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Summers D, Spencer K, Okasaki C, Huber JE. An Examination of Cognitive Heterogeneity in Parkinson Disease: The Dual-Syndrome Hypothesis. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:1127-1135. [PMID: 38446552 DOI: 10.1044/2024_jslhr-23-00621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
PURPOSE Cognitive impairment is one of the most debilitating nonmotor symptoms in Parkinson disease (PD), and its presentation is heterogeneous. One proposed model to explain cognitive variability in PD is the dual-syndrome hypothesis. This hypothesis delineates two cognitive profiles, a "fronto-striatal" profile and a "posterior cortical" profile according to symptom presentation, associated motor phenotype, and risk for dementia. The current study examined the dual-syndrome hypothesis in individuals with idiopathic PD to evaluate the existence of these profiles, determine the association with the motor phenotype (tremor dominant vs. postural instability/gait disorder), and assess the relative risk for dementia. METHOD A retrospective examination was conducted using data from the Parkinson's Progression Markers Initiative database at baseline (within 2 years of diagnosis) and 5 years after baseline. Descriptive categorizations, cluster analyses, generalized linear mixed models, and logistic regressions were used to address the research questions. RESULTS There was emerging evidence of cognitive profiles; however, these were not fully supported by cluster analyses. Baseline cognitive profile was associated with later motor phenotype, and as predicted, dementia risk was greatest in persons with baseline posterior cortical impairments. CONCLUSION The current results provide mixed support for the dual-syndrome hypothesis, with some evidence that the posterior cortical cognitive profile is associated with postural instability and gait disorder as well as greater dementia risk.
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Affiliation(s)
- Dale Summers
- Department of Speech and Hearing Sciences, University of Washington, Seattle
| | - Kristie Spencer
- Department of Speech and Hearing Sciences, University of Washington, Seattle
| | - Connie Okasaki
- Quantitative Ecology and Resource Management, University of Washington, Seattle
| | - Jessica E Huber
- Department of Communicative Disorders and Sciences, University at Buffalo, NY
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2
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Han G, Kim JS, Park YH, Kang SH, Kim HR, Hwangbo S, Chung TY, Shin HY, Na DL, Seo SW, Lim DH, Kim HJ. Decreased visual acuity is related to thinner cortex in cognitively normal adults: cross-sectional, single-center cohort study. Alzheimers Res Ther 2022; 14:99. [PMID: 35879770 PMCID: PMC9310451 DOI: 10.1186/s13195-022-01045-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 07/13/2022] [Indexed: 11/10/2022]
Abstract
Abstract
Background
Decreased visual acuity (VA) is reported to be a risk factor for dementia. However, the association between VA and cortical thickness has not been established. We investigated the association between VA and cortical thickness in cognitively normal adults.
Method
We conducted a cross-sectional, single-center cohort study with cognitively normal adults (aged ≥ 45) who received medical screening examinations at the Health Promotion Center at Samsung Medical Center. Subjects were categorized as bad (VA ≤ 20/40), fair (20/40 < VA ≤ 20/25), and good (VA > 20/25) VA group by using corrected VA in the Snellen system. Using 3D volumetric brain MRI, cortical thickness was calculated using the Euclidean distance between the linked vertices of the inner and outer surfaces. We analyzed the association between VA and cortical thickness after controlling for age, sex, hypertension, diabetes, dyslipidemia, intracranial volume, and education level.
Results
A total of 2756 subjects were analyzed in this study. Compared to the good VA group, the bad VA group showed overall thinner cortex (p = 0.015), especially in the parietal (p = 0.018) and occipital (p = 0.011) lobes. Topographical color maps of vertex-wise analysis also showed that the bad VA group showed a thinner cortex in the parieto-temporo-occipital area. These results were more robust in younger adults (aged 45 to 65) as decreased VA was associated with thinner cortex in more widespread regions in the parieto-temporo-occipital area.
Conclusion
Our results suggest that a thinner cortex in the visual processing area of the brain is related to decreased visual stimuli.
