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Chen Y, Qi Y, Li T, Lin A, Ni Y, Pu R, Sun B. A more objective PD diagnostic model: integrating texture feature markers of cerebellar gray matter and white matter through machine learning. Front Aging Neurosci 2024; 16:1393841. [PMID: 38912523 PMCID: PMC11190310 DOI: 10.3389/fnagi.2024.1393841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 05/27/2024] [Indexed: 06/25/2024] Open
Abstract
Objective The purpose of this study is to explore whether machine learning can be used to establish an effective model for the diagnosis of Parkinson's disease (PD) by using texture features extracted from cerebellar gray matter and white matter, so as to identify subtle changes that cannot be observed by the naked eye. Method This study involved a data collection period from June 2010 to March 2023, including 374 subjects from two cohorts. The Parkinson's Progression Markers Initiative (PPMI) served as the training set, with control group and PD patients (HC: 102 and PD: 102) from 24 global sites. Our institution's data was utilized as the test set (HC: 91 and PD: 79). Machine learning was employed to establish multiple models for PD diagnosis based on texture features of the cerebellum's gray and white matter. Results underwent evaluation through 5-fold cross-validation analysis, calculating the area under the receiver operating characteristic curve (AUC) for each model. The performance of each model was compared using the Delong test, and the interpretability of the optimized model was further augmented by employing Shapley additive explanations (SHAP). Results The AUCs for all pipelines in the validation dataset were compared using FeAture Explorer (FAE) software. Among the models established by Kruskal-Wallis (KW) and logistic regression via Lasso (LRLasso), the AUC was highest using the "one-standard error" rule. 'WM_original_glrlm_GrayLevelNonUniformity' was considered the most stable and predictive feature. Conclusion The texture features of cerebellar gray matter and white matter combined with machine learning may have potential value in the diagnosis of Parkinson's disease, in which the heterogeneity of white matter may be a more valuable imaging marker.
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Affiliation(s)
- Yini Chen
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yiwei Qi
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Tianbai Li
- Liaoning Provincial Key Laboratory for Research on the Pathogenic Mechanisms of Neurological Diseases, The First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Andong Lin
- Department of Neurology, Zhejiang Taizhou Municipal Hospital, Taizhou, Zhejiang, China
| | - Yang Ni
- Liaoning Provincial Key Laboratory for Research on the Pathogenic Mechanisms of Neurological Diseases, The First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Renwang Pu
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Bo Sun
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
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Subotic A, Gee M, Nelles K, Ba F, Dadar M, Duchesne S, Sharma B, Masellis M, Black SE, Almeida QJ, Smith EE, Pieruccini-Faria F, Montero-Odasso M, Camicioli R. Gray matter loss relates to dual task gait in Lewy body disorders and aging. J Neurol 2024; 271:962-975. [PMID: 37902878 DOI: 10.1007/s00415-023-12052-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 10/08/2023] [Indexed: 11/01/2023]
Abstract
BACKGROUND Within the spectrum of Lewy body disorders (LBD), both Parkinson's disease (PD) and dementia with Lewy bodies (DLB) are characterized by gait and balance disturbances, which become more prominent under dual-task (DT) conditions. The brain substrates underlying DT gait variations, however, remain poorly understood in LBD. OBJECTIVE To investigate the relationship between gray matter volume loss and DT gait variations in LBD. METHODS Seventy-nine participants including cognitively unimpaired PD, PD with mild cognitive impairment, PD with dementia (PDD), or DLB and 20 cognitively unimpaired controls were examined across a multi-site study. PDD and DLB were grouped together for analyses. Differences in gait speed between single and DT conditions were quantified by dual task cost (DTC). Cortical, subcortical, ventricle, and cerebellum brain volumes were obtained using FreeSurfer. Linear regression models were used to examine the relationship between gray matter volumes and DTC. RESULTS Smaller amygdala and total cortical volumes, and larger ventricle volumes were associated with a higher DTC across LBD and cognitively unimpaired controls. No statistically significant interaction between group and brain volumes were found. Adding cognitive and motor covariates or white matter hyperintensity volumes separately to the models did not affect brain volume and DTC associations. CONCLUSION Gray matter volume loss is associated with worse DT gait performance compared to single task gait, across cognitively unimpaired controls through and the LBD spectrum. Impairment in DT gait performance may be driven by age-related cortical neurodegeneration.
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Affiliation(s)
- Arsenije Subotic
- Department of Medicine, Division of Neurology, University of Alberta, 7-112J CSB, 11350-83 Ave NW, Edmonton, AB, T6G 2G3, Canada
| | - Myrlene Gee
- Department of Medicine, Division of Neurology, University of Alberta, 7-112J CSB, 11350-83 Ave NW, Edmonton, AB, T6G 2G3, Canada
| | - Krista Nelles
- Department of Medicine, Division of Neurology, University of Alberta, 7-112J CSB, 11350-83 Ave NW, Edmonton, AB, T6G 2G3, Canada
| | - Fang Ba
- Department of Medicine, Division of Neurology, University of Alberta, 7-112J CSB, 11350-83 Ave NW, Edmonton, AB, T6G 2G3, Canada
- Neuroscience and Mental Health Institute (NMHI), University of Alberta, Edmonton, AB, Canada
| | - Mahsa Dadar
- Department of Psychiatry, Douglas Mental Health University Health Centre, McGill University, Montreal, QC, Canada
| | - Simon Duchesne
- Department of Radiology and Nuclear Medicine, Faculty of Medicine, Laval University, Quebec City, QC, Canada
- CERVO Brain Research Center, Quebec City, QC, Canada
| | - Breni Sharma
- Cumming School of Medicine, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Mario Masellis
- Department of Medicine (Division of Neurology), University of Toronto, Toronto, ON, Canada
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Sandra E Black
- Department of Medicine (Division of Neurology), University of Toronto, Toronto, ON, Canada
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Quincy J Almeida
- Movement Disorders Research and Rehabilitation Centre, Carespace Health and Wellness, Waterloo, ON, Canada
| | - Eric E Smith
- Cumming School of Medicine, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
| | - Frederico Pieruccini-Faria
- Gait and Brain Lab, Parkwood Institute Lawson Health Research Institute, London, ON, Canada
- Department of Medicine and Division of Geriatric Medicine, Schulich School of Medicine and Dentistry, London, ON, Canada
| | - Manuel Montero-Odasso
- Gait and Brain Lab, Parkwood Institute Lawson Health Research Institute, London, ON, Canada
- Department of Medicine and Division of Geriatric Medicine, Schulich School of Medicine and Dentistry, London, ON, Canada
- Schulich School of Medicine and Dentistry, Department of Epidemiology and Biostatistics, University of Western Ontario, London, ON, Canada
| | - Richard Camicioli
- Department of Medicine, Division of Neurology, University of Alberta, 7-112J CSB, 11350-83 Ave NW, Edmonton, AB, T6G 2G3, Canada.
- Neuroscience and Mental Health Institute (NMHI), University of Alberta, Edmonton, AB, Canada.
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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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Regional cortical hypoperfusion and atrophy correlate with striatal dopaminergic loss in Parkinson's disease: a study using arterial spin labeling MR perfusion. Neuroradiology 2023; 65:569-577. [PMID: 36376524 DOI: 10.1007/s00234-022-03085-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 11/08/2022] [Indexed: 11/15/2022]
Abstract
PURPOSE To investigate the relationship of the striatal dopamine transporter density to changes in the gray matter (GM) volume and cerebral perfusion in patients with Parkinson's disease (PD). METHODS We evaluated the regional cerebral blood flow (CBF) and GM volume, concurrently measured using arterial spin labeling and T1-weighted magnetic resonance imaging, respectively, as well as the striatal specific binding ratio (SBR) in 123I-N-ω-fluoropropyl-2β-carboxymethoxy-3β-(4-iodophenyl)nortropane (123I-FP-CIT) single-photon emission computed tomography in 30 non-demented patients with PD (15 men and 15 women; mean age, 67.2 ± 8.8 years; mean Hoehn-Yahr stage, 2.2 ± 0.9). Voxel-wise regression analyses using statistical parametric mapping (SPM) were performed to explore the brain regions that showed correlations of the striatal SBR to the GM volume and CBF, respectively, with a height threshold of p < 0.0005 at the voxel level and p < 0.05 family-wise error-corrected at the cluster level. RESULTS SPM analysis showed a significant positive correlation between the SBR and GM volume in the inferior frontal gyrus (IFG). Whereas, a positive correlation between the SBR and CBF was widely found in the frontotemporal and parietotemporal regions, including the IFG. Notably, the opercular part of the IFG showed significant correlations in both SPM analyses of the GM volume (r2 = 0.90, p < 0.0001) and CBF (r2 = 0.88, p < 0.0001). CONCLUSION The voxel-wise analyses revealed the brain regions, mainly the IFG, that showed hypoperfusion and atrophy related to dopaminergic loss, which suggests that the progression of dopaminergic neurodegeneration leads to regional cortical dysfunction in PD.
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Clausi S, Siciliano L, Olivito G, Leggio M. Cerebellum and Emotion in Social Behavior. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1378:235-253. [PMID: 35902475 DOI: 10.1007/978-3-030-99550-8_15] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Accumulating evidence suggests that the cerebellum plays a crucial role not only in the motor and cognitive domains but also in emotions and social behavior. In the present chapter, after a general introduction on the significance of the emotional components of social behavior, we describe recent efforts to understand the contributions of the cerebellum in social cognition focusing on the emotional and affective aspects. Specifically, starting from the description of the cerebello-cortical networks subtending the social-affective domains, we illustrate the most recent findings on the social cerebellum and the possible functional mechanisms by which the cerebellum modulate social-affective behavior. Finally, we discuss the possible consequences of cerebellar dysfunction in the social-affective domain, focusing on those neurological and psychopathological conditions in which emotional and social behavior difficulties have been described as being associated with cerebellar structural or functional alterations.
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Affiliation(s)
- Silvia Clausi
- Ataxia Laboratory, Santa Lucia Foundation IRCCS, Rome, Italy. .,Psychology Department, Sapienza University, Rome, Italy.
| | - Libera Siciliano
- Ataxia Laboratory, Santa Lucia Foundation IRCCS, Rome, Italy.,Psychology Department, Sapienza University, Rome, Italy
| | - Giusy Olivito
- Ataxia Laboratory, Santa Lucia Foundation IRCCS, Rome, Italy.,Psychology Department, Sapienza University, Rome, Italy
| | - Maria Leggio
- Ataxia Laboratory, Santa Lucia Foundation IRCCS, Rome, Italy.,Psychology Department, Sapienza University, Rome, Italy
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6
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Zheng JH, Sun WH, Ma JJ, Wang ZD, Chang QQ, Dong LR, Shi XX, Li MJ, Gu Q, Chen SY, Li DS. Differences in neuroanatomy and functional connectivity between motor subtypes of Parkinson’s disease. Front Neurosci 2022; 16:905709. [PMID: 35937868 PMCID: PMC9354573 DOI: 10.3389/fnins.2022.905709] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 07/04/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe “postural instability/gait difficulty” (PIGD) and “tremor-dominant” (TD) motor subtypes of Parkinson’s disease (PD) differ in their clinical manifestations. The neurological basis of these differences is unclear.MethodsWe performed voxel-based morphometric analysis and measured amplitudes of low-frequency fluctuation (ALFF) on 87 PIGD patients and 51 TD patients. We complemented this neuroanatomical comparison with seed-to-voxel analysis to explore differences in functional connectivity.ResultsThe PIGD group showed significantly smaller gray matter volume in the medial frontal gyrus (mainly on the right side) than the TD group. Across all patients, gray matter volume in the medial frontal gyrus correlated negatively with severity of PIGD symptoms after controlling for age (r = −0.250, p = 0.003), but this correlation was not observed in separate analyses of only PIGD or TD patients. The PIGD group showed greater functional connectivity of the right superior frontal gyrus with the left lingual gyrus, right lateral occipital cortex, and right lingual gyrus. ALFF did not differ significantly between the two groups.ConclusionPostural instability/gait difficulty may be associated with smaller gray matter volume in medial frontal gyrus than TD, as well as with greater functional connectivity between the right superior frontal gyrus and occipital cortex. These results may help explain the clinical differences between the two motor subtypes of PD.
