88 patients, 88 matched controls), and Czech (20 patients, 16 matched controls). All subjects described the activities they perform during a regular day, and their monologues were automatically coded via morphological tagging, a computerized method that labels each word with a part-of-speech tag (e.g., noun, verb) and specific morphological tags (e.g., person, gender, number, tense). The ensuing data were subjected to machine-learning analyses to assess whether differential morphological patterns could classify between patients and controls and reflect the former's degree of motor impairment. Results showed robust classification rates, with over 80% of patients being discriminated from controls in each language separately. Moreover, the most discriminative morphological features were associated with the patients' motor compromise (as indicated by Pearson r correlations between predicted and collected motor impairment scores that ranged from moderate to moderate-to-strong across languages). Taken together, our results suggest that morphological patterning, an embodied frontostriatal domain, may be distinctively affected in PD across languages and even under ecological testing conditions.
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Affiliation(s)
- Elif Eyigoz
- IBM Research, T. J. Watson Research Center, New York, USA
| | - Melody Courson
- Department of Psychology, Université de Montréal, CRIUGM Research Center, Montréal, Canada
| | - Lucas Sedeño
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - Katharina Rogg
- Department of Social Psychology, University of Würzburg, Würzburg, Germany
| | - Juan Rafael Orozco-Arroyave
- Pattern Recognition Lab, Friedrich-Alexander-Universität, Erlangen-Nürnberg, Germany; GITA Lab, Faculty of Engineering, University of Antioquia (UdeA), Medellín, Colombia
| | - Elmar Nöth
- Pattern Recognition Lab, Friedrich-Alexander-Universität, Erlangen-Nürnberg, Germany
| | - Sabine Skodda
- Department of Neurology, Knappschaftskrankenhaus, Ruhr-University, Bochum, Germany
| | - Natalia Trujillo
- Neuroscience Group, Faculty of Medicine, University of Antioquia (UdeA), Medellín, Colombia; School of Public Health, University of Antioquia (UdeA), Medellín, Colombia
| | - Mabel Rodríguez
- National Institute of Mental Health, Prague, Czech Republic; Department of Psychology, Faculty of Arts, Charles University in Prague, Prague, Czech Republic
| | - Jan Rusz
- Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Czech Republic
| | - Edinson Muñoz
- Departamento de Lingüística y Literatura, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago, Chile
| | - Juan F Cardona
- Instituto de Psicología, Universidad del Valle, Cali, Colombia
| | - Eduar Herrera
- Departamento de Estudios Psicológicos, Universidad Icesi, Cali, Colombia
| | - Eugenia Hesse
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; Universidad de San Andrés, Buenos Aires, Argentina
| | - Agustín Ibáñez
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; Universidad de San Andrés, Buenos Aires, Argentina; Universidad Autónoma del Caribe, Barranquilla, Colombia; Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibáñez, Santiago de Chile, Chile; Global Brain Health Institute, University of California, San Francisco, United States
| | | | - Adolfo M García
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; Departamento de Lingüística y Literatura, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago, Chile; Universidad de San Andrés, Buenos Aires, Argentina; Global Brain Health Institute, University of California, San Francisco, United States; Faculty of Education, National University of Cuyo (UNCuyo), Mendoza, Argentina.
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16
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Tjokrowijoto P, Ceslis A, Sullivan JDO, Adam R, Mellick G, Silburn P, Robinson GA. Differential patterns of internally generated responses in parkinsonian disorders. Neuropsychologia 2020; 146:107569. [PMID: 32707163 DOI: 10.1016/j.neuropsychologia.2020.107569] [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: 01/16/2020] [Revised: 07/07/2020] [Accepted: 07/17/2020] [Indexed: 11/29/2022]
Abstract
Internally generated responses are centrally affected in parkinsonian disorders. This study investigated the cognitive components crucial for response generation as reflected in performance on verbal and non-verbal fluency tasks, which require voluntary internal generation of multiple responses. Participants with parkinsonian disorders (N = 58: 29 Parkinson's disease [PD], 22 corticobasal syndrome [CBS], 8 progressive supranuclear palsy [PSP]) and 89 age-matched controls completed baseline cognitive assessments and eight fluency tasks of four types: word, design, gesture, and ideational. We analysed the total number of correct responses generated and error rates (including repetitions and rule breaks) for PD, CBS and Control groups. The small PSP patient group's performance is reported for comparative purposes only. CBS patients were significantly reduced in the number of correct responses generated across all fluency tasks, without incurring significant errors. The only exception was that CBS patients produced a significantly higher number of repetitions on one nonverbal task (design fluency). By contrast, PD patients' generation was reduced on only three fluency tasks (phonemic word, meaningless gesture, conventional idea). However, they also produced a high error rate on four fluency tasks (rule-break errors: phonemic/semantic word; repetitions: semantic word, meaningless gestures). Overall, the pattern of fluency task performance differs between patient groups. Specifically, the quantity of responses generated is differentially and primarily affected in CBS patients, whereas the quality of responses generated is primarily affected in PD patients. This suggests potentially different patterns of performance for parkinsonian disorders and has implications for the cognitive processes crucial for internally-guided response generation.
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Affiliation(s)
- Priscilla Tjokrowijoto
- Neuropsychology Research Unit, School of Psychology, University of Queensland, St Lucia, Australia
| | - Amelia Ceslis
- Neuropsychology Research Unit, School of Psychology, University of Queensland, St Lucia, Australia
| | - John D O Sullivan
- Neurology Department, Royal Brisbane and Women's Hospital, Herston, Brisbane, Australia; Centre for Clinical Research, Faculty of Medicine, University of Queensland, Herston, Australia
| | - Robert Adam
- Neurology Department, Royal Brisbane and Women's Hospital, Herston, Brisbane, Australia; Centre for Clinical Research, Faculty of Medicine, University of Queensland, Herston, Australia
| | - George Mellick
- Griffith Institute for Drug Discovery, Nathan Campus, Griffith University, Brisbane, Australia
| | - Peter Silburn
- Neurosciences Queensland, St Andrew's War Memorial Hospital, Spring Hill, Australia; Queensland Brain Institute, University of Queensland, St Lucia, Queensland, Australia
| | - Gail A Robinson
- Neuropsychology Research Unit, School of Psychology, University of Queensland, St Lucia, Australia; Queensland Brain Institute, University of Queensland, St Lucia, Queensland, Australia.
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17
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Reduced Enhancement of Memory for Faces Encoded by Semantic and Socioemotional Processes in Patients with Parkinson's Disease. J Int Neuropsychol Soc 2020; 26:418-429. [PMID: 31822311 DOI: 10.1017/s1355617719001280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Patients with Parkinson's disease (PD) exhibit impaired semantic and socioemotional processes, which are thought to be related to dysfunctions in the fronto-striatal circuit. However, little is known about how the memory enhancement by these processes was reduced in PD. The present study investigated this issue. METHODS The retrieval performance of face memories encoded by semantic and socioemotional processes was compared between 24 PD patients and 24 age-matched healthy controls (HC). During encoding, participants were presented with unfamiliar faces and made judgment about them in three encoding conditions of semantic judgment (Semantics), attractiveness judgment (Attractiveness), and form judgment (Form). In Semantics, participants rated to what degree each face looked like an office worker, whereas in Attractiveness, participants rated how attractive each face was. The Form condition as a control required participants to judge the shape of each face. During retrieval after encoding, participants made old or new judgment for target and distracter faces. RESULTS In HC, the retrieval of faces encoded by Semantics and Attractiveness was significantly more accurate than that encoded by Form, whereas this memory enhancement was not identified in PD. In addition, individual scores in frontal lobe function and long-term memory correlated with the retrieval performance of memories encoded in Semantics and Attractiveness but not Form. CONCLUSIONS These findings suggest that the processing of semantic and socioemotional signals conveyed from faces could be impaired in PD and that the impairment of these processes could decrease the enhancement of face memories by semantic and socioemotional elaborations.
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18
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Weinkle LJ, Hoyt B, Thompson JA, Sillau S, Tanabe J, Honce J, Klepitskaya O. Association of MRI Measurements with Cognitive Outcomes After STN-DBS in Parkinson's Disease. Mov Disord Clin Pract 2018; 5:417-426. [PMID: 30363383 DOI: 10.1002/mdc3.12643] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 04/16/2018] [Accepted: 05/14/2018] [Indexed: 01/29/2023] Open
Abstract
Objectives Subthalamic nucleus deep brain stimulation (STN-DBS) is an effective treatment for improving the motor symptoms of Parkinson's disease (PD). Overall, cognitive function remains stable after STN-DBS in most patients. However, cognitive decline, specifically in the verbal fluency domain, is seen in a subset of STN-DBS patients. Currently, predictors of cognitive decline in PD patients treated with STN-DBS are not well known. Thus, identification of presurgical predictors might provide an important clinical tool for better risk-to-benefit assessment. This study explores whether whole brain white matter lesion (WML) volume, or hippocampal and forebrain volumes, measured quantitatively on MRI, are associated with cognitive changes following STN-DBS in PD patients. Methods We conducted a retrospective study using presurgical, and ≥ 6-month postsurgical neuropsychological (NP) evaluation scores from 43 PD patients with STN-DBS. Mean pre/post NP test scores for measures of executive function, attention, verbal fluency, memory, and visuospatial function were analyzed and correlated with WML volume, and brain volumetric data. Results Although cognitive measures of verbal fluency, executive function, attention, memory, and visuospatial function showed declines following STN-DBS, we observed limited evidence that white matter lesion burden or cortical atrophy contributed to cognitive change following STN-DBS. Conclusions These results suggest that post-STN-DBS cognitive changes may be unrelated to presurgical WML burden and presence of cortical atrophy.
