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Rong D, Hu CP, Yang J, Guo Z, Liu W, Yu M. Consistent abnormal activity in the putamen by dopamine modulation in Parkinson's disease: A resting-state neuroimaging meta-analysis. Brain Res Bull 2024; 210:110933. [PMID: 38508469 DOI: 10.1016/j.brainresbull.2024.110933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 02/16/2024] [Accepted: 03/17/2024] [Indexed: 03/22/2024]
Abstract
OBJECTIVE This study aimed to elucidate brain areas mediated by oral anti-parkinsonian medicine that consistently show abnormal resting-state activation in PD and to reveal their functional connectivity profiles using meta-analytic approaches. METHODS Searches of the PubMed, Web of Science databases identified 78 neuroimaging studies including PD OFF state (PD-OFF) versus (vs.) PD ON state (PD-ON) or PD-ON versus healthy controls (HCs) or PD-OFF versus HCs data. Coordinate-based meta-analysis and functional meta-analytic connectivity modeling (MACM) were performed using the activation likelihood estimation algorithm. RESULTS Brain activation in PD-OFF vs. PD-ON was significantly changed in the right putamen and left inferior parietal lobule (IPL). Contrast analysis indicated that PD-OFF vs. HCs had more consistent activation in the right paracentral lobule, right middle frontal gyrus, right thalamus, left superior parietal lobule and right putamen, whereas PD-ON vs. HCs elicited more consistent activation in the bilateral middle temporal gyrus, left occipital gyrus, right inferior frontal gyrus and right caudate. MACM revealed coactivation of the right putamen in the direct contrast of PD-OFF vs. PD-ON. Subtraction analysis of significant coactivation clusters for PD-OFF vs. PD-ON with the medium of HCs showed effects in the sensorimotor, top-down control, and visual networks. By overlapping the MACM maps of the two analytical strategies, we demonstrated that the coactivated brain region focused on the right putamen. CONCLUSIONS The convergence of local brain regions and co-activation neural networks are involved the putamen, suggesting its potential as a specific imaging biomarker to monitor treatment efficacy. SYSTEMATIC REVIEW REGISTRATION [https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD CRD42022304150].
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Affiliation(s)
- Danyan Rong
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, No.264, Guangzhou Road, Gulou District, Nanjing, Jiangsu 210029, China
| | - Chuan-Peng Hu
- School of Psychology, Nanjing Normal University, No.122, Ninghai Road, Gulou District, Nanjing, Jiangsu 210024, China
| | - Jiaying Yang
- Department of Public Health, School of Medicine & Holistic Integrative Medicine, Nanjing University of Chinese Medicine, No.138, Xianlin Road, Nanjing, Jiangsu 210023, China
| | - Zhiying Guo
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, No.264, Guangzhou Road, Gulou District, Nanjing, Jiangsu 210029, China
| | - Weiguo Liu
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, No.264, Guangzhou Road, Gulou District, Nanjing, Jiangsu 210029, China.
| | - Miao Yu
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, No.264, Guangzhou Road, Gulou District, Nanjing, Jiangsu 210029, China.
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Barbero JA, Unadkat P, Choi YY, Eidelberg D. Functional Brain Networks to Evaluate Treatment Responses in Parkinson's Disease. Neurotherapeutics 2023; 20:1653-1668. [PMID: 37684533 PMCID: PMC10684458 DOI: 10.1007/s13311-023-01433-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
Network analysis of functional brain scans acquired with [18F]-fluorodeoxyglucose positron emission tomography (FDG PET, to map cerebral glucose metabolism), or resting-state functional magnetic resonance imaging (rs-fMRI, to map blood oxygen level-dependent brain activity) has increasingly been used to identify and validate reproducible circuit abnormalities associated with neurodegenerative disorders such as Parkinson's disease (PD). In addition to serving as imaging markers of the underlying disease process, these networks can be used singly or in combination as an adjunct to clinical diagnosis and as a screening tool for therapeutics trials. Disease networks can also be used to measure rates of progression in natural history studies and to assess treatment responses in individual subjects. Recent imaging studies in PD subjects scanned before and after treatment have revealed therapeutic effects beyond the modulation of established disease networks. Rather, other mechanisms of action may be at play, such as the induction of novel functional brain networks directly by treatment. To date, specific treatment-induced networks have been described in association with novel interventions for PD such as subthalamic adeno-associated virus glutamic acid decarboxylase (AAV2-GAD) gene therapy, as well as sham surgery or oral placebo under blinded conditions. Indeed, changes in the expression of these networks with treatment have been found to correlate consistently with clinical outcome. In aggregate, these attributes suggest a role for functional brain networks as biomarkers in future clinical trials.
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Affiliation(s)
- János A Barbero
- Center for Neurosciences, The Feinstein Institutes for Medical Research, 350 Community Drive, Manhasset, NY, 11030, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, 11549, USA
| | - Prashin Unadkat
- Center for Neurosciences, The Feinstein Institutes for Medical Research, 350 Community Drive, Manhasset, NY, 11030, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, 11549, USA
- Elmezzi Graduate School of Molecular Medicine, Manhasset, NY, 11030, USA
| | - Yoon Young Choi
- Center for Neurosciences, The Feinstein Institutes for Medical Research, 350 Community Drive, Manhasset, NY, 11030, USA
| | - David Eidelberg
- Center for Neurosciences, The Feinstein Institutes for Medical Research, 350 Community Drive, Manhasset, NY, 11030, USA.