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Affiliation(s)
- Jin Hua Zheng
- Department of Neurology, Henan Provincial People’s Hospital, Zhengzhou, China
- Department of Neurology, People’s Hospital of Zhengzhou University, Zhengzhou, China
- Department of Neurology, People’s Hospital of Henan University, Zhengzhou, China
| | - Wen Hua Sun
- Department of Neurology, Henan Provincial People’s Hospital, Zhengzhou, China
- Department of Neurology, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Jian Jun Ma
- Department of Neurology, Henan Provincial People’s Hospital, Zhengzhou, China
- Department of Neurology, People’s Hospital of Zhengzhou University, Zhengzhou, China
- Department of Neurology, People’s Hospital of Henan University, Zhengzhou, China
- *Correspondence: Jian Jun Ma,
| | - Zhi Dong Wang
- Department of Neurology, Henan Provincial People’s Hospital, Zhengzhou, China
- Department of Neurology, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Qing Qing Chang
- Department of Neurology, Henan Provincial People’s Hospital, Zhengzhou, China
- Department of Neurology, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Lin Rui Dong
- Department of Neurology, Henan Provincial People’s Hospital, Zhengzhou, China
- Department of Neurology, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiao Xue Shi
- Department of Neurology, Henan Provincial People’s Hospital, Zhengzhou, China
- Department of Neurology, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Ming Jian Li
- Department of Neurology, Henan Provincial People’s Hospital, Zhengzhou, China
- Department of Neurology, People’s Hospital of Henan University, Zhengzhou, China
| | - Qi Gu
- Department of Neurology, Henan Provincial People’s Hospital, Zhengzhou, China
- Department of Neurology, People’s Hospital of Zhengzhou University, Zhengzhou, China
- Department of Neurology, People’s Hospital of Henan University, Zhengzhou, China
| | - Si Yuan Chen
- Department of Neurology, Henan Provincial People’s Hospital, Zhengzhou, China
- Department of Neurology, People’s Hospital of Zhengzhou University, Zhengzhou, China
- Department of Neurology, People’s Hospital of Henan University, Zhengzhou, China
| | - Dong Sheng Li
- Department of Neurology, Henan Provincial People’s Hospital, Zhengzhou, China
- Department of Neurology, People’s Hospital of Zhengzhou University, Zhengzhou, China
- Department of Neurology, People’s Hospital of Henan University, Zhengzhou, China
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7
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Piras F, Vecchio D, Assogna F, Pellicano C, Ciullo V, Banaj N, Edden RAE, Pontieri FE, Piras F, Spalletta G. Cerebellar GABA Levels and Cognitive Interference in Parkinson's disease and Healthy Comparators. J Pers Med 2020; 11:jpm11010016. [PMID: 33379134 PMCID: PMC7823866 DOI: 10.3390/jpm11010016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 12/14/2020] [Accepted: 12/24/2020] [Indexed: 01/30/2023] Open
Abstract
The neuroanatomical and molecular substrates for cognitive impairment in Parkinson Disease (PD) are far from clear. Evidence suggests a non-dopaminergic basis, and a crucial role for cerebellum in cognitive control in PD. We investigated whether a PD cognitive marker (response inhibition) was differently controlled by g-amino butyric acid (GABA) and/or by glutamate-glutamine (Glx) levels in the cerebellum of idiopathic PD patients, and healthy comparators (HC). Magnetic resonance spectroscopy of GABA/Glx (MEGA-PRESS acquisition sequence) was performed at 3 Tesla, and response inhibition assessed by the Stroop Word-Color Test (SWCT) and the Wisconsin Card Sorting Test (WCST). Linear correlations between cerebellar GABA/Glx levels, SWCT time/error interference effects and WCST perseverative errors were performed to test differences between correlation coefficients in PD and HC. Results showed that higher levels of mean cerebellar GABA were associated to SWCT increased time and error interference effects in PD, and the contrary in HC. Such effect dissociated by hemisphere, while correlation coefficients differences were significant in both right and left cerebellum. We conclude that MRS measured levels of cerebellar GABA are related in PD patients with decreased efficiency in filtering task-irrelevant information. This is crucial for developing pharmacological treatments for PD to potentially preserve cognitive functioning.
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Affiliation(s)
- Federica Piras
- Neuropsychiatry Laboratory, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Via Ardeatina 306/354, 00179 Rome, Italy; (F.P.); (D.V.); (F.A.); (C.P.); (V.C.); (N.B.); (F.P.)
| | - Daniela Vecchio
- Neuropsychiatry Laboratory, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Via Ardeatina 306/354, 00179 Rome, Italy; (F.P.); (D.V.); (F.A.); (C.P.); (V.C.); (N.B.); (F.P.)
| | - Francesca Assogna
- Neuropsychiatry Laboratory, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Via Ardeatina 306/354, 00179 Rome, Italy; (F.P.); (D.V.); (F.A.); (C.P.); (V.C.); (N.B.); (F.P.)
| | - Clelia Pellicano
- Neuropsychiatry Laboratory, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Via Ardeatina 306/354, 00179 Rome, Italy; (F.P.); (D.V.); (F.A.); (C.P.); (V.C.); (N.B.); (F.P.)
| | - Valentina Ciullo
- Neuropsychiatry Laboratory, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Via Ardeatina 306/354, 00179 Rome, Italy; (F.P.); (D.V.); (F.A.); (C.P.); (V.C.); (N.B.); (F.P.)
| | - Nerisa Banaj
- Neuropsychiatry Laboratory, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Via Ardeatina 306/354, 00179 Rome, Italy; (F.P.); (D.V.); (F.A.); (C.P.); (V.C.); (N.B.); (F.P.)
| | - Richard A. E. Edden
- Department of Radiology, Kennedy Krieger Institute 707 North Broadway, Johns Hopkins University, Baltimore, MD 21205, USA;
| | - Francesco E. Pontieri
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), “Sant’Andrea” University Hospital, via di Grottarossa 1035-1037, 00189 Rome, Italy;
| | - Fabrizio Piras
- Neuropsychiatry Laboratory, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Via Ardeatina 306/354, 00179 Rome, Italy; (F.P.); (D.V.); (F.A.); (C.P.); (V.C.); (N.B.); (F.P.)
| | - Gianfranco Spalletta
- Neuropsychiatry Laboratory, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Via Ardeatina 306/354, 00179 Rome, Italy; (F.P.); (D.V.); (F.A.); (C.P.); (V.C.); (N.B.); (F.P.)
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1977 Butler Blvd., Houston, TX 77030, USA
- Correspondence: ; Tel.: +39-06-51501575
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8
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Vascular Inflammation Is a Risk Factor Associated with Brain Atrophy and Disease Severity in Parkinson's Disease: A Case-Control Study. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2020; 2020:2591248. [PMID: 32733633 PMCID: PMC7376437 DOI: 10.1155/2020/2591248] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 05/04/2020] [Accepted: 06/01/2020] [Indexed: 12/14/2022]
Abstract
Introduction Systemic inflammation with elevated oxidative stress causing neuroinflammation is considered a major factor in the pathogenesis of Parkinson's disease (PD). The interface between systemic circulation and the brain parenchyma is the blood-brain barrier (BBB), which also plays a role in maintaining neurovascular homeostasis. Vascular cell adhesion molecule-1 (VCAM-1) and microRNAs (miRNAs) regulate brain vessel endothelial function, neoangiogenesis, and, in turn, neuronal homeostasis regulation, such that their dysregulation can result in neurodegeneration, such as gray matter atrophy, in PD. Objective Our aim was to evaluate the associations among specific levels of gray matter atrophy, peripheral vascular adhesion molecules, miRNAs, and clinical disease severity in order to achieve a clearer understanding of PD pathogenesis. Methods Blood samples were collected from 33 patients with PD and 27 healthy volunteers, and the levels of VCAM-1 and several miRNAs in those samples were measured. Voxel-based morphometry (VBM) analysis was performed using 3 T magnetic resonance imaging (MRI) and SPM (Statistical Parametric Mapping software program). The associations among the vascular parameter, miRNAs, gray matter volume, and clinical disease severity measurements were evaluated by partial correlation analysis. Results The levels of VCAM-1, miRNA-22, and miRNA-29a expression were significantly elevated in the PD patients. The gray matter volume atrophy in the left parahippocampus, bilateral posterior cingulate gyrus, fusiform gyrus, left temporal gyrus, and cerebellum was significantly correlated with increased clinical disease severity, the upregulation of miRNA levels, and increased vascular inflammation. Conclusion Patients with PD seem to have abnormal levels of vascular inflammatory markers and miRNAs in the peripheral circulation, and these levels are correlated with specific brain volume changes. This study reinforces the associations among peripheral inflammation, the BBB interface, and gray matter atrophy in PD and further demonstrates that BBB dysfunction with neurovascular impairment may play an important role in PD progression.
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9
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Food knowledge depends upon the integrity of both sensory and functional properties: a VBM, TBSS and DTI tractography study. Sci Rep 2019; 9:7439. [PMID: 31092880 PMCID: PMC6520382 DOI: 10.1038/s41598-019-43919-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 04/12/2019] [Indexed: 11/30/2022] Open
Abstract
Food constitutes a fuel of life for human beings. It is therefore of chief importance that their recognition system readily identifies the most relevant properties of food by drawing on semantic memory. One of the most relevant properties to be considered is the level of processing impressed by humans on food. We hypothesized that recognition of raw food capitalizes on sensory properties and that of transformed food on functional properties, consistently with the hypothesis of a sensory-functional organization of semantic knowledge. To test this hypothesis, patients with Alzheimer’s disease, frontotemporal dementia, primary progressive aphasia, and healthy controls performed lexical-semantic tasks with food (raw and transformed) and non-food (living and nonliving) stimuli. Correlations between task performance and local grey matter concentration (VBM) and white matter fractional anisotropy (TBSS) led to two main findings. First, recognition of raw food and living things implicated occipital cortices, typically involved in processing sensory information and, second, recognition of processed food and nonliving things implicated the middle temporal gyrus and surrounding white matter tracts, regions that have been associated with functional properties. In conclusion, the present study confirms and extends the hypothesis of a sensory and a functional organization of semantic knowledge.
