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Laurencin C, Lancelot S, Brosse S, Mérida I, Redouté J, Greusard E, Lamberet L, Liotier V, Le Bars D, Costes N, Thobois S, Boulinguez P, Ballanger B. Noradrenergic alterations in Parkinson's disease: a combined 11C-yohimbine PET/neuromelanin MRI study. Brain 2024; 147:1377-1388. [PMID: 37787503 PMCID: PMC10994534 DOI: 10.1093/brain/awad338] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 09/05/2023] [Accepted: 09/19/2023] [Indexed: 10/04/2023] Open
Abstract
Degeneration of the noradrenergic system is now considered a pathological hallmark of Parkinson's disease, but little is known about its consequences in terms of parkinsonian manifestations. Here, we evaluated two aspects of the noradrenergic system using multimodal in vivo imaging in patients with Parkinson's disease and healthy controls: the pigmented cell bodies of the locus coeruleus with neuromelanin sensitive MRI; and the density of α2-adrenergic receptors (ARs) with PET using 11C-yohimbine. Thirty patients with Parkinson's disease and 30 age- and sex-matched healthy control subjects were included. The characteristics of the patients' symptoms were assessed using the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS). Patients showed reduced neuromelanin signal intensity in the locus coeruleus compared with controls and diminished 11C-yohimbine binding in widespread cortical regions, including the motor cortex, as well as in the insula, thalamus and putamen. Clinically, locus coeruleus neuronal loss was correlated with motor (bradykinesia, motor fluctuations, tremor) and non-motor (fatigue, apathy, constipation) symptoms. A reduction of α2-AR availability in the thalamus was associated with tremor, while a reduction in the putamen, the insula and the superior temporal gyrus was associated with anxiety. These results highlight a multifaceted alteration of the noradrenergic system in Parkinson's disease since locus coeruleus and α2-AR degeneration were found to be partly uncoupled. These findings raise important issues about noradrenergic dysfunction that may encourage the search for new drugs targeting this system, including α2-ARs, for the treatment of Parkinson's disease.
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Affiliation(s)
- Chloé Laurencin
- Lyon Neuroscience Research Center (CRNL), INSERM U1028, CNRS UMR5292, University Lyon 1, F-69000 Lyon, France
- Department of Neurology C, Expert Parkinson Centre, Hospices Civils de Lyon, Pierre Wertheimer Neurological Hospital, NS-Park/F-CRIN, 69500 Bron, France
| | - Sophie Lancelot
- Lyon Neuroscience Research Center (CRNL), INSERM U1028, CNRS UMR5292, University Lyon 1, F-69000 Lyon, France
- CERMEP-Imagerie du Vivant, PET-MRI Department, 69500 Bron, France
| | - Sarah Brosse
- Lyon Neuroscience Research Center (CRNL), INSERM U1028, CNRS UMR5292, University Lyon 1, F-69000 Lyon, France
| | - Inés Mérida
- CERMEP-Imagerie du Vivant, PET-MRI Department, 69500 Bron, France
| | - Jérôme Redouté
- CERMEP-Imagerie du Vivant, PET-MRI Department, 69500 Bron, France
| | - Elise Greusard
- CERMEP-Imagerie du Vivant, PET-MRI Department, 69500 Bron, France
| | - Ludovic Lamberet
- CERMEP-Imagerie du Vivant, PET-MRI Department, 69500 Bron, France
| | | | - Didier Le Bars
- CERMEP-Imagerie du Vivant, PET-MRI Department, 69500 Bron, France
| | - Nicolas Costes
- CERMEP-Imagerie du Vivant, PET-MRI Department, 69500 Bron, France
| | - Stéphane Thobois
- Department of Neurology C, Expert Parkinson Centre, Hospices Civils de Lyon, Pierre Wertheimer Neurological Hospital, NS-Park/F-CRIN, 69500 Bron, France
- Institut des Sciences Cognitives Marc Jeannerod, UMR 5229, CNRS, 69500 Bron, France
| | - Philippe Boulinguez
- Lyon Neuroscience Research Center (CRNL), INSERM U1028, CNRS UMR5292, University Lyon 1, F-69000 Lyon, France
| | - Bénédicte Ballanger
- Lyon Neuroscience Research Center (CRNL), INSERM U1028, CNRS UMR5292, University Lyon 1, F-69000 Lyon, France
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2
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Qiu X, Tao Q, Zhang L, Kuang C, Xie Y, Zhang L, Yin S, Peng J, Jiang Y. Deletion of Bak1 alleviates microglial necroptosis and neuroinflammation after experimental subarachnoid hemorrhage. J Neurochem 2022; 164:829-846. [PMID: 36583235 DOI: 10.1111/jnc.15751] [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: 06/09/2022] [Revised: 11/18/2022] [Accepted: 12/06/2022] [Indexed: 12/31/2022]
Abstract
Microglial necroptosis exacerbates neurodegenerative diseases, central nervous system (CNS) injury, and demonstrates a proinflammatory process, but its contribution to subarachnoid hemorrhage (SAH) is poorly characterized. BCL-2 homologous antagonist-killer protein (Bak1), a critical regulatory molecule of endogenous apoptosis, can be involved in the pathologic process of necroptosis by regulating mitochondrial permeability. In this study, we revealed microglia undergo necroptosis after SAH in vivo and vitro. Western blot revealed that Bak1 was elevated at 24 h after SAH. Knocked down of Bak1 by adeno-associated virus attenuates microglial necroptosis, alleviates neuroinflammation, and improves neurologic function after SAH in mice. Furthermore, oxyhemoglobin (10 μM) induced necroptosis in BV2 microglia, increasing Bak1 expression and mediating proinflammatory phenotype transformation, exacerbating oxidative stress and neuroinflammation. Abrogating BV2 Bak1 could reduce necroptosis by down-regulating the expression of phosphorylated pseudokinase mixed lineage kinase domain-like protein (p-MLKL), then down-regulating proinflammatory phenotype gene expression. RNA-Seq showed that disrupting BV2 Bak1 down-regulates multiple immune and inflammatory pathways and ameliorates cell injury by elevating thrombospondin 1 (THBS1) expression. In summary, we identified a critical regulatory role for Bak1 in microglial necroptosis and neuroinflammation after SAH. Bak1 is expected to be a potential target for the treatment strategy of SAH.
