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Hapakova L, Necpal J, Kosutzka Z. The antisaccadic paradigm: A complementary neuropsychological tool in basal ganglia disorders. Cortex 2024; 178:116-140. [PMID: 38991475 DOI: 10.1016/j.cortex.2024.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 04/20/2024] [Accepted: 06/17/2024] [Indexed: 07/13/2024]
Abstract
This review explores the role of the antisaccadic task in understanding inhibitory mechanisms in basal ganglia disorders. It conducts a comparative analysis of saccadic profiles in conditions such as Parkinson's disease, Tourette syndrome, obsessive-compulsive disorder, Huntington's disease, and dystonia, revealing distinct patterns and proposing mechanisms for impaired performance. The primary focus is on two inhibitory mechanisms: global, pre-emptive inhibition responsible for suppressing prepotent responses, and slower, selective response inhibition. The antisaccadic task demonstrates practicality in clinical applications, aiding in differential diagnoses, treatment monitoring and reflecting gait control. To further enhance its differential diagnostic value, future directions should address issues such as the standardization of eye-tracking protocol and the integration of eye-tracking data with other disease indicators in a comprehensive dataset.
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Affiliation(s)
- Lenka Hapakova
- 2nd Department of Neurology, Comenius University Faculty of Medicine, University Hospital Bratislava, Bratislava, Slovakia.
| | - Jan Necpal
- Neurology Department, Hospital Zvolen, a. s., Zvolen, Slovakia.
| | - Zuzana Kosutzka
- 2nd Department of Neurology, Comenius University Faculty of Medicine, University Hospital Bratislava, Bratislava, Slovakia.
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Johari K, Berger JI. High-definition transcranial direct current stimulation over right dorsolateral prefrontal cortex differentially modulates inhibitory mechanisms for speech vs. limb movement. Psychophysiology 2023; 60:e14289. [PMID: 36883294 DOI: 10.1111/psyp.14289] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 01/25/2023] [Accepted: 02/17/2023] [Indexed: 03/09/2023]
Abstract
Evidence suggests that planning and execution of speech and limb movement are subserved by common neural substrates. However, less is known about whether they are supported by a common inhibitory mechanism. P3 event-related potentials (ERPs) is a neural signature of motor inhibition, which are found to be generated by several brain regions including the right dorsolateral prefrontal cortex (rDLPFC). However, the relative contribution of rDLPFC to the P3 response associated with speech versus limb inhibition remains elusive. We investigated the contribution of rDLPFC to the P3 underlying speech versus limb movement inhibition. Twenty-one neurotypical adults received both cathodal and sham high-definition transcranial direct current stimulation (HD-tDCS) over rDLPFC. ERPs were subsequently recorded while subjects were performing speech and limb Go/No-Go tasks. Cathodal HD-tDCS decreased accuracy for speech versus limb No-Go. Both speech and limb No-Go elicited a similar topographical distribution of P3, with significantly larger amplitudes for speech versus limb at a frontocentral location following cathodal HD-tDCS. Moreover, results showed stronger activation in cingulate cortex and rDLPFC for speech versus limb No-Go following cathodal HD-tDCS. These results indicate (1) P3 is an ERP marker of amodal inhibitory mechanisms that support both speech and limb inhibition, (2) larger P3 for speech versus limb No-Go following cathodal HD-tDCS may reflect the recruitment of additional neural resources-particularly within rDLPFC and cingulate cortex-as compensatory mechanisms to counteract the temporary stimulation-induced decline in speech inhibitory process. These findings have translational implications for neurological conditions that concurrently affect speech and limb movement.
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Affiliation(s)
- Karim Johari
- Human Neurophysiology and Neuromodulation Laboratory, Department of Communication Sciences and Disorders, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Joel I Berger
- Human Brain Research Laboratory, Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
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Przybyszewski AW, Śledzianowski A, Chudzik A, Szlufik S, Koziorowski D. Machine Learning and Eye Movements Give Insights into Neurodegenerative Disease Mechanisms. SENSORS (BASEL, SWITZERLAND) 2023; 23:2145. [PMID: 36850743 PMCID: PMC9968124 DOI: 10.3390/s23042145] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/07/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
Humans are a vision-dominated species; what we perceive depends on where we look. Therefore, eye movements (EMs) are essential to our interactions with the environment, and experimental findings show EMs are affected in neurodegenerative disorders (ND). This could be a reason for some cognitive and movement disorders in ND. Therefore, we aim to establish whether changes in EM-evoked responses can tell us about the progression of ND, such as Alzheimer's (AD) and Parkinson's diseases (PD), in different stages. In the present review, we have analyzed the results of psychological, neurological, and EM (saccades, antisaccades, pursuit) tests to predict disease progression with machine learning (ML) methods. Thanks to ML algorithms, from the high-dimensional parameter space, we were able to find significant EM changes related to ND symptoms that gave us insights into ND mechanisms. The predictive algorithms described use various approaches, including granular computing, Naive Bayes, Decision Trees/Tables, logistic regression, C-/Linear SVC, KNC, and Random Forest. We demonstrated that EM is a robust biomarker for assessing symptom progression in PD and AD. There are navigation problems in 3D space in both diseases. Consequently, we investigated EM experiments in the virtual space and how they may help find neurodegeneration-related brain changes, e.g., related to place or/and orientation problems. In conclusion, EM parameters with clinical symptoms are powerful precision instruments that, in addition to their potential for predictions of ND progression with the help of ML, could be used to indicate the different preclinical stages of both diseases.