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10
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Xu S, He XW, Zhao R, Chen W, Qin Z, Zhang J, Ban S, Li GF, Shi YH, Hu Y, Zhuang MT, Liu YS, Shen XL, Li J, Liu JR, Du X. Cerebellar functional abnormalities in early stage drug-naïve and medicated Parkinson's disease. J Neurol 2019; 266:1578-1587. [PMID: 30923933 DOI: 10.1007/s00415-019-09294-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 03/18/2019] [Accepted: 03/21/2019] [Indexed: 12/27/2022]
Abstract
Parkinson's disease (PD) is a progressive neurological degenerative disorder characterized by impaired motor function and non-motor dysfunctions. While recent studies have highlighted the role of the cerebellum in PD, our understanding of its role in PD remains limited. In the present study, we used resting-state fMRI to evaluate dysfunctions within the cerebellum in PD patients treated with medication and drug-naïve PD patients. We applied amplitude of low-frequency fluctuation (ALFF) and degree centrality (DC) analysis methods. Thirty-one patients with early stage PD (22 drug-naïve and 9 medicated patients) and 31 gender- and age-matched healthy controls were recruited in this study. ALFFs increased in the left cerebellar areas (lobules VI/VIIb/CruI/CruII and the dentate gyrus) and right cerebellar areas (lobules VI/VIIb/VIIIa/CruI/CruII and the dentate gyrus) of all PD patients and in the left and right cerebellar areas (lobules VI/VIIb/CruI and the dentate gyrus) of drug-naive PD patients but were not significantly changed in medicated PD patients. DC increased in the right cerebellar areas of all PD patients and medicated PD patients. All PD patients and all drug-naive PD patients showed significantly weaker functional connectivity (FC) between the left cerebellum and the left medial frontal gyrus. However, FC was significantly stronger between the right cerebellum and the left precentral and right middle occipital gyri in the medicated PD patients than in controls. Furthermore, a correlation analyses revealed that ALFF z scores in the left cerebellum (lobule VI) and right cerebellum (lobule VI/CruI and dentate gyrus) were negatively correlated with Mini-Mental State Examination (MMSE) scores in all PD patients and drug-naive patients. These results indicate that the cerebellum plays an important role in PD, mainly by exerting a compensatory effect in early stage PD. Additionally, antiparkinsonian medication would modified PD-induced changes in local neural activity and FC in PD patients. The results of this study offer novel insights into the roles of the cerebellum in early stage drug-naïve PD.
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Affiliation(s)
- Shuai Xu
- Shanghai Key Laboratory of Magnetic Resonance and Department of Physics, School of Physics and Materials Science, East China Normal University, 3663 North Zhong-Shan Road, Shanghai, 200062, People's Republic of China
| | - Xin-Wei He
- Department of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China.,Clinical Research Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, People's Republic of China
| | - Rong Zhao
- Department of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China.,Clinical Research Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, People's Republic of China
| | - Wei Chen
- Department of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China
| | - Zhaoxia Qin
- Shanghai Key Laboratory of Magnetic Resonance and Department of Physics, School of Physics and Materials Science, East China Normal University, 3663 North Zhong-Shan Road, Shanghai, 200062, People's Republic of China
| | - Jilei Zhang
- Shanghai Key Laboratory of Magnetic Resonance and Department of Physics, School of Physics and Materials Science, East China Normal University, 3663 North Zhong-Shan Road, Shanghai, 200062, People's Republic of China
| | - Shiyu Ban
- Shanghai Key Laboratory of Magnetic Resonance and Department of Physics, School of Physics and Materials Science, East China Normal University, 3663 North Zhong-Shan Road, Shanghai, 200062, People's Republic of China
| | - Ge-Fei Li
- Department of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China.,Clinical Research Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, People's Republic of China
| | - Yan-Hui Shi
- Department of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China.,Clinical Research Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, People's Republic of China
| | - Yue Hu
- Department of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China.,Clinical Research Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, People's Republic of China
| | - Mei-Ting Zhuang
- Department of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China
| | - Yi-Sheng Liu
- Department of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China
| | - Xiao-Lei Shen
- Department of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China
| | - Jianqi Li
- Shanghai Key Laboratory of Magnetic Resonance and Department of Physics, School of Physics and Materials Science, East China Normal University, 3663 North Zhong-Shan Road, Shanghai, 200062, People's Republic of China
| | - Jian-Ren Liu
- Department of Neurology and Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China. .,Clinical Research Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, People's Republic of China.
| | - Xiaoxia Du
- Shanghai Key Laboratory of Magnetic Resonance and Department of Physics, School of Physics and Materials Science, East China Normal University, 3663 North Zhong-Shan Road, Shanghai, 200062, People's Republic of China.
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11
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Cai X, Qiao J, Knox T, Iriah S, Kulkarni P, Madularu D, Morrison T, Waszczak B, Hartner JC, Ferris CF. In search of early neuroradiological biomarkers for Parkinson’s Disease: Alterations in resting state functional connectivity and gray matter microarchitecture in PINK1 −/− rats. Brain Res 2019; 1706:58-67. [DOI: 10.1016/j.brainres.2018.10.033] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 10/29/2018] [Accepted: 10/30/2018] [Indexed: 12/12/2022]
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12
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Suo X, Lei D, Cheng L, Li N, Zuo P, Wang DJJ, Huang X, Lui S, Kemp GJ, Peng R, Gong Q. Multidelay multiparametric arterial spin labeling perfusion MRI and mild cognitive impairment in early stage Parkinson's disease. Hum Brain Mapp 2018; 40:1317-1327. [PMID: 30548099 DOI: 10.1002/hbm.24451] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 10/12/2018] [Accepted: 10/16/2018] [Indexed: 02/05/2023] Open
Abstract
Mild cognitive impairment (MCI), a well-defined nonmotor manifestation of Parkinson's disease (PD), greatly impairs functioning and quality of life. However, the contribution of cerebral perfusion, quantified by arterial spin labeling (ASL), to MCI in PD remains poorly understood. The selection of an optimal delay time is difficult for single-delay ASL, a problem which is avoided by multidelay ASL. This study uses a multidelay multiparametric ASL to investigate cerebral perfusion including cerebral blood flow (CBF) and arterial transit time (ATT) in early stage PD patients exhibiting MCI using a voxel-based brain analysis. Magnetic resonance imaging data were acquired on a 3.0 T system at rest in 39 early stage PD patients either with MCI (PD-MCI, N = 22) or with normal cognition (PD-N, N = 17), and 36 age- and gender-matched healthy controls (HCs). CBF and ATT were compared among the three groups with SPM using analysis of variance followed by post hoc analyses to define regional differences and examine their relationship to clinical data. PD-MCI showed prolonged ATT in right thalamus compared to both PD-N and HC, and in right supramarginal gyrus compared to HC. PD-N showed shorter ATT in left superior frontal cortex compared to HC. Prolonged ATT in right thalamus was negatively correlated with the category fluency test (p = .027, r = -0.495) in the PD-MCI group. This study shows that ATT may be a more sensitive marker than CBF for the MCI, and highlights the potential role of thalamus and inferior parietal region for MCI in early stage PD.
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Affiliation(s)
- Xueling Suo
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Du Lei
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.,Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Lan Cheng
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Nannan Li
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Panli Zuo
- MR Collaborations NE Asia, Siemens Healthcare, Beijing, China
| | - Danny J J Wang
- Department of Neurology, University of California, Los Angeles, California
| | - Xiaoqi Huang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Su Lui
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Graham J Kemp
- Liverpool Magnetic Resonance Imaging Centre (LiMRIC) and Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, United Kingdom
| | - Rong Peng
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
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13
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Defining visual illusions in Parkinson's disease: Kinetopsia and object misidentification illusions. Parkinsonism Relat Disord 2018; 55:111-116. [DOI: 10.1016/j.parkreldis.2018.05.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 05/17/2018] [Accepted: 05/27/2018] [Indexed: 01/29/2023]
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14
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Considering total intracranial volume and other nuisance variables in brain voxel based morphometry in idiopathic PD. Brain Imaging Behav 2018; 12:1-12. [PMID: 28070745 DOI: 10.1007/s11682-016-9656-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Voxel-based morphometry (VBM) studies of Parkinson's disease (PD), have yielded mixed results, possibly due to several studies not accounting for common nuisance variables (age, sex, and total intracranial volume [TICV]). TICV is particularly important because there is evidence for larger TICV in PD. We explored the influence of these covariates on VBM by 1) comparing PD patients and controls before adding covariates, after adding age and sex, and after adding age, sex and TICV, and 2) by comparing controls split into large and small TICV before and after controlling for TICV, with age and sex accounted for in both analyses. Experiment 1 consisted of 40 PD participants and 40 controls. Experiment 2 consisted of 88 controls median split by TICV. All participants completed an MRI on a 3 T scanner. TICV was calculated as gray + white + CSF from Freesurfer. VBM was performed on T1 images using an optimized VBM protocol. Volume differences were assessed using a voxel-wise GLM analysis. Clusters were considered significant at >10 voxels and p < .05 corrected for familywise error. Before controlling for covariates, PD showed reduced GM in temporal, occipital, and cerebellar regions. Controlling for age and sex did not affect the pattern of significance. Controlling for TICV reduced the size of the significant region although it still contained portions of bilateral temporal lobes, occipital lobes and cerebellum. The large TICV group showed reduced volume in temporal, parietal, and cerebellar areas. None of these differences survived controlling for TICV. This demonstrates that TICV influences VBM results independently from other factors. Controlling for TICV in VBM studies is recommended.
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15
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Li Y, Wang SM, Guo L, Zhu J, Wang Y, Li L, Zhao YX. Effects of Melatonin Levels on Neurotoxicity of the Medial Prefrontal Cortex in a Rat Model of Parkinson's Disease. Chin Med J (Engl) 2018; 130:2726-2731. [PMID: 29133763 PMCID: PMC5695060 DOI: 10.4103/0366-6999.218025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Damage of the medial prefrontal cortex (mPFC) results in similar characteristics to the cognitive deficiency seen with the progress of Parkinson's disease (PD). Since the course of mPFC damage is still unclear, our study aimed to investigate the effects of melatonin (MT) on neurotoxicity in the mPFC of a rat model of PD. Methods: One hundred and fifty-four normal, male Wistar rats were randomly divided into the following five groups: normal + normal saline (NS), normal + 6-hydroxydopamine (6-OHDA), sham pinealectomy (PX) + 6-OHDA, PX + 6-OHDA, and MT + 6-OHDA. 6-OHDA was injected into the right substantia nigra pars compacta (SNc) and ventral tegmental area (VTA) of each group, except normal + NS, 60 days after the PX. In the MT treatment group, MT was administered immediately after the intraperitoneal injection at 4 p.m. every day, for 14 days. Neuronal apoptosis in the mPFC was examined using the TUNEL method, while the expression of tyrosine hydroxylase (TH), Bax, and Bcl-2 in this region was measured using immunohistochemistry. The concentration of malondialdehyde (MDA) in the mPFC was examined using the thiobarbituric acid method. Results: Rats in the normal + 6-OHDA and sham PX + 6-OHDA groups were combined into one group (Group N + 6-OHDA) since there was no significant discrepancy between the groups for all the detected parameters. Apoptosis of cells in the NS, MT + 6-OHDA, N + 6-OHDA, and PX + 6-OHDA groups was successively significantly increased (Hc = 256.25, P < 0.001). The gray value of TH (+) fibers in the NS, MT + 6-OHDA, N + 6-OHDA, and PX + 6-OHDA groups was also successively significantly increased (F = 99.33, P < 0.001). The staining intensities of Bax and Bcl-2 were as follows: Group NS +/+, Group MT + 6-OHDA ++/+, Group N + 6-OHDA ++/+, and PX + 6-OHDA +++/+. The concentrations of MDA in the NS, MT + 6-OHDA, N + 6-OHDA, and PX + 6-OHDA groups were significantly increased in sequence (Hc = 296.309, P < 0.001). Conclusions: Neuronal damage of the VTA by 6-OHDA might induce VTA-mPFC nerve fibers to undergo anterograde nerve damage, in turn inducing transneuronal damage of the mPFC. PX significantly exacerbated the neurotoxicity in the mPFC, which was induced by the neuronal injury of the VTA. However, MT replacement therapy significantly alleviated the neurotoxicity in the mPFC.