- Molecular Medicine and Neurology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, 11549, USA.
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Zheng J, Chen L, Cai G, Wang Y, Huang J, Lin X, Li Y, Yu Q, Chen X, Shi Y, Ye Q. The effect of Parkin gene S/N 167 polymorphism on resting spontaneous brain functional activity in Parkinson's Disease. Parkinsonism Relat Disord 2023; 113:105484. [PMID: 37454429 DOI: 10.1016/j.parkreldis.2023.105484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 05/09/2023] [Accepted: 06/04/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Genetic susceptibility plays a significant role in Parkinson's disease (PD) development. Carriers of the Parkin S/N167 mutation may have an increased risk of PD and altered spontaneous brain activity. OBJECTIVE This study aims to investigate the potential pathogenesis of PD through a comparative analysis of the amplitude of low-frequency fluctuations (ALFF) in resting-state functional magnetic resonance imaging (rs-fMRI) of subjects with Parkin gene S/N 167 polymorphisms, and to examine the association between spontaneous brain activity and clinical scale scores of PD. METHODS A total of 69 PD patients and 84 healthy controls (HC) were included in the study. Each subject was genotyped for the Parkin gene S/N 167 polymorphism and underwent rs-fMRI scans. ALFF analysis was employed to evaluate the relationship among genotypes, interactive brain regions, and clinical symptoms in PD. RESULTS PD patients exhibited decreased ALFF values in the right anterior lobe and vermis of the cerebellum compared to HC. No significant interaction was found between the gene's main effect and the "group × genotype" effect on brain ALFF values. One-factor ANOVA revealed no significant difference in ALFF values between PD subgroups; however, the ALFF values in the right anterior lobe and vermis of the cerebellum were lower in the PD-G and PD-GA groups compared to the HC-G and HC-GA groups. Spearman correlation analysis demonstrated that ALFF values in the PD-GG and PD-GA groups were negatively associated with UPDRS-III scores in the bilateral lingual gyrus (Lingual R/L). CONCLUSION Parkin gene S/N 167 polymorphisms may influence brain functional activity in specific brain regions, and ALFF values are associated with motor symptoms in PD patients.
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Affiliation(s)
- Jingxue Zheng
- Department of Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, Fujian, China; Fudan University Shanghai Cancer Center(Xiamen Branch), Xiamen, Fujian, China
| | - Lina Chen
- Department of Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
| | - Guoen Cai
- Department of Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
| | - Yingqing Wang
- Department of Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
| | - Jieming Huang
- Department of Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
| | - Xiaoling Lin
- Department of Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
| | - Yueping Li
- Department of Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
| | - Qianwen Yu
- Department of Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
| | - Xiaochun Chen
- Department of Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, Fujian, China; Institute of Neuroscience, Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China
| | - Yanchuan Shi
- Department of Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, Fujian, China; Department of Neurology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China.
| | - Qinyong Ye
- Department of Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, Fujian, China; Institute of Neuroscience, Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China.
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Kokkonen A, Honkanen EA, Corp DT, Joutsa J. Neurobiological effects of deep brain stimulation: A systematic review of molecular brain imaging studies. Neuroimage 2022; 260:119473. [PMID: 35842094 DOI: 10.1016/j.neuroimage.2022.119473] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 05/28/2022] [Accepted: 07/11/2022] [Indexed: 11/29/2022] Open
Abstract
Deep brain stimulation (DBS) is an established treatment for several brain disorders, including Parkinson's disease, essential tremor, dystonia and epilepsy, and an emerging therapeutic tool in many other neurological and psychiatric disorders. The therapeutic efficacy of DBS is dependent on the stimulation target, but its mechanisms of action are still relatively poorly understood. Investigating these mechanisms is challenging, partly because the stimulation devices and electrodes have limited the use of functional MRI in these patients. Molecular brain imaging techniques, such as positron emission tomography (PET) and single photon emission tomography (SPET), offer a unique opportunity to characterize the whole brain effects of DBS. Here, we investigated the direct effects of DBS by systematically reviewing studies performing an `on' vs `off' contrast during PET or SPET imaging. We identified 62 studies (56 PET and 6 SPET studies; 531 subjects). Approximately half of the studies focused on cerebral blood flow or glucose metabolism in patients Parkinson's disease undergoing subthalamic DBS (25 studies, n = 289), therefore Activation Likelihood Estimation analysis was performed on these studies. Across disorders and stimulation targets, DBS was associated with a robust local increase in ligand uptake at the stimulation site and target-specific remote network effects. Subthalamic nucleus stimulation in Parkinson's disease showed a specific pattern of changes in the motor circuit, including increased ligand uptake in the basal ganglia, and decreased ligand uptake in the primary motor cortex, supplementary motor area and cerebellum. However, there was only a handful of studies investigating other brain disorder and stimulation site combinations (1-3 studies each), or specific neurotransmitter systems, preventing definitive conclusions of the detailed molecular effects of the stimulation in these cases.
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Affiliation(s)
- Aleksi Kokkonen
- Turku Brain and Mind Center, Clinical Neurosciences, University of Turku, Turku, Finland; Turku PET Center, Neurocenter, Turku University Hospital, Turku, Finland.
| | - Emma A Honkanen
- Turku Brain and Mind Center, Clinical Neurosciences, University of Turku, Turku, Finland; Turku PET Center, Neurocenter, Turku University Hospital, Turku, Finland
| | - Daniel T Corp
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia; Center for Brain Circuit Therapeutics, Brigham and Women's Hospital, Boston, MA, United States of America
| | - Juho Joutsa
- Turku Brain and Mind Center, Clinical Neurosciences, University of Turku, Turku, Finland; Turku PET Center, Neurocenter, Turku University Hospital, Turku, Finland; Center for Brain Circuit Therapeutics, Brigham and Women's Hospital, Boston, MA, United States of America.
