1
|
Avila C, Sarter M. Cortico-striatal action control inherent of opponent cognitive-motivational styles. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.03.12.584623. [PMID: 38559086 PMCID: PMC10979997 DOI: 10.1101/2024.03.12.584623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Turning on cue or stopping at a red light requires the detection of such cues to select action sequences, or suppress action, in accordance with cue-associated action rules. Cortico-striatal projections are an essential part of the brain's attention-motor interface. Glutamate-sensing microelectrode arrays were used to measure glutamate transients in the dorsomedial striatum (DMS) of male and female rats walking a treadmill and executing cued turns and stops. Prelimbic-DMS projections were chemogenetically inhibited to determine their behavioral necessity and the cortico-striatal origin of cue-evoked glutamate transients. Furthermore, we investigated rats exhibiting preferably goal-directed (goal trackers, GTs) versus cue-driven attention (sign trackers, STs), to determine the impact of such cognitive-motivational biases on cortico-striatal control. GTs executed more cued turns and initiated such turns more slowly than STs. During turns, but not missed turns or cued stops, cue-evoked glutamate concentrations were higher in GTs than in STs. In conjunction with turn cue-evoked glutamate spike levels, the presence of a single spike rendered GTs to be almost twice as likely to turn than STs. In contrast, multiple glutamate spikes predicted GTs to be less likely to turn than STs. In GTs, but not STs, inhibition of prelimbic-DMS projections attenuated turn rates, turn cue-evoked glutamate peaks, and increased the number of spikes. These findings suggest that turn cue-evoked glutamate release in GTs is tightly controlled by cortico-striatal neuronal activity. In contrast, in STs, glutamate release from DMS glutamatergic terminals may be regulated by other striatal circuitry, preferably mediating cued suppression of action and reward tracking. Significance Statement Adaptive behavior involves the selection of behaviorally significant cues and the capacity of selected cues to control behavioral action. Neuronal projections from cortex to striatum are essential for such an integration of attentional with motor functions. Here we demonstrated that glutamate release from cortico-striatal projections primarily influences cued turns but not cued suppression of actions (cued stops). Cortico-striatal control of cued turning was especially powerful in rats which, as a psychological trait, preferably deploy goal-directed attention. Together, our findings demonstrate the role of cortico-striatal input in cued action selection, and they emphasize the experimental and biopsychological significance of investigating the brain's attentional-motor interface in the context of broader cognitive-motivational styles.
Collapse
|
2
|
Bartikofsky D, Hertz MJ, Bauer DS, Altschuler R, King WM, Stewart CE. Balance beam crossing times are slower after noise exposure in rats. Front Integr Neurosci 2023; 17:1196477. [PMID: 37497526 PMCID: PMC10368468 DOI: 10.3389/fnint.2023.1196477] [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: 03/29/2023] [Accepted: 06/15/2023] [Indexed: 07/28/2023] Open
Abstract
Introduction The vestibular system integrates signals related to vision, head position, gravity, motion, and body position to provide stability during motion through the environment. Disruption in any of these systems can reduce agility and lead to changes in ability to safely navigate one's environment. Causes of vestibular decline are diverse; however, excessive noise exposure can lead to otolith organ dysfunction. Specifically, 120 decibel (dB) sound pressure level (SPL) 1.5 kHz-centered 3-octave band noise (1.5 kHz 3OBN) causes peripheral vestibular dysfunction in rats, measured by vestibular short-latency evoked potential (VsEP) and reduced calretinin-immunolabeling of calyx-only afferent terminals in the striolar region of the saccule. The present study examined the functional impact of this noise exposure condition, examining changes in motor performance after noise exposure with a balance beam crossing task. Methods Balance beam crossing time in rats was assessed for 19 weeks before and 5 weeks after noise exposure. Balance beam crossings were scored to assess proficiency in the task. When animals were proficient, they received a single exposure to 120 dB SPL 3-octave band noise. Results During the initial training phase slower crossing times and higher scores, including multiple failures were observed. This was followed by a period of significant improvement leading to proficiency, characterized by fast and stable crossing times and consistently low scores. After noise exposure, crossing times were significantly elevated from baseline for 4-weeks. A total of 5 weeks after noise exposure, crossing times improved, and though still trending higher than baseline, they were no longer significantly different from baseline. Discussion These findings show that the noise-induced peripheral vestibular changes we previously observed at cellular and electro-physiological levels also have an impact at a functional level. It has been previously shown that imbalance is associated with slower walking speed in older adults and aged rats. These findings in noise-exposed rats may have implications for people who experience noisy environments and for seniors with a history of noise exposure who also experience balance disorders and may be at increased fall risk.
Collapse
Affiliation(s)
- Dylan Bartikofsky
- Lieutenant Colonel Charles S. Kettles VA Medical Center, Ann Arbor, MI, United States
| | - Mikayla Jade Hertz
- Lieutenant Colonel Charles S. Kettles VA Medical Center, Ann Arbor, MI, United States
| | - David S. Bauer
- Department of Otolaryngology/Head-Neck Surgery, Kresge Hearing Research Institute, University of Michigan, Ann Arbor, MI, United States
| | - Richard Altschuler
- Lieutenant Colonel Charles S. Kettles VA Medical Center, Ann Arbor, MI, United States
- Department of Otolaryngology/Head-Neck Surgery, Kresge Hearing Research Institute, University of Michigan, Ann Arbor, MI, United States
| | - W. Michael King
- Department of Otolaryngology/Head-Neck Surgery, Kresge Hearing Research Institute, University of Michigan, Ann Arbor, MI, United States
| | | |
Collapse
|
3
|
Witzig VS, Alosaimi F, Temel Y, Schulz JB, Jahanshahi A, Tan SKH. Gait improvement by high-frequency stimulation of the subthalamic nucleus in Parkinsonian mice is not associated with changes of the cholinergic system in the pedunculopontine nucleus. Neurosci Lett 2023; 802:137134. [PMID: 36801348 DOI: 10.1016/j.neulet.2023.137134] [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: 11/14/2022] [Revised: 01/30/2023] [Accepted: 02/14/2023] [Indexed: 02/18/2023]
Abstract
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is standard care for severe motor symptoms of Parkinson's disease (PD). However, a challenge of DBS remains improving gait. Gait has been associated with the cholinergic system in the pedunculopontine nucleus (PPN). In this study, we investigated the effects of long-term intermittent bilateral STN-DBS on PPN cholinergic neurons in the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) Parkinsonian mouse model. Motor behavior, previously assessed by the automated Catwalk gait analysis, demonstrated a parkinsonian-like motor phenotype with static and dynamic gait impairments, which were reversed by STN-DBS. In this study, a subset of brains was further immunohistochemically processed for choline acetyltransferase (ChAT) and the neuronal activation marker c-Fos. MPTP treatment resulted in a significant reduction of PPN ChAT expressing neurons compared to saline treatment. STN-DBS did not alter the number of ChAT expressing neurons, nor the number of double-labelled PPN neurons for ChAT and c-Fos. Although STN-DBS improved gait in our model this was not associated with an altered expression or activation of PPN acetylcholine neurons. Motor and gait effects of STN-DBS are therefore less likely to be mediated by the STN-PPN connection and PPN cholinergic system.
Collapse
Affiliation(s)
- V S Witzig
- Department of Neurology, RWTH Aachen University, Aachen, Germany.
| | - F Alosaimi
- Department of Neurosurgery, Maastricht University Medical Center, Maastricht, Netherlands
| | - Y Temel
- Department of Neurosurgery, Maastricht University Medical Center, Maastricht, Netherlands
| | - J B Schulz
- Department of Neurology, RWTH Aachen University, Aachen, Germany; JARA Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich and RWTH Aachen University, Aachen, Germany
| | - A Jahanshahi
- Department of Neurosurgery, Maastricht University Medical Center, Maastricht, Netherlands
| | - S K H Tan
- Department of Neurosurgery, Maastricht University Medical Center, Maastricht, Netherlands; Department of Neurosurgery, RWTH Aachen University, Aachen, Germany.
| |
Collapse
|
4
|
Bizpinar O, Onder H. Investigation of the gait parameters after donepezil treatment in patients with alzheimer' s disease. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-5. [PMID: 36745707 DOI: 10.1080/23279095.2023.2172681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Clinical studies remark that gait disturbance is common in patients with Alzheimer's disease (AD). However, the treatment response of gait disturbance in those patients may constitute a more interesting issue that is rarely addressed. METHODS In this prospective, interventional study, we included 14 consecutive patients with a new diagnosis of AD. Basal gait analysis was performed using a 'Gait Analyzer' program that was uploaded to a mobile phone. The gait parameters including Step time (ST), step length (SL), step number (SN), gait velocity (GV), and cadence were measured. Afterward, donepezil 5 mg daily was initiated, and the re-assessments were re-performed 8 weeks after the treatment. RESULTS The mean age was 71.78 ± 5.02 (F/M = 8/6). The evaluations after the donepezil treatment showed that there was a significant improvement in the SN (p = 0.021) and SL (p = 0.001) in comparison to the basal evaluations. The repeated analysis in the subgroup of early-stage AD subjects (n = 10) yielded that there were significant improvements in SN (p = 0.003), SL (p = 0.005), and cadence (p = 0.026) after treatment. CONCLUSIONS Our results support the efficiency of cholinergic treatment in gait functions in AD subjects.
Collapse
Affiliation(s)
- Ozlem Bizpinar
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Halil Onder
- Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| |
Collapse
|
5
|
Albin RL, Kanel P, van Laar T, van der Zee S, Roytman S, Koeppe RA, Scott PJH, Bohnen NI. No Dopamine Agonist Modulation of Brain [ 18F]FEOBV Binding in Parkinson's Disease. Mol Pharm 2022; 19:1176-1182. [PMID: 35289620 PMCID: PMC8983523 DOI: 10.1021/acs.molpharmaceut.1c00961] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The [18F]fluoroethoxybenzovesamicol ([18F]FEOBV) positron emission tomography (PET) ligand targets the vesicular acetylcholine transporter. Recent [18F]FEOBV PET rodent studies suggest that regional brain [18F]FEOBV binding may be modulated by dopamine D2-like receptor agents. We examined associations of regional brain [18F]FEOBV PET binding in Parkinson's disease (PD) subjects without versus with dopamine D2-like receptor agonist drug treatment. PD subjects (n = 108; 84 males, 24 females; mean age 68.0 ± 7.6 [SD] years), mean disease duration of 6.0 ± 4.0 years, and mean Movement Disorder Society-revised Unified PD Rating Scale III 35.5 ± 14.2 completed [18F]FEOBV brain PET imaging. Thirty-eight subjects were taking dopamine D2-like agonists. Vesicular monoamine transporter type 2 [11C]dihydrotetrabenazine (DTBZ) PET was available in a subset of 54 patients. Subjects on dopamine D2-like agonists were younger, had a longer duration of disease, and were taking a higher levodopa equivalent dose (LED) compared to subjects not taking dopamine agonists. A group comparison between subjects with versus without dopamine D2-like agonist use did not yield significant differences in cortical, striatal, thalamic, or cerebellar gray matter [18F]FEOBV binding. Confounder analysis using age, duration of disease, LED, and striatal [11C]DTBZ binding also failed to show significant regional [18F]FEOBV binding differences between these two groups. Chronic D2-like dopamine agonist use in PD subjects is not associated with significant alterations of regional brain [18F]FEOBV binding.
Collapse
Affiliation(s)
- Roger L Albin
- Department of Neurology, University of Michigan, Ann Arbor, Michigan 48109, United States.,GRECC & Neurology Service, VAAAHS, Ann Arbor, Michigan 48105, United States.,University of Michigan Udall Center, Ann Arbor, Michigan 48109, United States.,University of Michigan Parkinson's Foundation Research Center of Excellence, Ann Arbor, Michigan 48109, United States
| | - Prabesh Kanel
- University of Michigan Udall Center, Ann Arbor, Michigan 48109, United States.,Department of Radiology, University of Michigan, Ann Arbor, Michigan 48109, United States
| | - Teus van Laar
- University of Michigan Udall Center, Ann Arbor, Michigan 48109, United States.,Department of Neurology, University Medical Center Groningen, University of Groningen, 9713 AV Groningen, The Netherlands
| | - Sygrid van der Zee
- University of Michigan Udall Center, Ann Arbor, Michigan 48109, United States.,Department of Neurology, University Medical Center Groningen, University of Groningen, 9713 AV Groningen, The Netherlands
| | - Stiven Roytman
- Department of Radiology, University of Michigan, Ann Arbor, Michigan 48109, United States
| | - Robert A Koeppe
- University of Michigan Udall Center, Ann Arbor, Michigan 48109, United States.,Department of Radiology, University of Michigan, Ann Arbor, Michigan 48109, United States
| | - Peter J H Scott
- Department of Radiology, University of Michigan, Ann Arbor, Michigan 48109, United States
| | - Nicolaas I Bohnen
- Department of Neurology, University of Michigan, Ann Arbor, Michigan 48109, United States.,GRECC & Neurology Service, VAAAHS, Ann Arbor, Michigan 48105, United States.,University of Michigan Udall Center, Ann Arbor, Michigan 48109, United States.,University of Michigan Parkinson's Foundation Research Center of Excellence, Ann Arbor, Michigan 48109, United States.,Department of Radiology, University of Michigan, Ann Arbor, Michigan 48109, United States
| |
Collapse
|
6
|
Jackson MG, Brennan LJ, Henderson EJ, Robinson ESJ. Modelling falls in Parkinson’s disease and normal ageing in mice using a complex motor task. Brain Neurosci Adv 2022; 6:23982128221088794. [PMID: 35341069 PMCID: PMC8943449 DOI: 10.1177/23982128221088794] [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: 12/15/2021] [Accepted: 03/03/2022] [Indexed: 11/28/2022] Open
Abstract
Falls resulting from multifactorial deficits are common in both normal ageing and
Parkinson’s disease. Resultant injuries can lead to increased hospitalisation
and excess mortality. As the disease progresses, gait and balance deficits are
relatively refractory to dopaminergic treatments suggesting another system is
involved. Attentional impairment is a significant risk factor for falls, and
disruption to both the cortical cholinergic system and striatal dopaminergic
system increases falls in rats undergoing a complex motor task with high
attentional load. However, it is unclear whether this translates to mice and
whether normal ageing induces similar deficits. In this study, we use a complex
motor task to test the effects of acute dopaminergic and cholinergic antagonism
using alpha-flupentixol and scopolamine, respectively, in mice. We also test the
effects of normal ageing on complex motor performance and whether these changes
are sensitive to a clinical dose of the non-steroidal anti-inflammatory Rimadyl.