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Affiliation(s)
- Yan Li
- Department of Neurology, Jinan Central Hospital Affiliated to Shandong University, Jinan, Shandong 250013, China
| | - Shu-Mei Wang
- General Medical Teaching and Research Section, Jinan Central Hospital Affiliated to Shandong University, Jinan, Shandong 250013, China
| | - Lei Guo
- Department of Medical Imaging, Jinan Central Hospital Affiliated to Shandong University, Jinan, Shandong 250013, China
| | - Jian Zhu
- Department of Medical Imaging, Shandong Provincial Hospital, Jinan, Shandong 250014, China
| | - Ying Wang
- Department of Medical Imaging, Jinan Central Hospital Affiliated to Shandong University, Jinan, Shandong 250013, China
| | - Lei Li
- Department of Neurology, Jinan Central Hospital Affiliated to Shandong University, Jinan, Shandong 250013, China
| | - Yan-Xin Zhao
- Department of Neurology, Jinan Central Hospital Affiliated to Shandong University, Jinan, Shandong 250013, China
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16
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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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Kübel S, Stegmayer K, Vanbellingen T, Walther S, Bohlhalter S. Deficient supplementary motor area at rest: Neural basis of limb kinetic deficits in Parkinson's disease. Hum Brain Mapp 2018; 39:3691-3700. [PMID: 29722099 DOI: 10.1002/hbm.24204] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 04/16/2018] [Accepted: 04/23/2018] [Indexed: 12/14/2022] Open
Abstract
Parkinson's disease (PD) patients frequently suffer from limb kinetic apraxia (LKA) affecting quality of life. LKA denotes an impairment of precise and independent finger movements beyond bradykinesia, which is reliably assessed by coin rotation (CR) task. BOLD fMRI detected activation of a left inferior parietal-premotor praxis network in PD during CR. Here, we explored which network site is most critical for LKA using arterial spin labeling (ASL). Based on a hierarchical model, we hypothesized that LKA would predominantly affect the functional integrity of premotor areas including supplementary motor areas (SMA). Furthermore, we suspected that for praxis function with higher demand on temporal-spatial processing such as gesturing, inferior parietal lobule (IPL) upstream to premotor areas would be essential. A total of 21 PD patients and 20 healthy controls underwent ASL acquisition during rest. Behavioral assessment outside the scanner involved the CR, finger tapping task, and the test of upper limb apraxia (TULIA). Whole-brain analysis of activity at rest showed a significant reduction of CR-related perfusion in the left SMA of PD. Furthermore, the positive correlation between SMA perfusion and CR, seen in controls, was lost in patients. By contrast, TULIA was significantly associated with the perfusion of left IPL in both patients and controls. In conclusion, the findings suggest that LKA in PD are linked to an intrinsic disruption of the left SMA function, which may only be overcome by compensatory network activation. In addition, gestural performance relies on IPL which remains available for functional recruitment in early PD.
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Affiliation(s)
- Stefanie Kübel
- Neurocenter, Luzerner Kantonsspital, Spitalstrasse 31, Luzern 16, 6000, Switzerland
| | - Katharina Stegmayer
- University Hospital of Psychiatry, Bolligenstrasse 111, Bern 60, 3000, Switzerland
| | - Tim Vanbellingen
- Neurocenter, Luzerner Kantonsspital, Spitalstrasse 31, Luzern 16, 6000, Switzerland.,Gerontechnology and Rehabilitation Group, University of Bern, Murtenstrasse 50, Bern, 3008, Switzerland
| | - Sebastian Walther
- University Hospital of Psychiatry, Bolligenstrasse 111, Bern 60, 3000, Switzerland
| | - Stephan Bohlhalter
- Neurocenter, Luzerner Kantonsspital, Spitalstrasse 31, Luzern 16, 6000, Switzerland.,Department of Clinical Research, University of Bern, Bern, 3000, Switzerland
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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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Gu Q, Zhang H, Xuan M, Luo W, Huang P, Xia S, Zhang M. Automatic Classification on Multi-Modal MRI Data for Diagnosis of the Postural Instability and Gait Difficulty Subtype of Parkinson's Disease. JOURNAL OF PARKINSONS DISEASE 2017; 6:545-56. [PMID: 27176623 DOI: 10.3233/jpd-150729] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Patients with the postural instability and gait difficulty subtype (PIGD) of Parkinson's disease (PD) are a refractory challenge in clinical practice. Despite previous attempts that have been made at studying subtype-specific brain alterations across PD population, conclusive neuroimaging biomarkers on patients with the PIGD subtype are still lacking. Machine learning-based classifications are a promising tool for differential diagnosis that effectively integrate complex and multivariate data. OBJECTIVE Our present study aimed to introduce the machine learning-based automatic classification for the first time to distinguish patients with the PIGD subtype from those with the non-PIGD subtype of PD at the individual level. METHODS Fifty-two PD patients and forty-five normal controls (NCs) were recruited and underwent multi-modal MRI scans including a set of resting-state functional, 3D T1-weighted and diffusion tensor imaging sequences. By comparing the PD patients with the NCs, features that were not conducive to the subtype-specific classification were ruled out from massive brain features. We applied a support vector machine classifier with the recursive feature elimination method to multi-modal MRI data for selecting features with the best discriminating power, and evaluated the proposed classifier with the leave-one-out cross-validation. RESULTS Using this classifier, we obtained satisfactory diagnostic rates (accuracy = 92.31%, specificity = 96.97%, sensitivity = 84.21% and AUCmax = 0.9585). The diagnostic agreement evaluated by the Kappa test showed an almost perfect agreement with the existing clinical categorization (Kappa value = 0.83). CONCLUSIONS With these favorable results, our findings suggested the machine learning-based classification as an alternative technique to classifying clinical subtypes in PD.
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Affiliation(s)
- Quanquan Gu
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Huan Zhang
- Key Laboratory of Biomedical Engineering of Ministry of Education, Zhejiang University, Hangzhou, China.,Zhejiang Provincial Key Laboratory of Cardio-Cerebral Vascular Detection Technology and Medicinal Effectiveness Appraisal, Zhejiang University, Hangzhou, China
| | - Min Xuan
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wei Luo
- Department of Neurology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Peiyu Huang
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Shunren Xia
- Key Laboratory of Biomedical Engineering of Ministry of Education, Zhejiang University, Hangzhou, China.,Zhejiang Provincial Key Laboratory of Cardio-Cerebral Vascular Detection Technology and Medicinal Effectiveness Appraisal, Zhejiang University, Hangzhou, China
| | - Minming Zhang
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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20
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Heim B, Krismer F, De Marzi R, Seppi K. Magnetic resonance imaging for the diagnosis of Parkinson's disease. J Neural Transm (Vienna) 2017; 124:915-964. [PMID: 28378231 PMCID: PMC5514207 DOI: 10.1007/s00702-017-1717-8] [Citation(s) in RCA: 134] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 03/22/2017] [Indexed: 12/11/2022]
Abstract
The differential diagnosis of parkinsonian syndromes is considered one of the most challenging in neurology and error rates in the clinical diagnosis can be high even at specialized centres. Despite several limitations, magnetic resonance imaging (MRI) has undoubtedly enhanced the diagnostic accuracy in the differential diagnosis of neurodegenerative parkinsonism over the last three decades. This review aims to summarize research findings regarding the value of the different MRI techniques, including advanced sequences at high- and ultra-high-field MRI and modern image analysis algorithms, in the diagnostic work-up of Parkinson's disease. This includes not only the exclusion of alternative diagnoses for Parkinson's disease such as symptomatic parkinsonism and atypical parkinsonism, but also the diagnosis of early, new onset, and even prodromal Parkinson's disease.
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Affiliation(s)
- Beatrice Heim
- Department of Neurology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - Florian Krismer
- Department of Neurology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria.
| | - Roberto De Marzi
- Department of Neurology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - Klaus Seppi
- Department of Neurology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria.
- Neuroimaging Research Core Facility, Medical University Innsbruck, Innsbruck, Austria.
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21
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Structural changes in Parkinson's disease: voxel-based morphometry and diffusion tensor imaging analyses based on 123I-MIBG uptake. Eur Radiol 2017; 27:5073-5079. [PMID: 28677058 DOI: 10.1007/s00330-017-4941-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 06/02/2017] [Accepted: 06/09/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Patients with Parkinson's disease (PD) may exhibit symptoms of sympathetic dysfunction that can be measured using 123I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy. We investigated the relationship between microstructural brain changes and 123I-MIBG uptake in patients with PD using voxel-based morphometry (VBM) and diffusion tensor imaging (DTI) analyses. METHODS This retrospective study included 24 patients with PD who underwent 3 T magnetic resonance imaging and 123I-MIBG scintigraphy. They were divided into two groups: 12 MIBG-positive and 12 MIBG-negative cases (10 men and 14 women; age range: 60-81 years, corrected for gender and age). The heart/mediastinum count (H/M) ratio was calculated on anterior planar 123I-MIBG images obtained 4 h post-injection. VBM and DTI were performed to detect structural differences between these two groups. RESULTS Patients with low H/M ratio had significantly reduced brain volume at the right inferior frontal gyrus (uncorrected p < 0.0001, K > 90). Patients with low H/M ratios also exhibited significantly lower fractional anisotropy than those with high H/M ratios (p < 0.05) at the left anterior thalamic radiation, the left inferior fronto-occipital fasciculus, the left superior longitudinal fasciculus, and the left uncinate fasciculus. CONCLUSIONS VBM and DTI may reveal microstructural changes related to the degree of 123I-MIBG uptake in patients with PD. KEY POINTS • Advanced MRI methods may detect brain damage more precisely. • Voxel-based morphometry can detect grey matter changes in Parkinson's disease. • Diffusion tensor imaging can detect white matter changes in Parkinson's disease.
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22
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Abstract
Parkinson's disease is a neurodegenerative disorder predominantly resulting from dopamine depletion in the substantia nigra pars compacta. Some psychiatric disorders may have dopaminergic dysfunction as their substrate. We describe a well-documented case of Parkinson's disease associated with Bipolar Disorder. Although there is some knowledge about the association between these diseases, little is known about its pathophysiology and correlation. We believe that among various hypotheses, many neurotransmitters are linked to this pathophysiology.