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Affiliation(s)
- Xiancheng Qiu
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Laboratory of Neurological Diseases and Brain Function, The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Department of Neurosurgery, Shifang City People's Hospital, Shifang, China
| | - Qianke Tao
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Laboratory of Neurological Diseases and Brain Function, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Lihan Zhang
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Laboratory of Neurological Diseases and Brain Function, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Chenghao Kuang
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Laboratory of Neurological Diseases and Brain Function, The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Institute of Epigenetics and Brain Science, Southwest Medical University, Luzhou, China
| | - Yuke Xie
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Laboratory of Neurological Diseases and Brain Function, The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Institute of Epigenetics and Brain Science, Southwest Medical University, Luzhou, China
| | - Lifang Zhang
- Sichuan Clinical Research Center for Neurosurgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Shigang Yin
- Laboratory of Neurological Diseases and Brain Function, The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Institute of Epigenetics and Brain Science, Southwest Medical University, Luzhou, China.,Academician (Expert) Workstation of Sichuan Province, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Jianhua Peng
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Laboratory of Neurological Diseases and Brain Function, The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Institute of Epigenetics and Brain Science, Southwest Medical University, Luzhou, China.,Academician (Expert) Workstation of Sichuan Province, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Yong Jiang
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Laboratory of Neurological Diseases and Brain Function, The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Institute of Epigenetics and Brain Science, Southwest Medical University, Luzhou, China.,Academician (Expert) Workstation of Sichuan Province, The Affiliated Hospital of Southwest Medical University, Luzhou, China
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Criaud M, Laurencin C, Poisson A, Metereau E, Redouté J, Thobois S, Boulinguez P, Ballanger B. Noradrenaline and Movement Initiation Disorders in Parkinson’s Disease: A Pharmacological Functional MRI Study with Clonidine. Cells 2022; 11:cells11172640. [PMID: 36078048 PMCID: PMC9454805 DOI: 10.3390/cells11172640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/13/2022] [Accepted: 08/23/2022] [Indexed: 11/16/2022] Open
Abstract
Slowness of movement initiation is a cardinal motor feature of Parkinson’s disease (PD) and is not fully reverted by current dopaminergic treatments. This trouble could be due to the dysfunction of executive processes and, in particular, of inhibitory control of response initiation, a function possibly associated with the noradrenergic (NA) system. The implication of NA in the network supporting proactive inhibition remains to be elucidated using pharmacological protocols. For that purpose, we administered 150 μg of clonidine to 15 healthy subjects and 12 parkinsonian patients in a double-blind, randomized, placebo-controlled design. Proactive inhibition was assessed by means of a Go/noGo task, while pre-stimulus brain activity was measured by event-related functional MRI. Acute reduction in noradrenergic transmission induced by clonidine enhanced difficulties initiating movements reflected by an increase in omission errors and modulated the activity of the anterior node of the proactive inhibitory network (dorsomedial prefrontal and anterior cingulate cortices) in PD patients. We conclude that NA contributes to movement initiation by acting on proactive inhibitory control via the α2-adrenoceptor. We suggest that targeting noradrenergic dysfunction may represent a new treatment approach in some of the movement initiation disorders seen in Parkinson’s disease.