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Affiliation(s)
- Laura J Weinkle
- Department of Neurology University of Colorado School of Medicine Aurora Colorado USA.,Modern Human Anatomy Program University of Colorado School of Medicine Aurora Colorado USA
| | - Brian Hoyt
- Department of Neurosurgery University of Colorado School of Medicine Aurora Colorado USA
| | - John A Thompson
- Department of Neurosurgery University of Colorado School of Medicine Aurora Colorado USA.,Modern Human Anatomy Program University of Colorado School of Medicine Aurora Colorado USA
| | - Stefan Sillau
- Department of Neurology University of Colorado School of Medicine Aurora Colorado USA
| | - Jody Tanabe
- Department of Neuroradiology University of Colorado School of Medicine Aurora Colorado USA
| | - Justin Honce
- Department of Neuroradiology University of Colorado School of Medicine Aurora Colorado USA
| | - Olga Klepitskaya
- Department of Neurology University of Colorado School of Medicine Aurora Colorado USA
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19
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Di Tella S, Baglio F, Cabinio M, Nemni R, Traficante D, Silveri MC. Selection Processing in Noun and Verb Production in Left- and Right-Sided Parkinson's Disease Patients. Front Psychol 2018; 9:1241. [PMID: 30079043 PMCID: PMC6062671 DOI: 10.3389/fpsyg.2018.01241] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 06/28/2018] [Indexed: 12/17/2022] Open
Abstract
Verbs are more difficult to produce than nouns. Thus, if executive resources are reduced as in Parkinson's disease (PD), verbs are penalized compared to nouns. However, in an experimental condition in which it is the noun that must be selected from a larger number of alternatives compared to the verb, it is the noun production that becomes slower and more prone to errors. Indeed, patients are slower and less accurate than normal subjects when required to produce nouns from verbs (VN) in a morphology derivation tasks (e.g., "osservazione" from "osservare") ["observation" from "observe"] than verbs from nouns in a morphology generation task, in which only a verb can be generated from the noun (NV) (e.g., "fallire" from "fallimento") ["to fail" from "failure"]. In the Italian language morphology, in fact, generation and derivation tasks differ in the number of lexical entries among which the response must be selected. The left Inferior Frontal Gyrus (IFG) has been demonstrated to be involved in selection processes. In the present study, we explored if the ability to select words is related to the cortical thickness of the left IFG. Twelve right-sided PD with nigrostriatal hypofunctionality in the left hemisphere (RPD-LH), 9 left-sided PD with nigrostriatal hypofunctionality in the right hemisphere (LPD-RH) and 19 healthy controls (HC) took part in the study. NV and VN production tasks were administered; accuracy and reaction times (RTs) were collected. All 40 subjects received a structural MRI examination. Cortical thickness of the IFG and volumetric measurements for subcortical regions, thought to support selection processes, were computed using FreeSurfer. In VN derivation tasks RPD-LH patients were less accurate than LPD-RH patients (accuracy: 66% vs. 77%). No difference emerged among the three groups in RTs. Task accuracy/RTs and IFG thickness showed a significant correlation only in RPD-LH. Not only nouns (as expected) but also verbs were correlated with cortical thickness. This suggests that the linguistic nature of the stimuli along with executive resources are both relevant during word selection processes. Our data confirm that executive resources and language interact in the left IFG in word production tasks.
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Affiliation(s)
| | | | - Monia Cabinio
- IRCCS, Fondazione don Carlo Gnocchi ONLUS, Milan, Italy
| | - Raffaello Nemni
- IRCCS, Fondazione don Carlo Gnocchi ONLUS, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Daniela Traficante
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Maria C. Silveri
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
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20
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Wu L, Liu FT, Ge JJ, Zhao J, Tang YL, Yu WB, Yu H, Anderson T, Zuo CT, Chen L, Wang J. Clinical characteristics of cognitive impairment in patients with Parkinson's disease and its related pattern in 18 F-FDG PET imaging. Hum Brain Mapp 2018; 39:4652-4662. [PMID: 29999569 DOI: 10.1002/hbm.24311] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 05/12/2018] [Accepted: 06/27/2018] [Indexed: 01/26/2023] Open
Abstract
This study aimed to characterize the clinical features and the related cerebral glucose metabolism pattern of cognitive impairments in Parkinson's disease (PD) with positron emission tomography (PET) imaging. We recruited 168 PD patients and 100 age-matched healthy controls of similar education and gender distribution. All of those enrolled underwent clinical assessment including the unified Parkinson's disease rating scale motor score, Hoehn and Yahr scale, and comprehensive neuropsychological tests including domains of executive function, attention, memory, visuospatial function, and language. Demographics and the results of cognitive measures were compared between patients and healthy controls. Cognition status was classified as PD patients with dementia (PD-D), PD patients with mild cognitive impairment (PD-MCI), or PD patients with normal cognition (PD-NC). In 53 PD patients who underwent 18 F-fluorodeoxyglucose (18 F-FDG) PET imaging, correlations between Z-score values of the different cognitive domains and cerebral 18 F-FDG uptake were assessed using statistical parametric mapping (SPM8) corrected for age and motor severity. A total of 23.2% of PD patients were PD-MCI and 8.9% were PD-D. In the group of PD-MCI, 96.3% showed multiple-domain deficits, with executive function and attention impairment most predominantly involved. All the cognitive domain scores with the exception of language correlated with 18 F-FDG metabolisms, primarily in posterior temporo-parieto-occipital association cortical areas. This study found that cognitive impairment in PD particularly encompasses frontal/executive deficits. Posterior cortical areas, containing multiple neurotransmitters and neural circuits, may play an important role in the pathogenesis of cognitive impairment in PD.
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Affiliation(s)
- Lei Wu
- Department of Neurology & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
- Department of Neurology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Feng-Tao Liu
- Department of Neurology & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Jing-Jie Ge
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Jue Zhao
- Department of Neurology & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Yi-Lin Tang
- Department of Neurology & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Wen-Bo Yu
- Department of Neurology & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Huan Yu
- Department of Neurology & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Tim Anderson
- Department of Medicine, University of Otago, New Zealand Brain Research Institute, and Brain Research New Zealand, Christchurch, New Zealand
| | - Chuan-Tao Zuo
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Ling Chen
- Department of Neurology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jian Wang
- Department of Neurology & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
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21
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Ma X, Su W, Li S, Li C, Wang R, Chen M, Chen H. Cerebellar atrophy in different subtypes of Parkinson's disease. J Neurol Sci 2018; 392:105-112. [PMID: 30036781 DOI: 10.1016/j.jns.2018.06.027] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 06/27/2018] [Accepted: 06/28/2018] [Indexed: 01/20/2023]
Abstract
BACKGROUND To investigate, using Magnetic Resonance Imaging (MRI) and voxel-based morphometry (VBM), morphometric changes of cerebellum in Parkinson's disease with different motor and affective subtypes. METHODS Fifty-four patients with idiopathic Parkinson's disease (PD) were classified into tremor-predominant-PD (PDT) (n = 37) and akinetic/rigidity-predominant-PD (PDAR) (n = 17). Moreover, PD groups were divided into four affective subtypes, including depressive but not anxious PD (dPD, n = 5), anxious but not depressive PD (aPD, n = 8), comorbid depressive and anxious PD (coPD, n = 8), and PD patients without depressive or anxious symptoms (nPD, n = 33). They were additionally compared at a group level with thirty-nine normal controls (NCs). An analysis of covariance followed by post hoc tests was performed to examine the alterations of cerebellar grey matter volume (GMV) in different groups of PD. RESULTS Compared with NCs, PD showed grey matter (GM) atrophy in the right Crus II, pyramis, culmen, the right lobules IV, and V, and the left lobule VI. PDT, PDAR and NCs did not differ in the volume of the cerebellum. Relative to nPD group, dPD group exhibited GMV reduction in the left Crus I, while aPD group showed GMV reduction in the tonsil and the right lobule VIII. The GM atrophy was also found in the coPD group compared to NCs, including the tonsil, the left lobule VIII, the right lobule VI, the left Crus I, and vermis IV, and V. There was a significant negative correlation between the Hamilton Rating Scale for Depression (HAMD) score and the right lobule IX volume, and a significant negative correlation between the Hamilton Rating Scale for Anxiety (HAMA) score and the right lobule VIII volume. CONCLUSIONS These findings suggest that cerebellar changes are involved in PD. It also supports a possible role of the cerebellum in the depressive and anxious symptoms in PD.
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Affiliation(s)
- Xinxin Ma
- Department of Neurology, Beijing Hospital, National Center of Gerontology, No. 1 Da-Hua Road, Dong Dan, Beijing 100730, China
| | - Wen Su
- Department of Neurology, Beijing Hospital, National Center of Gerontology, No. 1 Da-Hua Road, Dong Dan, Beijing 100730, China
| | - Shuhua Li
- Department of Neurology, Beijing Hospital, National Center of Gerontology, No. 1 Da-Hua Road, Dong Dan, Beijing 100730, China
| | - Chunmei Li
- Department of Radiology, Beijing Hospital, National Center of Gerontology, No. 1 Da-Hua Road, Dong Dan, Beijing 100730, China
| | - Rui Wang
- Department of Radiology, Beijing Hospital, National Center of Gerontology, No. 1 Da-Hua Road, Dong Dan, Beijing 100730, China
| | - Min Chen
- Department of Radiology, Beijing Hospital, National Center of Gerontology, No. 1 Da-Hua Road, Dong Dan, Beijing 100730, China
| | - Haibo Chen
- Department of Neurology, Beijing Hospital, National Center of Gerontology, No. 1 Da-Hua Road, Dong Dan, Beijing 100730, China.