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Herz DM, Meder D, Camilleri JA, Eickhoff SB, Siebner HR. Brain Motor Network Changes in Parkinson's Disease: Evidence from Meta-Analytic Modeling. Mov Disord 2021; 36:1180-1190. [PMID: 33427336 PMCID: PMC8127399 DOI: 10.1002/mds.28468] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 12/09/2020] [Accepted: 12/10/2020] [Indexed: 12/30/2022] Open
Abstract
Background Motor‐related brain activity in Parkinson's disease has been investigated in a multitude of functional neuroimaging studies, which often yielded apparently conflicting results. Our previous meta‐analysis did not resolve inconsistencies regarding cortical activation differences in Parkinson's disease, which might be related to the limited number of studies that could be included. Therefore, we conducted a revised meta‐analysis including a larger number of studies. The objectives of this study were to elucidate brain areas that consistently show abnormal motor‐related activation in Parkinson's disease and to reveal their functional connectivity profiles using meta‐analytic approaches. Methods We applied a quantitative meta‐analysis of functional neuroimaging studies testing limb movements in Parkinson's disease comprising data from 39 studies, of which 15 studies (285 of 571 individual patients) were published after the previous meta‐analysis. We also conducted meta‐analytic connectivity modeling to elucidate the connectivity profiles of areas showing abnormal activation. Results We found consistent motor‐related underactivation of bilateral posterior putamen and cerebellum in Parkinson's disease. Primary motor cortex and the supplementary motor area also showed deficient activation, whereas cortical regions localized directly anterior to these areas expressed overactivation. Connectivity modeling revealed that areas showing decreased activation shared a common pathway through the posterior putamen, whereas areas showing increased activation were connected to the anterior putamen. Conclusions Despite conflicting results in individual neuroimaging studies, this revised meta‐analytic approach identified consistent patterns of abnormal motor‐related activation in Parkinson's disease. The distinct patterns of decreased and increased activity might be determined by their connectivity with different subregions of the putamen. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Damian M Herz
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - David Meder
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Julia A Camilleri
- Research Center Juelich, Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Juelich, Germany.,Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Duesseldorf, Duesseldorf, Germany
| | - Simon B Eickhoff
- Research Center Juelich, Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Juelich, Germany.,Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Duesseldorf, Duesseldorf, Germany
| | - Hartwig R Siebner
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.,Department of Neurology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark.,Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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6
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Kahan J, Mancini L, Flandin G, White M, Papadaki A, Thornton J, Yousry T, Zrinzo L, Hariz M, Limousin P, Friston K, Foltynie T. Deep brain stimulation has state-dependent effects on motor connectivity in Parkinson's disease. Brain 2020; 142:2417-2431. [PMID: 31219504 DOI: 10.1093/brain/awz164] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 03/12/2019] [Accepted: 04/18/2019] [Indexed: 12/17/2022] Open
Abstract
Subthalamic nucleus deep brain stimulation is an effective treatment for advanced Parkinson's disease; however, its therapeutic mechanism is unclear. Previous modelling of functional MRI data has suggested that deep brain stimulation has modulatory effects on a number of basal ganglia pathways. This work uses an enhanced data collection protocol to collect rare functional MRI data in patients with subthalamic nucleus deep brain stimulation. Eleven patients with Parkinson's disease and subthalamic nucleus deep brain stimulation underwent functional MRI at rest and during a movement task; once with active deep brain stimulation, and once with deep brain stimulation switched off. Dynamic causal modelling and Bayesian model selection were first used to compare a series of plausible biophysical models of the cortico-basal ganglia circuit that could explain the functional MRI activity at rest in an attempt to reproduce and extend the findings from our previous work. General linear modelling of the movement task functional MRI data revealed deep brain stimulation-associated signal increases in the primary motor and cerebellar cortices. Given the significance of the cerebellum in voluntary movement, we then built a more complete model of the motor system by including cerebellar-basal ganglia interactions, and compared the modulatory effects deep brain stimulation had on different circuit components during the movement task and again using the resting state data. Consistent with previous results from our independent cohort, model comparison found that the rest data were best explained by deep brain stimulation-induced increased (effective) connectivity of the cortico-striatal, thalamo-cortical and direct pathway and reduced coupling of subthalamic nucleus afferent and efferent connections. No changes in cerebellar connectivity were identified at rest. In contrast, during the movement task, there was functional recruitment of subcortical-cerebellar pathways, which were additionally modulated by deep brain stimulation, as well as modulation of local (intrinsic) cortical and cerebellar circuits. This work provides in vivo evidence for the modulatory effects of subthalamic nucleus deep brain stimulation on effective connectivity within the cortico-basal ganglia loops at rest, as well as further modulations in the cortico-cerebellar motor system during voluntary movement. We propose that deep brain stimulation has both behaviour-independent effects on basal ganglia connectivity, as well as behaviour-dependent modulatory effects.