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Affiliation(s)
| | - Nathália Novaretti
- MD. Department of Neuroscience and Behavior, Faculty of Medicine of Ribeirão Preto, USP, SP, Brazil
| | - Vitor Tumas
- MD PhD. Department of Neuroscience and Behavior, Faculty of Medicine of Ribeirão Preto, USP, SP, Brazil
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23
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Delgado-Alvarado M, Gago B, Navalpotro-Gomez I, Jiménez-Urbieta H, Rodriguez-Oroz MC. Biomarkers for dementia and mild cognitive impairment in Parkinson's disease. Mov Disord 2016; 31:861-81. [PMID: 27193487 DOI: 10.1002/mds.26662] [Citation(s) in RCA: 109] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Revised: 04/15/2016] [Accepted: 04/18/2016] [Indexed: 12/27/2022] Open
Abstract
Cognitive decline is one of the most frequent and disabling nonmotor features of Parkinson's disease. Around 30% of patients with Parkinson's disease experience mild cognitive impairment, a well-established risk factor for the development of dementia. However, mild cognitive impairment in patients with Parkinson's disease is a heterogeneous entity that involves different types and extents of cognitive deficits. Because it is not currently known which type of mild cognitive impairment confers a higher risk of progression to dementia, it would be useful to define biomarkers that could identify these patients to better study disease progression and possible interventions. In this sense, the identification among patients with Parkinson's disease and mild cognitive impairment of biomarkers associated with dementia would allow the early detection of this process. This review summarizes studies from the past 25 years that have assessed the potential biomarkers of dementia and mild cognitive impairment in Parkinson's disease patients. Despite the potential importance, no biomarker has as yet been validated. However, features such as low levels of epidermal and insulin-like growth factors or uric acid in plasma/serum and of Aß in CSF, reduction of cerebral cholinergic innervation and metabolism measured by PET mainly in posterior areas, and hippocampal atrophy in MRI might be indicative of distinct deficits with a distinct risk of dementia in subgroups of patients. Longitudinal studies combining the existing techniques and new approaches are needed to identify patients at higher risk of dementia. © 2016 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Manuel Delgado-Alvarado
- Biodonostia Health Research Institute, San Sebastián, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Belén Gago
- Biodonostia Health Research Institute, San Sebastián, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Irene Navalpotro-Gomez
- Biodonostia Health Research Institute, San Sebastián, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Haritz Jiménez-Urbieta
- Biodonostia Health Research Institute, San Sebastián, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - María C Rodriguez-Oroz
- Biodonostia Health Research Institute, San Sebastián, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.,Neurology Department, University Hospital Donostia, San Sebastián, Spain.,Ikerbasque (Basque Foundation for Science), Bilbao, Spain.,Basque Center on Cognition, Brain and Language (BCBL), San Sebastián, Spain.,Physiology Department, Medical School University of Navarra, Pamplona, Spain
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24
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Gray matter atrophy associated with mild cognitive impairment in Parkinson’s disease. Neurosci Lett 2016; 617:160-5. [DOI: 10.1016/j.neulet.2015.12.055] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 12/24/2015] [Indexed: 12/16/2022]
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25
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Cortical Thickness, Surface Area and Subcortical Volume Differentially Contribute to Cognitive Heterogeneity in Parkinson's Disease. PLoS One 2016; 11:e0148852. [PMID: 26919667 PMCID: PMC4768880 DOI: 10.1371/journal.pone.0148852] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Accepted: 01/25/2016] [Indexed: 01/11/2023] Open
Abstract
Parkinson’s disease (PD) is often associated with cognitive deficits, although their severity varies considerably between patients. Recently, we used voxel-based morphometry (VBM) to show that individual differences in gray matter (GM) volume relate to cognitive heterogeneity in PD. VBM does, however, not differentiate between cortical thickness (CTh) and surface area (SA), which might be independently affected in PD. We therefore re-analyzed our cohort using the surface-based method FreeSurfer, and investigated (i) CTh, SA, and (sub)cortical GM volume differences between 93 PD patients and 45 matched controls, and (ii) the relation between these structural measures and cognitive performance on six neuropsychological tasks within the PD group. We found cortical thinning in PD patients in the left pericalcarine gyrus, extending to cuneus, precuneus and lingual areas and left inferior parietal cortex, bilateral rostral middle frontal cortex, and right cuneus, and increased cortical surface area in the left pars triangularis. Within the PD group, we found negative correlations between (i) CTh of occipital areas and performance on a verbal memory task, (ii) SA and volume of the frontal cortex and visuospatial memory performance, and, (iii) volume of the right thalamus and scores on two verbal fluency tasks. Our primary findings illustrate that i) CTh and SA are differentially affected in PD, and ii) VBM and FreeSurfer yield non-overlapping results in an identical dataset. We argue that this discrepancy is due to technical differences and the subtlety of the PD-related structural changes.
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26
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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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27
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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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28
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Melzer TR, Myall DJ, MacAskill MR, Pitcher TL, Livingston L, Watts R, Keenan RJ, Dalrymple-Alford JC, Anderson TJ. Tracking Parkinson's Disease over One Year with Multimodal Magnetic Resonance Imaging in a Group of Older Patients with Moderate Disease. PLoS One 2015; 10:e0143923. [PMID: 26714266 PMCID: PMC4694717 DOI: 10.1371/journal.pone.0143923] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2015] [Accepted: 11/11/2015] [Indexed: 11/19/2022] Open
Abstract
Background & Objectives Cross-sectional magnetic resonance imaging (MRI) suggests that Parkinson’s disease (PD) is associated with changes in cerebral tissue volume, diffusion tensor imaging metrics, and perfusion values. Here, we performed a longitudinal multimodal MRI study—including structural, diffusion tensor imaging (DTI), and perfusion MRI—to investigate progressive brain changes over one year in a group of older PD patients at a moderate stage of disease. Methods Twenty-three non-demented PD (mean age (SD) = 69.5 (6.4) years, disease duration (SD) = 5.6 (4.3) years) and 23 matched control participants (mean age: 70.6 (6.8)) completed extensive neuropsychological and clinical assessment, and multimodal 3T MRI scanning at baseline and one year later. We used a voxel-based approach to assess change over time and group-by-time interactions for cerebral structural and perfusion metrics. Results Compared to controls, in PD participants there was localized grey matter atrophy over time in bilateral inferior and right middle temporal, and left orbito-frontal cortices. Using a voxel-based approach that focused on the centers of principal white matter tracts, the PD and control cohorts exhibited similar levels of change in DTI metrics. There was no significant change in perfusion, cognitive, or motor severity measures. Conclusions In a cohort of older, non-demented PD participants, macrostructural MRI detected atrophy in the PD group compared with the control group in temporal and orbito-frontal cortices. Changes in diffusion MRI along principal white matter tracts over one year were found, but this was not differentially affected by PD.
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Affiliation(s)
- Tracy R. Melzer
- New Zealand Brain Research Institute, Christchurch, New Zealand
- Department of Medicine, University of Otago, Christchurch, New Zealand
- * E-mail:
| | - Daniel J. Myall
- New Zealand Brain Research Institute, Christchurch, New Zealand
| | - Michael R. MacAskill
- New Zealand Brain Research Institute, Christchurch, New Zealand
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Toni L. Pitcher
- New Zealand Brain Research Institute, Christchurch, New Zealand
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Leslie Livingston
- New Zealand Brain Research Institute, Christchurch, New Zealand
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Richard Watts
- College of Medicine, University of Vermont, Burlington, VT, United States of America
| | - Ross J. Keenan
- New Zealand Brain Research Institute, Christchurch, New Zealand
- Christchurch Radiology Group, Christchurch, New Zealand
| | - John C. Dalrymple-Alford
- New Zealand Brain Research Institute, Christchurch, New Zealand
- Department of Medicine, University of Otago, Christchurch, New Zealand
- Department of Psychology, University of Canterbury, New Zealand
| | - Tim J. Anderson
- New Zealand Brain Research Institute, Christchurch, New Zealand
- Department of Medicine, University of Otago, Christchurch, New Zealand
- Department of Neurology, Christchurch Hospital, Christchurch, New Zealand
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29
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Mathys C, Caspers J, Langner R, Südmeyer M, Grefkes C, Reetz K, Moldovan AS, Michely J, Heller J, Eickhoff CR, Turowski B, Schnitzler A, Hoffstaedter F, Eickhoff SB. Functional Connectivity Differences of the Subthalamic Nucleus Related to Parkinson's Disease. Hum Brain Mapp 2015; 37:1235-53. [PMID: 26700444 DOI: 10.1002/hbm.23099] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Revised: 12/12/2015] [Accepted: 12/13/2015] [Indexed: 01/29/2023] Open
Abstract
A typical feature of Parkinson's disease (PD) is pathological activity in the subthalamic nucleus (STN). Here, we tested whether in patients with PD under dopaminergic treatment functional connectivity of the STN differs from healthy controls (HC) and whether some brain regions show (anti-) correlations between functional connectivity with STN and motor symptoms. We used functional magnetic resonance imaging to investigate whole-brain resting-state functional connectivity with STN in 54 patients with PD and 55 HC matched for age, gender, and within-scanner motion. Compared to HC, we found attenuated negative STN-coupling with Crus I of the right cerebellum and with right ventromedial prefrontal regions in patients with PD. Furthermore, we observed enhanced negative STN-coupling with bilateral intraparietal sulcus/superior parietal cortex, right sensorimotor, right premotor, and left visual cortex compared to HC. Finally, we found a decline in positive STN-coupling with the left insula related to severity of motor symptoms and a decline of inter-hemispheric functional connectivity between left and right STN with progression of PD-related motor symptoms. Motor symptom related uncoupling of the insula, a key region in the saliency network and for executive function, from the STN might be associated with well-known executive dysfunction in PD. Moreover, uncoupling between insula and STN might also induce an insufficient setting of thresholds for the discrimination between relevant and irrelevant salient environmental stimuli, explaining observations of disturbed response control in PD. In sum, motor symptoms in PD are associated with a reduced coupling between STN and a key region for executive function.