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22
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Vavougios GD, Doskas T, Kormas C, Krogfelt KA, Zarogiannis SG, Stefanis L. Identification of a prospective early motor progression cluster of Parkinson's disease: Data from the PPMI study. J Neurol Sci 2018; 387:103-108. [DOI: 10.1016/j.jns.2018.01.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Revised: 10/25/2017] [Accepted: 01/22/2018] [Indexed: 12/15/2022]
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23
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Ghazi Sherbaf F, Mohajer B, Ashraf-Ganjouei A, Mojtahed Zadeh M, Javinani A, Sanjari Moghaddam H, Shirin Shandiz M, Aarabi MH. Serum Insulin-Like Growth Factor-1 in Parkinson's Disease; Study of Cerebrospinal Fluid Biomarkers and White Matter Microstructure. Front Endocrinol (Lausanne) 2018; 9:608. [PMID: 30450079 PMCID: PMC6224341 DOI: 10.3389/fendo.2018.00608] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 09/24/2018] [Indexed: 01/07/2023] Open
Abstract
Background: Growing evidence shows that impaired signaling of Insulin-like Growth Factor-1 (IGF-1) is associated with neurodegenerative disorders, such as Parkinson's disease (PD). However, there is still controversy regarding its proinflammatory or neuroprotective function. In an attempt to elucidate the contribution of IGF-1 in PD, we aimed to discover the relation between serum IGF-1 levels in drug-naïve early PD patients and cerebrospinal fluid (CSF) biomarkers as well as microstructural changes in brain white matter. Methods: The association between quartiles of serum IGF-1 levels and CSF biomarkers (α-synuclein, dopamine, amyloid-β1-42, total tau, and phosphorylated tau) was investigated using adjusted regression models in 404 drug-naïve early PD patients with only mild motor manifestations and 188 age- and sex-matched healthy controls (HC) enrolled in the Parkinson's Progression Markers Initiative (PPMI). By using region of interest analysis and connectometry approach, we tracked the white matter microstructural integrity and diffusivity patterns in a subgroup of study participants with available diffusion MRI data to investigate the association between subcomponents of neural pathways with serum IGF-1 levels. Results: PD patients had higher levels of IGF-1 compared to HC, although not statistically significant (mean difference: 3.60, P = 0.44). However, after adjustment for possible confounders and correction for False Discovery Rate (FDR), IGF-1 was negatively correlated with CSF α-synuclein, total and phosphorylated tau levels only in PD subjects. The imaging analysis proved a significant negative correlation (FDR corrected P-value = 0.013) between continuous levels of serum IGF-1 in patients with PD and the connectivity, but not integrity, in following fibers while controlling for age, sex, body mass index, depressive symptoms, education years, cognitive status and disease duration: middle cerebellar peduncle, cingulum, genu and splenium of the corpus callosum. No significant association was found between brain white matter microstructral measures or CSF markers of healthy controls and levels of IGF-1. Conclusion: Altered connectivity in specific white matter structures, mainly involved in cognitive and motor deterioration, in association with higher serum IGF-1 levels might propose IGF-1 as a potential associate of worse outcome in response to higher burden of α-synucleinopathy and tauopathy in PD.
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Affiliation(s)
| | - Bahram Mohajer
- Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Ali Javinani
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mehdi Shirin Shandiz
- Department of Medical Physics, Zahedan University of Medical Sciences, Zahedan, Iran
- *Correspondence: Mehdi Shirin Shandiz
| | - Mohammad Hadi Aarabi
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Mohammad Hadi Aarabi
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24
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Díez-Cirarda M, Ojeda N, Peña J, Cabrera-Zubizarreta A, Lucas-Jiménez O, Gómez-Esteban JC, Gómez-Beldarrain MÁ, Ibarretxe-Bilbao N. Increased brain connectivity and activation after cognitive rehabilitation in Parkinson's disease: a randomized controlled trial. Brain Imaging Behav 2017; 11:1640-1651. [PMID: 27757820 PMCID: PMC5707237 DOI: 10.1007/s11682-016-9639-x] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Cognitive rehabilitation programs have demonstrated efficacy in improving cognitive functions in Parkinson's disease (PD), but little is known about cerebral changes associated with an integrative cognitive rehabilitation in PD. To assess structural and functional cerebral changes in PD patients, after attending a three-month integrative cognitive rehabilitation program (REHACOP). Forty-four PD patients were randomly divided into REHACOP group (cognitive rehabilitation) and a control group (occupational therapy). T1-weighted, diffusion weighted and functional magnetic resonance images (fMRI) during resting-state and during a memory paradigm (with learning and recognition tasks) were acquired at pre-treatment and post-treatment. Cerebral changes were assessed with repeated measures ANOVA 2 × 2 for group x time interaction. During resting-state fMRI, the REHACOP group showed significantly increased brain connectivity between the left inferior temporal lobe and the bilateral dorsolateral prefrontal cortex compared to the control group. Moreover, during the recognition fMRI task, the REHACOP group showed significantly increased brain activation in the left middle temporal area compared to the control group. During the learning fMRI task, the REHACOP group showed increased brain activation in the left inferior frontal lobe at post-treatment compared to pre-treatment. No significant structural changes were found between pre- and post-treatment. Finally, the REHACOP group showed significant and positive correlations between the brain connectivity and activation and the cognitive performance at post-treatment. This randomized controlled trial suggests that an integrative cognitive rehabilitation program can produce significant functional cerebral changes in PD patients and adds evidence to the efficacy of cognitive rehabilitation programs in the therapeutic approach for PD.
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Affiliation(s)
- María Díez-Cirarda
- Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Biskay, Spain
| | - Natalia Ojeda
- Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Biskay, Spain
| | - Javier Peña
- Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Biskay, Spain
| | | | - Olaia Lucas-Jiménez
- Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Biskay, Spain
| | - Juan Carlos Gómez-Esteban
- Neurodegenerative Unit, Biocruces Research Institute; Neurology Service, Cruces University Hospital, Bilbao, Biskay, Spain
| | | | - Naroa Ibarretxe-Bilbao
- Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Biskay, Spain.
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25
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Mild Cognitive Impairment in Parkinson's Disease: Clustering and Switching Analyses in Verbal Fluency Test. J Int Neuropsychol Soc 2017; 23:511-520. [PMID: 28494819 DOI: 10.1017/s1355617717000297] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVES Mild cognitive impairment is common in non-demented Parkinson disease patients (PD-MCI) and is considered as a risk factor for dementia. Executive dysfunction has been widely described in PD and the Verbal Fluency Tests (VFT) are often used for executive function assessment in this pathology. The Movement Disorder Society (MDS) published guidelines for PD-MCI diagnosis in 2012. However, no investigation has focused on the qualitative analysis of VFT in PD-MCI. The aim of this work was to study the clustering and switching strategies in VFT in PD-MCI patients. Moreover, these variables are considered as predictors for PD-MCI diagnosis. METHODS Forty-three PD patients and twenty normal controls were evaluated with a neuropsychological protocol and the MDS criteria for PD-MCI were applied. Clustering and switching analysis were conducted for VFT. RESULTS The percentage of patients diagnosed with PD-MCI was 37.2%. The Mann-Whitney U test analysis showed that PD-MCI performed poorly in different cognitive measures (digit span, Wisconsin Card Sorting Test, judgment of line orientation, and comprehension test), compared to PD patients without mild cognitive impairment (PD-nMCI). Phonemic fluency analyses showed that PD-MCI patients produced fewer words and switched significantly less, compared to controls and PD-nMCI. Concerning semantic fluency, the PD-MCI group differed significantly, compared to controls and PD-nMCI, in switches. Discriminant function analyses and logistic regression analyses revealed that switches predicted PD-MCI. CONCLUSIONS PD-MCI patients showed poor performance in VFT related to the deficient use of production strategies. The number of switches is a useful predictor for incident PD-MCI. (JINS, 2017, 23, 511-520).