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Affiliation(s)
- Marion Criaud
- Institute of Psychiatry Psychology & Neuroscience, Department Child & Adolescent Psychiatry, Kings College London, London SE24 9QR, UK
| | - Chloé Laurencin
- Université de Lyon, 69622 Lyon, France
- Université Claude Bernard Lyon 1, 69100 Villeurbanne, France
- INSERM U1028, Lyon Neuroscience Research Center (CRNL), 69000 Lyon, France
- CNRS UMR5292, Lyon Neuroscience Research Center (CRNL), 69000 Lyon, France
- Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, Centre Expert Parkinson, Hospices Civils de Lyon, 69677 Bron, France
| | - Alice Poisson
- Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, Centre Expert Parkinson, Hospices Civils de Lyon, 69677 Bron, France
| | - Elise Metereau
- Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, Centre Expert Parkinson, Hospices Civils de Lyon, 69677 Bron, France
| | | | - Stéphane Thobois
- Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, Centre Expert Parkinson, Hospices Civils de Lyon, 69677 Bron, France
- CNRS UMR5229, Institute of Cognitive Science Marc Jeannerod, 69500 Bron, France
| | - Philippe Boulinguez
- Université de Lyon, 69622 Lyon, France
- Université Claude Bernard Lyon 1, 69100 Villeurbanne, France
- INSERM U1028, Lyon Neuroscience Research Center (CRNL), 69000 Lyon, France
- CNRS UMR5292, Lyon Neuroscience Research Center (CRNL), 69000 Lyon, France
| | - Bénédicte Ballanger
- Université de Lyon, 69622 Lyon, France
- Université Claude Bernard Lyon 1, 69100 Villeurbanne, France
- INSERM U1028, Lyon Neuroscience Research Center (CRNL), 69000 Lyon, France
- CNRS UMR5292, Lyon Neuroscience Research Center (CRNL), 69000 Lyon, France
- Correspondence:
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Bos MJ, Buhre W, Temel Y, Joosten EAJ, Absalom AR, Janssen MLF. Effect of Anesthesia on Microelectrode Recordings During Deep Brain Stimulation Surgery: A Narrative Review. J Neurosurg Anesthesiol 2021; 33:300-307. [PMID: 31913866 DOI: 10.1097/ana.0000000000000673] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 12/04/2019] [Indexed: 12/31/2022]
Abstract
Deep brain stimulation (DBS) is an effective surgical treatment for patients with various neurological and psychiatric disorders. Clinical improvements rely on careful patient selection and accurate electrode placement. A common method for target localization is intraoperative microelectrode recording (MER). To facilitate MER, DBS surgery is traditionally performed under local or regional anesthesia. However, sedation or general anesthesia is sometimes needed for patients who are unable to tolerate the procedure fully awake because of severe motor symptoms, psychological distress, pain, or other forms of discomfort. The effect of anesthetic drugs on MER is controversial but likely depends on the type and dose of a particular anesthetic agent, underlying disease, and surgical target. In this narrative review, we provide an overview of the current literature on the anesthetic drugs most often used for sedation and anesthesia during DBS surgery, with a focus on their effects on MERs.
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Affiliation(s)
- Michaël J Bos
- Departments of Anesthesiology and Pain Medicine
- School for Mental Health and Neuroscience, Maastricht University, Maastricht
| | | | - Yasin Temel
- Neurosurgery
- School for Mental Health and Neuroscience, Maastricht University, Maastricht
| | - Elbert A J Joosten
- Departments of Anesthesiology and Pain Medicine
- School for Mental Health and Neuroscience, Maastricht University, Maastricht
| | - Anthony R Absalom
- Department of Anesthesiology, University Medical Center Groningen, Groningen, The Netherlands
| | - Marcus L F Janssen
- Neurology
- Clinical Neurophysiology, Maastricht University Medical Center
- School for Mental Health and Neuroscience, Maastricht University, Maastricht
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5
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De Pretto M, Mouthon M, Debove I, Pollo C, Schüpbach M, Spierer L, Accolla EA. Proactive inhibition is not modified by deep brain stimulation for Parkinson's disease: An electrical neuroimaging study. Hum Brain Mapp 2021; 42:3934-3949. [PMID: 34110074 PMCID: PMC8288097 DOI: 10.1002/hbm.25530] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 04/23/2021] [Accepted: 05/03/2021] [Indexed: 11/06/2022] Open
Abstract
In predictable contexts, motor inhibitory control can be deployed before the actual need for response suppression. The brain functional underpinnings of proactive inhibition, and notably the role of basal ganglia, are not entirely identified. We investigated the effects of deep brain stimulation of the subthalamic nucleus or internal globus pallidus on proactive inhibition in patients with Parkinson's disease. They completed a cued go/no-go proactive inhibition task ON and (unilateral) OFF stimulation while EEG was recorded. We found no behavioural effect of either subthalamic nucleus or internal globus pallidus deep brain stimulation on proactive inhibition, despite a general improvement of motor performance with subthalamic nucleus stimulation. In the non-operated and subthalamic nucleus group, we identified periods of topographic EEG modulation by the level of proactive inhibition. In the subthalamic nucleus group, source estimation analysis suggested the initial involvement of bilateral frontal and occipital areas, followed by a right lateralized fronto-basal network, and finally of right premotor and left parietal regions. Our results confirm the overall preservation of proactive inhibition capacities in both subthalamic nucleus and internal globus pallidus deep brain stimulation, and suggest a partly segregated network for proactive inhibition, with a preferential recruitment of the indirect pathway.