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Iarkov A, Mendoza C, Echeverria V. Cholinergic Receptor Modulation as a Target for Preventing Dementia in Parkinson's Disease. Front Neurosci 2021; 15:665820. [PMID: 34616271 PMCID: PMC8488354 DOI: 10.3389/fnins.2021.665820] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 08/26/2021] [Indexed: 12/20/2022] Open
Abstract
Parkinson’s disease (PD) is a neurodegenerative condition characterized by the loss of dopaminergic neurons in the substantia nigra pars compacta (SNpc) in the midbrain resulting in progressive impairment in cognitive and motor abilities. The physiological and molecular mechanisms triggering dopaminergic neuronal loss are not entirely defined. PD occurrence is associated with various genetic and environmental factors causing inflammation and mitochondrial dysfunction in the brain, leading to oxidative stress, proteinopathy, and reduced viability of dopaminergic neurons. Oxidative stress affects the conformation and function of ions, proteins, and lipids, provoking mitochondrial DNA (mtDNA) mutation and dysfunction. The disruption of protein homeostasis induces the aggregation of alpha-synuclein (α-SYN) and parkin and a deficit in proteasome degradation. Also, oxidative stress affects dopamine release by activating ATP-sensitive potassium channels. The cholinergic system is essential in modulating the striatal cells regulating cognitive and motor functions. Several muscarinic acetylcholine receptors (mAChR) and nicotinic acetylcholine receptors (nAChRs) are expressed in the striatum. The nAChRs signaling reduces neuroinflammation and facilitates neuronal survival, neurotransmitter release, and synaptic plasticity. Since there is a deficit in the nAChRs in PD, inhibiting nAChRs loss in the striatum may help prevent dopaminergic neurons loss in the striatum and its pathological consequences. The nAChRs can also stimulate other brain cells supporting cognitive and motor functions. This review discusses the cholinergic system as a therapeutic target of cotinine to prevent cognitive symptoms and transition to dementia in PD.
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Affiliation(s)
- Alexandre Iarkov
- Laboratorio de Neurobiología, Facultad de Ciencias de la Salud, Universidad San Sebastián, Concepción, Chile
| | - Cristhian Mendoza
- Laboratorio de Neurobiología, Facultad de Ciencias de la Salud, Universidad San Sebastián, Concepción, Chile
| | - Valentina Echeverria
- Laboratorio de Neurobiología, Facultad de Ciencias de la Salud, Universidad San Sebastián, Concepción, Chile.,Research & Development Service, Bay Pines VA Healthcare System, Bay Pines, FL, United States
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4
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De Roy J, Postuma RB, Brillon-Corbeil M, Montplaisir J, Génier Marchand D, Escudier F, Panisset M, Chouinard S, Gagnon JF. Detecting the Cognitive Prodrome of Dementia in Parkinson's Disease. JOURNAL OF PARKINSONS DISEASE 2021; 10:1033-1046. [PMID: 32310188 DOI: 10.3233/jpd-191857] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND More than 75% of Parkinson's disease (PD) patients will develop dementia. Previous studies on the cognitive predictors of dementia in PD had some methodological limitations and the cognitive tests identified as good predictors vary greatly. OBJECTIVE This prospective cohort study aims to identify the optimal cognitive predictors of dementia in PD using complementary statistical methods. METHODS Eighty PD patients without dementia underwent polysomnographic recording, a neurological examination, and a complete neuropsychological assessment at baseline. They were then followed for a mean of 4.3 years. Baseline group comparisons and survival analyses were used to identify optimal cognitive predictors. Moreover, patients who developed dementia were pair-matched at baseline according to age, sex, and education to healthy controls (2 : 1), and receiver operating characteristic curves were calculated for cognitive tests. RESULTS At follow-up, 23 patients (29%) developed dementia. PD patients who developed dementia had poorer baseline performance and a higher proportion of clinically impaired performance on several cognitive tests. Impaired baseline performance on the Block Design subtest was the best independent predictor of dementia (HR = 8). Moreover, the Trail Making Test part B (time) and Verbal Fluency (semantic) had the best psychometric properties (area under the curve >0.90) for identifying PD patients at risk of dementia. CONCLUSION The present study identified three cognitive tests as the most accurate to detect individuals with PD at high risk of developing dementia.