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26
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Differentiating Patients with Parkinson’s Disease from Normal Controls Using Gray Matter in the Cerebellum. THE CEREBELLUM 2016; 16:151-157. [DOI: 10.1007/s12311-016-0781-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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27
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Choi H, Cheon GJ, Kim HJ, Choi SH, Kim YI, Kang KW, Chung JK, Kim EE, Lee DS. Gray matter correlates of dopaminergic degeneration in Parkinson's disease: A hybrid PET/MR study using (18) F-FP-CIT. Hum Brain Mapp 2016; 37:1710-21. [PMID: 26846350 DOI: 10.1002/hbm.23130] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 01/14/2016] [Accepted: 01/20/2016] [Indexed: 01/15/2023] Open
Abstract
Dopaminergic degeneration is a hallmark of Parkinson's disease (PD), which causes various symptoms affected by corticostriatal circuits. So far, the relationship between cortical changes and dopamine loss in the striatum is unclear. Here, we evaluate the gray matter (GM) changes in accordance with striatal dopaminergic degeneration in PD using hybrid PET/MR. Sixteen patients with idiopathic PD underwent (18) F-FP-CIT PET/MR. To measure dopaminergic degeneration in PD, binding ratio (BR) of dopamine transporter in striatum was evaluated by (18) F-FP-CIT. Voxel-based morphometry (VBM) was used to evaluate GM density. We obtained voxelwise correlation maps of GM density according to the striatal BR. Voxel-by-voxel correlation between BR maps and GM density maps was done to evaluate region-specific correlation of striatal dopaminergic degeneration. There was a trend of positive correlation between striatal BR and GM density in the cerebellum, parahippocampal gyri, and frontal cortex. A trend of negative correlation between striatal BR and GM density in the medial occipital cortex was found. Voxel-by-voxel correlation revealed that the positive correlation was mainly dependent on anterior striatal BR, while posterior striatal BR mostly showed negative correlation with GM density in occipital and temporal cortices. Decreased GM density related to anterior striatal dopaminergic degeneration might demonstrate degeneration of dopaminergic nonmotor circuits. Furthermore, the negative correlation could be related to the motor circuits of posterior striatum. Our integrated PET/MR study suggests that the widespread structural progressive changes in PD could denote the cortical functional correlates of the degeneration of striatal dopaminergic circuits. Hum Brain Mapp 37:1710-1721, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Hongyoon Choi
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea
| | - Gi Jeong Cheon
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea.,Cancer Research Institute, Seoul National University, Seoul, Korea
| | - Han-Joon Kim
- Department of Neurology and Movement Disorder Center, Seoul National University Hospital, Seoul, Korea
| | - Seung Hong Choi
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.,Center for Nanoparticle Research, Institute for Basic Science, and School of Chemical and Biological Engineering, Seoul National University, Seoul, Korea
| | - Yong-Il Kim
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea.,Department of Molecular Medicine and Biopharmaceutical Science, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea
| | - Keon Wook Kang
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea.,Cancer Research Institute, Seoul National University, Seoul, Korea
| | - June-Key Chung
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea.,Cancer Research Institute, Seoul National University, Seoul, Korea
| | - E Edmund Kim
- Department of Molecular Medicine and Biopharmaceutical Science, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea.,Department of Radiological Sciences, University of California, Irvine, CA
| | - Dong Soo Lee
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea.,Department of Molecular Medicine and Biopharmaceutical Science, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea
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28
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O'Callaghan C, Hornberger M, Balsters JH, Halliday GM, Lewis SJG, Shine JM. Cerebellar atrophy in Parkinson's disease and its implication for network connectivity. Brain 2016; 139:845-55. [PMID: 26794597 DOI: 10.1093/brain/awv399] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 11/23/2015] [Indexed: 12/13/2022] Open
Abstract
Pathophysiological and atrophic changes in the cerebellum are documented in Parkinson's disease. Without compensatory activity, such abnormalities could potentially have more widespread effects on both motor and non-motor symptoms. We examined how atrophic change in the cerebellum impacts functional connectivity patterns within the cerebellum and between cerebellar-cortical networks in 42 patients with Parkinson's disease and 29 control subjects. Voxel-based morphometry confirmed grey matter loss across the motor and cognitive cerebellar territories in the patient cohort. The extent of cerebellar atrophy correlated with decreased resting-state connectivity between the cerebellum and large-scale cortical networks, including the sensorimotor, dorsal attention and default networks, but with increased connectivity between the cerebellum and frontoparietal networks. The severity of patients' motor impairment was predicted by a combination of cerebellar atrophy and decreased cerebellar-sensorimotor connectivity. These findings demonstrate that cerebellar atrophy is related to both increases and decreases in cerebellar-cortical connectivity in Parkinson's disease, identifying potential cerebellar driven functional changes associated with sensorimotor deficits. A post hoc analysis exploring the effect of atrophy in the subthalamic nucleus, a cerebellar input source, confirmed that a significant negative relationship between grey matter volume and intrinsic cerebellar connectivity seen in controls was absent in the patients. This suggests that the modulatory relationship of the subthalamic nucleus on intracerebellar connectivity is lost in Parkinson's disease, which may contribute to pathological activation within the cerebellum. The results confirm significant changes in cerebellar network activity in Parkinson's disease and reveal that such changes occur in association with atrophy of the cerebellum.
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Affiliation(s)
- Claire O'Callaghan
- 1 Brain and Mind Research Institute, University of Sydney, Sydney, Australia 2 Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - Michael Hornberger
- 3 Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Joshua H Balsters
- 4 Department of Health Sciences and Technology, Neural Control of Movement Laboratory, ETH Zurich, Switzerland
| | - Glenda M Halliday
- 5 Neuroscience Research Australia, Sydney, Australia 6 Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Simon J G Lewis
- 1 Brain and Mind Research Institute, University of Sydney, Sydney, Australia
| | - James M Shine
- 1 Brain and Mind Research Institute, University of Sydney, Sydney, Australia 5 Neuroscience Research Australia, Sydney, Australia 7 School of Psychology, Stanford University, Palo Alto, CA, USA
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Ham JH, Lee JJ, Sunwoo MK, Hong JY, Sohn YH, Lee PH. Effect of olfactory impairment and white matter hyperintensities on cognition in Parkinson's disease. Parkinsonism Relat Disord 2015; 24:95-9. [PMID: 26776568 DOI: 10.1016/j.parkreldis.2015.12.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2015] [Revised: 10/20/2015] [Accepted: 12/29/2015] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Although white matter hyperintensities (WMH) and olfactory dysfunction are independently associated with the cognitive impairments in Parkinson's disease (PD), the effects of simultaneous presence of these abnormalities remain unknown. Thus, we investigated the different effects of deep WMH and periventricular WMH on olfactory and cognitive performance and evaluated the additive effects of the concurrent presence of WMH and olfactory dysfunction on cognitive performance in PD. METHODS We enrolled 171 patients with non-demented PD whose WMH scores were assessed using a semi-quantitative visual rating system. The olfactory and cognitive performance was assessed using the Cross-Cultural Smell Identification (CCSI) test and the Seoul Neuropsychological Screening Battery. Additionally, the additive effects of concurrent WMH and olfactory dysfunction on cognitive performance were investigated using binary logistic regression. RESULTS The deep WMH score exhibited a significant negative correlation with the CCSI score (p = 0.026) but the total WMH and periventricular WMH did not. A multiple regression analysis revealed that the total WMH (β = -0.109, p = 0.011) and deep WMH (β = -0.153, p = 0.020) severities had significant negative correlations with semantic fluency. A logistic regression analysis revealed that the simultaneous presence of severe olfactory dysfunction and deep WMH was associated with a greater risk for the semantic fluency impairments (odds ratio = 15.909, p = 0.0005) compared to patients with mild deep WMH or high CCSI scores. CONCLUSIONS These data indicate that deep WMH was closely coupled with olfactory impairments and cognitive decline in PD. Moreover, the concurrent presence of severe deep WMH and olfactory impairments has a greater influence on semantic fluency.
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Affiliation(s)
- Jee Hyun Ham
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Jae Jung Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Mun-Kyung Sunwoo
- Department of Neurology, Bundang Jesaeng General Hospital, Seongnam, South Korea
| | - Jin Yong Hong
- Department of Neurology, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Young H Sohn
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea; Severance Biomedical Science Institute, Seoul, South Korea.
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Neuropsychological and imaging profile of patients with Parkinson's disease and freezing of gait. Parkinsonism Relat Disord 2015; 21:1184-90. [PMID: 26305999 DOI: 10.1016/j.parkreldis.2015.08.009] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 07/28/2015] [Accepted: 08/10/2015] [Indexed: 11/20/2022]
Abstract
BACKGROUND Neuropsychological evaluation with advanced neuroimaging may be a useful tool to determine the anatomical substrates that play crucial role in freezing of gait (FOG) in patients with Parkinson's Disease (PD). OBJECTIVES To compare the cognitive profile and gray matter (GM) changes (using Voxel Based Morphometry - VBM) between patients with PD with and without FOG (FOG+ve and FOG-ve). METHODS Seventeen FOG+ve (M:F = 11:6) and 21 FOG-ve (M:F = 11:10) were evaluated clinically and with a structured neuropsychological battery. All patients underwent 3 T MRI. In order to determine areas of GM atrophy, T1W volumetric MRI data of the two groups were compared using VBM and Statistical Parametric Mapping 8. RESULTS The mean age of FOG+ve and FOG-ve patients were 56.9 ± 6.6 and 47.4 ± 9.1 years respectively. There was no significant difference in the duration (6.0 ± 4.9 vs 5.2 ± 3.5 years, p < 0.05) and stage of PD (Hoehn & Yahr stage: 1.96 ± 0.53 vs 1.78 ± 0.37) between the two groups. Compared to the FOG-ve group, the FOG+ve group had (i) significant impairment in memory, attention, executive and visuospatial functions on neuropsychological tests, and (ii) significant GM atrophy in the right cerebellum (pyramis, declive), left cerebrum (Brodmann area (BA) 21 and 22) and right cerebrum (BA 10 and 6) on VBM analysis. CONCLUSIONS The FOG+ve group showed widespread involvement of cognition localizing to frontal, temporal (especially left) and parietal areas. VBM analysis showed significant GM atrophy in FOG+ve group in left temporal, right frontal areas (coinciding with that observed in neuropsychological tests) and significant involvement of right cerebellum.