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Affiliation(s)
- Joshua Kahan
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, WC1N 3BG, UK
| | - Laura Mancini
- Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, UCLH NHS Foundation Trust, London, WC1N 3BG, UK.,Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, WC1N 3BG, UK
| | - Guillaume Flandin
- The Wellcome Centre for Human Neuroimaging, UCL, London, WC1N 3AR, UK
| | - Mark White
- Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, UCLH NHS Foundation Trust, London, WC1N 3BG, UK.,Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, WC1N 3BG, UK
| | - Anastasia Papadaki
- Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, UCLH NHS Foundation Trust, London, WC1N 3BG, UK.,Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, WC1N 3BG, UK
| | - John Thornton
- Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, UCLH NHS Foundation Trust, London, WC1N 3BG, UK.,Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, WC1N 3BG, UK
| | - Tarek Yousry
- Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, UCLH NHS Foundation Trust, London, WC1N 3BG, UK.,Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, WC1N 3BG, UK
| | - Ludvic Zrinzo
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, WC1N 3BG, UK
| | - Marwan Hariz
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, WC1N 3BG, UK
| | - Patricia Limousin
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, WC1N 3BG, UK
| | - Karl Friston
- The Wellcome Centre for Human Neuroimaging, UCL, London, WC1N 3AR, UK
| | - Tom Foltynie
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, WC1N 3BG, UK
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Spay C, Meyer G, Lio G, Pezzoli G, Ballanger B, Cilia R, Boulinguez P. Resting state oscillations suggest a motor component of Parkinson's Impulse Control Disorders. Clin Neurophysiol 2019; 130:2065-2075. [PMID: 31541984 DOI: 10.1016/j.clinph.2019.08.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 07/02/2019] [Accepted: 08/14/2019] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Impulse control disorders (ICDs) in Parkinson's disease (PD) have been associated with cognitive impulsivity and dopaminergic dysfunction and treatment. The present study tests the neglected hypothesis that the neurofunctional networks involved in motor impulsivity might also be dysfunctional in PD-ICDs. METHODS We performed blind spectral analyses of resting state electroencephalographic (EEG) data in PD patients with and without ICDs to probe the functional integrity of all cortical networks. Analyses were performed directly at the source level after blind source separation. Discrete differences between groups were tested by comparing patients with and without ICDs. Gradual dysfunctions were assessed by means of correlations between power changes and clinical scores reflecting ICD severity (QUIP score). RESULTS Spectral signatures of ICDs were found in the medial prefrontal cortex, the dorsal anterior cingulate and the supplementary motor area, in the beta and gamma bands. Beta power changes in the supplementary motor area were found to predict ICDs severity. CONCLUSION ICDs are associated with abnormal activity within frequency bands and cortical circuits supporting the control of motor response inhibition. SIGNIFICANCE These results bring to the forefront the need to consider, in addition to the classical interpretation based on aberrant mesocorticolimbic reward processing, the issue of motor impulsivity in PD-ICDs and its potential implications for PD therapy.
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Affiliation(s)
- Charlotte Spay
- Université de Lyon, 92 rue Pasteur, 69007 Lyon, France; Université Lyon 1, 43 boulevard du 11 novembre 1918, 69622 Villeurbanne, France; INSERM, U 1028, Lyon Neuroscience Research Center, 95 boulevard Pinel, 69500 Bron, France; CNRS, UMR 5292, Lyon Neuroscience Research Center, 95 boulevard Pinel, 69500 Bron, France
| | - Garance Meyer
- Université de Lyon, 92 rue Pasteur, 69007 Lyon, France; Université Lyon 1, 43 boulevard du 11 novembre 1918, 69622 Villeurbanne, France; INSERM, U 1028, Lyon Neuroscience Research Center, 95 boulevard Pinel, 69500 Bron, France; CNRS, UMR 5292, Lyon Neuroscience Research Center, 95 boulevard Pinel, 69500 Bron, France
| | - Guillaume Lio
- Centre de Neuroscience Cognitive, UMR 5229, 67 boulevard Pinel, 69675 Bron, France
| | - Gianni Pezzoli
- Parkinson Institute, ASST Gaetano Pini-CTO, Via bignami 1, 20126 Milan, Italy
| | - Bénédicte Ballanger
- Université de Lyon, 92 rue Pasteur, 69007 Lyon, France; Université Lyon 1, 43 boulevard du 11 novembre 1918, 69622 Villeurbanne, France; INSERM, U 1028, Lyon Neuroscience Research Center, 95 boulevard Pinel, 69500 Bron, France; CNRS, UMR 5292, Lyon Neuroscience Research Center, 95 boulevard Pinel, 69500 Bron, France
| | - Roberto Cilia
- Parkinson Institute, ASST Gaetano Pini-CTO, Via bignami 1, 20126 Milan, Italy
| | - Philippe Boulinguez
- Université de Lyon, 92 rue Pasteur, 69007 Lyon, France; Université Lyon 1, 43 boulevard du 11 novembre 1918, 69622 Villeurbanne, France; INSERM, U 1028, Lyon Neuroscience Research Center, 95 boulevard Pinel, 69500 Bron, France; CNRS, UMR 5292, Lyon Neuroscience Research Center, 95 boulevard Pinel, 69500 Bron, France.