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Affiliation(s)
- Jessie De Roy
- Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, CIUSSS du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada.,Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada
| | - Ronald B Postuma
- Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, CIUSSS du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada.,Department of Neurology, Montreal General Hospital, Montreal, QC, Canada
| | - Marina Brillon-Corbeil
- Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, CIUSSS du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada.,Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada
| | - Jacques Montplaisir
- Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, CIUSSS du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada.,Department of Psychiatry, Université de Montréal, Montréal, QC, Canada
| | - Daphné Génier Marchand
- Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, CIUSSS du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada.,Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada
| | - Frédérique Escudier
- Research Centre, Institut Universitaire de gériatrie de Montréal, Montreal, QC, Canada
| | - Michel Panisset
- Unité des troubles du mouvement André Barbeau, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Sylvain Chouinard
- Unité des troubles du mouvement André Barbeau, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Jean-François Gagnon
- Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, CIUSSS du Nord-de-l'Île-de-Montréal, Montreal, QC, Canada.,Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada.,Research Centre, Institut Universitaire de gériatrie de Montréal, Montreal, QC, Canada
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Carlesimo GA, Taglieri S, Zabberoni S, Scalici F, Peppe A, Caltagirone C, Costa A. Subjective organization in the episodic memory of individuals with Parkinson's disease associated with mild cognitive impairment. J Neuropsychol 2021; 16:161-182. [PMID: 34089629 DOI: 10.1111/jnp.12256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Word clustering (i.e., the ability to reproduce the same word pairs in consecutive recall trials of an unrelated word list) has been extensively investigated as a proxy of subjective organization (SO) of memorandum. In healthy subjects and in groups of brain-damaged patients, the rate of SO generally predicts accuracy of word list recall. This study aimed at evaluating SO in the performance of patients with Parkinson's disease (PD) on a word list recall task in order to investigate the basic mechanisms of episodic memory impairment that are frequently observed in these patients. For this purpose, 56 PD patients, who were stratified according to the presence and quality of mild cognitive impairment (MCI), and a group of healthy controls (HCs) were administered a word list task and an extensive battery of neuropsychological tests. Results showed that recall accuracy on the word list task progressively decreased passing from HC to PD patients without cognitive impairment, to patients with single-domain dysexecutive MCI and to patients with multiple-domain dysexecutive and amnesic MCI. Conversely, only the latter PD group showed a lower SO score than that achieved by the other groups. In the overall PD group, correlational and regression analyses demonstrated that SO scores and a composite score of executive functions were not reciprocally related, but both provided an independent and significant contribution to the prediction of word list recall accuracy. These data are discussed in terms of the contribution of executive functions and hippocampal storage processes to the onset of memory impairment in PD.
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Affiliation(s)
- Giovanni Augusto Carlesimo
- Department of Systems Medicine, Tor Vergata University, Rome, Italy.,IRCCS Santa Lucia Foundation, Rome, Italy
| | - Sara Taglieri
- IRCCS Santa Lucia Foundation, Rome, Italy.,Niccolò Cusano University, Rome, Italy
| | | | | | | | - Carlo Caltagirone
- Department of Systems Medicine, Tor Vergata University, Rome, Italy.,IRCCS Santa Lucia Foundation, Rome, Italy
| | - Alberto Costa
- IRCCS Santa Lucia Foundation, Rome, Italy.,Niccolò Cusano University, Rome, Italy
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6
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Lin WC, Lu CH, Chiu PY, Yang SY. Plasma Total α-Synuclein and Neurofilament Light Chain: Clinical Validation for Discriminating Parkinson's Disease from Normal Control. Dement Geriatr Cogn Disord 2021; 49:401-409. [PMID: 33242863 DOI: 10.1159/000510325] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 07/15/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND A previously published paper (referred to as the original cohort) showed that using a cutoff value of 116.1 fg/mL for the plasma total α-synuclein concentrations could discriminate Parkinson's disease (PD) patients from normal controls (NCs). In this study, another independent cohort (referred to as the validation cohort) was recruited to validate the agreement between the clinical diagnosis and the use of plasma total α-synuclein to identify PD patients. In addition to total α-synuclein, plasma neurofilament light chain (NfL) in the validation cohort was detected. METHODS Seventy PD patients and 33 NCs were enrolled in the validation cohort. A clinical diagnosis and the immunomagnetic reduction (IMR) assay for plasma total α-synuclein were performed for each participant. Thirty-three of 70 PD patients and 23 of 33 NCs were subjected to the plasma NfL assay via IMR. RESULTS The positive, negative, and overall percentages of agreement between the clinical diagnosis and plasma total α-synuclein diagnosis determined based on 116.1 fg/mL as the cutoff value were found to be 0.943, 0.818, and 0.903, respectively. The PD patients and NCs showed plasma NfL levels of 8.38 ± 4.19 pg/mL and 17.6 ± 7.95 pg/mL (p < 0.001), respectively. The cutoff value of the plasma NfL level used to differentiate PD patients from NCs was 12.8 pg/mL, with sensitivity and specificity values of 0.788 and 0.870, respectively. CONCLUSION The results demonstrate the usefulness of the plasma total α-synuclein concentration to discriminate PD patients from NCs and reveal the elevation of the plasma NfL level in PD patients.