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Danti S, Toschi N, Diciotti S, Tessa C, Poletti M, Del Dotto P, Lucetti C. Cortical thickness inde novopatients with Parkinson disease and mild cognitive impairment with consideration of clinical phenotype and motor laterality. Eur J Neurol 2015. [DOI: 10.1111/ene.12785] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- S. Danti
- Division of Neurology Unit; Versilia Hospital; Lido di Camaiore Lucca Italy
| | - N. Toschi
- Medical Physics Section; Department of Biomedicine and Prevention; University of Rome ‘Tor Vergata’; Rome Italy
- Department of Athinoula A. Martinos Center for Biomedical Imaging; Massachusetts General Hospital; Boston MA USA
- Department of Radiology; Harvard Medical School; Boston MA USA
| | - S. Diciotti
- Department of Electrical, Electronic, and Information Engineering ‘Guglielmo Marconi’; University of Bologna; Cesena Italy
| | - C. Tessa
- Division of Radiology Unit; Versilia Hospital; Lido di Camaiore Lucca Italy
| | - M. Poletti
- Department of Mental Health and Pathological Addiction; AUSL Reggio Emilia; Reggio Emilia Italy
| | - P. Del Dotto
- Division of Neurology Unit; Versilia Hospital; Lido di Camaiore Lucca Italy
| | - C. Lucetti
- Division of Neurology Unit; Versilia Hospital; Lido di Camaiore Lucca Italy
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Duncan GW, Firbank MJ, Yarnall AJ, Khoo TK, Brooks DJ, Barker RA, Burn DJ, O'Brien JT. Gray and white matter imaging: A biomarker for cognitive impairment in early Parkinson's disease? Mov Disord 2015. [PMID: 26202802 DOI: 10.1002/mds.26312] [Citation(s) in RCA: 109] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND The aim of this work was to investigate the cortical and white matter changes that underlie cognitive impairment in patients with incident Parkinson's disease (PD) disease using voxel-based morphometry and diffusion tensor imaging. METHODS Newly diagnosed nondemented PD (n = 125) and control subjects (n = 50) were recruited from the Incidence of Cognitive Impairment in Cohorts with Longitudinal Evaluation in Parkinson's Disease Study and completed cognitive assessments and 3T structural and diffusion tensor MR imaging. Voxel-based morphometry was performed to investigate the relationship between gray matter volume and cognitive ability. Microstructural white matter changes were assessed with diffusion tensor imaging measures of fractional anisotropy and mean diffusivity using tract-based spatial statistics. RESULTS Increased mean diffusivity was observed bilaterally in subjects with PD, relative to controls (P = 0.019). Increased mean diffusivity was associated with performance on the semantic fluency and Tower of London tasks in frontal and parietal white matter tracts, including the cingulum, superior longitudinal fasciculus, inferior longitudinal fasciculus, and inferior fronto-occipital fasciculus. There was no difference in total gray matter volume between groups; however, bilateral reductions in frontal and parietal gray matter volume were associated with reduced performance on measures of executive function in PD subjects. CONCLUSIONS At the earliest stages of PD, regionally specific increases in central white matter mean diffusivity are present and suggest early axonal damage. Such changes are not accompanied by significant gray matter volume loss and are consistent with proposed models of pathological progression of the disease. Structural MRI, especially diffusion tensor imaging analysis, offers potential as a noninvasive biomarker reflecting cognitive impairment in PD.
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Affiliation(s)
- Gordon W Duncan
- Institute of Neuroscience, Newcastle University, Newcastle, United Kingdom.,Medicine of the Elderly, Western General Hospital, Edinburgh, United Kingdom
| | - Michael J Firbank
- Institute of Neuroscience, Newcastle University, Newcastle, United Kingdom
| | - Alison J Yarnall
- Institute of Neuroscience, Newcastle University, Newcastle, United Kingdom
| | - Tien K Khoo
- School of Medicine and Griffith Health Institute, Griffith University, Gold Coast, Australia
| | - David J Brooks
- Aarhus University, Aarhus, Denmark and Imperial College, London, United Kingdom
| | - Roger A Barker
- John van Geest Centre for Brain Repair, University of Cambridge, Cambridge, United Kingdom
| | - David J Burn
- Institute of Neuroscience, Newcastle University, Newcastle, United Kingdom
| | - John T O'Brien
- Institute of Neuroscience, Newcastle University, Newcastle, United Kingdom.,Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
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Guidi M, Paciaroni L, Paolini S, Scarpino O, Burn DJ. Semantic profiles in mild cognitive impairment associated with Alzheimer's and Parkinson's diseases. FUNCTIONAL NEUROLOGY 2015; 30:113-8. [PMID: 26415783 PMCID: PMC4610758 DOI: 10.11138/fneur/2015.30.2.113] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The temporal and the prefrontal cortices have different roles in semantic information processing: the temporal lobe is where knowledge is stored (Graham and Hodges, 1997), whereas the prefrontal cortex is more specifically involved in executive aspects of semantic processing. Relatively little is known about the semantic profiles of mild cognitive impairment (MCI) in Alzheimer's disease (AD) and Parkinson's disease (PD). This observational study investigated naming and semantic questionnaire performances in three groups of subjects: 10 patients with the amnestic-type MCI prodrome of AD (aMCI), 10 patients with early-stage executive-type MCI in PD (MCI-PD), and 10 normal subjects. The MCI-PD subjects demonstrated inferior performances on a semantic questionnaire, whereas the aMCI group displayed modest difficulties in a naming task. These differences may be explained by topographical differences in pathological involvement. Since the frontal areas are more functionally impaired in PD, we hypothesize that the semantic deficit may be a consequence of a deficiency in control of semantic processing. On the other hand, the semantic deficit in aMCI may be related to a lexical-semantic storage dysfunction resulting from pathological involvement of the temporal lobe.
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Affiliation(s)
- Marco Guidi
- Neurology Unit, Department of Neuroscience, AORMN, Pesaro, Italy
| | | | - Susy Paolini
- Neurology Unit, Geriatric Hospital, INRCA, Ancona, Italy
| | | | - David J. Burn
- Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, UK
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Neural-specific deletion of Htra2 causes cerebellar neurodegeneration and defective processing of mitochondrial OPA1. PLoS One 2014; 9:e115789. [PMID: 25531304 PMCID: PMC4274161 DOI: 10.1371/journal.pone.0115789] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Accepted: 11/27/2014] [Indexed: 01/28/2023] Open
Abstract
HTRA2, a serine protease in the intermembrane space, has important functions in mitochondrial stress signaling while its abnormal activity may contribute to the development of Parkinson’s disease. Mice with a missense or null mutation of Htra2 fail to thrive, suffer striatal neuronal loss, and a parkinsonian phenotype that leads to death at 30–40 days of age. While informative, these mouse models cannot separate neural contributions from systemic effects due to the complex phenotypes of HTRA2 deficiency. Hence, we developed mice carrying a Htra2-floxed allele to query the consequences of tissue-specific HTRA2 deficiency. We found that mice with neural-specific deletion of Htra2 exhibited atrophy of the thymus and spleen, cessation to gain weight past postnatal (P) day 18, neurological symptoms including ataxia and complete penetrance of premature death by P40. Histologically, increased apoptosis was detected in the cerebellum, and to a lesser degree in the striatum and the entorhinal cortex, from P25. Even earlier at P20, mitochondria in the cerebella already exhibited abnormal morphology, including swelling, vesiculation, and fragmentation of the cristae. Furthermore, the onset of these structural anomalies was accompanied by defective processing of OPA1, a key molecule for mitochondrial fusion and cristae remodeling, leading to depletion of the L-isoform. Together, these findings suggest that HTRA2 is essential for maintenance of the mitochondrial integrity in neurons. Without functional HTRA2, a lifespan as short as 40 days accumulates a large quantity of dysfunctional mitochondria that contributes to the demise of mutant mice.
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Colloby SJ, O׳Brien JT, Taylor JP. Patterns of cerebellar volume loss in dementia with Lewy bodies and Alzheimer׳s disease: A VBM-DARTEL study. Psychiatry Res 2014; 223:187-91. [PMID: 25037902 PMCID: PMC4333903 DOI: 10.1016/j.pscychresns.2014.06.006] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Revised: 05/27/2014] [Accepted: 06/19/2014] [Indexed: 12/20/2022]
Abstract
Evidence suggests that the cerebellum contributes to cognition as well as motor function. We investigated cerebellar grey matter (GM) and white matter (WM) changes from magnetic resonance images in dementia with Lewy bodies (DLB), Alzheimer׳s disease (AD) and healthy older subjects using voxel-based morphometry (VBM). Subjects (39 controls, 41 DLB, and 48 AD) underwent magnetic resonance imaging as well as clinical and cognitive assessments. VBM used SPM8 with a cerebellar brain mask to define the subspace for voxel analysis. Statistical analyses were conducted using the general linear model. Relative to findings in controls, VBM analysis revealed cerebellar GM loss in lobule VI bilaterally in AD and in left Crus I and right Crus II regions in DLB. WM deficits were confined to AD in the bilateral middle cerebellar peduncles. DLB demonstrates a different pattern of cerebellar GM loss which, although not significantly different from that in AD, could be an important feature in understanding the neurobiology of DLB and warrants further investigation.
