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Dzialas V, Hoenig MC, Prange S, Bischof GN, Drzezga A, van Eimeren T. Structural underpinnings and long-term effects of resilience in Parkinson's disease. NPJ Parkinsons Dis 2024; 10:94. [PMID: 38697984 PMCID: PMC11066097 DOI: 10.1038/s41531-024-00699-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 04/02/2024] [Indexed: 05/05/2024] Open
Abstract
Resilience in neuroscience generally refers to an individual's capacity to counteract the adverse effects of a neuropathological condition. While resilience mechanisms in Alzheimer's disease are well-investigated, knowledge regarding its quantification, neurobiological underpinnings, network adaptations, and long-term effects in Parkinson's disease is limited. Our study involved 151 Parkinson's patients from the Parkinson's Progression Marker Initiative Database with available Magnetic Resonance Imaging, Dopamine Transporter Single-Photon Emission Computed Tomography scans, and clinical information. We used an improved prediction model linking neuropathology to symptom severity to estimate individual resilience levels. Higher resilience levels were associated with a more active lifestyle, increased grey matter volume in motor-associated regions, a distinct structural connectivity network and maintenance of relative motor functioning for up to a decade. Overall, the results indicate that relative maintenance of motor function in Parkinson's patients may be associated with greater neuronal substrate, allowing higher tolerance against neurodegenerative processes through dynamic network restructuring.
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Affiliation(s)
- Verena Dzialas
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, 50937, Cologne, Germany
- University of Cologne, Faculty of Mathematics and Natural Sciences, 50923, Cologne, Germany
| | - Merle C Hoenig
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, 50937, Cologne, Germany
- Molecular Organization of the Brain, Institute for Neuroscience and Medicine II, Research Center Juelich, 52428, Juelich, Germany
| | - Stéphane Prange
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, 50937, Cologne, Germany
- Université de Lyon, Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR, 5229, Bron, France
| | - Gérard N Bischof
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, 50937, Cologne, Germany
- Molecular Organization of the Brain, Institute for Neuroscience and Medicine II, Research Center Juelich, 52428, Juelich, Germany
| | - Alexander Drzezga
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, 50937, Cologne, Germany
- Molecular Organization of the Brain, Institute for Neuroscience and Medicine II, Research Center Juelich, 52428, Juelich, Germany
- German Center for Neurodegenerative Diseases, 53127, Bonn, Germany
| | - Thilo van Eimeren
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, 50937, Cologne, Germany.
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, 50937, Cologne, Germany.
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Giustiniani A, Quartarone A. Defining the concept of reserve in the motor domain: a systematic review. Front Neurosci 2024; 18:1403065. [PMID: 38745935 PMCID: PMC11091373 DOI: 10.3389/fnins.2024.1403065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 04/08/2024] [Indexed: 05/16/2024] Open
Abstract
A reserve in the motor domain may underlie the capacity exhibited by some patients to maintain motor functionality in the face of a certain level of disease. This form of "motor reserve" (MR) could include cortical, cerebellar, and muscular processes. However, a systematic definition has not been provided yet. Clarifying this concept in healthy individuals and patients would be crucial for implementing prevention strategies and rehabilitation protocols. Due to its wide application in the assessment of motor system functioning, non-invasive brain stimulation (NIBS) may support such definition. Here, studies focusing on reserve in the motor domain and studies using NIBS were revised. Current literature highlights the ability of the motor system to create a reserve and a possible role for NIBS. MR could include several mechanisms occurring in the brain, cerebellum, and muscles, and NIBS may support the understanding of such mechanisms.
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Pan G, Jiang Y, Zhang W, Zhang X, Wang L, Cheng W. Identification of Parkinson's disease subtypes with distinct brain atrophy progression and its association with clinical progression. PSYCHORADIOLOGY 2024; 4:kkae002. [PMID: 38666137 PMCID: PMC10953620 DOI: 10.1093/psyrad/kkae002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/27/2024] [Accepted: 02/23/2024] [Indexed: 04/28/2024]
Abstract
Background Parkinson's disease (PD) patients suffer from progressive gray matter volume (GMV) loss, but whether distinct patterns of atrophy progression exist within PD are still unclear. Objective This study aims to identify PD subtypes with different rates of GMV loss and assess their association with clinical progression. Methods This study included 107 PD patients (mean age: 60.06 ± 9.98 years, 70.09% male) with baseline and ≥ 3-year follow-up structural MRI scans. A linear mixed-effects model was employed to assess the rates of regional GMV loss. Hierarchical cluster analysis was conducted to explore potential subtypes based on individual rates of GMV loss. Clinical score changes were then compared across these subtypes. Results Two PD subtypes were identified based on brain atrophy rates. Subtype 1 (n = 63) showed moderate atrophy, notably in the prefrontal and lateral temporal lobes, while Subtype 2 (n = 44) had faster atrophy across the brain, particularly in the lateral temporal region. Furthermore, subtype 2 exhibited faster deterioration in non-motor (MDS-UPDRS-Part Ⅰ, β = 1.26 ± 0.18, P = 0.016) and motor (MDS-UPDRS-Part Ⅱ, β = 1.34 ± 0.20, P = 0.017) symptoms, autonomic dysfunction (SCOPA-AUT, β = 1.15 ± 0.22, P = 0.043), memory (HVLT-Retention, β = -0.02 ± 0.01, P = 0.016) and depression (GDS, β = 0.26 ± 0.083, P = 0.019) compared to subtype 1. Conclusion The study has identified two PD subtypes with distinct patterns of atrophy progression and clinical progression, which may have implications for developing personalized treatment strategies.