Consistent with previous work, we show that cholinergic but not dopaminergic
antagonism impaired task performance. However, a combined approach did not
potentiate the deficit beyond observed with cholinergic antagonism alone. We
also show that task performance is impaired in aged mice relative to younger
controls, and that Rimadyl reduces number of foot slips in an age-specific
manner. Overall, these data support prior work showing the importance of the
cholinergic system in falls. The studies in aged mice found age-related
impairments and a role for inflammation but did not find evidence of an
interaction with attentional load, although only one manipulation was
tested.
Collapse
Affiliation(s)
- Megan G. Jackson
- School of Physiology, Pharmacology & Neuroscience, University of Bristol, Bristol, UK
| | - Laura J. Brennan
- School of Physiology, Pharmacology & Neuroscience, University of Bristol, Bristol, UK
| | - Emily J. Henderson
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Royal United Hospitals Bath, NHS Foundation Trust, Bath, UK
| | - Emma S. J. Robinson
- School of Physiology, Pharmacology & Neuroscience, University of Bristol, Bristol, UK
| |
Collapse
|
7
|
Wenger N, Vogt A, Skrobot M, Garulli EL, Kabaoglu B, Salchow-Hömmen C, Schauer T, Kroneberg D, Schuhmann M, Ip CW, Harms C, Endres M, Isaias I, Tovote P, Blum R. Rodent models for gait network disorders in Parkinson's disease - a translational perspective. Exp Neurol 2022; 352:114011. [PMID: 35176273 DOI: 10.1016/j.expneurol.2022.114011] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 01/23/2022] [Accepted: 02/10/2022] [Indexed: 11/26/2022]
Abstract
Gait impairments in Parkinson's disease remain a scientific and therapeutic challenge. The advent of new deep brain stimulation (DBS) devices capable of recording brain activity from chronically implanted electrodes has fostered new studies of gait in freely moving patients. The hope is to identify gait-related neural biomarkers and improve therapy using closed-loop DBS. In this context, animal models offer the opportunity to investigate gait network activity at multiple biological scales and address unresolved questions from clinical research. Yet, the contribution of rodent models to the development of future neuromodulation therapies will rely on translational validity. In this review, we summarize the most effective strategies to model parkinsonian gait in rodents. We discuss how clinical observations have inspired targeted brain lesions in animal models, and whether resulting motor deficits and network oscillations match recent findings in humans. Gait impairments with hypo-, bradykinesia and altered limb rhythmicity were successfully modelled in rodents. However, clear evidence for the presence of freezing of gait was missing. The identification of reliable neural biomarkers for gait impairments has remained challenging in both animals and humans. Moving forward, we expect that the ongoing investigation of circuit specific neuromodulation strategies in animal models will lead to future optimizations of gait therapy in Parkinson's disease.
Collapse
Affiliation(s)
- Nikolaus Wenger
- Department of Neurology with experimental Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany; Berlin Institute of Health, Germany.
| | - Arend Vogt
- Department of Neurology with experimental Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Matej Skrobot
- Department of Neurology with experimental Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Elisa L Garulli
- Department of Neurology with experimental Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Burce Kabaoglu
- Department of Neurology with experimental Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Christina Salchow-Hömmen
- Department of Neurology with experimental Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Thomas Schauer
- Technische Universität Berlin, Control Systems Group, 10587 Berlin, Germany
| | - Daniel Kroneberg
- Department of Neurology with experimental Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany; Berlin Institute of Health, Germany
| | - Michael Schuhmann
- Department of Neurology, University Hospital of Würzburg, Josef-Schneider-Straße 11, 97080 Wuerzburg, Germany
| | - Chi Wang Ip
- Department of Neurology, University Hospital of Würzburg, Josef-Schneider-Straße 11, 97080 Wuerzburg, Germany
| | - Christoph Harms
- Department of Neurology with experimental Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany; Center for Stroke Research Berlin, Charité-Universitätsmedizin Berlin, Germany
| | - Matthias Endres
- Department of Neurology with experimental Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Charitéplatz 1, 10117 Berlin, Germany; Center for Stroke Research Berlin, Charité-Universitätsmedizin Berlin, Germany; DZHK (German Center for Cardiovascular Research), Berlin Site, Germany; DZNE (German Center for Neurodegenerative Disease), Berlin Site, Germany
| | - Ioannis Isaias
- Department of Neurology, University Hospital of Würzburg, Josef-Schneider-Straße 11, 97080 Wuerzburg, Germany
| | - Philip Tovote
- Institute of Clinical Neurobiology, University Hospital Wuerzburg, Versbacher Str. 5, 97078 Wuerzburg, Germany; Center for Mental Health, University of Wuerzburg, Margarete-Höppel-Platz 1, 97080 Wuerzburg, Germany
| | - Robert Blum
- Department of Neurology, University Hospital of Würzburg, Josef-Schneider-Straße 11, 97080 Wuerzburg, Germany
| |
Collapse
|
8
|
Cholinergic systems, attentional-motor integration, and cognitive control in Parkinson's disease. PROGRESS IN BRAIN RESEARCH 2022; 269:345-371. [PMID: 35248201 PMCID: PMC8957710 DOI: 10.1016/bs.pbr.2022.01.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Dysfunction and degeneration of CNS cholinergic systems is a significant component of multi-system pathology in Parkinson's disease (PD). We review the basic architecture of human CNS cholinergic systems and the tools available for studying changes in human cholinergic systems. Earlier post-mortem studies implicated abnormalities of basal forebrain corticopetal cholinergic (BFCC) and pedunculopontine-laterodorsal tegmental (PPN-LDT) cholinergic projections in cognitive deficits and gait-balance deficits, respectively. Recent application of imaging methods, particularly molecular imaging, allowed more sophisticated correlation of clinical features with regional cholinergic deficits. BFCC projection deficits correlate with general and domain specific cognitive deficits, particularly for attentional and executive functions. Detailed analyses suggest that cholinergic deficits within the salience and cingulo-opercular task control networks, including both neocortical, thalamic, and striatal nodes, are a significant component of cognitive deficits in non-demented PD subjects. Both BFCC and PPN-LDT cholinergic projection systems, and striatal cholinergic interneuron (SChI), abnormalities are implicated in PD gait-balance disorders. In the context of experimental studies, these results indicate that disrupted attentional functions of BFCC and PPN-LDT cholinergic systems underlie impaired gait-balance functions. SChI dysfunction likely impairs intra-striatal integration of attentional and motor information. Thalamic and entorhinal cortex cholinergic deficits may impair multi-sensory integration. Overt degeneration of CNS systems may be preceded by increased activity of cholinergic neurons compensating for nigrostriatal dopaminergic deficits. Subsequent dysfunction and degeneration of cholinergic systems unmasks and exacerbates functional deficits secondary to dopaminergic denervation. Research on CNS cholinergic systems dysfunctions in PD requires a systems-level approach to understanding PD pathophysiology.
Collapse
|
9
|
Cholinesterase inhibitors for gait, balance, and fall in Parkinson disease: a meta-analysis. NPJ Parkinsons Dis 2021; 7:103. [PMID: 34824258 PMCID: PMC8617004 DOI: 10.1038/s41531-021-00251-1] [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: 06/29/2021] [Accepted: 11/04/2021] [Indexed: 11/08/2022] Open
Abstract
Gait disturbance and imbalance are the major symptoms of Parkinson disease (PD), with fall being the most undesirable consequence. However, few effective evidence-based treatments are available for alleviating these symptoms and preventing falls. Cholinesterase inhibitors (ChEIs) are a well-established treatment for PD dementia with possible impacts on gait, balance, and fall reduction. The present study involved a meta-analysis of randomized controlled trials (RCTs) to investigate the effects of ChEIs on gait, balance, and fall in patients with PD. We searched for studies using the PubMed, Embase, and Web of Science databases. The major outcomes were effects on gait parameters, balance, and fall. This study was registered with PROSPERO (CRD42021254733). Five RCTs were included in the present meta-analysis. ChEIs did not significantly increase gait speed in PD patients (mean difference [MD]: 0.03 m/s, 95% confidence interval [CI]: -0.02 to 0.07, p = 0.29). However, ChEI treatment significantly decreased step or stride variability during the single task (standard MD: -0.43, 95% CI = -0.79 to -0.06, p = 0.02). Regarding fall and balance, trending but nonsignificant beneficial effects were observed with ChEI treatment. In conclusion, although ChEI treatment did not significantly improve gait speed and reduce fall, it can significantly reduce step or stride variability. Considering that gait disorder is a challenging issue in patients with PD and that ChEIs are generally tolerable, the present meta-analysis may provide more evidence for the benefit of ChEIs on PD gait disturbance as an alternative treatment consideration.
Collapse
|
10
|
Amalric M, Pattij T, Sotiropoulos I, Silva JM, Sousa N, Ztaou S, Chiamulera C, Wahlberg LU, Emerich DF, Paolone G. Where Dopaminergic and Cholinergic Systems Interact: A Gateway for Tuning Neurodegenerative Disorders. Front Behav Neurosci 2021; 15:661973. [PMID: 34366802 PMCID: PMC8340002 DOI: 10.3389/fnbeh.2021.661973] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 06/14/2021] [Indexed: 12/18/2022] Open
Abstract
Historically, many investigations into neurodegenerative diseases have focused on alterations in specific neuronal populations such as, for example, the loss of midbrain dopaminergic neurons in Parkinson's disease (PD) and loss of cholinergic transmission in Alzheimer's disease (AD). However, it has become increasingly clear that mammalian brain activities, from executive and motor functioning to memory and emotional responses, are strictly regulated by the integrity of multiple interdependent neuronal circuits. Among subcortical structures, the dopaminergic nigrostriatal and mesolimbic pathways as well as cholinergic innervation from basal forebrain and brainstem, play pivotal roles in orchestrating cognitive and non-cognitive symptoms in PD and AD. Understanding the functional interactions of these circuits and the consequent neurological changes that occur during degeneration provides new opportunities to understand the fundamental inter-workings of the human brain as well as develop new potential treatments for patients with dysfunctional neuronal circuits. Here, excerpted from a session of the European Behavioral Pharmacology Society meeting (Braga, Portugal, August 2019), we provide an update on our recent work in behavioral and cellular neuroscience that primarily focuses on interactions between cholinergic and dopaminergic systems in PD models, as well as stress in AD. These brief discussions include descriptions of (1) striatal cholinergic interneurons (CINs) and PD, (2) dopaminergic and cholinergic modulation of impulse control, and (3) the use of an implantable cell-based system for drug delivery directly the into brain and (4) the mechanisms through which day life stress, a risk factor for AD, damage protein and RNA homeostasis leading to AD neuronal malfunction.
Collapse
Affiliation(s)
- Marianne Amalric
- Centre National de la Recherche Scientifique (CNRS), UMR 7291, Laboratoire de Neurosciences Cognitives, Aix-Marseille University (AMU), Marseille, France
| | - Tommy Pattij
- Amsterdam Neuroscience, Department of Anatomy and Neurosciences, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Ioannis Sotiropoulos
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B’s – PT Government Associate Laboratory, Braga, Portugal
| | - Joana M. Silva
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B’s – PT Government Associate Laboratory, Braga, Portugal
| | - Nuno Sousa
- ICVS/3B’s – PT Government Associate Laboratory, Braga, Portugal
| | - Samira Ztaou
- Centre National de la Recherche Scientifique (CNRS), UMR 7291, Laboratoire de Neurosciences Cognitives, Aix-Marseille University (AMU), Marseille, France
- Department of Molecular Therapeutics, New York State Psychiatric Institute, Department of Psychiatry, Columbia University, New York, NY, United States
| | - Cristiano Chiamulera
- Department of Diagnostic and Public Health, Section of Pharmacology, University of Verona, Verona, Italy
| | | | | | - Giovanna Paolone
- Department of Diagnostic and Public Health, Section of Pharmacology, University of Verona, Verona, Italy
| |
Collapse
|
11
|
Chuang MH, Ho LH, Kuo TF, Sheu SY, Liu YH, Lin PC, Tsai YC, Yang CH, Chu CM, Lin SZ. Regenerative Potential of Platelet-Rich Fibrin Releasate Combined with Adipose Tissue-Derived Stem Cells in a Rat Sciatic Nerve Injury Model. Cell Transplant 2021; 29:963689720919438. [PMID: 32538130 PMCID: PMC7586258 DOI: 10.1177/0963689720919438] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Sciatic nerve injuries, not uncommon in trauma with a limited degree of functional recovery, are considered a persistent clinical, social, and economic problem worldwide. Accumulating evidence suggests that stem cells can promote the tissue regeneration through various mechanisms. The aim of the present study was to investigate the role of adipose tissue–derived stem cells (ADSCs) and combine with platelet-rich fibrin releasate (PRFr) in the regeneration of sciatic nerve injury in rats. Twenty-four Sprague-Dawley rats were randomly assigned to four groups, a blade was used to transect the left hindlimb sciatic nerve, and silicon tubes containing one of the following (by injection) were used to bridge the nerve proximal and distal ends (10-mm gap): group 1: untreated controls; group 2: PRFr alone; group 3: ADSCs alone; group 4: PRFr + ADSCs-treated. Walking function was assessed in horizontal rung ladder apparatus to compare the demands of the tasks and test sensitivity at 1-mo interval for a total of 3 mo. The gross inspection and histological examination was performed at 3 mo post transplantation. Overall, PRFr + ADSCs-treated performed better compared with PRFr or ADSCs injections alone. Significant group differences of neurological function were observed in ladder rung walking tests in all treated groups compared to that of untreated controls (P < 0.05). This injection approach may provide a successfully employed technique to target sciatic nerve defects in vivo, and the combined strategy of ADSCs with PRFr appears to have a superior effect on nerve repair.