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Affiliation(s)
- Christian Mathys
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Düsseldorf, Düsseldorf, Germany
| | - Julian Caspers
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Düsseldorf, Düsseldorf, Germany.,Institute of Neuroscience and Medicine (INM-1, INM-3, INM-4), Research Centre Jülich, Jülich, Germany
| | - Robert Langner
- Institute of Neuroscience and Medicine (INM-1, INM-3, INM-4), Research Centre Jülich, Jülich, Germany.,Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, University Düsseldorf, Düsseldorf, Germany
| | - Martin Südmeyer
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, University Düsseldorf, Düsseldorf, Germany.,Center for Movement Disorders and Neuromodulation, Department of Neurology, Medical Faculty, University Düsseldorf, Düsseldorf, Germany
| | - Christian Grefkes
- Institute of Neuroscience and Medicine (INM-1, INM-3, INM-4), Research Centre Jülich, Jülich, Germany.,Department of Neurology, Neuromodulation & Neurorehabilitation Group, University of Cologne, Cologne, Germany
| | - Kathrin Reetz
- Institute of Neuroscience and Medicine (INM-1, INM-3, INM-4), Research Centre Jülich, Jülich, Germany.,Department of Neurology and JARA BRAIN, RWTH Aachen University, Aachen, Germany
| | - Alexia-Sabine Moldovan
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, University Düsseldorf, Düsseldorf, Germany
| | - Jochen Michely
- Institute of Neuroscience and Medicine (INM-1, INM-3, INM-4), Research Centre Jülich, Jülich, Germany.,Department of Neurology, Neuromodulation & Neurorehabilitation Group, University of Cologne, Cologne, Germany
| | - Julia Heller
- Department of Neurology and JARA BRAIN, RWTH Aachen University, Aachen, Germany
| | - Claudia R Eickhoff
- Institute of Neuroscience and Medicine (INM-1, INM-3, INM-4), Research Centre Jülich, Jülich, Germany.,Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, Germany
| | - Bernd Turowski
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Düsseldorf, Düsseldorf, Germany
| | - Alfons Schnitzler
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, University Düsseldorf, Düsseldorf, Germany.,Center for Movement Disorders and Neuromodulation, Department of Neurology, Medical Faculty, University Düsseldorf, Düsseldorf, Germany
| | - Felix Hoffstaedter
- Institute of Neuroscience and Medicine (INM-1, INM-3, INM-4), Research Centre Jülich, Jülich, Germany.,Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, University Düsseldorf, Düsseldorf, Germany
| | - Simon B Eickhoff
- Institute of Neuroscience and Medicine (INM-1, INM-3, INM-4), Research Centre Jülich, Jülich, Germany.,Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, University Düsseldorf, Düsseldorf, Germany
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30
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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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31
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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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32
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Luo C, Guo X, Song W, Chen Q, Yang J, Gong Q, Shang HF. The trajectory of disturbed resting-state cerebral function in Parkinson's disease at different Hoehn and Yahr stages. Hum Brain Mapp 2015; 36:3104-16. [PMID: 25959682 DOI: 10.1002/hbm.22831] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 04/08/2015] [Accepted: 04/24/2015] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE We aim to investigate the disturbance of neural network associated with the different clinical stages of Parkinson's disease (PD). METHOD We recruited 80 patients at different H&Y stages of PD (28 at H&Y stage I, 28 at H&Y stage II, 24 at H&Y stage III) and 30 normal controls. All participants underwent resting-state fMRI scans on a 3-T MR system. The amplitude of low-frequency fluctuation (ALFF) of blood oxygen level-dependent signals was used to characterize regional cerebral function. Functional integration across the brain regions was evaluated by a seed voxel correlation approach. RESULTS PD patients had decreased regional activities in left occipital and lingual regions; these regions show decreased functional connection pattern with temporal regions, which is deteriorating as H&Y stage ascending. In addition, PD patients, especially those at stage II, exhibit increased regional activity in the posterior regions of default mode network (DMN), increased anticorrelation between posterior cingulate cortex (PCC) and cortical regions outside DMN, and higher temporal coherence within DMN. Those indicate more highly functioned DMN in PD patients at stage II. CONCLUSIONS Our study demonstrated the trajectories of resting-state cerebral function disturbance in PD patients at different H&Y stages. Impairment in functional integration of occipital-temporal cortex might be a promising measurement to evaluate and potentially track functional substrates of disease evolution of PD.
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Affiliation(s)
- ChunYan Luo
- Department of Neurology, West China Hospital, SiChuan University, Chengdu Sichuan, China
| | - XiaoYan Guo
- Department of Neurology, West China Hospital, SiChuan University, Chengdu Sichuan, China
| | - Wei Song
- Department of Neurology, West China Hospital, SiChuan University, Chengdu Sichuan, China
| | - Qin Chen
- Department of Neurology, West China Hospital, SiChuan University, Chengdu Sichuan, China
| | - Jing Yang
- Department of Neurology, West China Hospital, SiChuan University, Chengdu Sichuan, China
| | - QiYong Gong
- Huaxi MR Research Center, Department of Radiology, West China Hospital, SiChuan University, Chengdu Sichuan, China
| | - Hui-Fang Shang
- Department of Neurology, West China Hospital, SiChuan University, Chengdu Sichuan, China
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Shoji Y, Nishio Y, Baba T, Uchiyama M, Yokoi K, Ishioka T, Hosokai Y, Hirayama K, Fukuda H, Aoki M, Hasegawa T, Takeda A, Mori E. Neural substrates of cognitive subtypes in Parkinson's disease: a 3-year longitudinal study. PLoS One 2014; 9:e110547. [PMID: 25330390 PMCID: PMC4203806 DOI: 10.1371/journal.pone.0110547] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 09/15/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The neuropsychological features and neuropathological progression patterns associated with rapidly evolving cognitive decline or dementia in Parkinson's disease (PD) remain to be elucidated. METHODS Fifty-three PD patients without dementia were recruited to participate in a 3-year longitudinal cohort study. The patients were grouped according to the Clinical Dementia Rating (CDR). Group-wise comparisons were made with regard to demographic characteristics, motor symptoms, neuropsychological performances and 18F-fluorodeoxyglucose positron emission tomography. RESULTS Patients who had memory-plus cognitive impairment (patients whose CDR was 0 at baseline and 0.5 in memory and other domains at follow-up, and those whose baseline CDR was 0.5 in memory and other domains) exhibited higher age at onset, visuoperceptual impairment, non-tremor-dominant motor disturbance, rapid symptomatic progression and posterior neocortical hypometabolism. In patients who were cognitively unimpaired and those who had memory-dominant cognitive impairment (patients whose CDR was 0 at baseline and 0.5 only in memory domain at follow-up, and those whose baseline CDR was 0.5 only in memory domain), the posterior neocortex was relatively unaffected until a later stage of the disease. CONCLUSIONS These results suggest that visuoperceptual impairment and the early involvement of the posterior neocortex may be risk factors for rapid symptomatic progression and dementia in PD.
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Affiliation(s)
- Yumiko Shoji
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University School of Medicine, Sendai, Japan
| | - Yoshiyuki Nishio
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University School of Medicine, Sendai, Japan
- * E-mail:
| | - Toru Baba
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University School of Medicine, Sendai, Japan
| | - Makoto Uchiyama
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University School of Medicine, Sendai, Japan
- Department of Speech, Language and Hearing Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Kayoko Yokoi
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University School of Medicine, Sendai, Japan
| | - Toshiyuki Ishioka
- Department of Occupational Therapy, Saitama Prefectural University, Koshigaya, Japan
| | - Yoshiyuki Hosokai
- Department of Diagnostic Image Analysis, Tohoku University School of Medicine, Sendai, Japan
| | - Kazumi Hirayama
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University School of Medicine, Sendai, Japan
- Department of Occupational Therapy, Yamagata Prefectural University of Health Science, Yamagata, Japan
| | - Hiroshi Fukuda
- Department of Radiology and Nuclear Medicine, Institute of Development, Aging, and Cancer, Tohoku University, Sendai, Japan
| | - Masashi Aoki
- Department of Neurology, Tohoku University School of Medicine, Sendai, Japan
| | - Takafumi Hasegawa
- Department of Neurology, Tohoku University School of Medicine, Sendai, Japan
| | - Atsushi Takeda
- Department of Neurology, Sendai Nishitaga Hospital, Sendai, Japan
| | - Etsuro Mori
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University School of Medicine, Sendai, Japan
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34
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Hiebert NM, Seergobin KN, Vo A, Ganjavi H, MacDonald PA. Dopaminergic therapy affects learning and impulsivity in Parkinson's disease. Ann Clin Transl Neurol 2014; 1:833-43. [PMID: 25493274 PMCID: PMC4241810 DOI: 10.1002/acn3.128] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2014] [Revised: 07/29/2014] [Accepted: 09/04/2014] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE The aim was to examine the effect of dopaminergic medication on stimulus-response learning versus performing decisions based on learning. METHOD To see the effect of dopaminergic therapy on stimulus-response learning and response selection, participants with Parkinson's disease (PD) were either tested on and/or off their prescribed dose of dopaminergic therapy during different testing days. Forty participants with PD and 34 healthy controls completed the experiment on consecutive days. On Day 1, participants learned to associate abstract images with spoken, "right" or "left" responses via feedback (Session 1). On Day 2, participants recalled these responses (Session 2) and indicated the location (i.e., right or left of center) of previously studied images intermixed with new images (Session 3). RESULTS Participants with PD off medication learned stimulus-response associations equally well compared to healthy controls. Learning was impaired by dopaminergic medication. Regardless of medication status, patients recalled the stimulus-response associations from Day 1 as well as controls. In Session 3 off medication, patients demonstrated enhanced facilitation relative to controls and patients on medication, when the stimulus location was congruent with the spoken response that was learned for the stimulus in Session 1. INTERPRETATION Learning in PD was comparable to that of healthy controls off medication. Learning was worsened by dopaminergic therapy in PD. We interpret greater facilitation in participants with PD off medication for congruent responses as evidence of greater impulsivity. This motor or reflexive impulsivity was normalized by medication in PD. These findings shed light on the cognitive profile of PD and have implications for dopaminergic treatment.
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Affiliation(s)
- Nole M Hiebert
- Brain and Mind Institute, University of Western Ontario London, Ontario, Canada, N6A 5B7 ; Department of Physiology and Pharmacology, University of Western Ontario London, Ontario, Canada, N6A 5C1
| | - Ken N Seergobin
- Brain and Mind Institute, University of Western Ontario London, Ontario, Canada, N6A 5B7
| | - Andrew Vo
- Brain and Mind Institute, University of Western Ontario London, Ontario, Canada, N6A 5B7 ; Department of Psychology, University of Western Ontario London, Ontario, Canada, N6A 5C2
| | - Hooman Ganjavi
- Department of Psychiatry, University of Western Ontario London, Ontario, Canada, N6A 5W9
| | - Penny A MacDonald
- Brain and Mind Institute, University of Western Ontario London, Ontario, Canada, N6A 5B7 ; Department of Physiology and Pharmacology, University of Western Ontario London, Ontario, Canada, N6A 5C1 ; Department of Psychology, University of Western Ontario London, Ontario, Canada, N6A 5C2 ; Department of Clinical Neurological Sciences, University of Western Ontario London, Ontario, Canada, N6A 5A5
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35
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Tessa C, Lucetti C, Giannelli M, Diciotti S, Poletti M, Danti S, Baldacci F, Vignali C, Bonuccelli U, Mascalchi M, Toschi N. Progression of brain atrophy in the early stages of Parkinson's disease: a longitudinal tensor-based morphometry study in de novo patients without cognitive impairment. Hum Brain Mapp 2014; 35:3932-44. [PMID: 24453162 PMCID: PMC6868950 DOI: 10.1002/hbm.22449] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Revised: 11/06/2013] [Accepted: 11/29/2013] [Indexed: 11/11/2022] Open
Abstract
The presence of brain atrophy and its progression in early Parkinson's disease (PD) are still a matter of debate, particularly in patients without cognitive impairment. The aim of this longitudinal study was to assess whether PD patients who remain cognitively intact develop progressive atrophic changes in the early stages of the disease. For this purpose, we employed high-resolution T1-weighted MR imaging to compare 22 drug-naïve de novo PD patients without cognitive impairment to 17 age-matched control subjects, both at baseline and at three-year follow-up. We used tensor-based morphometry to explore the presence of atrophic changes at baseline and to compute yearly atrophy rates, after which we performed voxel-wise group comparisons using threshold-free cluster enhancement. At baseline, we did not observe significant differences in regional atrophy in PD patients with respect to control subjects. In contrast, PD patients showed significantly higher yearly atrophy rates in the prefrontal cortex, anterior cingulum, caudate nucleus, and thalamus when compared to control subjects. Our results indicate that even cognitively preserved PD patients show progressive cortical and subcortical atrophic changes in regions related to cognitive functions and that these changes are already detectable in the early stages of the disease.