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Affiliation(s)
- Guoqing Pan
- School of Mathematical Sciences, Zhejiang Normal University, Jinhua 321004, China
- Fudan ISTBI—ZJNU Algorithm Centre for Brain-inspired Intelligence, Zhejiang Normal University, Jinhua 321004, China
| | - Yuchao Jiang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai 200433, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), Ministry of Education, Shanghai 200433, China
- Zhangjiang Fudan International Innovation Center, Shanghai 201210, China
| | - Wei Zhang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai 200433, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), Ministry of Education, Shanghai 200433, China
- Zhangjiang Fudan International Innovation Center, Shanghai 201210, China
| | - Xuejuan Zhang
- School of Mathematical Sciences, Zhejiang Normal University, Jinhua 321004, China
- Fudan ISTBI—ZJNU Algorithm Centre for Brain-inspired Intelligence, Zhejiang Normal University, Jinhua 321004, China
| | - Linbo Wang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai 200433, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), Ministry of Education, Shanghai 200433, China
- Zhangjiang Fudan International Innovation Center, Shanghai 201210, China
| | - Wei Cheng
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai 200433, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), Ministry of Education, Shanghai 200433, China
- Zhangjiang Fudan International Innovation Center, Shanghai 201210, China
- Shanghai Medical College and Zhongshan Hospital Immunotherapy Technology Transfer Center, Shanghai 200032, China
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Hoenig MC, Dzialas V, Drzezga A, van Eimeren T. The Concept of Motor Reserve in Parkinson's Disease: New Wine in Old Bottles? Mov Disord 2023; 38:16-20. [PMID: 36345092 DOI: 10.1002/mds.29266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 09/14/2022] [Accepted: 10/03/2022] [Indexed: 11/11/2022] Open
Affiliation(s)
- Merle C Hoenig
- Institute for Neuroscience and Medicine II, Molecular Organization of the Brain, Research Center Juelich, Julich, Germany.,Department of Nuclear Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Verena Dzialas
- Department of Nuclear Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.,Faculty of Mathematics and Natural Sciences, University of Cologne, Cologne, Germany
| | - Alexander Drzezga
- Institute for Neuroscience and Medicine II, Molecular Organization of the Brain, Research Center Juelich, Julich, Germany.,Department of Nuclear Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn/Cologne, Germany
| | - Thilo van Eimeren
- Department of Nuclear Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.,Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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Zhou Z, Zhou X, Xiang Y, Zhao Y, Pan H, Wu J, Xu Q, Chen Y, Sun Q, Wu X, Zhu J, Wu X, Li J, Yan X, Guo J, Tang B, Lei L, Liu Z. Subtyping of early-onset Parkinson's disease using cluster analysis: A large cohort study. Front Aging Neurosci 2022; 14:1040293. [PMID: 36437996 PMCID: PMC9692000 DOI: 10.3389/fnagi.2022.1040293] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 10/27/2022] [Indexed: 08/15/2023] Open
Abstract
BACKGROUND Increasing evidence suggests that early-onset Parkinson's disease (EOPD) is heterogeneous in its clinical presentation and progression. Defining subtypes of EOPD is needed to better understand underlying mechanisms, predict disease course, and eventually design more efficient personalized management strategies. OBJECTIVE To identify clinical subtypes of EOPD, assess the clinical characteristics of each EOPD subtype, and compare the progression between EOPD subtypes. MATERIALS AND METHODS A total of 1,217 patients were enrolled from a large EOPD cohort of the Parkinson's Disease & Movement Disorders Multicenter Database and Collaborative Network in China (PD-MDCNC) between January 2017 and September 2021. A comprehensive spectrum of motor and non-motor features were assessed at baseline. Cluster analysis was performed using data on demographics, motor symptoms and signs, and other non-motor manifestations. In 454 out of total patients were reassessed after a mean follow-up time of 1.5 years to compare progression between different subtypes. RESULTS Three subtypes were defined: mild motor and non-motor dysfunction/slow progression, intermediate and severe motor and non-motor dysfunction/malignant. Compared to patients with mild subtype, patients with the severe subtype were more likely to have rapid eye movement sleep behavior disorder, wearing-off, and dyskinesia, after adjusting for age and disease duration at baseline, and showed a more rapid progression in Unified Parkinson's Disease Rating Scale (UPDRS) total score (P = 0.002), UPDRS part II (P = 0.014), and III (P = 0.001) scores, Hoehn and Yahr stage (P = 0.001), and Parkinson's disease questionnaire-39 item version score (P = 0.012) at prospective follow-up. CONCLUSION We identified three different clinical subtypes (mild, intermediate, and severe) using cluster analysis in a large EOPD cohort for the first time, which is important for tailoring therapy to individuals with EOPD.
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Affiliation(s)
- Zhou Zhou
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, China
| | - Xiaoxia Zhou
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Yaqin Xiang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Yuwen Zhao
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Hongxu Pan
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Juan Wu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Qian Xu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Yase Chen
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Qiying Sun
- Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Xinyin Wu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Jianping Zhu
- Hunan KeY Health Technology Co., Ltd., Changsha, China
| | - Xuehong Wu
- Hunan KeY Health Technology Co., Ltd., Changsha, China
| | - Jianhua Li
- Hunan Creator Information Technology Co., Ltd., Changsha, China
| | - Xinxiang Yan
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Jifeng Guo
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China
| | - Beisha Tang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China
| | - Lifang Lei
- Department of Neurology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Zhenhua Liu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China
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