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Affiliation(s)
- Sean. J. Colloby
- Institute for Ageing and Health, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne NE4 5PL, UK,Corresponding author. Tel.: +44 191 208 1321; fax: +44 191 208 1301.
| | - John. T. O׳Brien
- Institute for Ageing and Health, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne NE4 5PL, UK,Department of Psychiatry, University of Cambridge, Cambridge CB2 0QC, UK
| | - John-Paul Taylor
- Institute for Ageing and Health, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne NE4 5PL, UK
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Cognitive and cortical thinning patterns of subjective cognitive decline in patients with and without Parkinson's disease. Parkinsonism Relat Disord 2014; 20:999-1003. [DOI: 10.1016/j.parkreldis.2014.06.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Revised: 05/16/2014] [Accepted: 06/17/2014] [Indexed: 11/21/2022]
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Segura B, Baggio HC, Marti MJ, Valldeoriola F, Compta Y, Garcia‐Diaz AI, Vendrell P, Bargallo N, Tolosa E, Junque C. Cortical thinning associated with mild cognitive impairment in Parkinson's disease. Mov Disord 2014; 29:1495-503. [DOI: 10.1002/mds.25982] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 05/23/2014] [Accepted: 07/02/2014] [Indexed: 01/11/2023] Open
Affiliation(s)
- Bàrbara Segura
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS)Catalonia Spain
- Department of Psychiatry and Clinical PsychobiologyUniversity of BarcelonaCatalonia Spain
| | - Hugo César Baggio
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS)Catalonia Spain
- Department of Psychiatry and Clinical PsychobiologyUniversity of BarcelonaCatalonia Spain
| | - Maria Josep Marti
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS)Catalonia Spain
- Centro de Investigación en Red de Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de BarcelonaCatalonia Spain
- Neurology Service, Institut Clínic de Neurociències (ICN), Parkinson's Disease and Movement Disorders Unit, Hospital Clínic de BarcelonaCatalonia Spain
| | - Francesc Valldeoriola
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS)Catalonia Spain
- Centro de Investigación en Red de Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de BarcelonaCatalonia Spain
- Neurology Service, Institut Clínic de Neurociències (ICN), Parkinson's Disease and Movement Disorders Unit, Hospital Clínic de BarcelonaCatalonia Spain
| | - Yaroslau Compta
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS)Catalonia Spain
- Centro de Investigación en Red de Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de BarcelonaCatalonia Spain
- Neurology Service, Institut Clínic de Neurociències (ICN), Parkinson's Disease and Movement Disorders Unit, Hospital Clínic de BarcelonaCatalonia Spain
| | | | - Pere Vendrell
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS)Catalonia Spain
- Department of Psychiatry and Clinical PsychobiologyUniversity of BarcelonaCatalonia Spain
- Centro de Investigación en Red de Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de BarcelonaCatalonia Spain
| | - Núria Bargallo
- Centre de Diagnostic per la Imatge, Hospital ClinicBarcelona Catalonia Spain
| | - Eduardo Tolosa
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS)Catalonia Spain
- Centro de Investigación en Red de Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de BarcelonaCatalonia Spain
- Neurology Service, Institut Clínic de Neurociències (ICN), Parkinson's Disease and Movement Disorders Unit, Hospital Clínic de BarcelonaCatalonia Spain
- University of BarcelonaCatalonia Spain
| | - Carme Junque
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS)Catalonia Spain
- Department of Psychiatry and Clinical PsychobiologyUniversity of BarcelonaCatalonia Spain
- Centro de Investigación en Red de Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de BarcelonaCatalonia Spain
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Pereira JB, Svenningsson P, Weintraub D, Brønnick K, Lebedev A, Westman E, Aarsland D. Initial cognitive decline is associated with cortical thinning in early Parkinson disease. Neurology 2014; 82:2017-25. [PMID: 24808018 DOI: 10.1212/wnl.0000000000000483] [Citation(s) in RCA: 138] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Our aim was to assess cortical thickness in a large multicenter cohort of drug-naive patients with early Parkinson disease (PD), with and without mild cognitive impairment (MCI), and explore the cognitive correlates of regional cortical thinning. METHODS One hundred twenty-three newly diagnosed patients with PD and 56 healthy controls with 3-tesla structural MRI scans and complete neuropsychological assessment from the Parkinson's Progression Markers Initiative were included. Modified Movement Disorders Society Task Force level II criteria were applied to diagnose MCI in PD. FreeSurfer image processing and analysis software was used to measure cortical thickness across groups and the association with cognitive domains and tests. RESULTS In patients with MCI, atrophy was found in temporal, parietal, frontal, and occipital areas compared with controls. Specific regional thinning in the right inferior temporal cortex was also found in cognitively normal patients. Memory, executive, and visuospatial performance was associated with temporoparietal and superior frontal thinning, suggesting a relationship between cognitive impairment and both anterior and posterior cortical atrophy in the whole patient sample. CONCLUSIONS These findings confirm that MCI is associated with widespread cortical atrophy. In addition, they suggest that regional cortical thinning is already present at the time of diagnosis in patients with early, untreated PD who do not meet the criteria for MCI. Together, the results indicate that cortical thinning can serve as a marker for initial cognitive decline in early PD.
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Affiliation(s)
- Joana B Pereira
- From the Department of Neurobiology, Care Sciences and Society (J.B.P., E.W.), and Centre for Alzheimer's Disease Research, Department of Neurobiology, Care Sciences and Society (D.A.), Karolinska Institutet, Stockholm; Centre for Molecular Medicine (P.S.), Department of Neurology and Clinical Neuroscience, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden; Department of Psychiatry and Neurology (D.W.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia VA Medical Center; and The Norwegian Center for Movement Disorders (K.B.), and Centre for Age-Related Medicine, Department of Psychiatry (A.L., D.A.), Stavanger University Hospital, Stavanger, Norway.
| | - Per Svenningsson
- From the Department of Neurobiology, Care Sciences and Society (J.B.P., E.W.), and Centre for Alzheimer's Disease Research, Department of Neurobiology, Care Sciences and Society (D.A.), Karolinska Institutet, Stockholm; Centre for Molecular Medicine (P.S.), Department of Neurology and Clinical Neuroscience, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden; Department of Psychiatry and Neurology (D.W.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia VA Medical Center; and The Norwegian Center for Movement Disorders (K.B.), and Centre for Age-Related Medicine, Department of Psychiatry (A.L., D.A.), Stavanger University Hospital, Stavanger, Norway
| | - Daniel Weintraub
- From the Department of Neurobiology, Care Sciences and Society (J.B.P., E.W.), and Centre for Alzheimer's Disease Research, Department of Neurobiology, Care Sciences and Society (D.A.), Karolinska Institutet, Stockholm; Centre for Molecular Medicine (P.S.), Department of Neurology and Clinical Neuroscience, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden; Department of Psychiatry and Neurology (D.W.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia VA Medical Center; and The Norwegian Center for Movement Disorders (K.B.), and Centre for Age-Related Medicine, Department of Psychiatry (A.L., D.A.), Stavanger University Hospital, Stavanger, Norway
| | - Kolbjørn Brønnick
- From the Department of Neurobiology, Care Sciences and Society (J.B.P., E.W.), and Centre for Alzheimer's Disease Research, Department of Neurobiology, Care Sciences and Society (D.A.), Karolinska Institutet, Stockholm; Centre for Molecular Medicine (P.S.), Department of Neurology and Clinical Neuroscience, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden; Department of Psychiatry and Neurology (D.W.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia VA Medical Center; and The Norwegian Center for Movement Disorders (K.B.), and Centre for Age-Related Medicine, Department of Psychiatry (A.L., D.A.), Stavanger University Hospital, Stavanger, Norway
| | - Alexander Lebedev
- From the Department of Neurobiology, Care Sciences and Society (J.B.P., E.W.), and Centre for Alzheimer's Disease Research, Department of Neurobiology, Care Sciences and Society (D.A.), Karolinska Institutet, Stockholm; Centre for Molecular Medicine (P.S.), Department of Neurology and Clinical Neuroscience, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden; Department of Psychiatry and Neurology (D.W.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia VA Medical Center; and The Norwegian Center for Movement Disorders (K.B.), and Centre for Age-Related Medicine, Department of Psychiatry (A.L., D.A.), Stavanger University Hospital, Stavanger, Norway
| | - Eric Westman
- From the Department of Neurobiology, Care Sciences and Society (J.B.P., E.W.), and Centre for Alzheimer's Disease Research, Department of Neurobiology, Care Sciences and Society (D.A.), Karolinska Institutet, Stockholm; Centre for Molecular Medicine (P.S.), Department of Neurology and Clinical Neuroscience, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden; Department of Psychiatry and Neurology (D.W.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia VA Medical Center; and The Norwegian Center for Movement Disorders (K.B.), and Centre for Age-Related Medicine, Department of Psychiatry (A.L., D.A.), Stavanger University Hospital, Stavanger, Norway
| | - Dag Aarsland
- From the Department of Neurobiology, Care Sciences and Society (J.B.P., E.W.), and Centre for Alzheimer's Disease Research, Department of Neurobiology, Care Sciences and Society (D.A.), Karolinska Institutet, Stockholm; Centre for Molecular Medicine (P.S.), Department of Neurology and Clinical Neuroscience, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden; Department of Psychiatry and Neurology (D.W.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia VA Medical Center; and The Norwegian Center for Movement Disorders (K.B.), and Centre for Age-Related Medicine, Department of Psychiatry (A.L., D.A.), Stavanger University Hospital, Stavanger, Norway
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Gerrits NJHM, van der Werf YD, Hofman M, Foncke EMJ, Klein M, Berendse HW, van den Heuvel OA. Gray matter differences contribute to variation in cognitive performance in Parkinson's disease. Eur J Neurol 2013; 21:245-52. [DOI: 10.1111/ene.12269] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Accepted: 08/23/2013] [Indexed: 11/29/2022]
Affiliation(s)
- N. J. H. M. Gerrits
- Department of Anatomy and Neurosciences; VU University Medical Center (VUmc); Amsterdam The Netherlands
| | - Y. D. van der Werf
- Department of Anatomy and Neurosciences; VU University Medical Center (VUmc); Amsterdam The Netherlands
- Netherlands Institute for Neurosciences; an institute of the Royal Netherlands Academy of Arts and Sciences; Amsterdam The Netherlands
| | - M. Hofman
- Department of Anatomy and Neurosciences; VU University Medical Center (VUmc); Amsterdam The Netherlands
| | | | - M. Klein
- Department of Medical Psychology; VUmc; Amsterdam The Netherlands
| | - H. W. Berendse
- Department of Neurology; VUmc; Amsterdam The Netherlands
| | - O. A. van den Heuvel
- Department of Anatomy and Neurosciences; VU University Medical Center (VUmc); Amsterdam The Netherlands
- Department of Psychiatry; VUmc; Amsterdam The Netherlands
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Filoteo JV, Reed JD, Litvan I, Harrington DL. Volumetric correlates of cognitive functioning in nondemented patients with Parkinson's disease. Mov Disord 2013; 29:360-7. [PMID: 24038502 DOI: 10.1002/mds.25633] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 07/08/2013] [Accepted: 07/15/2013] [Indexed: 12/25/2022] Open
Abstract
A challenge in Parkinson's disease (PD) is to identify biomarkers of early cognitive change because functioning in some domains may be more prognostic of dementia. Few studies have investigated whether structural magnetic resonance imaging (MRI) correlates in a regionally specific manner with functioning in different cognitive domains. The aim of this study was to identify neuroanatomical correlates of executive functioning, memory, and visual cognition in PD without dementia. 3T MRI was conducted in 51 PD patients and 39 control participants. Brain volumes were measured in structures comprising the frontostriatal cognitive-control system, the medial temporal memory system, the ventral object-based system, and the dorsal spatial-based system. Measures of executive functioning (Stroop Test; Letter Fluency), memory (California Verbal Learning Test), visuospatial cognition (Judgment of Line Orientation), and visuoconstruction (Pentagon Copy) were correlated with volumes comprising each system. Poorer executive functioning largely correlated with decreased frontostriatal volumes. Poorer memory correlated with decreased volumes in all medial temporal regions, but also with frontostriatal volumes. Poorer visuospatial cognition correlated with decreased volumes in the object-based system, whereas poorer visuoconstruction correlated with decreased frontal and object-based system volumes. These relationships were nonsignificant in the control group. This is the first study to demonstrate that subtle changes in multiple cognitive domains in PD without dementia correlate with regional volumes in specific systems implicated in the development of cognitive impairment. The findings suggest that structural MRI holds promise as a marker of early changes in different brain systems, some of which may predict future cognitive deterioration.