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Affiliation(s)
- Wei-Che Lin
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Cheng-Hsien Lu
- Department of Diagnostic Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Pai-Yi Chiu
- Department of Neurology, Show Chwan Memorial Hospital and MR-guided Focus Ultrasound Center, Chang Bin Show Chwan Memorial Hospital, Chunghwa, Taiwan
| | - Shieh-Yueh Yang
- MagQu Co., Ltd., New Taipei City, Taiwan, .,MagQu LLC, Surprise, Arizona, USA,
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7
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Chung SJ, Jeon S, Yoo HS, Lee YH, Yun M, Lee SK, Lee PH, Sohn YH, Evans AC, Ye BS. Neural Correlates of Cognitive Performance in Alzheimer's Disease- and Lewy Bodies-Related Cognitive Impairment. J Alzheimers Dis 2021; 73:873-885. [PMID: 31868668 DOI: 10.3233/jad-190814] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Clinicopathological studies have demonstrated that the neuropsychological profiles and outcomes are different between two dementia subtypes, namely Alzheimer's disease (AD) and Lewy bodies-related disease. OBJECTIVE We investigated the neural correlates of cognitive dysfunction in patients with AD-related cognitive impairment (ADCI) and those with Lewy bodies-related cognitive impairment (LBCI). METHODS We enrolled 216 ADCI patients, 183 LBCI patients, and 30 controls. Cortical thickness and diffusion tensor imaging analyses were performed to correlate gray matter and white matter (WM) abnormalities to cognitive composite scores for memory, visuospatial, and attention/executive domains in the ADCI spectrum (ADCI patients and controls) and the LBCI spectrum (LBCI patients and controls) separately. RESULTS Memory dysfunction correlated with cortical thinning and increased mean diffusivity in the AD-prone regions, particularly the medial temporal region, in ADCI. Meanwhile, it only correlated with increased mean diffusivity in the WM adjacent to the anteromedial temporal, insula, and basal frontal cortices in LBCI. Visuospatial dysfunction correlated with cortical thinning in posterior brain regions in ADCI, while it correlated with decreased fractional anisotropy in the corpus callosum and widespread WM regions in LBCI. Attention/executive dysfunction correlated with cortical thinning and WM abnormalities in widespread brain regions in both disease spectra; however, ADCI had more prominent correlation with cortical thickness and LBCI did with fractional anisotropy values. CONCLUSIONS Our study demonstrated that ADCI and LBCI have different neural correlates with respect to cognitive dysfunction. Cortical thinning had greater effects on cognitive dysfunction in the ADCI, while WM disruption did in the LBCI.
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Affiliation(s)
- Seok Jong Chung
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Seun Jeon
- McGill Center for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Han Soo Yoo
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Yang Hyun Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Mijin Yun
- Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Seung-Koo Lee
- Department of Radiology, Yonsei University College of Medicine, Seoul, South Korea
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Young Ho Sohn
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Alan C Evans
- McGill Center for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Byoung Seok Ye
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
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8
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Thomas GEC, Leyland LA, Schrag AE, Lees AJ, Acosta-Cabronero J, Weil RS. Brain iron deposition is linked with cognitive severity in Parkinson's disease. J Neurol Neurosurg Psychiatry 2020; 91:418-425. [PMID: 32079673 PMCID: PMC7147185 DOI: 10.1136/jnnp-2019-322042] [Citation(s) in RCA: 123] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 01/14/2020] [Accepted: 01/22/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Dementia is common in Parkinson's disease (PD) but measures that track cognitive change in PD are lacking. Brain tissue iron accumulates with age and co-localises with pathological proteins linked to PD dementia such as amyloid. We used quantitative susceptibility mapping (QSM) to detect changes related to cognitive change in PD. METHODS We assessed 100 patients with early-stage to mid-stage PD, and 37 age-matched controls using the Montreal Cognitive Assessment (MoCA), a validated clinical algorithm for risk of cognitive decline in PD, measures of visuoperceptual function and the Movement Disorders Society Unified Parkinson's Disease Rating Scale part 3 (UPDRS-III). We investigated the association between these measures and QSM, an MRI technique sensitive to brain tissue iron content. RESULTS We found QSM increases (consistent with higher brain tissue iron content) in PD compared with controls in prefrontal cortex and putamen (p<0.05 corrected for multiple comparisons). Whole brain regression analyses within the PD group identified QSM increases covarying: (1) with lower MoCA scores in the hippocampus and thalamus, (2) with poorer visual function and with higher dementia risk scores in parietal, frontal and medial occipital cortices, (3) with higher UPDRS-III scores in the putamen (all p<0.05 corrected for multiple comparisons). In contrast, atrophy, measured using voxel-based morphometry, showed no differences between groups, or in association with clinical measures. CONCLUSIONS Brain tissue iron, measured using QSM, can track cognitive involvement in PD. This may be useful to detect signs of early cognitive change to stratify groups for clinical trials and monitor disease progression.