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Affiliation(s)
- Andrzej W. Przybyszewski
- Polish-Japanese Academy of Information Technology, The Faculty of Information Technology, 86 Koszykowa Street, 02-008 Warsaw, Poland
- Department of Neurology, University of Massachusetts Medical School, 65 Lake Avenue, Worcester, MA 01655, USA
| | - Albert Śledzianowski
- Polish-Japanese Academy of Information Technology, The Faculty of Information Technology, 86 Koszykowa Street, 02-008 Warsaw, Poland
| | - Artur Chudzik
- Polish-Japanese Academy of Information Technology, The Faculty of Information Technology, 86 Koszykowa Street, 02-008 Warsaw, Poland
| | - Stanisław Szlufik
- Department of Neurology, Faculty of Health Science, Medical University of Warsaw, 8 Kondratowicza Street, 03-242 Warsaw, Poland
| | - Dariusz Koziorowski
- Department of Neurology, Faculty of Health Science, Medical University of Warsaw, 8 Kondratowicza Street, 03-242 Warsaw, Poland
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Trevarrow MP, Munoz MJ, Rivera YM, Arora R, Drane QH, Rosenow JM, Sani SB, Pal GD, Verhagen Metman L, Goelz LC, Corcos DM, David FJ. The Effects of Subthalamic Nucleus Deep Brain Stimulation and Retention Delay on Memory-Guided Reaching Performance in People with Parkinson's Disease. JOURNAL OF PARKINSON'S DISEASE 2023; 13:917-935. [PMID: 37522216 PMCID: PMC10578280 DOI: 10.3233/jpd-225041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/03/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND Subthalamic nucleus deep brain stimulation (STN-DBS) improves intensive aspects of movement (velocity) in people with Parkinson's disease (PD) but impairs the more cognitively demanding coordinative aspects of movement (error). We extended these findings by evaluating STN-DBS induced changes in intensive and coordinative aspects of movement during a memory-guided reaching task with varying retention delays. OBJECTIVE We evaluated the effect of STN-DBS on motor control during a memory-guided reaching task with short and long retention delays in participants with PD and compared performance to healthy controls (HC). METHODS Eleven participants with PD completed the motor section of the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS III) and performed a memory-guided reaching task under four different STN-DBS conditions (DBS-OFF, DBS-RIGHT, DBS-LEFT, and DBS-BOTH) and two retention delays (0.5 s and 5 s). An additional 13 HC completed the memory-guided reaching task. RESULTS Unilateral and bilateral STN-DBS improved the MDS-UPDRS III scores. In the memory-guided reaching task, both unilateral and bilateral STN-DBS increased the intensive aspects of movement (amplitude and velocity) in the direction toward HC but impaired coordinative aspects of movement (error) away from the HC. Furthermore, movement time was decreased but reaction time was unaffected by STN-DBS. Shorter retention delays increased amplitude and velocity, decreased movement times, and decreased error, but increased reaction times in the participants with PD. There were no interactions between STN-DBS condition and retention delay. CONCLUSION STN-DBS may affect cognitive-motor functioning by altering activity throughout cortico-basal ganglia networks and the oscillatory activity subserving them.