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Affiliation(s)
- J Vincent Filoteo
- Psychology Service, VA San Diego Healthcare System, San Diego, California, USA; Research Service, VA San Diego Healthcare System, San Diego, California, USA; Department of Psychiatry, University of California, San Diego, San Diego, California, USA
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Ellfolk U, Joutsa J, Rinne JO, Parkkola R, Jokinen P, Karrasch M. Striatal volume is related to phonemic verbal fluency but not to semantic or alternating verbal fluency in early Parkinson's disease. J Neural Transm (Vienna) 2013; 121:33-40. [PMID: 23913130 PMCID: PMC3889690 DOI: 10.1007/s00702-013-1073-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Accepted: 07/22/2013] [Indexed: 12/13/2022]
Abstract
Verbal fluency impairments are frequent in Parkinson’s disease (PD) and they may be present already at early stages. Semantic fluency impairment is associated with Parkinson’s disease dementia and temporal, frontal and cerebellar cortical changes. Few studies have addressed cerebral structural correlates of different verbal fluency tasks in early stage PD. We therefore studied gray matter volumes of T1-weighted MRI images using voxel-based morphometry in relation to semantic, phonemic, and alternating verbal fluency in younger (mean age <65 years), early stage (mean disease duration <3 years), non-demented PD patients (n = 28) and healthy controls (n = 27). We found a significant association between worse phonemic fluency and smaller striatal, namely right caudate gray matter volume in the PD group only (family-wise error corrected p = 0.007). Reduced semantic fluency was associated with smaller gray matter volumes in left parietal cortex (p = 0.037) and at trend level with smaller bilateral cerebellum gray matter volume across groups (p = 0.062), but not in the separate PD or control groups. There were no significant relationships between alternating fluency and gray matter volumes in the whole sample or in the groups separately. The fact that phonemic fluency, but not semantic or alternating fluency, was associated with caudate gray matter volume at early stage PD suggests that different fluency tasks rely on different neural substrates, and that language networks supporting semantic search and verbal-semantic switching are unrelated to brain gray matter volume at early disease stages in PD.
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Affiliation(s)
- Ulla Ellfolk
- Department of Psychology and Logopedics, Abo Akademi University, 20500, Turku, Finland,
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42
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Neurocognitive and atrophic patterns in Parkinson's disease based on subjective memory complaints. J Neurol 2013; 259:1706-12. [PMID: 22289965 DOI: 10.1007/s00415-011-6404-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2011] [Revised: 12/26/2011] [Accepted: 12/27/2011] [Indexed: 10/14/2022]
Abstract
Ample evidence has suggested that individuals with subjective memory complaints are at a higher risk for cognitive decline. Nevertheless, the significance of subjective memory complaints in Parkinson’s disease has not been studied until now. We investigated whether the patterns of cognitive profiles and gray matter density differed in cognitively normal patients with Parkinson’s disease based on the presence of subjective memory complaints. Using a single question with a yes or no answer, cognitively normal patients with Parkinson’s disease were classified as with (n = 20) or without subjective memory complaints (n = 15). Cognitive profiles and gray matter density were examined using standardized neuropsychological tests and voxel-based morphometry. No significant differences in demographic characteristics were observed between groups. The detailed neuropsychological tests demonstrated that Parkinson’s disease patients with subjective memory complaints had significantly decreased verbal fluency and slightly lower scores on the backward digit-span test compared with those without subjective memory complaints. A voxel-based morphometry analysis revealed that Parkinson’s disease patients with subjective memory complaints had significantly decreased gray matter density in the anterior cingulate gyrus and right inferior parietal lobule compared with those without subjective memory complaints. Our data demonstrated that Parkinson’s disease patients with subjective memory complaints showed a poorer performance on tasks related to verbal fluency and attention with more severe cortical atrophy compared to those without subjective memory complaints, suggesting that subjective memory complaints in patients with Parkinson’s disease may represent an early manifestation of underlying Parkinson’s disease-related pathological changes.
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Wu T, Hallett M. The cerebellum in Parkinson's disease. Brain 2013; 136:696-709. [PMID: 23404337 PMCID: PMC7273201 DOI: 10.1093/brain/aws360] [Citation(s) in RCA: 516] [Impact Index Per Article: 46.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Revised: 10/24/2012] [Accepted: 11/06/2012] [Indexed: 11/30/2022] Open
Abstract
Parkinson's disease is a chronic progressive neurodegenerative disorder characterized by resting tremor, slowness of movements, rigidity, gait disturbance and postural instability. Most investigations on Parkinson's disease focused on the basal ganglia, whereas the cerebellum has often been overlooked. However, increasing evidence suggests that the cerebellum may have certain roles in the pathophysiology of Parkinson's disease. Anatomical studies identified reciprocal connections between the basal ganglia and cerebellum. There are Parkinson's disease-related pathological changes in the cerebellum. Functional or morphological modulations in the cerebellum were detected related to akinesia/rigidity, tremor, gait disturbance, dyskinesia and some non-motor symptoms. It is likely that the major roles of the cerebellum in Parkinson's disease include pathological and compensatory effects. Pathological changes in the cerebellum might be induced by dopaminergic degeneration, abnormal drives from the basal ganglia and dopaminergic treatment, and may account for some clinical symptoms in Parkinson's disease. The compensatory effect may help maintain better motor and non-motor functions. The cerebellum is also a potential target for some parkinsonian symptoms. Our knowledge about the roles of the cerebellum in Parkinson's disease remains limited, and further attention to the cerebellum is warranted.
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Affiliation(s)
- Tao Wu
- Department of Neurobiology, Key Laboratory on Neurodegenerative Disorders of Ministry of Education, Beijing Institute of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
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Pereira JB, Junqué C, Bartrés-Faz D, Martí MJ, Sala-Llonch R, Compta Y, Falcón C, Vendrell P, Pascual-Leone Á, Valls-Solé J, Tolosa E. Modulation of verbal fluency networks by transcranial direct current stimulation (tDCS) in Parkinson’s disease. Brain Stimul 2013; 6:16-24. [DOI: 10.1016/j.brs.2012.01.006] [Citation(s) in RCA: 92] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2011] [Revised: 12/26/2011] [Accepted: 01/17/2012] [Indexed: 10/28/2022] Open
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Levin BE, Katzen HL, Maudsley A, Post J, Myerson C, Govind V, Nahab F, Scanlon B, Mittel A. Whole-brain proton MR spectroscopic imaging in Parkinson's disease. J Neuroimaging 2012; 24:39-44. [PMID: 23228009 DOI: 10.1111/j.1552-6569.2012.00733.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2011] [Revised: 05/03/2012] [Accepted: 05/28/2011] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND AND PURPOSE To examine the distributions of proton magnetic resonance spectroscopy (MRS) observed metabolites in Parkinson's disease (PD) throughout the whole brain. METHODS Twelve PD patients and 18 age-matched controls were studied using neuropsychological testing, MRI and volumetric MR spectroscopic imaging. Average values of signal normalized metabolite values for N-acetyl-aspartate, total-creatine, and total-choline (NAA, total-Cre, total-Cho, respectively) and their ratios were calculated for gray matter (GM) and white matter (WM) in each lobar brain region. RESULTS Analyses revealed altered metabolite values in PD subjects relative to controls within the GM of the temporal lobe (right: elevated Cre, P = .027; decreased NAA/Cre, P = .019; decreased Cho/Cre, P = .001 and left: decreased NAA/Cre; P = .001, decreased Cho/Cre, P = .007); the right occipital lobe (decreased NAA, P = .032 and NAA/Cre, P = .016); and the total cerebrum GM (decreased NAA/Cre, P = .029). No meaningful correlations were obtained between abnormal metabolite values and the neuropsychological measures. CONCLUSIONS PD is associated with widespread alterations of brain metabolite concentrations, with a primary finding of increased creatine. Higher creatine values in our PD sample may reflect greater neuronal energy expenditure early in the disease process that is compensatory. This is the first whole brain MRS study of PD that has examined metabolite changes across a large fraction of the brain volume, including the cortical mantle.