Collapse
Affiliation(s)
- Ming-Hsi Chuang
- Ph.D. Program of Technology Management, Chung Hwa University, Hsinchu, Taiwan
| | - Li-Hsing Ho
- Department of Technology Management, Chung Hwa University, Hsinchu, Taiwan
| | - Tzong-Fu Kuo
- School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan
- Department of Post-Baccalaureate Veterinary Medicine, Asia University, Taichung, Taiwan
- Tzong-Fu Kuo, Department of Post-Baccalaureate Veterinary Medicine, Asia University, 500, Lioufeng Rd., Wufeng, Taichung 41354, Taiwan. Li-Hsing Ho, Department of Technology Management, Chung Hwa University, 707, Sec.2, WuFu Rd., Hsinchu 30012, Taiwan. Emails: ;
| | - Shi-Yuan Sheu
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Integrated Chinese and Western Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yu-Hao Liu
- School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan
- Dental Anatomy Division, Department of Oral Science, Kanagawa Dental University, Yokosuka, Japan
| | - Po-Cheng Lin
- Gwo Xi Stem Cell Applied Technology Co., Ltd, Hsinchu, Taiwan
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Chen Tsai
- Department of Biotechnology and Laboratory Science in Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chang-Huan Yang
- Gwo Xi Stem Cell Applied Technology Co., Ltd, Hsinchu, Taiwan
| | - Chi-Ming Chu
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
- Department of Public Health, China Medical University, Taichung, Taiwan
- Big Data Research Center, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Shinn-Zong Lin
- Bioinnovation Center, Tzu Chi Foundation, Hualien, Taiwan
- Department of Neurosurgery, Buddhist Tzu Chi General Hospital, Tzu Chi University, Hualien, Taiwan
| |
Collapse
|
12
|
Albin RL, Müller MLTM, Bohnen NI, Spino C, Sarter M, Koeppe RA, Szpara A, Kim K, Lustig C, Dauer WT. α4β2 * Nicotinic Cholinergic Receptor Target Engagement in Parkinson Disease Gait-Balance Disorders. Ann Neurol 2021; 90:130-142. [PMID: 33977560 DOI: 10.1002/ana.26102] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 05/10/2021] [Accepted: 05/10/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Attentional deficits following degeneration of brain cholinergic systems contribute to gait-balance deficits in Parkinson disease (PD). As a step toward assessing whether α4β2* nicotinic acetylcholine receptor (nAChR) stimulation improves gait-balance function, we assessed target engagement of the α4β2* nAChR partial agonist varenicline. METHODS Nondemented PD participants with cholinergic deficits were identified with [18 F]fluoroethoxybenzovesamicol positron emission tomography (PET). α4β2* nAChR occupancy after subacute oral varenicline treatment was measured with [18 F]flubatine PET. With a dose selected from the nAChR occupancy experiment, varenicline effects on gait, balance, and cognition were assessed in a double-masked placebo-controlled crossover study. Primary endpoints were normal pace gait speed and a measure of postural stability. RESULTS Varenicline doses (0.25mg per day, 0.25mg twice daily [b.i.d.], 0.5mg b.i.d., and 1.0mg b.i.d.) produced 60 to 70% receptor occupancy. We selected 0.5mg orally b.i.d for the crossover study. Thirty-three participants completed the crossover study with excellent tolerability. Varenicline had no significant impact on the postural stability measure and caused slower normal pace gait speed. Varenicline narrowed the difference in normal pace gait speed between dual task and no dual task gait conditions, reduced dual task cost, and improved sustained attention test performance. We obtained identical conclusions in 28 participants with treatment compliance confirmed by plasma varenicline measurements. INTERPRETATION Varenicline occupied α4β2* nicotinic acetylcholine receptors, was tolerated well, enhanced attention, and altered gait performance. These results are consistent with target engagement. α4β2* agonists may be worth further evaluation for mitigation of gait and balance disorders in PD. ANN NEUROL 2021;90:130-142.
Collapse
Affiliation(s)
- Roger L Albin
- Neurology Service and GRECC, VAAAHS, Ann Arbor, MI.,Department of Neurology, University of Michigan, Ann Arbor, MI.,University of Michigan Morris K. Udall Parkinson's Disease Research Center of Excellence, Ann Arbor, MI.,University of Michigan Parkinson's Foundation Research Center of Excellence, Ann Arbor, MI
| | - Martijn L T M Müller
- University of Michigan Morris K. Udall Parkinson's Disease Research Center of Excellence, Ann Arbor, MI.,University of Michigan Parkinson's Foundation Research Center of Excellence, Ann Arbor, MI.,Department of Radiology, University of Michigan, Ann Arbor, MI
| | - Nicolaas I Bohnen
- Neurology Service and GRECC, VAAAHS, Ann Arbor, MI.,Department of Neurology, University of Michigan, Ann Arbor, MI.,University of Michigan Morris K. Udall Parkinson's Disease Research Center of Excellence, Ann Arbor, MI.,University of Michigan Parkinson's Foundation Research Center of Excellence, Ann Arbor, MI.,Department of Radiology, University of Michigan, Ann Arbor, MI
| | - Cathie Spino
- University of Michigan Morris K. Udall Parkinson's Disease Research Center of Excellence, Ann Arbor, MI.,Department of Biostatistics, University of Michigan, Ann Arbor, MI
| | - Martin Sarter
- University of Michigan Morris K. Udall Parkinson's Disease Research Center of Excellence, Ann Arbor, MI.,Department of Psychology, University of Michigan, Ann Arbor, MI
| | - Robert A Koeppe
- Department of Radiology, University of Michigan, Ann Arbor, MI
| | - Ashley Szpara
- Department of Neurology, University of Michigan, Ann Arbor, MI.,University of Michigan Morris K. Udall Parkinson's Disease Research Center of Excellence, Ann Arbor, MI
| | - Kamin Kim
- Department of Psychology, University of Michigan, Ann Arbor, MI
| | - Cindy Lustig
- University of Michigan Parkinson's Foundation Research Center of Excellence, Ann Arbor, MI.,Department of Psychology, University of Michigan, Ann Arbor, MI
| | - William T Dauer
- Neurology Service and GRECC, VAAAHS, Ann Arbor, MI.,Department of Neurology, University of Michigan, Ann Arbor, MI.,University of Michigan Morris K. Udall Parkinson's Disease Research Center of Excellence, Ann Arbor, MI.,Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX.,Department of Neuroscience, University of Texas Southwestern Medical Center, Dallas, TX.,Peter J. O'Donnell Brain Institute, University of Texas Southwestern Medical Center, Dallas, TX
| |
Collapse
|
13
|
Sarter M, Avila C, Kucinski A, Donovan E. Make a Left Turn: Cortico-Striatal Circuitry Mediating the Attentional Control of Complex Movements. Mov Disord 2021; 36:535-546. [PMID: 33615556 DOI: 10.1002/mds.28532] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 01/21/2021] [Accepted: 01/25/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND In movement disorders such as Parkinson's disease (PD), cholinergic signaling is disrupted by the loss of basal forebrain cholinergic neurons, as well as aberrant activity in striatal cholinergic interneurons (ChIs). Several lines of evidence suggest that gait imbalance, a key disabling symptom of PD, may be driven by alterations in high-level frontal cortical and cortico-striatal processing more typically associated with cognitive dysfunction. METHODS Here we describe the corticostriatal circuitry that mediates the cognitive-motor interactions underlying such complex movement control. The ability to navigate dynamic, obstacle-rich environments requires the continuous integration of information about the environment with movement selection and sequencing. The cortical-attentional processing of extero- and interoceptive cues requires modulation by cholinergic activity to guide striatal movement control. Cue-derived information is "transferred" to striatal circuitry primarily via fronto-striatal glutamatergic projections. RESULT Evidence from parkinsonian fallers and from a rodent model reproducing the dual cholinergic-dopaminergic losses observed in these patients supports the main hypotheses derived from this neuronal circuitry-guided conceptualization of parkinsonian falls. Furthermore, in the striatum, ChIs constitute a particularly critical node for the integration of cortical with midbrain dopaminergic afferents and thus for cues to control movements. CONCLUSION Procholinergic treatments that enhance or rescue cortical and striatal mechanisms may improve complex movement control in parkinsonian fallers and perhaps also in older persons suffering from gait disorders and a propensity for falls. © 2021 International Parkinson and Movement Disorder Society.
Collapse
Affiliation(s)
- Martin Sarter
- Department of Psychology & Neuroscience Program, University of Michigan, Ann Arbor, Michigan, USA
| | - Cassandra Avila
- Department of Psychology & Neuroscience Program, University of Michigan, Ann Arbor, Michigan, USA
| | - Aaron Kucinski
- Department of Psychology & Neuroscience Program, University of Michigan, Ann Arbor, Michigan, USA
| | - Eryn Donovan
- Department of Psychology & Neuroscience Program, University of Michigan, Ann Arbor, Michigan, USA
| |
Collapse
|
14
|
Chambers NE, Coyle M, Sergio J, Lanza K, Saito C, Topping B, Clark SD, Bishop C. Effects of pedunculopontine nucleus cholinergic lesion on gait and dyskinesia in hemiparkinsonian rats. Eur J Neurosci 2021; 53:2835-2847. [PMID: 33426708 DOI: 10.1111/ejn.15106] [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] [Received: 10/22/2020] [Revised: 01/02/2021] [Accepted: 01/04/2021] [Indexed: 11/30/2022]
Abstract
Pedunculopontine nucleus (PPN) cholinergic neurons are implicated in freezing of gait in Parkinson's disease (PD) and motor stereotypy in normal animals, but the causal role of these neurons on specific gait parameters and treatment-induced dyskinesia remains speculative. Therefore, we examined whether selective cholinergic lesion of the rostral PPN affects PD motor and gait deficits, L-DOPA-induced dyskinesia and motor improvement, and DA-agonist-induced dyskinesia. Sprague-Dawley rats were assigned to one unilaterally lesioned group: Sham lesion, PPN cholinergic lesion with diphtheria urotensin II fusion toxin, medial forebrain bundle dopamine lesion with 6-hydroxydopamine, or dual acetylcholine and dopamine lesion. We used gait analysis and forepaw adjusting steps to examine PD gait and motor deficits. Forepaw adjusting steps were also used to assess motor improvement with L-DOPA treatment. The abnormal involuntary movements scale measured L-DOPA and dopamine D1- and D2-receptor agonist-induced dyskinesia. Lesions, verified via tyrosine hydroxylase and choline acetyltransferase immunohistochemistry reduced an average of 95% of nigral dopamine neurons and 80% of PPN cholinergic neurons, respectively. Rats receiving acetylcholine and dual lesion demonstrated enhanced freezing, and acetylcholine lesioned rats exhibited increased print area and stand index. Dopamine and dual lesion produced similar forepaw adjusting steps task on and off L-DOPA. Relative to DA lesioned rats, dual lesioned rats displayed reduced L-DOPA and DA agonist-induced dyskinesia at specific time points. Our results indicate that PPN cholinergic neurons affect gait parameters related to postural stability. Therefore, therapeutically targeting PPN cholinergic neurons could reduce intractable postural instability in PD without affecting motor benefits or side effects of L-DOPA treatment.
Collapse
Affiliation(s)
- Nicole E Chambers
- Department of Psychology, Behavioral Neuroscience Program, Binghamton University, Binghamton, NY, USA
| | - Michael Coyle
- Department of Psychology, Behavioral Neuroscience Program, Binghamton University, Binghamton, NY, USA
| | - Jordan Sergio
- Department of Psychology, Behavioral Neuroscience Program, Binghamton University, Binghamton, NY, USA
| | - Kathryn Lanza
- Department of Psychology, Behavioral Neuroscience Program, Binghamton University, Binghamton, NY, USA
| | - Carolyn Saito
- Department of Psychology, Behavioral Neuroscience Program, Binghamton University, Binghamton, NY, USA
| | - Brent Topping
- Department of Psychology, Behavioral Neuroscience Program, Binghamton University, Binghamton, NY, USA
| | - Stewart D Clark
- Department of Pharmacology and Toxicology, Jacobs School of Medicine & Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USA
| | - Christopher Bishop
- Department of Psychology, Behavioral Neuroscience Program, Binghamton University, Binghamton, NY, USA
| |
Collapse
|
15
|
Pelosin E, Cerulli C, Ogliastro C, Lagravinese G, Mori L, Bonassi G, Mirelman A, Hausdorff JM, Abbruzzese G, Marchese R, Avanzino L. A Multimodal Training Modulates Short Afferent Inhibition and Improves Complex Walking in a Cohort of Faller Older Adults With an Increased Prevalence of Parkinson's Disease. J Gerontol A Biol Sci Med Sci 2021; 75:722-728. [PMID: 30874799 DOI: 10.1093/gerona/glz072] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Falls are frequent in Parkinson's disease and aging. Impairments in the cholinergic-mediated attentional supervision of gait may contribute to increased fall risk, especially when obstacles challenge gait. Interventions combining motor-cognitive approaches have been shown to improve motor performance, cognitive skills, and falls number. Here, we hypothesized that an intervention simulating an attention-demanding walking condition could affect not only complex gait performance and fall risk but also short-latency afferent inhibition (SAI), as a marker of cholinergic activity. METHODS Thirty-nine participants at falls risk (24 Parkinson's disease participants and 15 older adults) were recruited in a randomized controlled trial. Participants were assigned to treadmill training or treadmill training with non-immersive virtual reality intervention and trained three times a week for 6 weeks. SAI, a transcranial magnetic stimulation paradigm, was used to assess cholinergic activity. Gait kinematics was measured during usual walking and while negotiating physical obstacles. Transcranial magnetic stimulation and gait assessments were performed pre, post, and 6 months post-intervention. RESULTS Treadmill training combined with non-immersive virtual reality induced an increase in inhibition of the SAI protocol on cortical excitability, improved obstacle negotiation performance, and induced a reduction of the number of falls compared with treadmill training. Furthermore, the more SAI increased after training, the more the obstacle negotiation performance improved and fall rate decreased. CONCLUSIONS We provide evidence that an innovative rehabilitation approach targeting cognitive components of complex motor actions can induce changes in cortical cholinergic activity, as indexed by SAI, thereby enabling functional gait improvements.
Collapse
Affiliation(s)
- Elisa Pelosin
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genoa, Italy.,Ospedale Policlinico San Martino, IRCSS, Genova, Italy
| | - Cecilia Cerulli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genoa, Italy
| | - Carla Ogliastro
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genoa, Italy.,Ospedale Policlinico San Martino, IRCSS, Genova, Italy
| | - Giovanna Lagravinese
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genoa, Italy
| | - Laura Mori
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genoa, Italy.,Ospedale Policlinico San Martino, IRCSS, Genova, Italy
| | - Gaia Bonassi
- Department of Experimental Medicine, Section of Human Physiology and Centro Polifunzionale di Scienze Motorie, University of Genoa, Italy
| | - Anat Mirelman
- Center for the Study of Movement, Cognition and Mobility, Department of Neurology, Tel Aviv Sourasky Medical Center, Israel.,Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Israel
| | - Jeffrey M Hausdorff
- Center for the Study of Movement, Cognition and Mobility, Department of Neurology, Tel Aviv Sourasky Medical Center, Israel.,Department of Physical Therapy, Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Israel.,Rush Alzheimer's Disease Center and Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois
| | - Giovanni Abbruzzese
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genoa, Italy.,Ospedale Policlinico San Martino, IRCSS, Genova, Italy
| | | | - Laura Avanzino
- Ospedale Policlinico San Martino, IRCSS, Genova, Italy.,Department of Experimental Medicine, Section of Human Physiology and Centro Polifunzionale di Scienze Motorie, University of Genoa, Italy
| |
Collapse
|
16
|
Reduction of falls in a rat model of PD falls by the M1 PAM TAK-071. Psychopharmacology (Berl) 2021; 238:1953-1964. [PMID: 33735392 PMCID: PMC7969347 DOI: 10.1007/s00213-021-05822-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 03/08/2021] [Indexed: 01/03/2023]
Abstract
RATIONALE In addition to the disease-defining motor symptoms, patients with Parkinson's disease (PD) exhibit gait dysfunction, postural instability, and a propensity for falls. These dopamine (DA) replacement-resistant symptoms in part have been attributed to loss of basal forebrain (BF) cholinergic neurons and, in interaction with striatal dopamine (DA) loss, to the resulting disruption of the attentional control of balance and complex movements. Rats with dual cholinergic-DA losses ("DL rats") were previously demonstrated to model PD falls and associated impairments of gait and balance. OBJECTIVES We previously found that the muscarinic M1-positive allosteric modulator (PAM) TAK-071 improved the attentional performance of rats with BF cholinergic losses. Here, we tested the hypotheses that TAK-071 reduces fall rates in DL rats. RESULTS Prior to DL surgery, female rats were trained to traverse a rotating straight rod as well as a rod with two zigzag segments. DL rats were refamiliarized with such traversals post-surgery and tested over 7 days on increasingly demanding testing conditions. TAK-071 (0.1, 0.3 mg/kg, p.o.) was administered prior to daily test sessions over this 7-day period. As before, DL rats fell more frequently than sham-operated control rats. Treatment of DL rats with TAK-071 reduced falls from the rotating rod and the rotating zigzag rod, specifically when the angled part of the zigzag segment, upon entering, was at a steep, near vertical angle. CONCLUSIONS TAK-071 may benefit complex movement control, specifically in situations which disrupt the patterning of forward movement and require the interplay between cognitive and motor functions to modify movement based on information about the state of dynamic surfaces, balance, and gait.