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Affiliation(s)
- Michael De Pretto
- Neurology Unit, Medicine Section, Faculty of Sciences and Medicine, University of Fribourg, Fribourg, Switzerland
| | - Michael Mouthon
- Neurology Unit, Medicine Section, Faculty of Sciences and Medicine, University of Fribourg, Fribourg, Switzerland
| | - Ines Debove
- Movement Disorders Center, Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Claudio Pollo
- Department of Neurosurgery, Inselspital University Hospital Bern, Bern, Switzerland
| | - Michael Schüpbach
- Movement Disorders Center, Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Lucas Spierer
- Neurology Unit, Medicine Section, Faculty of Sciences and Medicine, University of Fribourg, Fribourg, Switzerland
| | - Ettore A Accolla
- Neurology Unit, Medicine Section, Faculty of Sciences and Medicine, University of Fribourg, Fribourg, Switzerland.,Neurology Unit, Department of Medicine, HFR - Cantonal Hospital Fribourg, Fribourg, Switzerland
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6
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The Human Basal Ganglia Mediate the Interplay between Reactive and Proactive Control of Response through Both Motor Inhibition and Sensory Modulation. Brain Sci 2021; 11:brainsci11050560. [PMID: 33925153 PMCID: PMC8146223 DOI: 10.3390/brainsci11050560] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/24/2021] [Accepted: 04/26/2021] [Indexed: 11/17/2022] Open
Abstract
The basal ganglia (BG) have long been known for contributing to the regulation of motor behaviour by means of a complex interplay between tonic and phasic inhibitory mechanisms. However, after having focused for a long time on phasic reactive mechanisms, it is only recently that psychological research in healthy humans has modelled tonic proactive mechanisms of control. Mutual calibration between anatomo-functional and psychological models is still needed to better understand the unclear role of the BG in the interplay between proactive and reactive mechanisms of control. Here, we implemented an event-related fMRI design allowing proper analysis of both the brain activity preceding the target-stimulus and the brain activity induced by the target-stimulus during a simple go/nogo task, with a particular interest in the ambiguous role of the basal ganglia. Post-stimulus activity was evoked in the left dorsal striatum, the subthalamus nucleus and internal globus pallidus by any stimulus when the situation was unpredictable, pinpointing its involvement in reactive, non-selective inhibitory mechanisms when action restraint is required. Pre-stimulus activity was detected in the ventral, not the dorsal, striatum, when the situation was unpredictable, and was associated with changes in functional connectivity with the early visual, not the motor, cortex. This suggests that the ventral striatum supports modulatory influence over sensory processing during proactive control.
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Bos MJ, de Korte-de Boer D, Alzate Sanchez AM, Duits A, Ackermans L, Temel Y, Absalom AR, Buhre WF, Roberts MJ, Janssen MLF. Impact of Procedural Sedation on the Clinical Outcome of Microelectrode Recording Guided Deep Brain Stimulation in Patients with Parkinson's Disease. J Clin Med 2021; 10:1557. [PMID: 33917205 PMCID: PMC8068017 DOI: 10.3390/jcm10081557] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/01/2021] [Accepted: 04/05/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Subthalamic nucleus (STN) deep brain stimulation (DBS) has become a routine treatment of advanced Parkinson's disease (PD). DBS surgery is commonly performed under local anesthesia (LA) to obtain reliable microelectrode recordings. However, procedural sedation and/or analgesia (PSA) is often desirable to improve patient comfort. The impact of PSA in addition to LA on outcome is largely unknown. Therefore, we performed an observational study to assess the effect of PSA compared to LA alone during STN DBS surgery on outcome in PD patients. METHODS Seventy PD patients (22 under LA, 48 under LA + PSA) scheduled for STN DBS implantation were included. Dexmedetomidine, clonidine or remifentanil were used for PSA. The primary outcome was the change in Movement Disorders Society Unified Parkinson's Disease Rating Score III (MDS-UPDRS III) and levodopa equivalent daily dosage (LEDD) between baseline, one month before surgery, and twelve months postoperatively. Secondary outcome measures were motor function during activities of daily living (MDS-UPDRS II), cognitive alterations and surgical adverse events. Postoperative assessment was conducted in "on" stimulation and "on" medication conditions. RESULTS At twelve months follow-up, UPDRS III and UPDRS II scores in "on" medication conditions were similar between the LA and PSA groups. The two groups showed a similar LEDD reduction and an equivalent decline in executive function measured by the Stroop Color-Word Test, Trail Making Test-B, and verbal fluency. The incidence of perioperative and postoperative adverse events was similar between groups. CONCLUSION This study demonstrates that PSA during STN DBS implantation surgery in PD patients was not associated with differences in motor and non-motor outcome after twelve months compared with LA only.
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Affiliation(s)
- Michael J. Bos
- Department of Anesthesiology and Pain Medicine, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands; (D.d.K.-d.B.); (W.F.B.)
- Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, The Netherlands; (A.M.A.S.); (A.D.); (Y.T.); (M.L.F.J.)
| | - Dianne de Korte-de Boer
- Department of Anesthesiology and Pain Medicine, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands; (D.d.K.-d.B.); (W.F.B.)
| | - Ana Maria Alzate Sanchez
- Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, The Netherlands; (A.M.A.S.); (A.D.); (Y.T.); (M.L.F.J.)
| | - Annelien Duits
- Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, The Netherlands; (A.M.A.S.); (A.D.); (Y.T.); (M.L.F.J.)
- Department of Medical Psychology, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands
| | - Linda Ackermans
- Department of Neurosurgery, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands;
| | - Yasin Temel
- Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, The Netherlands; (A.M.A.S.); (A.D.); (Y.T.); (M.L.F.J.)
- Department of Neurosurgery, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands;
| | - Anthony R. Absalom
- Department of Anesthesiology, University Medical Center Groningen, Groningen University, Hanzeplein 1, 9713 GZ Groningen, The Netherlands;
| | - Wolfgang F. Buhre
- Department of Anesthesiology and Pain Medicine, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands; (D.d.K.-d.B.); (W.F.B.)
- Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, The Netherlands; (A.M.A.S.); (A.D.); (Y.T.); (M.L.F.J.)
| | - Mark J. Roberts
- Faculty of Psychology and Neuroscience, Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, The Netherlands;
| | - Marcus L. F. Janssen
- Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, The Netherlands; (A.M.A.S.); (A.D.); (Y.T.); (M.L.F.J.)
- Department of Clinical Neurophysiology, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands
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Meyer GM, Spay C, Beliakova A, Gaugain G, Pezzoli G, Ballanger B, Boulinguez P, Cilia R. Inhibitory control dysfunction in parkinsonian impulse control disorders. Brain 2021; 143:3734-3747. [PMID: 33320929 DOI: 10.1093/brain/awaa318] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 07/07/2020] [Accepted: 08/03/2020] [Indexed: 12/27/2022] Open
Abstract
Impulse control disorders (ICDs) in Parkinson's disease have been associated with dysfunctions in the control of value- or reward-based responding (choice impulsivity) and abnormalities in mesocorticolimbic circuits. The hypothesis that dysfunctions in the control of response inhibition (action impulsivity) also play a role in Parkinson's disease ICDs has recently been raised, but the underlying neural mechanisms have not been probed directly. We used high-resolution EEG recordings from 41 patients with Parkinson's disease with and without ICDs to track the spectral and dynamical signatures of different mechanisms involved in inhibitory control in a simple visuomotor task involving no selection between competing responses and no reward to avoid potential confounds with reward-based decision. Behaviourally, patients with Parkinson's disease with ICDs proved to be more impulsive than those without ICDs. This was associated with decreased beta activity in the precuneus and in a region of the medial frontal cortex centred on the supplementary motor area. The underlying dynamical patterns pinpointed dysfunction of proactive inhibitory control, an executive mechanism intended to gate motor responses in anticipation of stimulation in uncertain contexts. The alteration of the cortical drive of proactive response inhibition in Parkinson's disease ICDs pinpoints the neglected role the precuneus might play in higher order executive functions in coordination with the supplementary motor area, specifically for switching between executive settings. Clinical perspectives are discussed in the light of the non-dopaminergic basis of this function.
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Affiliation(s)
- Garance M Meyer
- Université de Lyon, F-69622, Lyon, France.,Université Lyon 1, Villeurbanne, France.,INSERM, U 1028, Lyon Neuroscience Research Center, Lyon, F-69000, France.,CNRS, UMR 5292, Lyon Neuroscience Research Center, Lyon, F-69000, France
| | - Charlotte Spay
- Université de Lyon, F-69622, Lyon, France.,Université Lyon 1, Villeurbanne, France.,INSERM, U 1028, Lyon Neuroscience Research Center, Lyon, F-69000, France.,CNRS, UMR 5292, Lyon Neuroscience Research Center, Lyon, F-69000, France
| | - Alina Beliakova
- Université de Lyon, F-69622, Lyon, France.,Université Lyon 1, Villeurbanne, France.,INSERM, U 1028, Lyon Neuroscience Research Center, Lyon, F-69000, France.,CNRS, UMR 5292, Lyon Neuroscience Research Center, Lyon, F-69000, France
| | - Gabriel Gaugain
- Université de Lyon, F-69622, Lyon, France.,Université Lyon 1, Villeurbanne, France.,INSERM, U 1028, Lyon Neuroscience Research Center, Lyon, F-69000, France.,CNRS, UMR 5292, Lyon Neuroscience Research Center, Lyon, F-69000, France
| | - Gianni Pezzoli
- Fondazione Grigioni per il Morbo di Parkinson, Milan, Italy.,Previous affiliation: Parkinson Institute, ASST "Gaetano Pini-CTO", Milan, Italy
| | - Bénédicte Ballanger
- Université de Lyon, F-69622, Lyon, France.,Université Lyon 1, Villeurbanne, France.,INSERM, U 1028, Lyon Neuroscience Research Center, Lyon, F-69000, France.,CNRS, UMR 5292, Lyon Neuroscience Research Center, Lyon, F-69000, France
| | - Philippe Boulinguez
- Université de Lyon, F-69622, Lyon, France.,Université Lyon 1, Villeurbanne, France.,INSERM, U 1028, Lyon Neuroscience Research Center, Lyon, F-69000, France.,CNRS, UMR 5292, Lyon Neuroscience Research Center, Lyon, F-69000, France
| | - Roberto Cilia
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Department of Clinical Neurosciences, Parkinson and Movement Disorders Unit, Milan, Italy.,Previous affiliation: Parkinson Institute, ASST "Gaetano Pini-CTO", Milan, Italy
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9
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Abstract