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Affiliation(s)
- Bonnie E Levin
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL; Department of Psychology, University of Miami, Coral Gables, FL
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Ibarretxe-Bilbao N, Junque C, Segura B, Baggio HC, Marti MJ, Valldeoriola F, Bargallo N, Tolosa E. Progression of cortical thinning in early Parkinson's disease. Mov Disord 2012; 27:1746-53. [PMID: 23124622 DOI: 10.1002/mds.25240] [Citation(s) in RCA: 90] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2012] [Revised: 08/03/2012] [Accepted: 09/16/2012] [Indexed: 01/23/2023] Open
Abstract
The aim of this study was to investigate the progression of cortical thinning and gray-matter (GM) volume loss in early Parkinson's disease (PD). MRI and neuropsychological assessment were obtained at baseline and follow-up (mean ± standard deviation = 35.50 ± 1.88 months) in a group of 16 early-PD patients (H & Y stage ≤II and disease duration ≤5 years) and 15 healthy controls matched for age, gender, and years of education. FreeSurfer software was used for the analysis of cortical thickness as well as for cortical and subcortical volumetric analyses. Voxel-based morphometry analysis was performed using SPM8. Compared to controls, PD patients showed greater regional cortical thinning in bilateral frontotemporal regions as well as greater over-time total GM loss and amygdalar volume reduction. PD patients and controls presented similar over-time changes in cognitive functioning. In early-PD patients, global GM loss, amygdalar atrophy, and cortical thinning in frontotemporal regions are specifically associated with the PD-degenerative process.
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Affiliation(s)
- Naroa Ibarretxe-Bilbao
- Centro de Investigación en Red de Enfermedades Neurodegenerativas, Hospital Clínic de Barcelona, Catalonia, Spain
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Cognitive profiles in Parkinson's disease and their relation to dementia: a data-driven approach. Int J Alzheimers Dis 2012; 2012:910757. [PMID: 23119224 PMCID: PMC3483831 DOI: 10.1155/2012/910757] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Accepted: 08/01/2012] [Indexed: 01/30/2023] Open
Abstract
Parkinson's disease is characterized by a substantial cognitive heterogeneity, which is apparent in different profiles and levels of severity. To date, a distinct clinical profile for patients with a potential risk of developing dementia still has to be identified. We introduce a data-driven approach to detect different cognitive profiles and stages. Comprehensive neuropsychological data sets from a cohort of 121 Parkinson's disease patients with and without dementia were explored by a factor analysis to characterize different cognitive domains. Based on the factor scores that represent individual performance in each domain, hierarchical cluster analyses determined whether subgroups of Parkinson's disease patients show varying cognitive profiles. A six-factor solution accounting for 65.2% of total variance fitted best to our data and revealed high internal consistencies (Cronbach's alpha coefficients >0.6). The cluster analyses suggested two independent patient clusters with different cognitive profiles. They differed only in severity of cognitive impairment and self-reported limitation of activities of daily living function but not in motor performance, disease duration, or dopaminergic medication.
Based on a data-driven approach, divers cognitive profiles were identified, which separated early and more advanced stages of cognitive impairment in Parkinson's disease without dementia. Importantly, these profiles were independent of motor progression.
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Ash S, Xie SX, Gross RG, Dreyfuss M, Boller A, Camp E, Morgan B, O'Shea J, Grossman M. The organization and anatomy of narrative comprehension and expression in Lewy body spectrum disorders. Neuropsychology 2012; 26:368-84. [PMID: 22309984 PMCID: PMC3348419 DOI: 10.1037/a0027115] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE Patients with Lewy body spectrum disorders (LBSD) such as Parkinson's disease, Parkinson's disease with dementia, and dementia with Lewy bodies exhibit deficits in both narrative comprehension and narrative expression. The present research examines the hypothesis that these impairments are due to a material-neutral deficit in organizational executive resources rather than to impairments of language per se. We predicted that comprehension and expression of narrative would be similarly affected and that deficits in both expression and comprehension of narrative would be related to the same anatomic distribution of prefrontal disease. METHOD We examined 29 LBSD patients and 26 healthy seniors on their comprehension and expression of narrative discourse. For comprehension, we measured accuracy and latency in judging events with high and low associativity from familiar scripts such as "going fishing." The expression task involved maintaining the connectedness of events while narrating a story from a wordless picture book. RESULTS LBSD patients were impaired on measures of narrative organization during both comprehension and expression relative to healthy seniors. Measures of organization during narrative expression and comprehension were significantly correlated with each other. These measures both correlated with executive measures but not with neuropsychological measures of lexical semantics or grammar. Voxel-based morphometry revealed overlapping regressions relating frontal atrophy to narrative comprehension, narrative expression, and measures of executive control. CONCLUSIONS Difficulty with narrative discourse in LBSD stems in part from a deficit of organization common to comprehension and expression. This deficit is related to prefrontal cortical atrophy in LBSD.
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Affiliation(s)
- Sharon Ash
- University of Pennsylvania, Philadelphia, PA, USA.
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Ash S, McMillan C, Gross RG, Cook P, Gunawardena D, Morgan B, Boller A, Siderowf A, Grossman M. Impairments of speech fluency in Lewy body spectrum disorder. BRAIN AND LANGUAGE 2012; 120:290-302. [PMID: 22099969 PMCID: PMC3299896 DOI: 10.1016/j.bandl.2011.09.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2011] [Revised: 08/08/2011] [Accepted: 09/16/2011] [Indexed: 05/10/2023]
Abstract
Few studies have examined connected speech in demented and non-demented patients with Parkinson's disease (PD). We assessed the speech production of 35 patients with Lewy body spectrum disorder (LBSD), including non-demented PD patients, patients with PD dementia (PDD), and patients with dementia with Lewy bodies (DLB), in a semi-structured narrative speech sample in order to characterize impairments of speech fluency and to determine the factors contributing to reduced speech fluency in these patients. Both demented and non-demented PD patients exhibited reduced speech fluency, characterized by reduced overall speech rate and long pauses between sentences. Reduced speech rate in LBSD correlated with measures of between-utterance pauses, executive functioning, and grammatical comprehension. Regression analyses related non-fluent speech, grammatical difficulty, and executive difficulty to atrophy in frontal brain regions. These findings indicate that multiple factors contribute to slowed speech in LBSD, and this is mediated in part by disease in frontal brain regions.
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Affiliation(s)
- Sharon Ash
- Department of Neurology, University of Pennsylvania School of Medicine, United States.
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50
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Gross RG, McMillan CT, Chandrasekaran K, Dreyfuss M, Ash S, Avants B, Cook P, Moore P, Libon DJ, Siderowf A, Grossman M. Sentence processing in Lewy body spectrum disorder: the role of working memory. Brain Cogn 2012; 78:85-93. [PMID: 22218297 PMCID: PMC3265703 DOI: 10.1016/j.bandc.2011.12.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2011] [Revised: 10/06/2011] [Accepted: 12/09/2011] [Indexed: 11/26/2022]
Abstract
Prior work has related sentence processing to executive deficits in non-demented patients with Parkinson's disease (PD). We extended this investigation to patients with dementia with Lewy bodies (DLB) and PD dementia (PDD) by examining grammatical and working memory components of sentence processing in the full range of patients with Lewy body spectrum disorder (LBSD). Thirty-three patients with LBSD were given a two-alternative, forced-choice sentence-picture matching task. Sentence type, working memory, and grammatical structure were systematically manipulated in the sentences. We found that patients with PDD and DLB were significantly impaired relative to non-demented PD patients and healthy controls. The deficit in PDD/DLB was most pronounced for sentences lengthened by the strategic placement of an additional prepositional phrase and for sentences with an additional proposition due to a center-embedded clause. However, there was no effect for subject-relative versus object-relative grammatical structure. An MRI voxel-based morphometry analysis in a subset of patients showed significant gray matter thinning in the frontal lobe bilaterally, and this extended to temporal, parietal and occipital regions. A regression analysis related sentence processing difficulty in LBSD to frontal neocortex, including inferior prefrontal, premotor, and dorsolateral prefrontal regions, as well as right superior temporal cortex. These findings are consistent with the hypothesis that patients with PDD and DLB have difficulty processing sentences with increased working memory demands and that this deficit is related in part to their frontal disease.
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Affiliation(s)
- Rachel G Gross
- Department of Neurology, University of Pennsylvania School of Medicine, United States
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