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Niethammer M, Tang CC, Vo A, Nguyen N, Spetsieris P, Dhawan V, Ma Y, Small M, Feigin A, During MJ, Kaplitt MG, Eidelberg D. Gene therapy reduces Parkinson’s disease symptoms by reorganizing functional brain connectivity. Sci Transl Med 2018; 10:10/469/eaau0713. [DOI: 10.1126/scitranslmed.aau0713] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 09/05/2018] [Accepted: 11/08/2018] [Indexed: 12/24/2022]
Abstract
Gene therapy is emerging as a promising approach for treating neurological disorders, including Parkinson’s disease (PD). A phase 2 clinical trial showed that delivering glutamic acid decarboxylase (GAD) into the subthalamic nucleus (STN) of patients with PD had therapeutic effects. To determine the mechanism underlying this response, we analyzed metabolic imaging data from patients who received gene therapy and those randomized to sham surgery, all of whom had been scanned preoperatively and at 6 and 12 months after surgery. Those who receivedGADgene therapy developed a unique treatment-dependent polysynaptic brain circuit that we termed as theGAD–related pattern (GADRP), which reflected the formation of new polysynaptic functional pathways linking the STN to motor cortical regions. Patients in both the treatment group and the sham group expressed the previously reported placebo network (the sham surgery–related pattern or SSRP) when blinded to the treatment received. However, only the appearance of the GADRP correlated with clinical improvement in the gene therapy–treated subjects. Treatment-induced brain circuits can thus be useful in clinical trials for isolating true treatment responses and providing insight into their underlying biological mechanisms.
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Ma X, Su W, Li S, Li C, Wang R, Chen M, Chen H. Cerebellar atrophy in different subtypes of Parkinson's disease. J Neurol Sci 2018; 392:105-112. [PMID: 30036781 DOI: 10.1016/j.jns.2018.06.027] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 06/27/2018] [Accepted: 06/28/2018] [Indexed: 01/20/2023]
Abstract
BACKGROUND To investigate, using Magnetic Resonance Imaging (MRI) and voxel-based morphometry (VBM), morphometric changes of cerebellum in Parkinson's disease with different motor and affective subtypes. METHODS Fifty-four patients with idiopathic Parkinson's disease (PD) were classified into tremor-predominant-PD (PDT) (n = 37) and akinetic/rigidity-predominant-PD (PDAR) (n = 17). Moreover, PD groups were divided into four affective subtypes, including depressive but not anxious PD (dPD, n = 5), anxious but not depressive PD (aPD, n = 8), comorbid depressive and anxious PD (coPD, n = 8), and PD patients without depressive or anxious symptoms (nPD, n = 33). They were additionally compared at a group level with thirty-nine normal controls (NCs). An analysis of covariance followed by post hoc tests was performed to examine the alterations of cerebellar grey matter volume (GMV) in different groups of PD. RESULTS Compared with NCs, PD showed grey matter (GM) atrophy in the right Crus II, pyramis, culmen, the right lobules IV, and V, and the left lobule VI. PDT, PDAR and NCs did not differ in the volume of the cerebellum. Relative to nPD group, dPD group exhibited GMV reduction in the left Crus I, while aPD group showed GMV reduction in the tonsil and the right lobule VIII. The GM atrophy was also found in the coPD group compared to NCs, including the tonsil, the left lobule VIII, the right lobule VI, the left Crus I, and vermis IV, and V. There was a significant negative correlation between the Hamilton Rating Scale for Depression (HAMD) score and the right lobule IX volume, and a significant negative correlation between the Hamilton Rating Scale for Anxiety (HAMA) score and the right lobule VIII volume. CONCLUSIONS These findings suggest that cerebellar changes are involved in PD. It also supports a possible role of the cerebellum in the depressive and anxious symptoms in PD.
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Affiliation(s)
- Xinxin Ma
- Department of Neurology, Beijing Hospital, National Center of Gerontology, No. 1 Da-Hua Road, Dong Dan, Beijing 100730, China
| | - Wen Su
- Department of Neurology, Beijing Hospital, National Center of Gerontology, No. 1 Da-Hua Road, Dong Dan, Beijing 100730, China
| | - Shuhua Li
- Department of Neurology, Beijing Hospital, National Center of Gerontology, No. 1 Da-Hua Road, Dong Dan, Beijing 100730, China
| | - Chunmei Li
- Department of Radiology, Beijing Hospital, National Center of Gerontology, No. 1 Da-Hua Road, Dong Dan, Beijing 100730, China
| | - Rui Wang
- Department of Radiology, Beijing Hospital, National Center of Gerontology, No. 1 Da-Hua Road, Dong Dan, Beijing 100730, China
| | - Min Chen
- Department of Radiology, Beijing Hospital, National Center of Gerontology, No. 1 Da-Hua Road, Dong Dan, Beijing 100730, China
| | - Haibo Chen
- Department of Neurology, Beijing Hospital, National Center of Gerontology, No. 1 Da-Hua Road, Dong Dan, Beijing 100730, China.
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10
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Tanguy A, Jönsson L, Ishihara L. Inventory of real world data sources in Parkinson's disease. BMC Neurol 2017; 17:213. [PMID: 29216834 PMCID: PMC5721688 DOI: 10.1186/s12883-017-0985-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 11/22/2017] [Indexed: 11/10/2022] Open
Abstract
Background Real world data have an important role to play in the evaluation of epidemiology and burden of disease; and in assisting health-care decision-makers, especially related to coverage and payment decisions. However, there is currently no overview of the existing longitudinal real world data sources in Parkinson’s disease (PD) in the USA. Such an assessment can be very helpful, to support a future effort to harmonize real world data collection and use the available resources in an optimal way. Methods The objective of this comprehensive literature review is to systematically identify and describe the longitudinal, real world data sources in PD in the USA, and to provide a summary of their measurements (categorized into 8 main dimensions: motor and neurological functions, cognition, psychiatry, activities of daily living, sleep, quality of life, autonomic symptoms and other). The literature search was performed using MEDLINE, EMBASE and internet key word search. Results Of the 53 data sources identified between May and August 2016, 16 were still ongoing. Current medications (81%) and comorbidities (79%) were frequently collected, in comparison to medical imaging (36%), genetic information (30%), caregiver burden (11%) and healthcare costs (2%). Many different measurements (n = 108) were performed and an interesting variability among used measurements was revealed. Conclusions Many longitudinal real world data sources on PD exist. Different types of measurements have been performed over time. To allow comparison and pooling of these multiple data sources, it will be essential to harmonize practices in terms of types of measurements.