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Affiliation(s)
- Carlo Tessa
- Division of RadiologyVersilia Hospital, AUSL 12 Viareggio, Lido di Camaiore (Lu)Italy
| | - Claudio Lucetti
- Division of NeurologyVersilia Hospital, AUSL 12 Viareggio, Lido di Camaiore (Lu)Italy
| | - Marco Giannelli
- Unit of Medical PhysicsPisa University Hospital “Azienda Ospedaliero‐Universitaria Pisana”PisaItaly
| | - Stefano Diciotti
- Quantitative and Functional Neuroradiology Research UnitDepartment of Experimental and Clinical Biomedical SciencesUniversity of FlorenceFlorenceItaly
| | - Michele Poletti
- Department of Mental Health and Pathological AddictionAUSL Reggio EmiliaReggio EmiliaItaly
| | - Sabrina Danti
- Division of PsychologyVersilia Hospital, AUSL 12 ViareggioLido di Camaiore (Lu)Italy
| | | | - Claudio Vignali
- Division of RadiologyVersilia Hospital, AUSL 12 Viareggio, Lido di Camaiore (Lu)Italy
| | | | - Mario Mascalchi
- Quantitative and Functional Neuroradiology Research UnitDepartment of Experimental and Clinical Biomedical SciencesUniversity of FlorenceFlorenceItaly
| | - Nicola Toschi
- Medical Physics SectionDepartment of Biomedicine and PreventionFaculty of MedicineUniversity of Rome “Tor Vergata”RomeItaly
- Department of RadiologyAthinoula A. Martinos Center for Biomedical ImagingBostonMassachusetts
- Harvard Medical SchoolBostonMassachusetts
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36
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Mak E, Bergsland N, Dwyer MG, Zivadinov R, Kandiah N. Subcortical atrophy is associated with cognitive impairment in mild Parkinson disease: a combined investigation of volumetric changes, cortical thickness, and vertex-based shape analysis. AJNR Am J Neuroradiol 2014; 35:2257-64. [PMID: 25082821 DOI: 10.3174/ajnr.a4055] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND AND PURPOSE The involvement of subcortical deep gray matter and cortical thinning associated with mild Parkinson disease remains poorly understood. We assessed cortical thickness and subcortical volumes in patients with Parkinson disease without dementia and evaluated their associations with cognitive dysfunction. MATERIALS AND METHODS The study included 90 patients with mild Parkinson disease without dementia. Neuropsychological assessments classified the sample into patients with mild cognitive impairment (n = 25) and patients without cognitive impairment (n = 65). Volumetric data for subcortical structures were obtained by using the FMRIB Integrated Registration and Segmentation Tool while whole-brain, gray and white matter volumes were estimated by using Structural Image Evaluation, with Normalization of Atrophy. Vertex-based shape analyses were performed to investigate shape differences in subcortical structures. Vertex-wise group differences in cortical thickness were also assessed. Volumetric comparisons between Parkinson disease with mild cognitive impairment and Parkinson disease with no cognitive impairment were performed by using ANCOVA. Associations of subcortical structures with both cognitive function and disease severity were assessed by using linear regression models. RESULTS Compared with Parkinson disease with no cognitive impairment, Parkinson disease with mild cognitive impairment demonstrated reduced volumes of the thalamus (P = .03) and the nucleus accumbens (P = .04). Significant associations were found for the nucleus accumbens and putamen with performances on the attention/working memory domains (P < .05) and nucleus accumbens and language domains (P = .04). The 2 groups did not differ in measures of subcortical shape or in cortical thickness. CONCLUSIONS Patients with Parkinson disease with mild cognitive impairment demonstrated reduced subcortical volumes, which were associated with cognitive deficits. The thalamus, nucleus accumbens, and putamen may serve as potential biomarkers for Parkinson disease-mild cognitive impairment.
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Affiliation(s)
- E Mak
- From the Department of Neurology (E.M., N.B., M.G.D., R.Z.), Buffalo Neuroimaging Analysis Center Department of Neurology (E.M., N.K.), National Neuroscience Institute, Singapore
| | - N Bergsland
- From the Department of Neurology (E.M., N.B., M.G.D., R.Z.), Buffalo Neuroimaging Analysis Center Istituto de Ricovero e Cura a Carattere Scientifico "S. Maria Nascente," Don Gnocchi Foundation (N.B.), Milan, Italy
| | - M G Dwyer
- From the Department of Neurology (E.M., N.B., M.G.D., R.Z.), Buffalo Neuroimaging Analysis Center
| | - R Zivadinov
- From the Department of Neurology (E.M., N.B., M.G.D., R.Z.), Buffalo Neuroimaging Analysis Center MR Imaging Clinical Translational Research Center (R.Z.), School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York
| | - N Kandiah
- Department of Neurology (E.M., N.K.), National Neuroscience Institute, Singapore
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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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Lanoue AC, Blatt GJ, Soghomonian JJ. Decreased parvalbumin mRNA expression in dorsolateral prefrontal cortex in Parkinson's disease. Brain Res 2013; 1531:37-47. [PMID: 23891794 DOI: 10.1016/j.brainres.2013.07.025] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 06/28/2013] [Accepted: 07/18/2013] [Indexed: 11/15/2022]
Abstract
It has recently been shown that expression of the rate-limiting GABA-synthesizing enzyme glutamic acid decarboxylase (GAD) is decreased in Brodmann area 9 (BA9) of the dorsolateral prefrontal cortex (DLPFC) in Parkinson's disease (PD) compared to control brains (Lanoue, A.C., Dumitriu, A., Myers, R.H., Soghomonian, JJ., 2010. Exp. Neurol. 206 (1), 207-217). A subpopulation of cortical GABAergic interneurons expresses the calcium-binding protein parvalbumin and plays a critical role in the control of pyramidal neuron excitability and the generation of cortical gamma frequency oscillations. In view of its key role in the physiology of the cerebral cortex, we sought to determine whether the expression of parvalbumin and the number of parvalbumin-expressing neurons are altered in BA9 of PD brains. First, isotopic in situ hybridization histochemistry was used to examine mRNA expression of parvalbumin on post-mortem brain sections. Second, immunohistochemistry and design-based stereology were used to determine the density of parvalbumin-positive interneurons in BA9. Quantification of mRNA labeling at the single cell level showed a significant decrease in parvalbumin expression in PD cases. In contrast, neuronal density of parvalbumin-positive neurons was not significantly different between PD and controls. Results confirm that the GABAergic system is altered in the DLPFC in PD and identify the contribution of parvalbumin-expressing neurons in these alterations. We speculate that these effects could contribute to altered cortical excitability and oscillatory activity previously documented in PD.
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Affiliation(s)
- Amélie C Lanoue
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA 02118, USA
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Parkinson's disease-cognitive rating scale: Psychometrics for mild cognitive impairment. Mov Disord 2013; 28:1376-83. [DOI: 10.1002/mds.25568] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Revised: 05/07/2013] [Accepted: 05/16/2013] [Indexed: 11/07/2022] Open
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Biundo R, Calabrese M, Weis L, Facchini S, Ricchieri G, Gallo P, Antonini A. Anatomical correlates of cognitive functions in early Parkinson's disease patients. PLoS One 2013; 8:e64222. [PMID: 23717572 PMCID: PMC3661458 DOI: 10.1371/journal.pone.0064222] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Accepted: 04/12/2013] [Indexed: 11/18/2022] Open
Abstract
Background Cognitive deficits may occur early in Parkinson's disease (PD) but the extent of cortical involvement associated with cognitive dysfunction needs additional investigations. The aim of our study is to identify the anatomical pattern of cortical thickness alterations in patients with early stage PD and its relationship with cognitive disability. Methods We recruited 29 PD patients and 21 healthy controls. All PD patients performed an extensive neuropsychological examination and 14 were diagnosed with mild cognitive impairment (PD-MCI). Surface-based cortical thickness analysis was applied to investigate the topographical distribution of cortical and subcortical alterations in early PD compared with controls and to assess the relationship between cognition and regional cortical changes in PD-MCI. Results Overall PD patients showed focal cortical (occipital-parietal areas, orbito-frontal and olfactory areas) and subcortical thinning when compared with controls. PD-MCI showed a wide spectrum of cognitive deficits and related significant regional thickening in the right parietal-frontal as well as in the left temporal-occipital areas. Conclusion Our results confirm the presence of changes in grey matter thickness at relatively early PD stage and support previous studies showing thinning and atrophy in the neocortex and subcortical regions. Relative cortical thickening in PD-MCI may instead express compensatory neuroplasticity. Brain reserve mechanisms might first modulate cognitive decline during the initial stages of PD.
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Affiliation(s)
- Roberta Biundo
- Department for Parkinson's Disease, "Fondazione Ospedale San Camillo," I.R.C.C.S., Venice, Italy.
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Davidson PSR, Cook SP, McGhan L, Bouchard T, Camicioli R. Source memory in normal aging and Parkinson's disease. J Neuropsychol 2013; 7:179-92. [DOI: 10.1111/jnp.12018] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2012] [Revised: 02/28/2013] [Accepted: 03/07/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Patrick S. R. Davidson
- School of Psychology; Bruyère Research Institute; Centre for Stroke Recovery; University of Ottawa; Canada
| | - Shaun P. Cook
- Department of Psychology; Millersville University; Pennsylvania USA
| | | | - Thomas Bouchard
- Glenrose Rehabilitation Hospital; Edmonton Canada
- Department of Medicine (Neurology); University of Alberta; Canada
| | - Richard Camicioli
- Glenrose Rehabilitation Hospital; Edmonton Canada
- Department of Medicine (Neurology); University of Alberta; Canada
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Rosenberg-Katz K, Herman T, Jacob Y, Giladi N, Hendler T, Hausdorff JM. Gray matter atrophy distinguishes between Parkinson disease motor subtypes. Neurology 2013; 80:1476-84. [PMID: 23516323 DOI: 10.1212/wnl.0b013e31828cfaa4] [Citation(s) in RCA: 118] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To assess differences in gray matter (GM) atrophy between 2 Parkinson disease (PD) subtypes: the tremor dominant (TD) subtype and the postural instability gait difficulty (PIGD) subtype. METHODS Patients were classified as belonging to the predominately PIGD (n = 30) or predominately TD (n = 29) subtype. Voxel-based morphometry was used to compare GM in these 2 subtypes and to evaluate correlations between predefined regions of interest and the degree of symptoms. In the regions where GM atrophy was associated with symptoms, the relationship between GM volumes and functional connectivity was examined. RESULTS GM was reduced in the predominately PIGD group, compared with the predominately TD group, in areas that involve motor, cognitive, limbic, and associative functions (p < 0.05, false discovery rate corrected). Lower GM volumes in the pre-supplementary motor area (SMA) and in the primary motor area were associated with increased severity of PIGD symptoms (r = -0.42, p < 0.001; r = -0.38, p < 0.003, respectively). Higher GM volumes within the pre-SMA were associated with stronger functional connectivity between the pre-SMA and the putamen (r = 0.415, p < 0.025) in the patients with predominately PIGD. CONCLUSIONS In patients with PD, PIGD symptoms are apparently associated with GM atrophy in motor-related regions and decreased functional connectivity. GM degeneration and a related decrease in spontaneous coactivation between cortical and subcortical motor-planning areas may partially account for the unique clinical characteristics of a subset of patients with PD.