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Affiliation(s)
- Michael P. Trevarrow
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA
| | - Miranda J. Munoz
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA
| | - Yessenia M. Rivera
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA
| | - Rishabh Arora
- Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Quentin H. Drane
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA
| | - Joshua M. Rosenow
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Sepehr B. Sani
- Department of Neurosurgery, Rush University Medical Center, Chicago, IL, USA
| | - Gian D. Pal
- Department of Neurology, Division of Movement Disorders, Rutgers - Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Leonard Verhagen Metman
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Lisa C. Goelz
- Department of Kinesiology and Nutrition, UIC College of Applied Health Sciences, Chicago, IL, USA
| | - Daniel M. Corcos
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA
- McCormick School of Engineering, Northwestern University, Evanston, IL, USA
| | - Fabian J. David
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA
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Waldthaler J, Sperlich A, Stüssel C, Steidel K, Timmermann L, Pedrosa DJ. Stimulation of non-motor subthalamic nucleus impairs selective response inhibition via prefrontal connectivity. Brain Commun 2023; 5:fcad121. [PMID: 37113315 PMCID: PMC10128876 DOI: 10.1093/braincomms/fcad121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 03/03/2023] [Indexed: 04/29/2023] Open
Abstract
Given the inconsistent results in the past, there is an ongoing debate whether and how deep brain stimulation in the subthalamic nucleus modifies cognitive control processes like response inhibition in persons with Parkinson's disease. In this study, we examined how the location of the stimulation volume within the subthalamic nucleus affects the performance in an antisaccade task but also how its structural connectivity is related to response inhibition. Antisaccade error rates and latencies were collected in 14 participants on and off deep brain stimulation in a randomized order. Stimulation volumes were computed based on patient-specific lead localizations using preoperative MRI and postoperative CT scans. Structural connectivity of the stimulation volumes with pre-defined cortical oculomotor control regions as well as whole-brain connectivity was estimated using a normative connectome. We showed that the detrimental effect of deep brain stimulation on response inhibition, measured as antisaccade error rate, depended upon the magnitude of the intersection of volumes of activated tissue with the non-motor subregion of the subthalamic nucleus and on its structural connectivity with regions of the prefrontal oculomotor network including bilateral frontal eye fields and right anterior cingulate cortex. Our results corroborate previous recommendations for avoidance of stimulation in the ventromedial non-motor subregion of the subthalamic nucleus which connects to the prefrontal cortex to prevent stimulation-induced impulsivity. Furthermore, antisaccades were initiated faster with deep brain stimulation when the stimulation volume was connected to fibres passing the subthalamic nucleus laterally and projecting onto the prefrontal cortex, indicating that improvement of voluntary saccade generation with deep brain stimulation may be an off-target effect driven by stimulation of corticotectal fibres directly projecting from the frontal and supplementary eye fields onto brainstem gaze control areas. Taken together, these findings could help implement individualized circuit-based deep brain stimulation strategies that avoid impulsive side effects while improving voluntary oculomotor control.
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Affiliation(s)
- Josefine Waldthaler
- Correspondence to: Josefine Waldthaler, Department of Neurology, University Hospitals Gießen and Marburg, Baldingerstraße, 35033 Marburg, Hesse, Germany E-mail:
| | - Alexander Sperlich
- Department of Neurology, University Hospital Gießen and Marburg, 35033 Marburg, Germany
| | - Charlotte Stüssel
- Department of Neurology, University Hospital Gießen and Marburg, 35033 Marburg, Germany
| | - Kenan Steidel
- Department of Neurology, University Hospital Gießen and Marburg, 35033 Marburg, Germany
| | - Lars Timmermann
- Department of Neurology, University Hospital Gießen and Marburg, 35033 Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Philipps-University Marburg and Justus-Liebig-University Giessen, 35033 Marburg, Germany
| | - David J Pedrosa
- Department of Neurology, University Hospital Gießen and Marburg, 35033 Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Philipps-University Marburg and Justus-Liebig-University Giessen, 35033 Marburg, Germany
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Reverse Visually Guided Reaching in Patients with Parkinson’s Disease. PARKINSON'S DISEASE 2022; 2022:8132923. [PMID: 35386952 PMCID: PMC8979744 DOI: 10.1155/2022/8132923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 01/11/2022] [Accepted: 02/22/2022] [Indexed: 11/18/2022]
Abstract
In addition to motor symptoms such as difficulty in movement initiation and bradykinesia, patients with Parkinson’s disease (PD) display nonmotor executive cognitive dysfunction with deficits in inhibitory control. Preoperative psychological assessments are used to screen for impulsivity that may be worsened by deep brain stimulation (DBS) of the subthalamic nucleus (STN). However, it is unclear whether anti-Parkinson’s therapy, such as dopamine replacement therapy (DRT) or DBS, which has beneficial effects on motor function, adversely affects inhibitory control or its domains. The detrimental effects of STN-DBS are more apparent when tasks test the inhibition of habitual prepotent responses or involve complex cognitive loads. Our goal was to use a reverse visually guided reaching (RVGR) task, a hand-based version of the antisaccade task, to simultaneously measure motor performance and response inhibition in subjects with PD. We recruited 55 healthy control subjects, 26 PD subjects receiving treatment with DRTs, and 7 PD subjects receiving treatment with STN-DBS and DRTs. In the RVGR task, a cursor moved opposite to the subject’s hand movement. This was compared to visually guided reaching (VGR) where the cursor moved in the same direction as the subject’s hand movement. Reaction time, mean speed, and direction errors (in RVGR) were assessed. Reaction times were longer, and mean speeds were slower during RVGR compared to VGR in all three groups but worse in untreated subjects with PD. Treatment with DRTs, DBS, or DBS + DRT improved the reaction time and speed on the RVGR task to a greater extent than VGR. Additionally, DBS or DBS + DRT demonstrated an increase in direction errors, which was correlated with decreased reaction time. These results show that the RVGR task quantifies the benefit of STN-DBS on bradykinesia and the concomitant reduction of proactive inhibitory control. The RVGR task has the potential to be used to rapidly screen for preoperative deficits in inhibitory control and to titrate STN-DBS, to maximize the therapeutic benefits on movement, and minimize impaired inhibitory control.
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