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Affiliation(s)
- Audrey Tanguy
- Lundbeck SAS, 37-45 Quai du Président Roosevelt, CEDEX 92445, Issy-les-Moulineaux, France
| | - Linus Jönsson
- Lundbeck SAS, 37-45 Quai du Président Roosevelt, CEDEX 92445, Issy-les-Moulineaux, France
| | - Lianna Ishihara
- Lundbeck SAS, 37-45 Quai du Président Roosevelt, CEDEX 92445, Issy-les-Moulineaux, France.
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11
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Parkinson's Disease Is Not Simply a Prion Disorder. J Neurosci 2017; 37:9799-9807. [PMID: 29021297 DOI: 10.1523/jneurosci.1787-16.2017] [Citation(s) in RCA: 129] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 06/09/2017] [Accepted: 06/17/2017] [Indexed: 12/31/2022] Open
Abstract
The notion that prion-like spreading of misfolded α-synuclein (α-SYN) causes Parkinson's disease (PD) has received a great deal of attention. Although attractive in its simplicity, the hypothesis is difficult to reconcile with postmortem analysis of human brains and connectome-mapping studies. An alternative hypothesis is that PD pathology is governed by regional or cell-autonomous factors. Although these factors provide an explanation for the pattern of neuronal loss in PD, they do not readily explain the apparently staged distribution of Lewy pathology in many PD brains, the feature of the disease that initially motivated the spreading hypothesis by Braak and colleagues. While each hypothesis alone has its shortcomings, a synthesis of the two can explain much of what we know about the etiopathology of PD.Dual Perspectives Companion Paper: Prying into the Prion Hypothesis for Parkinson's Disease, by Patrik Brundin and Ronald Melki.
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12
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Blesa J, Trigo-Damas I, Dileone M, Del Rey NLG, Hernandez LF, Obeso JA. Compensatory mechanisms in Parkinson's disease: Circuits adaptations and role in disease modification. Exp Neurol 2017; 298:148-161. [PMID: 28987461 DOI: 10.1016/j.expneurol.2017.10.002] [Citation(s) in RCA: 151] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 09/27/2017] [Accepted: 10/03/2017] [Indexed: 12/21/2022]
Abstract
The motor features of Parkinson's disease (PD) are well known to manifest only when striatal dopaminergic deficit reaches 60-70%. Thus, PD has a long pre-symptomatic and pre-motor evolution during which compensatory mechanisms take place to delay the clinical onset of disabling manifestations. Classic compensatory mechanisms have been attributed to changes and adjustments in the nigro-striatal system, such as increased neuronal activity in the substantia nigra pars compacta and enhanced dopamine synthesis and release in the striatum. However, it is not so clear currently that such changes occur early enough to account for the pre-symptomatic period. Other possible mechanisms relate to changes in basal ganglia and motor cortical circuits including the cerebellum. However, data from early PD patients are difficult to obtain as most studies have been carried out once the diagnosis and treatments have been established. Likewise, putative compensatory mechanisms taking place throughout disease evolution are nearly impossible to distinguish by themselves. Here, we review the evidence for the role of the best known and other possible compensatory mechanisms in PD. We also discuss the possibility that, although beneficial in practical terms, compensation could also play a deleterious role in disease progression.
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Affiliation(s)
- Javier Blesa
- HM CINAC, Hospital Universitario HM Puerta del Sur, Móstoles, Madrid, Spain; Biomedical Research Center of Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain.
| | - Inés Trigo-Damas
- HM CINAC, Hospital Universitario HM Puerta del Sur, Móstoles, Madrid, Spain; Biomedical Research Center of Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain
| | - Michele Dileone
- HM CINAC, Hospital Universitario HM Puerta del Sur, Móstoles, Madrid, Spain; Biomedical Research Center of Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain
| | - Natalia Lopez-Gonzalez Del Rey
- HM CINAC, Hospital Universitario HM Puerta del Sur, Móstoles, Madrid, Spain; Biomedical Research Center of Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain
| | - Ledia F Hernandez
- HM CINAC, Hospital Universitario HM Puerta del Sur, Móstoles, Madrid, Spain; Biomedical Research Center of Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain
| | - José A Obeso
- HM CINAC, Hospital Universitario HM Puerta del Sur, Móstoles, Madrid, Spain; Biomedical Research Center of Neurodegenerative Diseases (CIBERNED), Instituto Carlos III, Madrid, Spain.