Collapse
|
17
|
Morales-Martínez A, Zamorano-Carrillo A, Montes S, El-Hafidi M, Sánchez-Mendoza A, Soria-Castro E, Martínez-Lazcano JC, Martínez-Gopar PE, Ríos C, Pérez-Severiano F. Rich fatty acids diet of fish and olive oils modifies membrane properties in striatal rat synaptosomes. Nutr Neurosci 2021; 24:1-12. [PMID: 30822260 DOI: 10.1080/1028415x.2019.1584692] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: Essential fatty acids (EFAs) and non-essential fatty acids (nEFAs) exert experimental and clinical neuroprotection in neurodegenerative diseases. The main EFAs, eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), nEFAs, and oleic acid (OA) contained in olive and fish oils are inserted into the cell membranes, but the exact mechanism through which they exert neuroprotection is still unknown. Objectives and Methods: In this study, we assessed the fatty acids content and membrane fluidity in striatal rat synaptosomes after fatty acid-rich diets (olive- or a fish-oil diet, 15% w/w). Then, we evaluated the effect of enriching striatum synaptosomes with fatty acids on the oxidative damage produced by the prooxidants ferrous sulfate (FeSO4) or quinolinic acid (QUIN). Results and Discussion: Lipid profile analysis in striatal synaptosomes showed that EPA content increased in the fish oil group in comparison with control and olive groups. Furthermore, we found that synaptosomes enriched with fatty acids and incubated with QUIN or FeSO4 showed a significant oxidative damage reduction. Results suggest that EFAs, particularly EPA, improve membrane fluidity and confer antioxidant effect.
Collapse
Affiliation(s)
- Adriana Morales-Martínez
- Departamento de Neuroquímica, Instituto Nacional de Neurología y Neurocirugía, Ciudad de México, México
- Laboratorio de Investigación de Bioquímica y Biofísica Computacional, ENMH, Instituto Politécnico Nacional, Ciudad de México, México
| | - Absalom Zamorano-Carrillo
- Laboratorio de Investigación de Bioquímica y Biofísica Computacional, ENMH, Instituto Politécnico Nacional, Ciudad de México, México
| | - Sergio Montes
- Departamento de Neuroquímica, Instituto Nacional de Neurología y Neurocirugía, Ciudad de México, México
| | - Mohammed El-Hafidi
- Departamento de Biomedicina Cardiovascular, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
| | - Alicia Sánchez-Mendoza
- Departamento de Farmacología, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
| | - Elizabeth Soria-Castro
- Departamento de Patología, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
| | | | | | - Camilo Ríos
- Departamento de Neuroquímica, Instituto Nacional de Neurología y Neurocirugía, Ciudad de México, México
| | - Francisca Pérez-Severiano
- Departamento de Neuroquímica, Instituto Nacional de Neurología y Neurocirugía, Ciudad de México, México
| |
Collapse
|
18
|
Policastro G, Brunelli M, Tinazzi M, Chiamulera C, Emerich DF, Paolone G. Cytokine-, Neurotrophin-, and Motor Rehabilitation-Induced Plasticity in Parkinson's Disease. Neural Plast 2020; 2020:8814028. [PMID: 33293946 PMCID: PMC7714573 DOI: 10.1155/2020/8814028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 11/06/2020] [Accepted: 11/19/2020] [Indexed: 02/06/2023] Open
Abstract
Neuroinflammation and cytokine-dependent neurotoxicity appear to be major contributors to the neuropathology in Parkinson's disease (PD). While pharmacological advancements have been a mainstay in the treatment of PD for decades, it is becoming increasingly clear that nonpharmacological approaches including traditional and nontraditional forms of exercise and physical rehabilitation can be critical adjunctive or even primary treatment avenues. Here, we provide an overview of preclinical and clinical research detailing the biological role of proinflammatory molecules in PD and how motor rehabilitation can be used to therapeutically modulate neuroinflammation, restore neural plasticity, and improve motor function in PD.
Collapse
Affiliation(s)
| | - Matteo Brunelli
- Department of Diagnostic and Public Health, University of Verona, Verona, Italy
| | - Michele Tinazzi
- Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | | | | | - Giovanna Paolone
- Department of Diagnostic and Public Health, University of Verona, Verona, Italy
| |
Collapse
|
19
|
Paolone G. From the Gut to the Brain and Back: Therapeutic Approaches for the Treatment of Network Dysfunction in Parkinson's Disease. Front Neurol 2020; 11:557928. [PMID: 33117258 PMCID: PMC7575743 DOI: 10.3389/fneur.2020.557928] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 09/04/2020] [Indexed: 12/16/2022] Open
Abstract
Parkinson's disease (PD) is a complex, multisystem, progressive, degenerative disorder characterized by severe, debilitating motor dysfunction, cognitive impairments, and mood disorders. Although preclinical research has traditionally focused on the motor deficits resulting from the loss of nigrostriatal dopaminergic neurons, up to two thirds of PD patients present separate and distinct behavioral changes. Loss of basal forebrain cholinergic neurons occurs as early as the loss of dopaminergic cells and contributes to the cognitive decline in PD. In addition, attentional deficits can limit posture control and movement efficacy caused by dopaminergic cell loss. Complicating the picture further is intracellular α-synuclein accumulation beginning in the enteric nervous system and diffusing to the substantia nigra through the dorsal motor neurons of the vagus nerve. It seems that α-synuclein's role is that of mediating dopamine synthesis, storage, and release, and its function has not been completely understood. Treating a complex, multistage network disorder, such as PD, likely requires a multipronged approach. Here, we describe a few approaches that could be used alone or perhaps in combination to achieve a greater mosaic of behavioral benefit. These include (1) using encapsulated, genetically modified cells as delivery vehicles for administering neuroprotective trophic factors, such as GDNF, in a direct and sustained means to the brain; (2) immunotherapeutic interventions, such as vaccination or the use of monoclonal antibodies against aggregated, pathological α-synuclein; (3) the continuous infusion of levodopa-carbidopa through an intestinal gel pad to attenuate the loss of dopaminergic function and manage the motor and non-motor complications in PD patients; and (4) specific rehabilitation treatment programs for drug-refractory motor complications.
Collapse
Affiliation(s)
- Giovanna Paolone
- Department of Diagnostic and Public Health - Section of Pharmacology, University of Verona, Verona, Italy
| |
Collapse
|
20
|
Weiss D, Schoellmann A, Fox MD, Bohnen NI, Factor SA, Nieuwboer A, Hallett M, Lewis SJG. Freezing of gait: understanding the complexity of an enigmatic phenomenon. Brain 2020; 143:14-30. [PMID: 31647540 DOI: 10.1093/brain/awz314] [Citation(s) in RCA: 87] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 08/07/2019] [Accepted: 08/16/2019] [Indexed: 12/15/2022] Open
Abstract
Diverse but complementary methodologies are required to uncover the complex determinants and pathophysiology of freezing of gait. To develop future therapeutic avenues, we need a deeper understanding of the disseminated functional-anatomic network and its temporally associated dynamic processes. In this targeted review, we will summarize the latest advances across multiple methodological domains including clinical phenomenology, neurogenetics, multimodal neuroimaging, neurophysiology, and neuromodulation. We found that (i) locomotor network vulnerability is established by structural damage, e.g. from neurodegeneration possibly as result from genetic variability, or to variable degree from brain lesions. This leads to an enhanced network susceptibility, where (ii) modulators can both increase or decrease the threshold to express freezing of gait. Consequent to a threshold decrease, (iii) neuronal integration failure of a multilevel brain network will occur and affect one or numerous nodes and projections of the multilevel network. Finally, (iv) an ultimate pathway might encounter failure of effective motor output and give rise to freezing of gait as clinical endpoint. In conclusion, we derive key questions from this review that challenge this pathophysiological view. We suggest that future research on these questions should lead to improved pathophysiological insight and enhanced therapeutic strategies.
Collapse
Affiliation(s)
- Daniel Weiss
- Centre for Neurology, Department for Neurodegenerative Diseases, and Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Anna Schoellmann
- Centre for Neurology, Department for Neurodegenerative Diseases, and Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Michael D Fox
- Berenson-Allen Center, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical Center, Boston, MA, USA.,Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Nicolaas I Bohnen
- Departments of Radiology and Neurology, University of Michigan, Ann Arbor, MI, USA; Veterans Administration Ann Arbor Healthcare System, Ann Arbor, MI, USA; Morris K. Udall Center of Excellence for Parkinson's Disease Research, University of Michigan, Ann Arbor, MI, USA
| | - Stewart A Factor
- Department of Neurology, Emory School of Medicine, Atlanta, GA, USA
| | - Alice Nieuwboer
- Neuromotor Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Mark Hallett
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Simon J G Lewis
- Parkinson's Disease Research Clinic, Brain and Mind Centre, University of Sydney, Australia
| |
Collapse
|
21
|
Cholinergic nucleus 4 atrophy and gait impairment in Parkinson's disease. J Neurol 2020; 268:95-101. [PMID: 32725313 DOI: 10.1007/s00415-020-10111-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/21/2020] [Accepted: 07/23/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND There is evidence that cortical cholinergic denervation contributes to gait and balance impairment in Parkinson's Disease (PD), especially reduced gait speed. OBJECTIVES The objective of this study was to determine the relationship between cholinergic basal forebrain gray matter density (GMD) and gait in PD patients. METHODS We investigated 66 PD patients who underwent a pre-surgical evaluation for a neurosurgical procedure to treat motor symptoms of PD. As part of this evaluation patients had a brain MRI and formal gait assessments. By applying probabilistic maps of the cholinergic basal forebrain to voxel-based morphometry of brain MRI, we calculated gray matter density (GMD) for cholinergic nucleus 4 (Ch4), cholinergic nucleus 1, 2, and 3 (Ch123), and the entire cortex. RESULTS Reduced Ch4 GMD was associated with reduced Fast Walking Speed in the "on" medication state (FWSON, p = 0.004). Bilateral cortical GMD was also associated with FWSON (p = 0.009), but Ch123 GMD was not (p = 0.1). Bilateral cortical GMD was not associated with FWSON after adjusting for Ch4 GMD (p = 0.44). While Ch4 GMD was not associated with improvement in Timed Up and Go (TUG) or Cognitive TUG in the "on" medication state, reduced Ch4 GMD was associated with greater percent worsening based on dual tasks (p = 0.021). CONCLUSIONS Reduced Ch4 GMD is associated with slower gait speed in PD and greater percent worsening in TUG during dual tasks in patients with PD. These findings have implications for planning of future clinical trials investigating cholinergic therapies to improve gait impairment in PD.
Collapse
|
22
|
Complex Movement Control in a Rat Model of Parkinsonian Falls: Bidirectional Control by Striatal Cholinergic Interneurons. J Neurosci 2020; 40:6049-6067. [PMID: 32554512 DOI: 10.1523/jneurosci.0220-20.2020] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 05/10/2020] [Accepted: 05/15/2020] [Indexed: 01/18/2023] Open
Abstract
Older persons and, more severely, persons with Parkinson's disease (PD) exhibit gait dysfunction, postural instability and a propensity for falls. These dopamine (DA) replacement-resistant symptoms are associated with losses of basal forebrain and striatal cholinergic neurons, suggesting that falls reflect disruption of the corticostriatal transfer of movement-related cues and their striatal integration with movement sequencing. To advance a rodent model of the complex movement deficits of Parkinsonian fallers, here we first demonstrated that male and female rats with dual cortical cholinergic and striatal DA losses (DL rats) exhibit cued turning deficits, modeling the turning deficits seen in these patients. As striatal cholinergic interneurons (ChIs) are positioned to integrate movement cues with gait, and as ChI loss has been associated with falls in PD, we next used this task, as well as a previously established task used to reveal heightened fall rates in DL rats, to broadly test the role of ChIs. Chemogenetic inhibition of ChIs in otherwise intact male and female rats caused cued turning deficits and elevated fall rates. Spontaneous turning was unaffected. Furthermore, chemogenetic stimulation of ChIs in DL rats reduced fall rates and restored cued turning performance. Stimulation of ChIs was relatively more effective in rats with viral transfection spaces situated lateral to the DA depletion areas in the dorsomedial striatum. These results indicate that striatal ChIs are essential for the control of complex movements, and they suggest a therapeutic potential of stimulation of ChIs to restore gait and balance, and to prevent falls in PD.SIGNIFICANCE STATEMENT In persons with Parkinson's disease, gait dysfunction and the associated risk for falls do not benefit from dopamine replacement therapy and often result in long-term hospitalization and nursing home placement. Here, we first validated a new task to demonstrate impairments in cued turning behavior in rodents modeling the cholinergic-dopaminergic losses observed in Parkinsonian fallers. We then demonstrated the essential role of striatal cholinergic interneurons for turning behavior as well as for traversing dynamic surfaces and avoiding falls. Stimulation of these interneurons in the rat model rescued turning performance and reduced fall rates. Our findings indicate the feasibility of investigating the neuronal circuitry underling complex movement control in rodents, and that striatal cholinergic interneurons are an essential node of such circuitry.