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Affiliation(s)
- Keren Rosenberg-Katz
- Movement Disorders Unit, Department of Neurology, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
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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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Rae CL, Correia MM, Altena E, Hughes LE, Barker RA, Rowe JB. White matter pathology in Parkinson's disease: the effect of imaging protocol differences and relevance to executive function. Neuroimage 2012; 62:1675-84. [PMID: 22713671 PMCID: PMC3413883 DOI: 10.1016/j.neuroimage.2012.06.012] [Citation(s) in RCA: 95] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Revised: 05/18/2012] [Accepted: 06/08/2012] [Indexed: 02/02/2023] Open
Abstract
Diffusion magnetic resonance imaging is increasingly used as a non-invasive method to investigate white matter structure in neurological and neuropsychiatric disease. However, many options are available for the acquisition sequence and analysis method. Here we used Parkinson's disease as a model neurodegenerative disorder to compare imaging protocols and analysis options. We investigated fractional anisotropy and mean diffusivity of white matter in patients and age-matched controls, comparing two datasets acquired with different imaging protocols. One protocol prioritised the number of b value acquisitions, whilst the other prioritised the number of gradient directions. The dataset with more gradient directions was more sensitive to reductions in fractional anisotropy in Parkinson's disease, whilst the dataset with more b values was more sensitive to increases in mean diffusivity. Moreover, the areas of reduced fractional anisotropy were highly similar to areas of increased mean diffusivity in PD patients. Next, we compared two widely used analysis methods: tract-based spatial statistics identified reduced fractional anisotropy and increased mean diffusivity in Parkinson's disease in many of the major white matter tracts in the frontal and parietal lobes. Voxel-based analyses were less sensitive, with similar patterns of white matter pathology observed only at liberal statistical thresholds. We also used tract-based spatial statistics to identify correlations between a test of executive function (phonemic fluency), fractional anisotropy and mean diffusivity in prefrontal white matter in both Parkinson's disease patients and controls. These findings suggest that in Parkinson's disease there is widespread pathology of cerebral white matter, and furthermore, pathological white matter in the frontal lobe may be associated with executive dysfunction. Diffusion imaging protocols that prioritised the number of directions versus the number of b values were differentially sensitive to alternative markers of white matter pathology, such as fractional anisotropy and mean diffusivity.
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Key Words
- dti, diffusion tensor imaging
- fa, fractional anisotropy
- fwe, family-wise error
- h&y, hoehn and yahr
- md, mean diffusivity
- mmse, mini-mental state examination
- mr, magnetic resonance
- pd, parkinson's disease
- tbss, tract-based spatial statistics
- tfce, threshold-free cluster enhancement
- updrs, unified parkinson's disease rating scale
- dti
- tbss
- vbm
- parkinson's disease
- executive function
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Affiliation(s)
- Charlotte L. Rae
- MRC Cognition and Brain Sciences Unit, Cambridge, CB2 7EF, UK,Corresponding author at: MRC Cognition and Brain Sciences Unit, 15 Chaucer Road, Cambridge, CB2 7EF, UK. Fax: + 44 1223 359062.
| | | | - Ellemarije Altena
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 2QQ, UK
| | - Laura E. Hughes
- MRC Cognition and Brain Sciences Unit, Cambridge, CB2 7EF, UK,Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 2QQ, UK
| | - Roger A. Barker
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 2QQ, UK,Cambridge Centre for Brain Repair, University of Cambridge, CB2 0PY, UK
| | - James B. Rowe
- MRC Cognition and Brain Sciences Unit, Cambridge, CB2 7EF, UK,Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 2QQ, UK,Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, CB2 3EB, UK
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Baba T, Kikuchi A, Hirayama K, Nishio Y, Hosokai Y, Kanno S, Hasegawa T, Sugeno N, Konno M, Suzuki K, Takahashi S, Fukuda H, Aoki M, Itoyama Y, Mori E, Takeda A. Severe olfactory dysfunction is a prodromal symptom of dementia associated with Parkinson's disease: a 3 year longitudinal study. ACTA ACUST UNITED AC 2012; 135:161-9. [PMID: 22287381 DOI: 10.1093/brain/awr321] [Citation(s) in RCA: 191] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Dementia is one of the most debilitating symptoms of Parkinson's disease. A recent longitudinal study suggests that up to 80% of patients with Parkinson's disease will eventually develop dementia. Despite its clinical importance, the development of dementia is still difficult to predict at early stages. We previously identified olfactory dysfunction as one of the most important indicators of cortical hypometabolism in Parkinson's disease. In this study, we investigated the possible associations between olfactory dysfunction and the risk of developing dementia within a 3-year observation period. Forty-four patients with Parkinson's disease without dementia underwent the odour stick identification test for Japanese, memory and visuoperceptual assessments, (18)F-fluorodeoxyglucose positron emission tomography scans and magnetic resonance imaging scans at baseline and 3 years later. A subgroup of patients with Parkinson's disease who exhibited severe hyposmia at baseline showed more pronounced cognitive decline at the follow-up survey. By the end of the study, 10 of 44 patients with Parkinson's disease had developed dementia, all of whom had severe hyposmia at baseline. The multivariate logistic analysis identified severe hyposmia and visuoperceptual impairment as independent risk factors for subsequent dementia within 3 years. The patients with severe hyposmia had an 18.7-fold increase in their risk of dementia for each 1 SD (2.8) decrease in the score of odour stick identification test for Japanese. We also found an association between severe hyposmia and a characteristic distribution of cerebral metabolic decline, which was identical to that of dementia associated with Parkinson's disease. Furthermore, volumetric magnetic resonance imaging analyses demonstrated close relationships between olfactory dysfunction and the atrophy of focal brain structures, including the amygdala and other limbic structures. Together, our findings suggest that brain regions related to olfactory function are closely associated with cognitive decline and that severe hyposmia is a prominent clinical feature that predicts the subsequent development of Parkinson's disease dementia.
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Affiliation(s)
- Toru Baba
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
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Sawada Y, Nishio Y, Suzuki K, Hirayama K, Takeda A, Hosokai Y, Ishioka T, Itoyama Y, Takahashi S, Fukuda H, Mori E. Attentional set-shifting deficit in Parkinson's disease is associated with prefrontal dysfunction: an FDG-PET study. PLoS One 2012; 7:e38498. [PMID: 22685575 PMCID: PMC3369918 DOI: 10.1371/journal.pone.0038498] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2011] [Accepted: 05/07/2012] [Indexed: 11/17/2022] Open
Abstract
The attentional set-shifting deficit that has been observed in Parkinson's disease (PD) has long been considered neuropsychological evidence of the involvement of meso-prefrontal and prefrontal-striatal circuits in cognitive flexibility. However, recent studies have suggested that non-dopaminergic, posterior cortical pathologies may also contribute to this deficit. Although several neuroimaging studies have addressed this issue, the results of these studies were confounded by the use of tasks that required other cognitive processes in addition to set-shifting, such as rule learning and working memory. In this study, we attempted to identify the neural correlates of the attentional set-shifting deficit in PD using a compound letter task and 18F-fluoro-deoxy-glucose (FDG) positron emission tomography during rest. Shift cost, which is a measure of attentional set-shifting ability, was significantly correlated with hypometabolism in the right dorsolateral prefrontal cortex, including the putative human frontal eye field. Our results provide direct evidence that dysfunction in the dorsolateral prefrontal cortex makes a primary contribution to the attentional set-shifting deficit that has been observed in PD patients.
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Affiliation(s)
- Yoichi Sawada
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan
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Agosta F, Canu E, Stojković T, Pievani M, Tomić A, Sarro L, Dragašević N, Copetti M, Comi G, Kostić VS, Filippi M. The topography of brain damage at different stages of Parkinson's disease. Hum Brain Mapp 2012; 34:2798-807. [PMID: 22528144 DOI: 10.1002/hbm.22101] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2011] [Revised: 03/12/2012] [Accepted: 03/19/2012] [Indexed: 11/09/2022] Open
Abstract
This study investigated gray matter (GM) and white matter (WM) damage in 89 patients at different clinical stages of Parkinson's disease (PD) (17 early, 46 mild, 14 moderate, and 12 severe) to differentiate the trajectories of tissue injury in this condition. PD patients had a very little GM atrophy even at the more advanced stages of the disease. Microstructural damage to the WM occurs with increasing PD severity and involves the brainstem, thalamocortical pathways, olfactory tracts, as well as the major interhemispheric, limbic, and extramotor association tracts. The most marked WM damage was found in moderate vs. mild cases. WM damage correlated with the degree of global cognitive deficits. WM abnormalities beyond the nigrostriatal system accumulate with increasing PD severity. WM damage is likely to contribute to the more severe motor and nonmotor dysfunctions occurring in patients at the later stages.
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Affiliation(s)
- Federica Agosta
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
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49
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Schapira AHV, Hillbom M. Publishing changes and information delivery in the clinical neurosciences. Eur J Neurol 2011. [DOI: 10.1111/j.1468-1331.2011.03594.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Pan PL, Song W, Shang HF. Voxel-wise meta-analysis of gray matter abnormalities in idiopathic Parkinson's disease. Eur J Neurol 2011; 19:199-206. [PMID: 21762435 DOI: 10.1111/j.1468-1331.2011.03474.x] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Structural neuroimaging studies on idiopathic Parkinson's disease (IPD) with voxel-based morphometry (VBM) yielded variable and conflicting findings. A systematic review of VBM studies of patients with IPD and healthy control (HC) subjects published in PubMed, ISI Web of Science, Embase, and Medline databases from 1995 to 25 October 2010 was conducted. Coordinates were extracted from clusters of significant gray matter (GM) difference between patients with IPD and HC subjects. Meta-analysis was performed using signed differential mapping. A total of 17 VBM studies involving 498 patients with IPD and 375 HC subjects met the inclusion criteria. A significant regional GM volume decrease was detected in the left inferior frontal gyrus (BA47) extending to the left superior temporal gyrus (BA38) and the left insula (BA13) of patients with IPD compared with HC subjects. The findings of this study remain largely unchanged in quartile and jackknife sensitivity analyses and in subgroup analyses. Robust GM reductions in the inferior frontal/orbitofrontal gyrus (BA47) are implicated in IPD, and the reductions may be related to the mediation of the non-motor IPD symptoms, such as cognitive, emotional, and autonomic functions. Further studies must be conducted to determine whether the findings are specific to all IPD subtypes or different from the atypical Parkinsonism.
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Affiliation(s)
- P L Pan
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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