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13
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Walther S, Schäppi L, Federspiel A, Bohlhalter S, Wiest R, Strik W, Stegmayer K. Resting-State Hyperperfusion of the Supplementary Motor Area in Catatonia. Schizophr Bull 2017; 43:972-981. [PMID: 27729486 PMCID: PMC5581902 DOI: 10.1093/schbul/sbw140] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Catatonia is a psychomotor syndrome that not only frequently occurs in the context of schizophrenia but also in other conditions. The neural correlates of catatonia remain unclear due to small-sized studies. We therefore compared resting-state cerebral blood flow (rCBF) and gray matter (GM) density between schizophrenia patients with current catatonia and without catatonia and healthy controls. We included 42 schizophrenia patients and 41 controls. Catatonia was currently present in 15 patients (scoring >2 items on the Bush Francis Catatonia Rating Scale screening). Patients did not differ in antipsychotic medication or positive symptoms. We acquired whole-brain rCBF using arterial spin labeling and GM density. We compared whole-brain perfusion and GM density over all and between the groups using 1-way ANCOVAs (F and T tests). We found a group effect (F test) of rCBF within bilateral supplementary motor area (SMA), anterior cingulate cortex, dorsolateral prefrontal cortex, left interior parietal lobe, and cerebellum. T tests indicated 1 cluster (SMA) to be specific to catatonia. Moreover, catatonia of excited and retarded types differed in SMA perfusion. Furthermore, increased catatonia severity was associated with higher perfusion in SMA. Finally, catatonia patients had a distinct pattern of GM density reduction compared to controls with prominent GM loss in frontal and insular cortices. SMA resting-state hyperperfusion is a marker of current catatonia in schizophrenia. This is highly compatible with a dysregulated motor system in catatonia, particularly affecting premotor areas. Moreover, SMA perfusion was differentially altered in retarded and excited catatonia subtypes, arguing for distinct pathobiology.
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Affiliation(s)
- Sebastian Walther
- Translational Research Center, University Hospital of Psychiatry, Bern, Switzerland;,To whom correspondence should be addressed; Translational Research Center, University Hospital of Psychiatry, Bolligenstrasse 111, 3060 Bern, Switzerland; tel: +41-31-930-9483, fax: +41-31-930-9404, e-mail:
| | - Lea Schäppi
- Translational Research Center, University Hospital of Psychiatry, Bern, Switzerland
| | - Andrea Federspiel
- Translational Research Center, University Hospital of Psychiatry, Bern, Switzerland
| | - Stephan Bohlhalter
- Neurology and Neurorehabilitation Center, Luzerner Kantonsspital, Lucerne, Switzerland
| | - Roland Wiest
- Support Center of Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern, Switzerland
| | - Werner Strik
- Translational Research Center, University Hospital of Psychiatry, Bern, Switzerland
| | - Katharina Stegmayer
- Translational Research Center, University Hospital of Psychiatry, Bern, Switzerland
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Surmeier DJ, Halliday GM, Simuni T. Calcium, mitochondrial dysfunction and slowing the progression of Parkinson's disease. Exp Neurol 2017; 298:202-209. [PMID: 28780195 DOI: 10.1016/j.expneurol.2017.08.001] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 07/25/2017] [Accepted: 08/01/2017] [Indexed: 12/20/2022]
Abstract
Parkinson's disease is characterized by progressively distributed Lewy pathology and neurodegeneration. The motor symptoms of clinical Parkinson's disease (cPD) are unequivocally linked to the degeneration of dopaminergic neurons in the substantia nigra pars compacta (SNc). Several features of these neurons appear to make them selectively vulnerable to factors thought to cause cPD, like aging, genetic mutations and environmental toxins. Among these features, Ca2+ entry through Cav1 channels is particularly amenable to pharmacotherapy in early stage cPD patients. This review outlines the linkage between these channels, mitochondrial oxidant stress and cPD pathogenesis. It also summarizes considerations that went into the design and execution of the ongoing Phase 3 clinical trial with an inhibitor of these channels - isradipine.
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Affiliation(s)
- D James Surmeier
- Department of Physiology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA; Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
| | - Glenda M Halliday
- Brain and Mind Centre, Sydney Medical School, University of Sydney, 2006, Australia; School of Medical Sciences, University of New South Wales, Neuroscience Research Australia, Sydney 2052, Australia
| | - Tanya Simuni
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
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15
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Politis M, Pagano G, Niccolini F. Imaging in Parkinson's Disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2017; 132:233-274. [DOI: 10.1016/bs.irn.2017.02.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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16
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Meles SK, Teune LK, de Jong BM, Dierckx RA, Leenders KL. Metabolic Imaging in Parkinson Disease. J Nucl Med 2016; 58:23-28. [DOI: 10.2967/jnumed.116.183152] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 11/18/2016] [Indexed: 01/04/2023] Open
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17
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Jourdain VA, Tang CC, Holtbernd F, Dresel C, Choi YY, Ma Y, Dhawan V, Eidelberg D. Flow-metabolism dissociation in the pathogenesis of levodopa-induced dyskinesia. JCI Insight 2016; 1:e86615. [PMID: 27699242 DOI: 10.1172/jci.insight.86615] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Levodopa-induced dyskinesia (LID) is the most common, disruptive complication of Parkinson's disease (PD) pharmacotherapy, yet despite decades of research, the changes in regional brain function underlying LID remain largely unknown. We previously found that the cerebral vasomotor and metabolic responses to levodopa are dissociated in PD subjects. Nonetheless, it is unclear whether levodopa-mediated dissociation is exaggerated in LID or distinguishes LID from non-LID subjects. To explore this possibility, we used dual-tracer positron emission tomography to quantify regional cerebral blood flow and metabolic activity in 28 PD subjects (14 LID, 14 non-LID), scanned before and during intravenous levodopa infusion. Levodopa-mediated dissociation was most prominent in the posterior putamen (P < 0.0001) and greater in LID than in non-LID and test-retest subjects. Strikingly, LID subjects also showed increased sensorimotor cortex (SMC) activity in the baseline, unmedicated state. Imaging data from an independent PD sample (106 subjects) linked these differences to loss of mesocortical dopamine terminals in advanced patients. In aggregate, the data suggest that LID results from an overactive vasomotor response to levodopa in the putamen on a background of disease-related increases in SMC activity. LID may thus be amenable to treatment that modulates the function of these 2 regions.