Collapse
|
23
|
Wahlberg LU, Emerich DF, Kordower JH, Bell W, Fradet T, Paolone G. Long-term, stable, targeted biodelivery and efficacy of GDNF from encapsulated cells in the rat and Goettingen miniature pig brain. CURRENT RESEARCH IN PHARMACOLOGY AND DRUG DISCOVERY 2020; 1:19-29. [PMID: 34909639 PMCID: PMC8663965 DOI: 10.1016/j.crphar.2020.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 04/14/2020] [Accepted: 04/16/2020] [Indexed: 12/19/2022] Open
Abstract
Delivering glial cell line-derived neurotrophic factor (GDNF) to the brain is a potential treatment for Parkinson's Disease (PD). Here we use an implantable encapsulated cell technology that uses modified human clonal ARPE-19 cells to deliver of GDNF to the brain. In vivo studies demonstrated sustained delivery of GDNF to the rat striatum over 6 months. Anatomical benefits and behavioral efficacy were shown in 6-OHDA lesioned rats where nigral dopaminergic neurons were preserved in neuroprotection studies and dopaminergic fibers were restored in neurorecovery studies. When larger, clinical-sized devices were implanted for 3 months into the putamen of Göttingen minipigs, GDNF was widely distributed throughout the putamen and caudate producing a significant upregulation of tyrosine hydroxylase immunohistochemistry. These results are the first to provide clear evidence that implantation of encapsulated GDNF-secreting cells deliver efficacious and biologically relevant amounts of GDNF in a sustained and targeted manner that is scalable to treat the large putamen in patients with Parkinson's disease.
Collapse
Affiliation(s)
| | | | - Jeffrey H Kordower
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | | | | | - Giovanna Paolone
- Department of Diagnostic and Public Health, Section of Pharmacology, University of Verona P.le, LA Scuro, Verona, Italy
| |
Collapse
|
24
|
Rescuing the attentional performance of rats with cholinergic losses by the M1 positive allosteric modulator TAK-071. Psychopharmacology (Berl) 2020; 237:137-153. [PMID: 31620809 DOI: 10.1007/s00213-019-05354-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Accepted: 08/15/2019] [Indexed: 02/07/2023]
Abstract
RATIONALE Loss of basal forebrain cholinergic neurons contributes to the severity of the cognitive decline in age-related dementia and, in patients with Parkinson's disease (PD), to impairments in gait and balance and the resulting risks for falls. Contrasting with the extensive evidence indicating an essential role of cholinergic activity in mediating cognitive, specifically attentional abilities, treatment with conventional acetylcholinesterase inhibitors (AChEIs) has not fulfilled the promise of efficacy of pro-cholinergic treatments. OBJECTIVES Here, we investigated the potential usefulness of a muscarinic M1 positive allosteric modulator (PAM) in an animal model of cholinergic loss-induced impairments in attentional performance. Given evidence indicating that fast, transient cholinergic signaling mediates the detection of cues in attentional contexts, we hypothesized that a M1 PAM amplifies such transient signaling and thereby rescues attentional performance. RESULTS Rats performed an operant sustained attention task (SAT), including in the presence of a distractor (dSAT) and during a post-distractor (post-dSAT) period. The post-dSAT period served to assess the capacity for recovering performance following a disruptive event. Basal forebrain infusions of the cholino-specific immunotoxin 192 IgG-saporin impaired SAT performance, and greater cholinergic losses predicted lower post-dSAT performance. Administration of TAK-071 (0.1, 0.3 mg/kg, p.o., administered over 6-day blocks) improved the performance of all rats during the post-dSAT period (main effect of dose). Drug-induced improvement of post-dSAT performance was relatively greater in lesioned rats, irrespective of sex, but also manifested in female control rats. TAK-071 primarily improved perceptual sensitivity (d') in lesioned rats and facilitated the adoption of a more liberal response bias (B˝D) in all female rats. CONCLUSIONS These findings suggest that TAK-071 may benefit the attentional performance of patients with partial cholinergic losses and specifically in situations that tax top-down, or goal-driven, attentional control.
Collapse
|
25
|
Koshy Cherian A, Kucinski A, Wu R, de Jong IEM, Sarter M. Co-treatment with rivastigmine and idalopirdine reduces the propensity for falls in a rat model of falls in Parkinson's disease. Psychopharmacology (Berl) 2019; 236:1701-1715. [PMID: 30607479 DOI: 10.1007/s00213-018-5150-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 12/11/2018] [Indexed: 11/24/2022]
Abstract
RATIONALE Falls in patients with Parkinson's disease (PD) are associated with cognitive, specifically attentional impairments and with losses in cholinergic projection systems. We previously established an animal model of the combined basal forebrain cholinergic-striatal dopaminergic losses of PD fallers (Dual Lesioned, DL, rats) and demonstrated that treating DL rats with an acetylcholinesterase inhibitor (AChEI), donepezil, together with a 5HT6 receptor antagonist, idalopirdine, reduced fall frequency and improved associated aspects of the performance of DL rats traversing rotating rods. OBJECTIVES Here, we employed a longer and more taxing rotating beam apparatus to determine the potential therapeutic efficacy of idalopirdine when combined with the pseudo-irreversible, and thus relatively long-acting, AChE- and butyrylcholinesterase- (BuChE) inhibitor rivastigmine. RESULTS As before, vehicle-treated DL rats fell more frequently, committed more slips, and exhibited more movement stoppages than intact control rats. Repeated intermittent administration of rivastigmine and idalopirdine significantly improved the performance of DL rats. Rivastigmine alone also produced strong trends for reducing falls and slips. The combination treatment was more effective than rivastigmine alone in reducing stoppages and stoppage-associated falls. As before, idalopirdine treatment alone was ineffective. CONCLUSIONS These results extend the prediction that the combined treatment with idalopirdine and an AChEI improves complex movement control and reduces the propensity for falls in patients with movement disorders. Because of the importance of finding better treatments for gait and balance deficits in PD, the present results may further motivate a clinical exploration of the usefulness of this combination treatment.
Collapse
Affiliation(s)
- Ajeesh Koshy Cherian
- Department of Psychology, University of Michigan, 530 Church Street, Ann Arbor, MI, 48109, USA
| | - Aaron Kucinski
- Department of Psychology, University of Michigan, 530 Church Street, Ann Arbor, MI, 48109, USA
| | - Ryan Wu
- Department of Psychology, University of Michigan, 530 Church Street, Ann Arbor, MI, 48109, USA
| | | | - Martin Sarter
- Department of Psychology, University of Michigan, 530 Church Street, Ann Arbor, MI, 48109, USA.
| |
Collapse
|
26
|
Kucinski A, Kim Y, Sarter M. Basal forebrain chemogenetic inhibition disrupts the superior complex movement control of goal-tracking rats. Behav Neurosci 2019; 133:121-134. [PMID: 30688488 DOI: 10.1037/bne0000290] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Sign- and goal-tracking behavior signifies the influence of opposed cognitive-motivational styles, with the former being characterized by a tendency for approaching and contacting reward cues, including a readiness for attending, bottom-up, to salient cues, and a relatively greater vulnerability for developing and maintaining addiction-like behaviors. We previously demonstrated that these styles also impact the cognitive-motor interactions that are taxed during traversal of dynamic surfaces, with goal-trackers (GTs) making less movement errors and falling less frequently than sign-trackers (STs). The present experiment tested the hypothesis that complex movement control in GTs, but not STs, depends on activation of the basal forebrain projection system to telencephalic regions. Chemogenetic inhibition of the basal forebrain increased movement errors and falls in GTs during traversal of a rotating zigzag rod but had no significant effect on the relatively lower performance of STs. Neurochemical evidence confirmed the efficacy of the inhibitory designer receptor exclusively activated by designer drug (DREADD). Administration of clozapine-N-oxide (CNO) had no significant effect in GTs not expressing the DREADD. These results indicate that GTs, but not STs, activate the basal forebrain projection system to mediate their relatively superior ability for complex movement control. STs may also serve as an animal model in research on the role of basal forebrain systems in aging- and Parkinson's disease-associated falls. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Collapse
Affiliation(s)
| | - Youngsoo Kim
- Department of Psychology and Neuroscience Program
| | | |
Collapse
|
27
|
Morris R, Martini DN, Madhyastha T, Kelly VE, Grabowski TJ, Nutt J, Horak F. Overview of the cholinergic contribution to gait, balance and falls in Parkinson's disease. Parkinsonism Relat Disord 2019; 63:20-30. [PMID: 30796007 DOI: 10.1016/j.parkreldis.2019.02.017] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 01/02/2019] [Accepted: 02/13/2019] [Indexed: 10/27/2022]
Abstract
Mobility deficits, including gait disturbance, balance impairments and falls, are common features of Parkinson's disease (PD) that negatively impact quality of life. Mobility deficits respond poorly to dopaminergic medications, indicating a role for additional neurotransmitters. Due to the critical role of cortical input to gait and balance, acetylcholine-an essential neurotransmitter system for attention-has become an area of interest for mobility. This review aimed to identify the role of cholinergic function on gait, balance, and falls in PD using three techniques; pharmacological, imaging, and electrophysiological. Studies supported the role of the cholinergic system for mobility in PD, with the most promising evidence indicating a role in falls. Imaging studies demonstrated involvement of anterior cholinergic (basal forebrain) systems in gait, and posterior (brainstem) systems in balance. However, this review identified a small number of studies which used varying protocols, making comparisons difficult. Further studies are warranted, measuring comprehensive gait and balance characteristics as well as gold standard falls detection to further quantify the relationship between ACh and mobility in PD.
Collapse
Affiliation(s)
- Rosie Morris
- Department of Neurology, Oregon Health and Science University, Portland, OR, USA
| | - Douglas N Martini
- Department of Neurology, Oregon Health and Science University, Portland, OR, USA
| | - Tara Madhyastha
- Department of Radiology, University of Washington School of Medicine, Seattle, WA, USA
| | - Valerie E Kelly
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Thomas J Grabowski
- Department of Radiology, University of Washington School of Medicine, Seattle, WA, USA
| | - John Nutt
- Department of Neurology, Oregon Health and Science University, Portland, OR, USA
| | - Fay Horak
- Department of Neurology, Oregon Health and Science University, Portland, OR, USA; Portland Veterans Affairs Health Care System, Portland, OR, USA.
| |
Collapse
|
28
|
Sarter M, Lustig C. Cholinergic double duty: cue detection and attentional control. Curr Opin Psychol 2019; 29:102-107. [PMID: 30711909 DOI: 10.1016/j.copsyc.2018.12.026] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 11/26/2018] [Accepted: 12/31/2018] [Indexed: 02/08/2023]
Abstract
Cholinergic signaling in the cortex involves fast or transient signaling as well as a relatively slower neuromodulatory component. These two components of cholinergic activity mediate separate yet interacting aspects of cue detection and attentional control. The transient component appears to support the activation of cue-associated task or response sets, whereas the slower modulatory component stabilizes task-set and context representations, therefore potentially facilitating top-down control. Evidence from humans expressing genetic variants of the choline transporter as well as from patients with degenerating cholinergic systems supports the hypothesis that attentional control capacities depend on levels of cholinergic neuromodulation. Deficits in cholinergic-attentional control impact diverse cognitive functions, including timing, working memory, and complex movement control.
Collapse
Affiliation(s)
- Martin Sarter
- Department of Psychology and Neuroscience Program, University of Michigan, Ann Arbor, MI 48109, United States.
| | - Cindy Lustig
- Department of Psychology and Neuroscience Program, University of Michigan, Ann Arbor, MI 48109, United States
| |
Collapse
|
29
|
Molecular Imaging of the Cholinergic System in Parkinson's Disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2018; 141:211-250. [PMID: 30314597 DOI: 10.1016/bs.irn.2018.07.027] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
One of the first identified neurotransmitters in the brain, acetylcholine, is an important modulator that drives changes in neuronal and glial activity. For more than two decades, the main focus of molecular imaging of the cholinergic system in Parkinson's disease (PD) has been on cognitive changes. Imaging studies have confirmed that degeneration of the cholinergic system is a major determinant of dementia in PD. Within the last decade, the focus is expanding to studying cholinergic correlates of mobility impairments, dyskinesias, olfaction, sleep, visual hallucinations and risk taking behavior in this disorder. These studies increasingly recognize that the regional topography of cholinergic brain areas associates with specific functions. In parallel with this trend, more recent molecular cholinergic imaging approaches are investigating cholinergic modulatory functions and contributions to large-scale brain network functions. A novel area of research is imaging cholinergic innervation functions of peripheral autonomic organs that may have the potential of future prodromal diagnosis of PD. Finally, emerging evidence of hypercholinergic activity in prodromal and symptomatic leucine-rich repeat kinase 2 PD may reflect neuronal cholinergic compensation versus a response to neuro-inflammation. Molecular imaging of the cholinergic system has led to many new insights in the etiology of dopamine non-responsive symptoms of PD (more "malignant" hypocholinergic disease phenotype) and is poised to guide and evaluate future cholinergic drug development in this disorder.
Collapse
|
30
|
Kucinski A, Lustig C, Sarter M. Addiction vulnerability trait impacts complex movement control: Evidence from sign-trackers. Behav Brain Res 2018; 350:139-148. [PMID: 29705686 PMCID: PMC6506847 DOI: 10.1016/j.bbr.2018.04.045] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 04/25/2018] [Accepted: 04/25/2018] [Indexed: 11/15/2022]
Abstract
Cognitive-motivational vulnerability traits are associated with increased risk for substance addiction and relapse. Sign-tracking (ST) behavior in rats is associated with poor attentional control, mediated by an unresponsive basal forebrain cholinergic system, and an increased risk for substance addiction/relapse. A separate literature links poor attentional control and cholinergic losses to increased fall risk in Parkinson's disease. Here we tested the hypothesis that the relatively inferior attentional control of STs extends to complex movement control and a propensity for falls. STs were found to fall more often than goal-trackers (GTs) while traversing a straight rotating rod and, similar to human fallers, when taxed by a secondary task. Furthermore, STs fell more often while traversing a rotating zig-zag rod. GTs exhibited fewer falls from this rod by avoiding entry to the rotating zig-zag sections when in, or rotating toward, a difficult traversal state. Goal-tracking rats approached risky movement situations using strategies indicative of superior top-down control. These results suggest that the impact of opponent cognitive-cholinergic traits extends to complex movement control, and that impairments in the cognitive-motor interface are likely to be comorbid with addiction vulnerability. Sign-tracking indexes an endophenotype that may increase the risk for a wide range of neurobehavioral disorders.
