STN-DBS affects language processing differentially in Parkinson's disease: Multiple-case MEG study

Effects of STN-DBS on cognition and mood in young-onset Parkinson's disease: a two-year follow-up

Background

The effects of subthalamic nucleus deep brain stimulation (STN-DBS) on the cognition and mood of patients with PD are still not uniformly concluded, and young-onset Parkinson's disease (YOPD) is even less explored.

Objective

To observe the effectiveness of STN-DBS on the cognition and mood of YOPD patients.

Methods

A total of 27 subjects, with a mean age at onset of 39.48 ± 6.24 and age at surgery for STN-DBS of 48.44 ± 4.85, were followed up preoperatively and for 2 years postoperatively. Using the Unified Parkinson disease rating scale (UPDRS), H&Y(Hoehn and Yahr stage), 39-Item Parkinson's Disease Questionnaire (PDQ-39), Mini-mental state examination (MMSE), Montreal Cognitive Assessment (MoCA), Hamilton depression scale (HAMD), Hamilton anxiety scale (HAMA) to assess motor, cognition, and mood.

Results

At the 2-year follow-up after STN-DBS, YOPD patients showed significant improvements in motor and quality of life (UPDRS III: p < 0.001, PDQ-39: p < 0.001); overall cognition was not significantly different from preoperative (MMSE: p = 0.275, MoCA: p = 0.913), although language function was significantly impaired compared to preoperative (MMSE: p = 0.004, MoCA: p = 0.009); depression and anxiety symptoms also improved significantly (HAMD: p < 0.001, HAMA: p < 0.001) and the depression score correlated significantly with motor (preoperative: r = 0.493, p = 0.009), disease duration (preoperative: r = 0.519, p = 0.006; postoperative: r = 0.406, p = 0.036) and H&Y (preoperative: r = 0.430, p = 0.025; postoperative: r = 0.387, p = 0.046); total anxiety scores were also significantly correlated with motor (preoperative: r = 0.553, p = 0.003; postoperative: r = 0.444, p = 0.020), disease duration (preoperative: r = 0.417, p = 0.031), PDQ-39 (preoperative: r = 0.464, p = 0.015) and H&Y (preoperative: r = 0.440, p = 0.022; postoperative: r = 0.526, p = 0.005).

Conclusion

STN-DBS is a safe and effective treatment for YOPD. The mood improved significantly, and overall cognition was not impaired, were only verbal fluency decreased but did not affect the improvement in quality of life.

Speech comprehension across time, space, frequency, and age: MEG-MVPA classification of intertrial phase coherence

Language is a key part of human cognition, essential for our well-being at all stages of our lives. Whereas many neurocognitive abilities decline with age, for language the picture is much less clear, and how exactly speech comprehension changes with ageing is still unknown. To investigate this, we employed magnetoencephalography (MEG) and recorded neuromagnetic brain responses to auditory linguistic stimuli in healthy participants of younger and older age using a passive task-free paradigm and a range of different linguistic stimulus contrasts, which enabled us to assess neural processing of spoken language at multiple levels (lexical, semantic, morphosyntactic). Using machine learning-based classification algorithms to scrutinise intertrial phase coherence of MEG responses in cortical source space, we found that patterns of oscillatory neural activity diverged between younger and older participants across several frequency bands (alpha, beta, gamma) for all tested linguistic information types. The results suggest multiple age-related changes in the brain's neurolinguistic circuits, which may be due to both healthy ageing in general and compensatory processes in particular.

Multi-dimensional sensorimotor grounding of concrete and abstract categories

Semantic categories, and the concepts belonging to them, have commonly been defined by their relative concreteness, that is, their reliance on perception. However, sensorimotor grounding must be regarded as going beyond the basic five senses and incorporate a multi-dimensional variety of perceptual and action experience. We present a series of exploratory analyses examining the sensorimotor grounding of participant-produced member concepts for 117 categories, spanning concrete (e.g. animal and furniture) and highly abstract (e.g. unit of time and science) categories. We found that both concrete and abstract categories are strongly grounded in multi-dimensional sensorimotor experience. Both domains were dominated by vision and, to a lesser extent, head movements, but concrete categories were more grounded in touch and hand-arm action, while abstract categories were more grounded in hearing and interoception. Importantly, this pattern of grounding was not uniform, and subdomains of concrete (e.g. ingestibles, animates, natural categories and artefacts) and abstract (e.g. internal, social and non-social) categories were grounded in different profiles of sensorimotor experience. Overall, these findings suggest that the distinction between abstract and concrete categories is not as clearcut as ontological assumptions might suggest, and that the strength and diversity of sensorimotor grounding in abstract categories must not be underestimated. This article is part of the theme issue 'Concepts in interaction: social engagement and inner experiences'.

Deep brain stimulation of subthalamic nucleus modulates cortical auditory processing in advanced Parkinson’s Disease

Deep brain stimulation (DBS) has proven its clinical efficacy in Parkinson’s disease (PD), but its exact mechanisms and cortical effects continue to be unclear. Subthalamic (STN) DBS acutely modifies auditory evoked responses, but its long-term effect on auditory cortical processing remains ambiguous. We studied with magnetoencephalography the effect of long-term STN DBS on auditory processing in patients with advanced PD. DBS resulted in significantly increased contra-ipsilateral auditory response latency difference at ~100 ms after stimulus onset compared with preoperative state. The effect is likely due to normalization of neuronal asynchrony in the auditory pathways. The present results indicate that STN DBS in advanced PD patients has long-lasting effects on cortical areas outside those confined to motor processing. Whole-head magnetoencephalography provides a feasible tool to study motor and non-motor neural networks in PD, and to track possible changes related to cortical reorganization or plasticity induced by DBS.