BACKGROUND Microelectrode recordings (MERs) are used during deep brain stimulation surgery (DBS) to optimize patient outcomes and provide a unique method of collecting data regarding neurological conditions. However, MERs can be affected by anesthetics such as dexmedetomidine. Little is known about the effects of dexmedetomidine (DEX) on the globus pallidus interna (GPi), a common target for DBS. The primary aim of this study is to investigate the hypothesis that DEX is associated with alterations in GPi MERs. METHODS We conducted a retrospective analysis comparing MERs from patients with Parkinson's disease (PD) and dystonia who underwent insertion of DBS of the GPi under DEX sedation with those who went through the same procedure without DEX (No DEX). RESULTS Firing rates for GPi neurons in the DEX group were lower (57.44 ± 2.04; mean ± SEM, n = 163 cells) than the No DEX group (69.53 ± 2.06, n = 112 cells, P < 0.0001). Overall, DEX was associated with a greater proportion of GPi cells classified as firing in bursty pattern compared to our No DEX group. (29.41%, n = 153 vs 14.81%, n = 108, P = 0.008). This effect was present for both PD and dystonia patients who underwent the procedure. High doses of DEX were associated with lower firing rates than low doses. CONCLUSIONS Our results suggest that DEX is associated with a decrease in GPi firing rates and are associated with an increase in burstiness. Furthermore, these effects are similar between dystonia and PD patients. Lastly, the effects of DEX may differ between high doses and low doses.
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10
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David FJ, Munoz MJ, Corcos DM. The effect of STN DBS on modulating brain oscillations: consequences for motor and cognitive behavior. Exp Brain Res 2020; 238:1659-1676. [PMID: 32494849 PMCID: PMC7415701 DOI: 10.1007/s00221-020-05834-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Accepted: 05/15/2020] [Indexed: 12/11/2022]
Abstract
In this review, we highlight Professor John Rothwell's contribution towards understanding basal ganglia function and dysfunction, as well as the effects of subthalamic nucleus deep brain stimulation (STN DBS). The first section summarizes the rate and oscillatory models of basal ganglia dysfunction with a focus on the oscillation model. The second section summarizes the motor, gait, and cognitive mechanisms of action of STN DBS. In the final section, we summarize the effects of STN DBS on motor and cognitive tasks. The studies reviewed in this section support the conclusion that high-frequency STN DBS improves the motor symptoms of Parkinson's disease. With respect to cognition, STN DBS can be detrimental to performance especially when the task is cognitively demanding. Consolidating findings from many studies, we find that while motor network oscillatory activity is primarily correlated to the beta-band, cognitive network oscillatory activity is not confined to one band but is subserved by activity in multiple frequency bands. Because of these findings, we propose a modified motor and associative/cognitive oscillatory model that can explain the consistent positive motor benefits and the negative and null cognitive effects of STN DBS. This is clinically relevant because STN DBS should enhance oscillatory activity that is related to both motor and cognitive networks to improve both motor and cognitive performance.
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Affiliation(s)
- Fabian J David
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, 645 North Michigan Avenue, Suite 1100, Chicago, IL, 60611, USA.
| | - Miranda J Munoz
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, 645 North Michigan Avenue, Suite 1100, Chicago, IL, 60611, USA
| | - Daniel M Corcos
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, 645 North Michigan Avenue, Suite 1100, Chicago, IL, 60611, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
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Spay C, Meyer G, Lio G, Pezzoli G, Ballanger B, Cilia R, Boulinguez P. Resting state oscillations suggest a motor component of Parkinson's Impulse Control Disorders. Clin Neurophysiol 2019; 130:2065-2075. [PMID: 31541984 DOI: 10.1016/j.clinph.2019.08.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 07/02/2019] [Accepted: 08/14/2019] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Impulse control disorders (ICDs) in Parkinson's disease (PD) have been associated with cognitive impulsivity and dopaminergic dysfunction and treatment. The present study tests the neglected hypothesis that the neurofunctional networks involved in motor impulsivity might also be dysfunctional in PD-ICDs. METHODS We performed blind spectral analyses of resting state electroencephalographic (EEG) data in PD patients with and without ICDs to probe the functional integrity of all cortical networks. Analyses were performed directly at the source level after blind source separation. Discrete differences between groups were tested by comparing patients with and without ICDs. Gradual dysfunctions were assessed by means of correlations between power changes and clinical scores reflecting ICD severity (QUIP score). RESULTS Spectral signatures of ICDs were found in the medial prefrontal cortex, the dorsal anterior cingulate and the supplementary motor area, in the beta and gamma bands. Beta power changes in the supplementary motor area were found to predict ICDs severity. CONCLUSION ICDs are associated with abnormal activity within frequency bands and cortical circuits supporting the control of motor response inhibition. SIGNIFICANCE These results bring to the forefront the need to consider, in addition to the classical interpretation based on aberrant mesocorticolimbic reward processing, the issue of motor impulsivity in PD-ICDs and its potential implications for PD therapy.