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Affiliation(s)
| | | | - Anette-Eleonore Schrag
- Department of Clinical Neuroscience, UCL Institute of Neurology, London, UK
- Movement Disorders Consortium, University College London, London, UK
| | - Andrew John Lees
- Reta Lila Institute for Brain Studies, University College London, London, UK
| | | | - Rimona Sharon Weil
- Dementia Research Centre, UCL Institute of Neurology, London, UK
- Wellcome Centre for Human Neuroimaging, University College London, London, UK
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9
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Krajcovicova L, Klobusiakova P, Rektorova I. Gray Matter Changes in Parkinson's and Alzheimer's Disease and Relation to Cognition. Curr Neurol Neurosci Rep 2019; 19:85. [PMID: 31720859 PMCID: PMC6854046 DOI: 10.1007/s11910-019-1006-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE OF REVIEW We summarize structural (s)MRI findings of gray matter (GM) atrophy related to cognitive impairment in Alzheimer's disease (AD) and Parkinson's disease (PD) in light of new analytical approaches and recent longitudinal studies results. RECENT FINDINGS The hippocampus-to-cortex ratio seems to be the best sMRI biomarker to discriminate between various AD subtypes, following the spatial distribution of tau pathology, and predict rate of cognitive decline. PD is clinically far more variable than AD, with heterogeneous underlying brain pathology. Novel multivariate approaches have been used to describe patterns of early subcortical and cortical changes that relate to more malignant courses of PD. New emerging analytical approaches that combine structural MRI data with clinical and other biomarker outcomes hold promise for detecting specific GM changes in the early stages of PD and preclinical AD that may predict mild cognitive impairment and dementia conversion.
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Affiliation(s)
- Lenka Krajcovicova
- Applied Neuroscience Research Group, CEITEC, Masaryk University, Kamenice 5, Brno, Czech Republic
- First Department of Neurology, Faculty of Medicine, St. Anne's University Hospital, Masaryk University, Pekarska 53, Brno, Czech Republic
| | - Patricia Klobusiakova
- Applied Neuroscience Research Group, CEITEC, Masaryk University, Kamenice 5, Brno, Czech Republic
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Irena Rektorova
- Applied Neuroscience Research Group, CEITEC, Masaryk University, Kamenice 5, Brno, Czech Republic.
- First Department of Neurology, Faculty of Medicine, St. Anne's University Hospital, Masaryk University, Pekarska 53, Brno, Czech Republic.
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10
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Kozak VV. [Determining the risk of dementia in Parkinson's disease: possibilities and perspectives]. Zh Nevrol Psikhiatr Im S S Korsakova 2019; 119:137-143. [PMID: 31407694 DOI: 10.17116/jnevro2019119061137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Dementia in Parkinson's disease (D-PD) worsens the course of PD, and it is associated with a decrease in the quality of life of patients and caregivers, as well as with elevated costs for patient care, and, as a consequence, leads to a significant cost increase in the health management. Early detection of the risk of dementia in patients with PD is one of the challenges of modern clinical neurology. Various methods for the detection of morphologic and functional changes associated with D-PD risk (prognostic biomarkers) were suggested. The aim of this article is a brief review of current achievements in the search for and evaluation of the effectiveness of such biomarkers. The review included the following methods: clinical examination, neuroimaging, examination of biological fluids, genetic analysis, neurophysiological methods and combined methods. Biomarkers of D-PD can contribute to optimization of the selection of pharmacological or non-pharmacological methods of preventing cognitive impairment at early stages of PD, and, therefore, to potential improvement of the overall clinical outcomes.