Collapse
Affiliation(s)
- Aaron Kucinski
- Department of Psychology and Neuroscience Program, University of Michigan, Ann Arbor, MI 48109, USA
| | - Cindy Lustig
- Department of Psychology and Neuroscience Program, University of Michigan, Ann Arbor, MI 48109, USA
| | - Martin Sarter
- Department of Psychology and Neuroscience Program, University of Michigan, Ann Arbor, MI 48109, USA.
| |
Collapse
|
31
|
Bohnen NI, Grothe MJ, Ray NJ, Müller ML, Teipel SJ. Recent advances in cholinergic imaging and cognitive decline-Revisiting the cholinergic hypothesis of dementia. CURRENT GERIATRICS REPORTS 2018; 7:1-11. [PMID: 29503795 PMCID: PMC5831510 DOI: 10.1007/s13670-018-0234-4] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE OF REVIEW Although the cholinergic hypothesis of dementia provided a successful paradigm for the development of new drugs for dementia, this hypothesis has waned in popularity. Cholinergic brain imaging may provide novel insights into the viability of this hypothesis. RECENT FINDINGS Cholinergic receptor and forebrain volumetric studies suggest an important role of the cholinergic system in maintaining brain network integrity that may deteriorate with cognitive decline in Alzheimer disease (AD) and Lewy body disorders (LBD). Bidirectional changes in regional receptor expression may suggest the presence of compensatory responses to neurodegenerative injury. Cholinergic system changes are more complex in LBD because of additional subcortical degenerations compared to AD. Cholinergic-dopaminergic interactions affect attentional, verbal learning and executive functions, and impairments in these two transmitter systems may jointly increase the risk of dementia in Parkinson disease. SUMMARY The cholinergic hypothesis is evolving from a primary focus on memory toward expanded cognitive functions modulated by regionally more complex and interactive brain networks. Cholinergic network adaptation may serve as a novel research target in neurodegeneration.
Collapse
Affiliation(s)
- Nicolaas I. Bohnen
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
- Veterans Administration Ann Arbor Healthcare System, Ann Arbor, MI, USA
- Morris K. Udall Center of Excellence for Parkinson's Disease Research, University of Michigan, Ann Arbor, MI, United States
| | - Michel J. Grothe
- German Center for Neurodegenerative Diseases (DZNE) - Rostock/Greifswald, Rostock, Germany
- Department of Psychosomatic Medicine, University of Rostock, Rostock, Germany
| | - Nicola J. Ray
- Department of Psychology, Manchester Metropolitan University, Manchester, United Kingdom
| | - Martijn L.T.M. Müller
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA
- Morris K. Udall Center of Excellence for Parkinson's Disease Research, University of Michigan, Ann Arbor, MI, United States
| | - Stefan J. Teipel
- German Center for Neurodegenerative Diseases (DZNE) - Rostock/Greifswald, Rostock, Germany
- Department of Psychosomatic Medicine, University of Rostock, Rostock, Germany
| |
Collapse
|
32
|
Compensatory dopaminergic-cholinergic interactions in conflict processing: Evidence from patients with Parkinson's disease. Neuroimage 2018; 190:94-106. [PMID: 29337277 DOI: 10.1016/j.neuroimage.2018.01.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 12/29/2017] [Accepted: 01/07/2018] [Indexed: 01/21/2023] Open
Abstract
Executive functions are complex both in the cognitive operations involved and in the neural structures and functions that support those operations. This complexity makes executive function highly vulnerable to the detrimental effects of aging, brain injury, and disease, but may also open paths to compensation. Neural compensation is often used to explain findings of additional or altered patterns of brain activations by older adults or patient populations compared to young adults or healthy controls, especially when associated with relatively preserved performance. Here we test the hypothesis of an alternative form of compensation, between different neuromodulator systems. 135 patients with Parkinson's Disease (PD) completed vesicular monoamine transporter type2 (VMAT2) and acetylcholinesterase PET scanning to assess the integrity of nigrostriatal dopaminergic, thalamic cholinergic, and cortical cholinergic pathways, and a behavioral test (Stroop + task-switching) that puts high demands on conflict processing, an important aspect of executive control. Supporting the compensatory hypothesis, regression models controlling for age and other covariates revealed an interaction between caudate dopamine and cortical cholinergic integrity: Cortical cholinergic integrity was a stronger predictor of conflict processing in patients with relatively low caudate dopaminergic function. These results suggest that although frontostriatal dopaminergic function plays a central role in executive control, cholinergic systems may also make an important contribution. The present results suggest potential pathways for remediation, and that the appropriate interventions for each patient may depend on their particular profile of decline. Furthermore, they help to elucidate the brain systems that underlie executive control, which may be important for understanding other disorders as well as executive function in healthy adults.
Collapse
|
33
|
Herb JN, Rane S, Isaacs DA, Van Wouwe N, Roman OC, Landman BA, Dawant BM, Hedera P, Zald DH, Neimat JS, Wylie SA, Donahue MJ, Claassen DO. Cortical Implications of Advancing Age and Disease Duration in Parkinson's Disease Patients with Postural Instability and Gait Dysfunction. JOURNAL OF PARKINSONS DISEASE 2017; 6:441-51. [PMID: 27164041 DOI: 10.3233/jpd-150753] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Parkinson's Disease patients with predominant gait dysfunction appear to have reduced cortical thickness compared to other motor phenotypes. The extent to which advancing age or disease duration impact the pattern of these distinctions is unclear. OBJECTIVE We examine if PD patients with predominant signs of postural instability and gait dysfunction are distinguished by distinct patterns of cerebral atrophy, and how these differences are influenced by age and disease duration. METHODS The Unified Parkinson's Disease Rating Score (UPDRS) was administered to 196 PD patients (age = 61.4±8.9yrs) in the Off and On dopamine state. All completed a structural T1-weighted brain MRI. We defined 3 motor phenotypes: tremor dominant, akinetic-rigid, and postural instability with gait disorder. General linear modeling quantified cortical thickness in relation to disease duration, and motor improvement after dopaminergic therapy. Cortical thickness and subcortical volumes were compared between the three motor subtypes, after controlling for disease duration and age. RESULTS We identified 177/196 patients who met criteria for a motor subtype. When corrected for disease duration, postural-instability patients had marked cortical thinning of the bilateral frontal-temporal and posterior cortical regions (cuneus/precuneus). After regressing for age, reduced frontal thickness was evident in patients with gait dysfunction. Widespread cortical thinning was associated with increasing disease duration and reduced motor improvement to dopaminergic therapy. CONCLUSIONS Results emphasize that the profile of motor signs, especially prominent gait manifestations, relate to cortical thinning in distinct regions. Unique patterns of atrophy appear to be driven by advancing pathology related to age and disease duration.
Collapse
Affiliation(s)
- Joshua N Herb
- School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Swati Rane
- Department of Radiology, Vanderbilt University, Nashville, TN, USA
| | - David A Isaacs
- Department of Neurology, Vanderbilt University, Nashville, TN, USA
| | | | - Olivia C Roman
- Department of Neurology, Vanderbilt University, Nashville, TN, USA
| | - Bennett A Landman
- Department of Radiology, Vanderbilt University, Nashville, TN, USA.,Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Benoit M Dawant
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Peter Hedera
- Department of Neurology, Vanderbilt University, Nashville, TN, USA
| | - David H Zald
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Joseph S Neimat
- Department of Neurosurgery, Vanderbilt University, Nashville, TN, USA
| | - Scott A Wylie
- Department of Neurology, Vanderbilt University, Nashville, TN, USA
| | - Manus J Donahue
- Department of Radiology, Vanderbilt University, Nashville, TN, USA
| | | |
Collapse
|
34
|
Ballinger EC, Ananth M, Talmage DA, Role LW. Basal Forebrain Cholinergic Circuits and Signaling in Cognition and Cognitive Decline. Neuron 2017; 91:1199-1218. [PMID: 27657448 DOI: 10.1016/j.neuron.2016.09.006] [Citation(s) in RCA: 438] [Impact Index Per Article: 62.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2016] [Indexed: 02/04/2023]
Abstract
Recent work continues to place cholinergic circuits at center stage for normal executive and mnemonic functioning and provides compelling evidence that the loss of cholinergic signaling and cognitive decline are inextricably linked. This Review focuses on the last few years of studies on the mechanisms by which cholinergic signaling contributes to circuit activity related to cognition. We attempt to identify areas of controversy, as well as consensus, on what is and is not yet known about how cholinergic signaling in the CNS contributes to normal cognitive processes. In addition, we delineate the findings from recent work on the extent to which dysfunction of cholinergic circuits contributes to cognitive decline associated with neurodegenerative disorders.
Collapse
Affiliation(s)
- Elizabeth C Ballinger
- Medical Scientist Training Program, Program in Neuroscience, Department of Neurobiology & Behavior, Stony Brook University, Stony Brook, NY 11794, USA.
| | - Mala Ananth
- Program in Neuroscience, Department of Neurobiology & Behavior, Department of Psychiatry & Behavioral Science, Stony Brook University, Stony Brook, NY 11794, USA
| | - David A Talmage
- Department of Pharmacological Sciences, CNS Disorders Center, Center for Molecular Medicine, Stony Brook University, Stony Brook, NY 11794, USA
| | - Lorna W Role
- Department of Neurobiology & Behavior, Neurosciences Institute, CNS Disorders Center, Center for Molecular Medicine, Stony Brook University, Stony Brook, NY 11794, USA.
| |
Collapse
|
35
|
Chomiak T, Watts A, Meyer N, Pereira FV, Hu B. A training approach to improve stepping automaticity while dual-tasking in Parkinson's disease: A prospective pilot study. Medicine (Baltimore) 2017; 96:e5934. [PMID: 28151878 PMCID: PMC5293441 DOI: 10.1097/md.0000000000005934] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Deficits in motor movement automaticity in Parkinson's disease (PD), especially during multitasking, are early and consistent hallmarks of cognitive function decline, which increases fall risk and reduces quality of life. This study aimed to test the feasibility and potential efficacy of a wearable sensor-enabled technological platform designed for an in-home music-contingent stepping-in-place (SIP) training program to improve step automaticity during dual-tasking (DT). METHODS This was a 4-week prospective intervention pilot study. The intervention uses a sensor system and algorithm that runs off the iPod Touch which calculates step height (SH) in real-time. These measurements were then used to trigger auditory (treatment group, music; control group, radio podcast) playback in real-time through wireless headphones upon maintenance of repeated large amplitude stepping. With small steps or shuffling, auditory playback stops, thus allowing participants to use anticipatory motor control to regain positive feedback. Eleven participants were recruited from an ongoing trial (Trial Number: ISRCTN06023392). Fear of falling (FES-I), general cognitive functioning (MoCA), self-reported freezing of gait (FOG-Q), and DT step automaticity were evaluated. RESULTS While we found no significant effect of training on FES-I, MoCA, or FOG-Q, we did observe a significant group (music vs podcast) by training interaction in DT step automaticity (P<0.01). CONCLUSION Wearable device technology can be used to enable musically-contingent SIP training to increase motor automaticity for people living with PD. The training approach described here can be implemented at home to meet the growing demand for self-management of symptoms by patients.
Collapse
|
36
|
Cai C, Yuan K, Yin J, Feng D, Bi Y, Li Y, Yu D, Jin C, Qin W, Tian J. Striatum morphometry is associated with cognitive control deficits and symptom severity in internet gaming disorder. Brain Imaging Behav 2016; 10:12-20. [PMID: 25720356 DOI: 10.1007/s11682-015-9358-8] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Internet gaming disorder (IGD), identified in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) Section III as a condition warranting more clinical research, may be associated with impaired cognitive control. Previous IGD-related studies had revealed structural abnormalities in the prefrontal cortex, an important part of prefrontal-striatal circuits, which play critical roles in cognitive control. However, little is known about the relationship between the striatal nuclei (caudate, putamen, and nucleus accumbens) volumes and cognitive control deficit in individuals with IGD. Twenty-seven adolescents with IGD and 30 age-, gender- and education-matched healthy controls participated in this study. The volume differences of the striatum were assessed by measuring subcortical volume in FreeSurfer. Meanwhile, the Stroop task was used to detect cognitive control deficits. Correlation analysis was used to investigate the relationship between striatal volumes and performance in the Stroop task as well as severity in IGD. Relative to controls, the IGD committed more incongruent condition response errors during the Stroop task and showed increased volumes of dorsal striatum (caudate) and ventral striatum (nucleus accumbens). In addition, caudate volume was correlated with Stroop task performance and nucleus accumbens (NAc) volume was associated with the internet addiction test (IAT) score in the IGD group. The increased volumes of the right caudate and NAc and their association with behavioral characteristics (i.e., cognitive control and severity) in IGD were detected in the present study. Our findings suggest that the striatum may be implicated in the underlying pathophysiology of IGD.
Collapse
Affiliation(s)
- Chenxi Cai
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710071, People's Republic of China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, Xi'an, People's Republic of China
| | - Kai Yuan
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710071, People's Republic of China. .,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, Xi'an, People's Republic of China.
| | - Junsen Yin
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710071, People's Republic of China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, Xi'an, People's Republic of China
| | - Dan Feng
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710071, People's Republic of China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, Xi'an, People's Republic of China
| | - Yanzhi Bi
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710071, People's Republic of China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, Xi'an, People's Republic of China
| | - Yangding Li
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710071, People's Republic of China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, Xi'an, People's Republic of China
| | - Dahua Yu
- Inner Mongolia Key Laboratory of Pattern Recognition and Intelligent Image Processing, School of Information Engineering, Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia, 014010, People's Republic of China.
| | - Chenwang Jin
- Department of Medical Imaging, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Wei Qin
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710071, People's Republic of China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, Xi'an, People's Republic of China
| | - Jie Tian
- School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710071, People's Republic of China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, Xi'an, People's Republic of China.,Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, People's Republic of China
| |
Collapse
|
37
|
Wicks B, Waxler DE, White KM, Duncan N, Bergmann J, Cole RD, Parikh V, Bangasser DA. Method for testing sustained attention in touchscreen operant chambers in rats. J Neurosci Methods 2016; 277:30-37. [PMID: 27939962 DOI: 10.1016/j.jneumeth.2016.12.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Revised: 12/04/2016] [Accepted: 12/05/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Sustained attention, the ability to detect rare and unpredictable events, is central to cognitive performance. This construct can be tested in rodents using a Sustained Attention Task (SAT), where rats are trained to detect an unpredictably occurring signal (a brief light presentation) from non-signal events. The traditional version of this task utilizes an operant chamber with a central panel light for the signal and two retractable response levers. Adaptation of SAT to the increasingly popular touchscreen operant chambers, which do not have levers or fixed lights, could enhance the versatility of the task. NEW METHOD Here we developed a touchscreen version of SAT where the light signal is presented in the center of the touchscreen, followed by a tone to indicate the beginning of the response period. Rats indicate their choice during this period by touching their nose to one of two touchscreen response areas. The remaining parameters were kept similar to the traditional version. RESULTS Rats acquired touchscreen SAT at a similar rate to the traditional version. As with the traditional version, shorter stimulus durations on the signaled trials reduced accuracy and the presence of a distractor (a flashing houselight) disrupted performance on the touchscreen version. COMPARISON TO EXISTING METHOD Collectively, these data suggest that the touchscreen version is comparable to the traditional version of the SAT, and is an equally valid way of measuring sustained attention. CONCLUSIONS Many researchers with touchscreen chambers could easily implement our modifications in order to study sustained attention.