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Affiliation(s)
- Charlotte Spay
- Université de Lyon, 92 rue Pasteur, 69007 Lyon, France; Université Lyon 1, 43 boulevard du 11 novembre 1918, 69622 Villeurbanne, France; INSERM, U 1028, Lyon Neuroscience Research Center, 95 boulevard Pinel, 69500 Bron, France; CNRS, UMR 5292, Lyon Neuroscience Research Center, 95 boulevard Pinel, 69500 Bron, France
| | - Garance Meyer
- Université de Lyon, 92 rue Pasteur, 69007 Lyon, France; Université Lyon 1, 43 boulevard du 11 novembre 1918, 69622 Villeurbanne, France; INSERM, U 1028, Lyon Neuroscience Research Center, 95 boulevard Pinel, 69500 Bron, France; CNRS, UMR 5292, Lyon Neuroscience Research Center, 95 boulevard Pinel, 69500 Bron, France
| | - Guillaume Lio
- Centre de Neuroscience Cognitive, UMR 5229, 67 boulevard Pinel, 69675 Bron, France
| | - Gianni Pezzoli
- Parkinson Institute, ASST Gaetano Pini-CTO, Via bignami 1, 20126 Milan, Italy
| | - Bénédicte Ballanger
- Université de Lyon, 92 rue Pasteur, 69007 Lyon, France; Université Lyon 1, 43 boulevard du 11 novembre 1918, 69622 Villeurbanne, France; INSERM, U 1028, Lyon Neuroscience Research Center, 95 boulevard Pinel, 69500 Bron, France; CNRS, UMR 5292, Lyon Neuroscience Research Center, 95 boulevard Pinel, 69500 Bron, France
| | - Roberto Cilia
- Parkinson Institute, ASST Gaetano Pini-CTO, Via bignami 1, 20126 Milan, Italy
| | - Philippe Boulinguez
- Université de Lyon, 92 rue Pasteur, 69007 Lyon, France; Université Lyon 1, 43 boulevard du 11 novembre 1918, 69622 Villeurbanne, France; INSERM, U 1028, Lyon Neuroscience Research Center, 95 boulevard Pinel, 69500 Bron, France; CNRS, UMR 5292, Lyon Neuroscience Research Center, 95 boulevard Pinel, 69500 Bron, France.
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12
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Meyer GM, Spay C, Laurencin C, Ballanger B, Sescousse G, Boulinguez P. Functional imaging studies of Impulse Control Disorders in Parkinson's disease need a stronger neurocognitive footing. Neurosci Biobehav Rev 2019; 98:164-176. [PMID: 30639672 DOI: 10.1016/j.neubiorev.2019.01.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 11/22/2018] [Accepted: 01/07/2019] [Indexed: 02/06/2023]
Abstract
Impulse control disorders (ICDs) in Parkinson's disease (PD) are associated with dopaminergic dysfunction and treatment, but have no satisfactory therapeutic solution. While studies assessing the neurofunctional bases of ICDs are important for advancing our understanding and management of ICDs, they remain sparse and inconsistent. Based on a systematic analysis of the neuroimaging literature, the present review pinpoints various abnormalities beyond the mesocorticolimbic circuit that supports reward processing, suggesting possible dysfunction at the sensorimotor, executive and affective levels. We advocate that: 1) Future studies should use more sophisticated psychological models and behavioral designs that take into account the potentially multifaceted aspect of ICDs; this would allow a more accurate assessment of the underlying neurocognitive processes, which are not all dependent on the dopaminergic system. 2) Future neuroimaging studies should rely more strongly on task-based, event-related analyses to disentangle the various mechanisms that can be dysfunctional in ICDs. We believe these guidelines constitute a prerequisite towards distinguishing causes, correlates and individual susceptibility factors of PD patients with ICDs.