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Affiliation(s)
- V V Kozak
- University of Basel, Hospital of the University of Basel, Basel, Switzerland
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11
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Saredakis D, Collins-Praino LE, Gutteridge DS, Stephan BC, Keage HA. Conversion to MCI and dementia in Parkinson's disease: a systematic review and meta-analysis. Parkinsonism Relat Disord 2019; 65:20-31. [DOI: 10.1016/j.parkreldis.2019.04.020] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 04/15/2019] [Accepted: 04/28/2019] [Indexed: 12/20/2022]
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12
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Chung SJ, Park YH, Yoo HS, Lee YH, Ye BS, Sohn YH, Lee JM, Lee PH. Mild cognitive impairment reverters have a favorable cognitive prognosis and cortical integrity in Parkinson's disease. Neurobiol Aging 2019; 78:168-177. [PMID: 30947112 DOI: 10.1016/j.neurobiolaging.2019.02.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 02/25/2019] [Accepted: 02/28/2019] [Indexed: 01/16/2023]
Abstract
This study aimed to investigate whether reversion to cognitively normal status (CogN) is related to a favorable cognitive prognosis in Parkinson's disease with mild cognitive impairment (PD-MCI). We recruited 217 patients with PD-MCI who underwent serial neuropsychological assessments 3-5 times (mean interval, 1.84 years). Thirty-six patients reverted to CogN (reverters) during follow-up, whereas the other 181 did not (nonreverters). We assessed the risk of cognitive worsening in PD-MCI reverters, nonreverters, and patients with PD-CogN (n = 88). In addition, we performed comparative analyses of comprehensive neuroimaging studies between the PD-MCI reverter (n = 17) and nonreverter (n = 34) subgroups. PD-MCI reverters had a lower risk of dementia conversion than nonreverters. In addition, PD-MCI reverters had similar risks of cognitive worsening with patients with PD-CogN. PD-MCI reverters exhibited greater cortical thickness in the right parahippocampal gyrus and less severely decreased functional connectivity in the default mode and executive control networks relative to nonreverters. Our results suggest that PD-MCI reverters have relatively preserved structural and functional integrity and a favorable cognitive prognosis compared with nonreverters.
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Affiliation(s)
- Seok Jong Chung
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology, National Health Insurance Service Ilsan Hospital, Goyang, South Korea
| | - Yeong-Hun Park
- Department of Biomedical Engineering, Hanyang University, Seoul, South Korea
| | - Han Soo Yoo
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Yang Hyun Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Byoung Seok Ye
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Young H Sohn
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Jong-Min Lee
- Department of Biomedical Engineering, Hanyang University, Seoul, South Korea.
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea; Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, South Korea.
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13
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Nie K, Gao Y, Mei M, Guo M, Huang Z, Wang L, Zhao J, Zhang Y, Wang L. The clinical characteristics and cognitive features of mild cognitive impairment in Parkinson's disease and the analysis of relevant factors. J Clin Neurosci 2019; 63:142-148. [PMID: 30732989 DOI: 10.1016/j.jocn.2019.01.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 12/14/2018] [Accepted: 01/18/2019] [Indexed: 12/24/2022]
Abstract
The purpose of this work is to investigate the clinical characteristics, cognitive impairment features, and subgroup types of Parkinson's disease (PD) subjects with mild cognitive impairment (PD-MCI) in the Chinese population and to analyze relevant risk factors for PD-MCI. A total of 234 non-dementia PD subjects were collected. Standardized neuropsychological assessments of overall cognitive level and four cognitive domains (memory, executive function, attention and visuospatial function) were performed using MDS Task Force diagnostic criteria for PD-MCI. PD-MCI subjects were further divided into four subgroups: nonamnestic single-domain impairment type (PD-naMCI-SD), nonamnestic multiple-domain impairment type (PD-naMCI-MD), amnestic single-domain impairment type (PD-aMCI-SD), and amnestic multiple-domain impairment type (PD-aMCI-MD). The clinical characteristics of and risk factors for all subgroups were analyzed. PD-MCI was found in 45.3% of the non-dementia PD subjects. Differences between the PD-MCI and PD with normal cognition groups with respect to age, age of onset, years of education, and motor symptom severity were significant (P < 0.05). The single-domain impairment type was the largest PD-MCI subgroup (52.83%). Memory and executive function impairment were most frequent (22.64% and 20.75%, respectively). Among the four subgroups, the number of years of education was significantly different (P = 0.003). The overall cognitive function in amnestic multiple-domain impairment type was significantly worse compared with that in those with single-domain impairment type. Regression analysis results showed that old age, high UPDRS-III score, and hyperhomocysteinemia were risk factors for PD-MCI, whereas high education level was a protective factor. Early prevention of MCI-related risk factors provides effective means to retard cognitive decline in PD patients.