Collapse
Affiliation(s)
- Brittany Wicks
- Department of Psychology and Neuroscience Program, Temple University, Philadelphia, PA 19122, United States
| | - David E Waxler
- Department of Psychology and Neuroscience Program, Temple University, Philadelphia, PA 19122, United States
| | - Kyle M White
- Department of Psychology and Neuroscience Program, Temple University, Philadelphia, PA 19122, United States
| | - Nina Duncan
- Department of Psychology and Neuroscience Program, Temple University, Philadelphia, PA 19122, United States
| | - Joy Bergmann
- Department of Psychology and Neuroscience Program, Temple University, Philadelphia, PA 19122, United States
| | - Robert D Cole
- Department of Psychology and Neuroscience Program, Temple University, Philadelphia, PA 19122, United States
| | - Vinay Parikh
- Department of Psychology and Neuroscience Program, Temple University, Philadelphia, PA 19122, United States
| | - Debra A Bangasser
- Department of Psychology and Neuroscience Program, Temple University, Philadelphia, PA 19122, United States.
| |
Collapse
|
38
|
Burk JA. Reducing falls in a model of impaired cognitive control of movement (Commentary on Kucinski et al.). Eur J Neurosci 2016; 45:215-216. [PMID: 27868266 DOI: 10.1111/ejn.13466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Joshua A Burk
- Department of Psychology, College of William & Mary, Williamsburg, VA, 23187, USA
| |
Collapse
|
39
|
Snijders AH, Takakusaki K, Debu B, Lozano AM, Krishna V, Fasano A, Aziz TZ, Papa SM, Factor SA, Hallett M. Physiology of freezing of gait. Ann Neurol 2016; 80:644-659. [DOI: 10.1002/ana.24778] [Citation(s) in RCA: 137] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 09/14/2016] [Accepted: 09/15/2016] [Indexed: 11/08/2022]
Affiliation(s)
- Anke H. Snijders
- Department of Neurology, Donders Institute for Brain, Cognition, and Behavior; Radboud University Medical Center; Nijmegen the Netherlands
- Maasziekenhuis Pantein; Boxmeer the Netherlands
| | - Kaoru Takakusaki
- Research Center for Brain Function and Medical Engineering; Asahikawa Medical University; Asahikawa Japan
| | - Bettina Debu
- Joseph Fourier University, Grenoble Universities; Grenoble France
| | - Andres M. Lozano
- Division of Neurosurgery; University of Toronto; Toronto Ontario Canada
| | - Vibhor Krishna
- Division of Neurosurgery; University of Toronto; Toronto Ontario Canada
- Department of Neurosurgery; Ohio State University; Columbus OH
| | - Alfonso Fasano
- Morton and Gloria Shulman Movement Disorders Centre and the Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital; University Health Network; Toronto Ontario Canada
| | - Tipu Z. Aziz
- John Radcliffe Hospital; Headington Oxford United Kingdom
| | - Stella M. Papa
- Department of Neurology, Jean and Paul Amos Parkinson's Disease and Movement Disorders Center; Emory University School of Medicine; Atlanta GA
| | - Stewart A. Factor
- Department of Neurology, Jean and Paul Amos Parkinson's Disease and Movement Disorders Center; Emory University School of Medicine; Atlanta GA
| | - Mark Hallett
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health; Bethesda MD
| |
Collapse
|
40
|
Rosenberg-Katz K, Maidan I, Jacob Y, Giladi N, Mirelman A, Hausdorff JM. Alterations in conflict monitoring are related to functional connectivity in Parkinson's disease. Cortex 2016; 82:277-286. [DOI: 10.1016/j.cortex.2016.06.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2016] [Revised: 06/02/2016] [Accepted: 06/16/2016] [Indexed: 02/03/2023]
|
41
|
Kucinski A, de Jong IEM, Sarter M. Reducing falls in Parkinson's disease: interactions between donepezil and the 5-HT 6 receptor antagonist idalopirdine on falls in a rat model of impaired cognitive control of complex movements. Eur J Neurosci 2016; 45:217-231. [PMID: 27469080 DOI: 10.1111/ejn.13354] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 07/11/2016] [Accepted: 07/21/2016] [Indexed: 11/30/2022]
Abstract
Falls are a leading cause of death in the elderly and, in a majority of patients with Parkinson's disease (PD), the leading levodopa-insensitive cause of hospitalization and long-term care. Falling in PD has been attributed to degeneration of forebrain cholinergic neurons that, in interaction with striatal dopamine losses, impairs the cognitive control of balance, gait, and movement. We previously established an animal model of these dual cholinergic-dopaminergic losses ("DL rats") and a behavioral test system (Michigan Complex Motor Control Task, MCMCT) to measure falls associated with traversing dynamic surfaces and distractors. Because the combined treatment of the acetylcholinesterase inhibitor donepezil and the 5-HT6 receptor antagonist idalopirdine (Lu AE58054) was reported to exhibit synergistic pro-cholinergic activity in rats and improved cognition in patients with moderate Alzheimer's disease, here we assessed the effects of this treatment on MCMCT performance and attention in DL rats. Compared with the vehicle-treated group, the combined treatment greatly reduced (Cohen's d = 0.96) falls in DL rats when traversing dynamic surfaces and when exposed to a passive distractor. However, falls associated with a dual task distractor and sustained attentional performance did not benefit from this treatment. Analyses of the behavior in fall-prone moments suggested that this treatment improved the efficacy and speed of re-instating forward movement after relatively short stoppages. This treatment may reduce fall propensity in PD patients via maintaining planned movement sequences in working memory and improving the vigor of executing such movements following brief periods of freezing of gait.
Collapse
Affiliation(s)
- Aaron Kucinski
- Department of Psychology, University of Michigan, 530 Church Street, Ann Arbor, MI, 48109, USA
| | | | - Martin Sarter
- Department of Psychology, University of Michigan, 530 Church Street, Ann Arbor, MI, 48109, USA
| |
Collapse
|
42
|
Fasano A, Herman T, Tessitore A, Strafella AP, Bohnen NI. Neuroimaging of Freezing of Gait. JOURNAL OF PARKINSONS DISEASE 2016; 5:241-54. [PMID: 25757831 PMCID: PMC4923721 DOI: 10.3233/jpd-150536] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Functional brain imaging techniques appear ideally suited to explore the pathophysiology of freezing of gait (FOG). In the last two decades, techniques based on magnetic resonance or nuclear medicine imaging have found a number of structural changes and functional disconnections between subcortical and cortical regions of the locomotor network in patients with FOG. FOG seems to be related in part to disruptions in the "executive-attention" network along with regional tissue loss including the premotor area, inferior frontal gyrus, precentral gyrus, the parietal and occipital areas involved in visuospatial functions of the right hemisphere. Several subcortical structures have been also involved in the etiology of FOG, principally the caudate nucleus and the locomotor centers in the brainstem. Maladaptive neural compensation may present transiently in the presence of acute conflicting motor, cognitive or emotional stimulus processing, thus causing acute network overload and resulting in episodic impairment of stepping.In this review we will summarize the state of the art of neuroimaging research for FOG. We will also discuss the limitations of current approaches and delineate the next steps of neuroimaging research to unravel the pathophysiology of this mysterious motor phenomenon.
Collapse
Affiliation(s)
- Alfonso Fasano
- Morton and Gloria Shulman Movement Disorders Centre and the Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Talia Herman
- Center for the study of Movement, Cognition and Mobility, Department of Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Alessandro Tessitore
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples, Naples, Italy
| | - Antonio P Strafella
- Morton and Gloria Shulman Movement Disorders Centre and the Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Nicolaas I Bohnen
- Departments of Radiology and Neurology, University of Michigan, and Neurology Service and GRECC, VAAAHS, Ann Arbor, MI, USA
| |
Collapse
|
43
|
Asakawa T, Fang H, Sugiyama K, Nozaki T, Hong Z, Yang Y, Hua F, Ding G, Chao D, Fenoy AJ, Villarreal SJ, Onoe H, Suzuki K, Mori N, Namba H, Xia Y. Animal behavioral assessments in current research of Parkinson's disease. Neurosci Biobehav Rev 2016; 65:63-94. [PMID: 27026638 DOI: 10.1016/j.neubiorev.2016.03.016] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 03/22/2016] [Accepted: 03/22/2016] [Indexed: 12/21/2022]
Abstract
Parkinson's disease (PD), a neurodegenerative disorder, is traditionally classified as a movement disorder. Patients typically suffer from many motor dysfunctions. Presently, clinicians and scientists recognize that many non-motor symptoms are associated with PD. There is an increasing interest in both motor and non-motor symptoms in clinical studies on PD patients and laboratory research on animal models that imitate the pathophysiologic features and symptoms of PD patients. Therefore, appropriate behavioral assessments are extremely crucial for correctly understanding the mechanisms of PD and accurately evaluating the efficacy and safety of novel therapies. This article systematically reviews the behavioral assessments, for both motor and non-motor symptoms, in various animal models involved in current PD research. We addressed the strengths and weaknesses of these behavioral tests and their appropriate applications. Moreover, we discussed potential mechanisms behind these behavioral tests and cautioned readers against potential experimental bias. Since most of the behavioral assessments currently used for non-motor symptoms are not particularly designed for animals with PD, it is of the utmost importance to greatly improve experimental design and evaluation in PD research with animal models. Indeed, it is essential to develop specific assessments for non-motor symptoms in PD animals based on their characteristics. We concluded with a prospective view for behavioral assessments with real-time assessment with mobile internet and wearable device in future PD research.
Collapse
Affiliation(s)
- Tetsuya Asakawa
- Department of Neurosurgery, Hamamatsu University School of Medicine, Hamamatsu-city, Shizuoka, Japan; Department of Psychiatry, Hamamatsu University School of Medicine, Hamamatsu-city, Shizuoka, Japan.
| | - Huan Fang
- Department of Pharmacy, Jinshan Hospital of Fudan University, Shanghai, China
| | - Kenji Sugiyama
- Department of Neurosurgery, Hamamatsu University School of Medicine, Hamamatsu-city, Shizuoka, Japan
| | - Takao Nozaki
- Department of Neurosurgery, Hamamatsu University School of Medicine, Hamamatsu-city, Shizuoka, Japan
| | - Zhen Hong
- Department of Neurology, Huashan Hospital of Fudan University, Shanghai, China
| | - Yilin Yang
- The First People's Hospital of Changzhou, Soochow University School of Medicine, Changzhou, China
| | - Fei Hua
- The First People's Hospital of Changzhou, Soochow University School of Medicine, Changzhou, China
| | - Guanghong Ding
- Shanghai Key Laboratory of Acupuncture Mechanism and Acupoint Function, Fudan University, Shanghai, China
| | - Dongman Chao
- Department of Neurosurgery, The University of Texas McGovern Medical School,Houston, TX, USA
| | - Albert J Fenoy
- Department of Neurosurgery, The University of Texas McGovern Medical School,Houston, TX, USA
| | - Sebastian J Villarreal
- Department of Neurosurgery, The University of Texas McGovern Medical School,Houston, TX, USA
| | - Hirotaka Onoe
- Functional Probe Research Laboratory, RIKEN Center for Life Science Technologies, Kobe, Japan
| | - Katsuaki Suzuki
- Department of Psychiatry, Hamamatsu University School of Medicine, Hamamatsu-city, Shizuoka, Japan
| | - Norio Mori
- Department of Psychiatry, Hamamatsu University School of Medicine, Hamamatsu-city, Shizuoka, Japan
| | - Hiroki Namba
- Department of Neurosurgery, Hamamatsu University School of Medicine, Hamamatsu-city, Shizuoka, Japan
| | - Ying Xia
- Department of Neurosurgery, The University of Texas McGovern Medical School,Houston, TX, USA.
| |
Collapse
|
44
|
Henderson EJ, Lord SR, Brodie MA, Gaunt DM, Lawrence AD, Close JCT, Whone AL, Ben-Shlomo Y. Rivastigmine for gait stability in patients with Parkinson's disease (ReSPonD): a randomised, double-blind, placebo-controlled, phase 2 trial. Lancet Neurol 2016; 15:249-58. [PMID: 26795874 DOI: 10.1016/s1474-4422(15)00389-0] [Citation(s) in RCA: 186] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 12/02/2015] [Accepted: 12/07/2015] [Indexed: 12/12/2022]
Abstract
BACKGROUND Falls are a frequent and serious complication of Parkinson's disease and are related partly to an underlying cholinergic deficit that contributes to gait and cognitive dysfunction in these patients. Gait dysfunction can lead to an increased variability of gait from one step to another, raising the likelihood of falls. In the ReSPonD trial we aimed to assess whether ameliorating this cholinergic deficit with the acetylcholinesterase inhibitor rivastigmine would reduce gait variability. METHODS We did this randomised, double-blind, placebo-controlled, phase 2 trial at the North Bristol NHS Trust Hospital, Bristol, UK, in patients with Parkinson's disease recruited from community and hospital settings in the UK. We included patients who had fallen at least once in the year before enrolment, were able to walk 18 m without an aid, had no previous exposure to an acetylcholinesterase inhibitor, and did not have dementia. Our clinical trials unit randomly assigned (1:1) patients to oral rivastigmine or placebo capsules (both taken twice a day) using a computer-generated randomisation sequence and web-based allocation. Rivastigmine was uptitrated from 3 mg per day to the target dose of 12 mg per day over 12 weeks. Both the trial team and patients were masked to treatment allocation. Masking was achieved with matched placebo capsules and a dummy uptitration schedule. The primary endpoint was difference in step time variability between the two groups at 32 weeks, adjusted for baseline age, cognition, step time variability, and number of falls in the previous year. We measured step time variability with a triaxial accelerometer during an 18 m walking task in three conditions: normal walking, simple dual task with phonemic verbal fluency (walking while naming words beginning with a single letter), and complex dual task switching with phonemic verbal fluency (walking while naming words, alternating between two letters of the alphabet). Analysis was by modified intention to treat; we excluded from the primary analysis patients who withdrew, died, or did not attend the 32 week assessment. This trial is registered with ISRCTN, number 19880883. FINDINGS Between Oct 4, 2012 and March 28, 2013, we enrolled 130 patients and randomly assigned 65 to the rivastigmine group and 65 to the placebo group. At week 32, compared with patients assigned to placebo (59 assessed), those assigned to rivastigmine (55 assessed) had improved step time variability for normal walking (ratio of geometric means 0.72, 95% CI 0.58-0.88; p=0.002) and the simple dual task (0.79; 0.62-0.99; p=0.045). Improvements in step time variability for the complex dual task did not differ between groups (0.81, 0.60-1.09; p=0.17). Gastrointestinal side-effects were more common in the rivastigmine group than in the placebo group (p<0.0001); 20 (31%) patients in the rivastigmine group versus three (5%) in the placebo group had nausea and 15 (17%) versus three (5%) had vomiting. INTERPRETATION Rivastigmine can improve gait stability and might reduce the frequency of falls. A phase 3 study is needed to confirm these findings and show cost-effectiveness of rivastigmine treatment. FUNDING Parkinson's UK.