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Affiliation(s)
- Garance M Meyer
- Université de Lyon, Université Claude Bernard Lyon 1, Lyon Neuroscience Research Center, INSERM, U 1028, CNRS, UMR 5292, Action Control and Related Disorders team, F-69000, Lyon, France
| | - Charlotte Spay
- Université de Lyon, Université Claude Bernard Lyon 1, Lyon Neuroscience Research Center, INSERM, U 1028, CNRS, UMR 5292, Action Control and Related Disorders team, F-69000, Lyon, France
| | - Chloé Laurencin
- Université de Lyon, Université Claude Bernard Lyon 1, Lyon Neuroscience Research Center, INSERM, U 1028, CNRS, UMR 5292, Neuroplasticity and Neuropathology of Olfactory Perception team, F-69000, Lyon, France; Service de Neurologie C, Centre Expert Parkinson, Hôpital Neurologique Pierre, Wertheimer, Hospices Civils de Lyon, Lyon, France
| | - Bénédicte Ballanger
- Université de Lyon, Université Claude Bernard Lyon 1, Lyon Neuroscience Research Center, INSERM, U 1028, CNRS, UMR 5292, Neuroplasticity and Neuropathology of Olfactory Perception team, F-69000, Lyon, France
| | - Guillaume Sescousse
- Université de Lyon, Université Claude Bernard Lyon 1, Lyon Neuroscience Research Center, INSERM, U 1028, CNRS, UMR 5292, PsyR2 team, F-69000, Lyon, France
| | - Philippe Boulinguez
- Université de Lyon, Université Claude Bernard Lyon 1, Lyon Neuroscience Research Center, INSERM, U 1028, CNRS, UMR 5292, Action Control and Related Disorders team, F-69000, Lyon, France.
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13
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Spay C, Meyer G, Welter ML, Lau B, Boulinguez P, Ballanger B. Functional imaging correlates of akinesia in Parkinson's disease: Still open issues. NEUROIMAGE-CLINICAL 2018; 21:101644. [PMID: 30584015 PMCID: PMC6412010 DOI: 10.1016/j.nicl.2018.101644] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 12/13/2018] [Accepted: 12/15/2018] [Indexed: 11/19/2022]
Abstract
Akinesia is a major manifestation of Parkinson's disease (PD) related to difficulties or failures of willed movement to occur. Akinesia is still poorly understood and is not fully alleviated by standard therapeutic strategies. One reason is that the area of the clinical concept has blurred boundaries referring to confounded motor symptoms. Here, we review neuroimaging studies which, by providing access to finer-grained mechanisms, have the potential to reveal the dysfunctional brain processes that account for akinesia. It comes out that no clear common denominator could be identified across studies that are too heterogeneous with respect to the clinical/theoretical concepts and methods used. Results reveal, however, that various abnormalities within but also outside the motor and dopaminergic pathways might be associated with akinesia in PD patients. Notably, numerous yet poorly reproducible neural correlates were found in different brain regions supporting executive control by means of resting-state or task-based studies. This includes for instance the dorsolateral prefrontal cortex, the inferior frontal cortex, the supplementary motor area, the medial prefrontal cortex, the anterior cingulate cortex or the precuneus. This observation raises the issue of the multidimensional nature of akinesia. Yet, other open issues should be considered conjointly to drive future investigations. Above all, a unified terminology is needed to allow appropriate association of behavioral symptoms with brain mechanisms across studies. We adhere to a use of the term akinesia restricted to dysfunctions of movement initiation, ranging from delayed response to freezing or even total abolition of movement. We also call for targeting more specific neural mechanisms of movement preparation and action triggering with more sophisticated behavioral designs/event-related neurofunctional analyses. More work is needed to provide reliable evidence, but answering these still open issues might open up new prospects, beyond dopaminergic therapy, for managing this disabling symptom. No clear picture of the neural bases of PD akinesia can be drawn from the literature. Akinesia should be disentangled from bradykinesia and hypokinesia. Movement initiation dysfunctions may arise from both motor and executive disorders. Future neuroimaging studies should probe more specific neurocognitive processes. Future studies should look beyond the dopaminergic basal-ganglia circuitry.
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Affiliation(s)
- Charlotte Spay
- Université de Lyon, Université Claude Bernard Lyon 1, Lyon Neuroscience Resaerch Center, INSERM, U 1028, CNRS, UMR 5292, Action Control and Related Disorders team, F-69000, Lyon, France
| | - Garance Meyer
- Université de Lyon, Université Claude Bernard Lyon 1, Lyon Neuroscience Resaerch Center, INSERM, U 1028, CNRS, UMR 5292, Action Control and Related Disorders team, F-69000, Lyon, France
| | - Marie-Laure Welter
- Neurophysiology Department, CIC-CRB 1404, Rouen University Hospital, University of Rouen, F-76000 Rouen, France
| | - Brian Lau
- Sorbonne Universités, UPMC Univ Paris 06, UMR S 1127, CNRS UMR 7225, Institut du Cerveau et de la Moelle Epinière, F-75013 Paris, France
| | - Philippe Boulinguez
- Université de Lyon, Université Claude Bernard Lyon 1, Lyon Neuroscience Resaerch Center, INSERM, U 1028, CNRS, UMR 5292, Action Control and Related Disorders team, F-69000, Lyon, France
| | - Bénédicte Ballanger
- Université de Lyon, Université Claude Bernard Lyon 1, Lyon Neuroscience Research Center, INSERM, U 1028, CNRS, UMR 5292, Neuroplasticity and Neuropathology of Olfactory Perception team, F-69000, Lyon, France.
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