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Affiliation(s)
- Kun Nie
- Department of Neurology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Neuroscience Institute, No. 106 Zhongshan Er Road, Guangzhou, Guangdong Province 510080, PR China
| | - Yuyuan Gao
- Department of Neurology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Neuroscience Institute, No. 106 Zhongshan Er Road, Guangzhou, Guangdong Province 510080, PR China
| | - Mingjin Mei
- Department of Neurology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Neuroscience Institute, No. 106 Zhongshan Er Road, Guangzhou, Guangdong Province 510080, PR China
| | - Manli Guo
- Department of Neurology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Neuroscience Institute, No. 106 Zhongshan Er Road, Guangzhou, Guangdong Province 510080, PR China
| | - Zhiheng Huang
- Department of Neurology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Neuroscience Institute, No. 106 Zhongshan Er Road, Guangzhou, Guangdong Province 510080, PR China
| | - Limin Wang
- Department of Neurology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Neuroscience Institute, No. 106 Zhongshan Er Road, Guangzhou, Guangdong Province 510080, PR China
| | - Jiehao Zhao
- Department of Neurology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Neuroscience Institute, No. 106 Zhongshan Er Road, Guangzhou, Guangdong Province 510080, PR China
| | - Yuhu Zhang
- Department of Neurology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Neuroscience Institute, No. 106 Zhongshan Er Road, Guangzhou, Guangdong Province 510080, PR China.
| | - Lijuan Wang
- Department of Neurology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Neuroscience Institute, No. 106 Zhongshan Er Road, Guangzhou, Guangdong Province 510080, PR China.
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Gao Y, Nie K, Mei M, Guo M, Huang Z, Wang L, Zhao J, Huang B, Zhang Y, Wang L. Changes in Cortical Thickness in Patients With Early Parkinson's Disease at Different Hoehn and Yahr Stages. Front Hum Neurosci 2018; 12:469. [PMID: 30542273 PMCID: PMC6278611 DOI: 10.3389/fnhum.2018.00469] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 11/07/2018] [Indexed: 12/30/2022] Open
Abstract
Objectives: This study was designed to explore changes in cortical thickness in patients with early Parkinson’s disease (PD) at different Hoehn and Yahr (H-Y) stages and to demonstrate the association of abnormally altered brain regions with part III of the Unified Parkinson’s Disease Rating Scale (UPDRS-III). Materials and Methods: Sixty early PD patients and 29 age- and gender-matched healthy controls (HCs) were enrolled in this study. All PD patients underwent comprehensive clinical and neuropsychological evaluations and 3.0 T magnetic resonance scanning. Patients with H-Y stage ≤1.5 were included in the mild group, and all other patients were included in the moderate group. FreeSurfer software was used to calculate cortical thickness. We assessed the relationship between UPDRS-III and regional changes in cortical thinning, including the bilateral fusiform and the temporal lobe. Results: The average cortical thickness of the temporal pole, fusiform gyrus, insula of the left hemisphere and fusiform gyrus, isthmus cingulate cortex, inferior temporal gyrus, middle temporal cortex and posterior cingulate cortex of the right hemisphere exhibited significant decreasing trends in HCs group and PD groups (i.e., the mild group and moderate group). After controlling for the effects of age, gender, and disease duration, the UPDRS-III scores in patients with early PD were correlated with the cortical thickness of the left and right fusiform gyrus and the left temporal pole (p < 0.05). Conclusion: The average cortical thickness of specific brain regions reduced with increasing disease severity in early PD patients at different H-Y stages, and the UPDRS-III scores of early PD patients were correlated with cortical thickness of the bilateral fusiform gyrus and the left temporal pole.