Collapse
Affiliation(s)
- Emily J Henderson
- School of Social and Community Medicine, University of Bristol, Bristol, UK.
| | - Stephen R Lord
- Neuroscience Research Australia, University of New South Wales, Sydney, NSW, Australia
| | - Matthew A Brodie
- Neuroscience Research Australia, University of New South Wales, Sydney, NSW, Australia
| | - Daisy M Gaunt
- Bristol Randomised Trials Collaboration, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Andrew D Lawrence
- School of Psychology and Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff University, UK
| | - Jacqueline C T Close
- Neuroscience Research Australia, University of New South Wales, Sydney, NSW, Australia; Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - A L Whone
- Bristol Institute of Clinical Neurosciences, University of Bristol, UK; Department of Neurology, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
| | - Y Ben-Shlomo
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| |
Collapse
|
45
|
Kucinski A, Sarter M. Modeling Parkinson's disease falls associated with brainstem cholinergic systems decline. Behav Neurosci 2015; 129:96-104. [PMID: 25798629 DOI: 10.1037/bne0000048] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
In addition to the primary disease-defining symptoms, approximately half of patients with Parkinson's disease (PD) suffer from postural instability, impairments in gait control and a propensity for falls. Consistent with evidence from patients, we previously demonstrated that combined striatal dopamine (DA) and basal forebrain (BF) cholinergic cell loss causes falls in rats traversing dynamic surfaces. Because evidence suggests that degeneration of brainstem cholinergic neurons arising from the pedunculopontine nucleus (PPN) also contributes to impaired gait and falls, here we assessed the effects of selective cholinergic PPN lesions in combination with striatal DA loss or BF cholinergic cells loss as well as losses in all 3 regions. Results indicate that all combination losses that included the BF cholinergic system slowed traversal and increased slips and falls. However, the performance of rats with losses in all 3 regions (PPN, BF, and DA) was not more severely impaired than following combined BF cholinergic and striatal DA lesions. These results confirm the hypothesis that BF cholinergic-striatal disruption of attentional-motor interactions is a primary source of falls. Additional losses of PPN cholinergic neurons may worsen posture and gait control in situations not captured by the current testing conditions.
Collapse
|
46
|
Why do patients with Parkinson's disease fall? A cross-sectional analysis of possible causes of falls. NPJ PARKINSONS DISEASE 2015; 1:15011. [PMID: 28409181 PMCID: PMC5388183 DOI: 10.1038/npjparkd.2015.11] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: Falls in Parkinson’s disease (PD) are associated with significant injury, disability, hospitalization, and reduced quality of life. Aims: To identify modifiable medical causes of falls in a cohort of PD patients. Methods: Eighty seven PD patients were interviewed and examined using validated scales assessing motor and nonmotor aspects of PD, comorbidities and medication use. The frequency of falls in the last month was the primary outcome measure. Falls were hypothesized to be associated with increasing age, advanced motor severity, particularly axial features (e.g., freezing and postural instability), and dyskinesia. Nonmotor features hypothesized to be associated with falls included; cognitive impairment, psychosis, sleep disorders, cardiovascular dysfunction, and ophthalmological and medical comorbidities. Results: Fallers had longer disease duration, higher Levodopa-equivalent doses, greater ‘On’ time with dyskinesia (all P<0.005), and higher scores on some Movement Disorder Society-Unified Parkinson’s Disease Rating Scale items, particularly axial scores. However, patients with falls did not differ from non-fallers in age or overall motor UPDRS scores. Severity of psychosis, executive cognitive impairment, autonomic (particularly cardiovascular) dysfunction and sleep disturbances (particularly REM sleep behavioral disorder) were significantly associated with falls (all P<0.005). Fallers more frequently reported use of antidepressants (both tricyclics and SSRIs) and neuroleptics (P<0.001), but not hypnotics. There was no difference in medical comorbidities, ophthalmological assessments, fatigue, and apathy scores between the groups. In logistic regression analysis, cardiovascular dysfunction, antidepressant use, and REM sleep behavioral disorder were significantly associated with falls. Conclusions: The causes of falls in PD are multifactorial and extend beyond motor impairment and dyskinesia; addressing these in patients already treated with dopaminergic medications has the potential to improve this important complication of PD.
Collapse
|
47
|
Bohnen NI, Albin RL, Müller MLTM, Petrou M, Kotagal V, Koeppe RA, Scott PJH, Frey KA. Frequency of cholinergic and caudate nucleus dopaminergic deficits across the predemented cognitive spectrum of Parkinson disease and evidence of interaction effects. JAMA Neurol 2015; 72:194-200. [PMID: 25506674 DOI: 10.1001/jamaneurol.2014.2757] [Citation(s) in RCA: 105] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
IMPORTANCE Little is known about the relative contributions of multisystem degenerative processes across the spectrum of predemented cognitive decline in Parkinson disease (PD). OBJECTIVE To investigate the relative frequency of caudate nucleus dopaminergic and forebrain cholinergic deficits across a spectrum of cognitively impaired patients with PD to explore their relative, individual, and combined contributions to cognitive impairment in PD. DESIGN, SETTING, AND PARTICIPANTS A cross-sectional study at an academic movement disorders clinic that included a predominantly nondemented cohort of 143 patients with PD. The mean (SD) age of patients was 65.5 (7.4) years and the mean (SD) Hoehn and Yahr stage was 2.4 (0.6). MAIN OUTCOMES AND MEASURES Binary classification of carbon 11-labeled [11C]PMP acetylcholinesterase and caudate nucleus [11C]DTBZ monoaminergic positron-emission tomography imaging based on normative data. The frequency of significant degenerative processes based on normative values was determined for consecutive intervals of cognitive impairment, ranging from no or minimal (z > -0.5) to more severe (z ≤ -2) cognitive impairment. RESULTS Across the spectrum from minimal (z > -0.5) to more severe (z ≤ -2) global cognitive impairment scores, caudate nucleus dopaminergic denervation was relatively frequent in individuals with minimal or no cognitive changes (51.1%) and increased in patients with more severe cognitive impairments (χ2 = 12.8; P = .01). Cortical cholinergic denervation frequency increased monotonically with increasing cognitive impairment from 24.7% (z > -0.5) to 85.7% (z ≤ -2); χ2 = 23.2; P = .001). Eighty-seven percent of patients with neocortical cholinergic deficits had caudate nucleus dopaminergic deficits. Multiple regression analysis (F = 7.51; P < .001) showed both independent cognitive predictions for caudate nucleus dopaminergic (F = 7.25; P = .008) and cortical cholinergic (F = 7.50; P = .007) degenerations as well as interaction effects (F = 5.40; P = .02). CONCLUSIONS AND RELEVANCE Cortical cholinergic denervation is a major neurodegeneration associated with progressive declines across the spectrum of cognitive impairment in PD and typically occurs in the context of significant caudate nucleus dopaminergic denervation. Our findings imply that dopaminergic and cholinergic degenerations exhibit both independent and interactive contributions to cognitive impairment in PD.
Collapse
Affiliation(s)
- Nicolaas I Bohnen
- Division of Nuclear Medicine, Department of Radiology, University of Michigan, Ann Arbor2Department of Neurology, University of Michigan, Ann Arbor3Neurology Service and Geriatric Research Education and Clinical Center, Veterans Administration Ann Arbor H
| | - Roger L Albin
- Department of Neurology, University of Michigan, Ann Arbor3Neurology Service and Geriatric Research Education and Clinical Center, Veterans Administration Ann Arbor Healthcare System, Ann Arbor, Michigan4Michigan Alzheimer Disease Center, Ann Arbor
| | - Martijn L T M Müller
- Division of Nuclear Medicine, Department of Radiology, University of Michigan, Ann Arbor
| | - Myria Petrou
- Division of Nuclear Medicine, Department of Radiology, University of Michigan, Ann Arbor
| | - Vikas Kotagal
- Department of Neurology, University of Michigan, Ann Arbor
| | - Robert A Koeppe
- Division of Nuclear Medicine, Department of Radiology, University of Michigan, Ann Arbor
| | - Peter J H Scott
- Division of Nuclear Medicine, Department of Radiology, University of Michigan, Ann Arbor
| | - Kirk A Frey
- Division of Nuclear Medicine, Department of Radiology, University of Michigan, Ann Arbor2Department of Neurology, University of Michigan, Ann Arbor
| |
Collapse
|
48
|
Berry AS, Blakely RD, Sarter M, Lustig C. Cholinergic capacity mediates prefrontal engagement during challenges to attention: evidence from imaging genetics. Neuroimage 2015; 108:386-95. [PMID: 25536497 PMCID: PMC4469545 DOI: 10.1016/j.neuroimage.2014.12.036] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 11/01/2014] [Accepted: 12/14/2014] [Indexed: 10/24/2022] Open
Abstract
In rodent studies, elevated cholinergic neurotransmission in right prefrontal cortex (PFC) is essential for maintaining attentional performance, especially in challenging conditions. Apparently paralleling the rises in acetylcholine seen in rodent studies, fMRI studies in humans reveal right PFC activation at or near Brodmann's areas 9 (BA 9) increases in response to elevated attentional demand. In the present study, we leveraged human genetic variability in the cholinergic system to test the hypothesis that the cholinergic system contributes to the BA 9 response to attentional demand. Specifically, we scanned (BOLD fMRI) participants with a polymorphism of the choline transporter gene that is thought to limit choline transport capacity (Ile89Val variant of the choline transporter gene SLC5A7, rs1013940) and matched controls while they completed a task previously used to demonstrate demand-related increases in right PFC cholinergic transmission in rats and right PFC activation in humans. As hypothesized, we found that although controls showed the typical pattern of robust BA 9 responses to increased attentional demand, Ile89Val participants did not. Further, pattern analysis of activation within this region significantly predicted participant genotype. Additional exploratory pattern classification analyses suggested that Ile89Val participants differentially recruited orbitofrontal cortex and parahippocampal gyrus to maintain attentional performance to the level of controls. These results contribute to a growing body of translational research clarifying the role of cholinergic signaling in human attention and functional neural measures, and begin to outline the risk and resiliency factors associated with potentially suboptimal cholinergic function with implications for disorders characterized by cholinergic dysregulation.
Collapse
Affiliation(s)
- Anne S Berry
- Neuroscience Program, University of Michigan, Ann Arbor, MI 49109-1043, USA
| | - Randy D Blakely
- Department of Pharmacology, Vanderbilt University School of Medicine, Nashville TN 37232, USA
| | - Martin Sarter
- Neuroscience Program, University of Michigan, Ann Arbor, MI 49109-1043, USA; Psychology Department, University of Michigan, Ann Arbor, MI 49109-1043, USA
| | - Cindy Lustig
- Neuroscience Program, University of Michigan, Ann Arbor, MI 49109-1043, USA; Psychology Department, University of Michigan, Ann Arbor, MI 49109-1043, USA.
| |
Collapse
|
49
|
Kucinski A, Albin RL, Lustig C, Sarter M. Modeling falls in Parkinson's disease: Slow gait, freezing episodes and falls in rats with extensive striatal dopamine loss. Behav Brain Res 2015; 282:155-64. [PMID: 25595423 DOI: 10.1016/j.bbr.2015.01.012] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Revised: 12/09/2014] [Accepted: 01/06/2015] [Indexed: 11/17/2022]
Abstract
Falls in patients with Parkinson's disease (PD) are a major and levodopa-unresponsive source of morbidity. We previously described an animal model of falls resulting from impairments in attentional-motor interactions. Reproducing the multisystem dopaminergic-cholinergic cell loss in patients with a history for falls, partial loss of striatal dopamine innervation interacted with loss of forebrain cholinergic neurons to generate falls that was hypothesized to reflect impairments in the attentional control of gait and balance and the sequencing of complex movements [1]. As clinical evidence also indicates that basal ganglia dopamine (DA) loss per se is associated with severe discoordination and thus a greater risk for falls, here we demonstrate that relatively extensive striatal DA loss, in contrast to the lack of effects of smaller, dorsal striatal DA losses and sham lesions, increased falls and slips and caused slowing while traversing dynamic surfaces. Falls in large DA rats were associated specifically with spontaneous or slip-triggered stoppages of forward movement. Collectively, the evidence suggests that low motivation or vigor for movement in general, and for initiating corrective movements in particular, are major sources for falls in rats with large DA losses. Falls are a result of complex cognitive-motor interactions, and rats with large DA losses model the impact of a propensity for freezing of gait when traversing dynamic surfaces.
Collapse
Affiliation(s)
| | - Roger L Albin
- Neurology Service and GRECC, VAAAHS; Department of Neurology
| | - Cindy Lustig
- Department of Psychology; Neuroscience Program, University of Michigan, Ann Arbor, MI, USA
| | - Martin Sarter
- Department of Psychology; Neuroscience Program, University of Michigan, Ann Arbor, MI, USA.
| |
Collapse
|
50
|
Lustig C, Sarter M. Attention and the Cholinergic System: Relevance to Schizophrenia. Curr Top Behav Neurosci 2015; 28:327-62. [PMID: 27418070 DOI: 10.1007/7854_2015_5009] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Traditional methods of drug discovery often rely on a unidirectional, "bottom-up" approach: A search for molecular compounds that target a particular neurobiological substrate (e.g., a receptor type), the refinement of those compounds, testing in animal models using high-throughput behavioral screening methods, and then human testing for safety and effectiveness. Many attempts have found the "effectiveness" criterion to be a major stumbling block, and we and others have suggested that success may be improved by an alternative approach that considers the neural circuits mediating the effects of genetic and molecular manipulations on behavior and cognition. We describe our efforts to understand the cholinergic system's role in attention using parallel approaches to test main hypotheses in both rodents and humans as well as generating converging evidence using methods and levels of analysis tailored to each species. The close back-and-forth between these methods has enhanced our understanding of the cholinergic system's role in attention both "bottom-up" and "top-down"-that is, the basic neuroscience identifies potential neuronal circuit-based mechanisms of clinical symptoms, and the patient and genetic populations serve as natural experiments to test and refine hypotheses about its contribution to specific processes. Together, these studies have identified (at least) two major and potentially independent contributions of the cholinergic system to attention: a neuromodulatory component that influences cognitive control in response to challenges from distractors that either make detection more difficult or draw attention away from the distractor, and a phasic or transient cholinergic signal that instigates a shift from ongoing behavior and the activation of cue-associated response. Right prefrontal cortex appears to play a particularly important role in the neuromodulatory component integrating motivational and cognitive influences for top-down control across populations, whereas the transient cholinergic signal involves orbitofrontal regions associated with shifts between internal and external attention. Understanding how these two modes of cholinergic function interact and are perturbed in schizophrenia will be an important prerequisite for developing effective treatments.
Collapse
Affiliation(s)
- Cindy Lustig
- Department of Psychology, University of Michigan, 530 Church Street, Ann Arbor, MI, 48103, USA.
| | - Martin Sarter
- Department of Psychology, University of Michigan, 530 Church Street, Ann Arbor, MI, 48103, USA
| |
Collapse
|