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Affiliation(s)
- Yuyuan Gao
- Department of Neurology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Neuroscience Institute, Guangzhou, China
| | - Kun Nie
- Department of Neurology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Neuroscience Institute, Guangzhou, China
| | - Mingjin Mei
- Department of Neurology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Neuroscience Institute, Guangzhou, China
| | - Manli Guo
- Department of Neurology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Neuroscience Institute, Guangzhou, China
| | - Zhiheng Huang
- Department of Neurology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Neuroscience Institute, Guangzhou, China
| | - Limin Wang
- Department of Neurology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Neuroscience Institute, Guangzhou, China
| | - Jiehao Zhao
- Department of Neurology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Neuroscience Institute, Guangzhou, China
| | - Biao Huang
- Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yuhu Zhang
- Department of Neurology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Neuroscience Institute, Guangzhou, China
| | - Lijuan Wang
- Department of Neurology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Neuroscience Institute, Guangzhou, China
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15
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Kunst J, Marecek R, Klobusiakova P, Balazova Z, Anderkova L, Nemcova-Elfmarkova N, Rektorova I. Patterns of Grey Matter Atrophy at Different Stages of Parkinson's and Alzheimer's Diseases and Relation to Cognition. Brain Topogr 2018; 32:142-160. [PMID: 30206799 DOI: 10.1007/s10548-018-0675-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 09/04/2018] [Indexed: 11/25/2022]
Abstract
Using MRI, a characteristic pattern of grey matter (GM) atrophy has been described in the early stages of Alzheimer's disease (AD); GM patterns at different stages of Parkinson's disease (PD) have been inconclusive. Few studies have directly compared structural changes in groups with mild cognitive impairment (MCI) caused by different pathologies (AD, PD). We used several analytical methods to determine GM changes at different stages of both PD and AD. We also evaluated associations between GM changes and cognitive measurements. Altogether 144 subjects were evaluated: PD with normal cognition (PD-NC; n = 23), PD with MCI (PD-MCI; n = 24), amnestic MCI (aMCI; n = 27), AD (n = 12), and age-matched healthy controls (HC; n = 58). All subjects underwent structural MRI and cognitive examination. GM volumes were analysed using two different techniques: voxel-based morphometry (VBM) and source-based morphometry (SBM), which is a multivariate method. In addition, cortical thickness (CT) was evaluated to assess between-group differences in GM. The cognitive domain z-scores were correlated with GM changes in individual patient groups. GM atrophy in the anterior and posterior cingulate, as measured by VBM, in the temporo-fronto-parietal component, as measured by SBM, and in the posterior cortical regions as well as in the anterior cingulate and frontal region, as measured by CT, differentiated aMCI from HC. Major hippocampal and temporal lobe atrophy (VBM, SBM) and to some extent occipital atrophy (SBM) differentiated AD from aMCI and from HC. Correlations with cognitive deficits were present only in the AD group. PD-MCI showed greater GM atrophy than PD-NC in the orbitofrontal regions (VBM), which was related to memory z-scores, and in the left superior parietal lobule (CT); more widespread limbic and fronto-parieto-occipital neocortical atrophy (all methods) differentiated this group from HC. Only CT revealed subtle GM atrophy in the anterior cingulate, precuneus, and temporal neocortex in PD-NC as compared to HC. None of the methods differentiated PD-MCI from aMCI. Both MCI groups showed distinct limbic and fronto-temporo-parietal neocortical atrophy compared to HC with no specific between-group differences. AD subjects displayed a typical pattern of major temporal lobe atrophy which was associated with deficits in all cognitive domains. VBM and CT were more sensitive than SBM in identifying frontal and posterior cortical atrophy in PD-MCI as compared to PD-NC. Our data support the notion that the results of studies using different analytical methods cannot be compared directly. Only CT measures revealed some subtle differences between HC and PD-NC.
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Affiliation(s)
- Jonas Kunst
- Medical Faculty, Masaryk University, Brno, Czech Republic.,Brain and Mind Research Programme, CEITEC Masaryk University, Brno, Czech Republic
| | - Radek Marecek
- Brain and Mind Research Programme, CEITEC Masaryk University, Brno, Czech Republic
| | - Patricia Klobusiakova
- Medical Faculty, Masaryk University, Brno, Czech Republic.,Brain and Mind Research Programme, CEITEC Masaryk University, Brno, Czech Republic
| | - Zuzana Balazova
- Brain and Mind Research Programme, CEITEC Masaryk University, Brno, Czech Republic
| | - Lubomira Anderkova
- Brain and Mind Research Programme, CEITEC Masaryk University, Brno, Czech Republic
| | | | - Irena Rektorova
- Brain and Mind Research Programme, CEITEC Masaryk University, Brno, Czech Republic. .,Movement Disorders Centre, First Department of Neurology, St Anne's University Hospital, Masaryk University, Pekarska 53, 656 91, Brno, Czech Republic.
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