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18
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Holtbernd F, Tang CC, Feigin A, Dhawan V, Ghilardi MF, Paulsen JS, Guttman M, Eidelberg D. Longitudinal Changes in the Motor Learning-Related Brain Activation Response in Presymptomatic Huntington's Disease. PLoS One 2016; 11:e0154742. [PMID: 27192167 PMCID: PMC4871440 DOI: 10.1371/journal.pone.0154742] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 04/18/2016] [Indexed: 11/19/2022] Open
Abstract
Neurocognitive decline, including deficits in motor learning, occurs in the presymptomatic phase of Huntington's disease (HD) and precedes the onset of motor symptoms. Findings from recent neuroimaging studies have linked these deficits to alterations in fronto-striatal and fronto-parietal brain networks. However, little is known about the temporal dynamics of these networks when subjects approach phenoconversion. Here, 10 subjects with presymptomatic HD were scanned with 15O-labeled water at baseline and again 1.5 years later while performing a motor sequence learning task and a kinematically matched control task. Spatial covariance analysis was utilized to characterize patterns of change in learning-related neural activation occurring over time in these individuals. Pattern expression was compared to corresponding values in 10 age-matched healthy control subjects. Spatial covariance analysis revealed significant longitudinal changes in the expression of a specific learning-related activation pattern characterized by increasing activity in the right orbitofrontal cortex, with concurrent reductions in the right medial prefrontal and posterior cingulate regions, the left insula, left precuneus, and left cerebellum. Changes in the expression of this pattern over time correlated with baseline measurements of disease burden and learning performance. The network changes were accompanied by modest improvement in learning performance that took place concurrently in the gene carriers. The presence of increased network activity in the setting of stable task performance is consistent with a discrete compensatory mechanism. The findings suggest that this effect is most pronounced in the late presymptomatic phase of HD, as subjects approach clinical onset.
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Affiliation(s)
- Florian Holtbernd
- Center for Neurosciences, The Feinstein Institute for Medical Research, Manhasset, New York, United States of America
| | - Chris C. Tang
- Center for Neurosciences, The Feinstein Institute for Medical Research, Manhasset, New York, United States of America
| | - Andrew Feigin
- Center for Neurosciences, The Feinstein Institute for Medical Research, Manhasset, New York, United States of America
- Department of Neurology, Northwell Health, Manhasset, New York, United States of America
| | - Vijay Dhawan
- Center for Neurosciences, The Feinstein Institute for Medical Research, Manhasset, New York, United States of America
| | - Maria Felice Ghilardi
- Department of Physiology, Pharmacology, and Neuroscience, City University of New York Medical School, New York, New York, United States of America
| | - Jane S. Paulsen
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa, United States of America
| | - Mark Guttman
- Department of Neurology, University of Toronto, Toronto, Ontario, Canada
| | - David Eidelberg
- Center for Neurosciences, The Feinstein Institute for Medical Research, Manhasset, New York, United States of America
- Department of Neurology, Northwell Health, Manhasset, New York, United States of America
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19
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Differentiating Patients with Parkinson’s Disease from Normal Controls Using Gray Matter in the Cerebellum. THE CEREBELLUM 2016; 16:151-157. [DOI: 10.1007/s12311-016-0781-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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20
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Miocinovic S, de Hemptinne C, Qasim S, Ostrem JL, Starr PA. Patterns of Cortical Synchronization in Isolated Dystonia Compared With Parkinson Disease. JAMA Neurol 2016; 72:1244-51. [PMID: 26409266 DOI: 10.1001/jamaneurol.2015.2561] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
IMPORTANCE Isolated dystonia and Parkinson disease (PD) are disorders of the basal gangliothalamocortical network. They have largely distinct clinical profiles, but both disorders respond to deep brain stimulation (DBS) in the same subcortical targets using similar stimulation paradigms, suggesting pathophysiologic overlap. We hypothesized that, similar to PD, isolated dystonia is associated with elevated cortical neuronal synchronization. OBJECTIVE To investigate the electrophysiologic characteristics of the sensorimotor cortex arm-related area using a temporary subdural electrode strip in patients with isolated dystonia and PD undergoing DBS implantation in the awake state. DESIGN, SETTING, AND PARTICIPANTS An observational study recruited patients scheduled for DBS at the University of California, San Francisco and the San Francisco Veterans Affairs Medical Center. Data were collected from May 1, 2008, through April 1, 2015. Findings are reported for 22 patients with isolated cervical or segmental dystonia (8 with [DYST-ARM] and 14 without [DYST] arm symptoms) and 14 patients with akinetic rigid PD. Data were analyzed from November 1, 2014, through May 1, 2015. MAIN OUTCOMES AND MEASURES Cortical local field potentials, power spectral density, and phase-amplitude coupling (PAC). RESULTS Among our 3 groups that together included 36 patients, cortical PAC was present in primary motor and premotor arm-related areas for all groups, but the DYST group was less likely to exhibit increased PAC (P = .008). Similar to what has been shown for patients with PD, subthalamic DBS reversibly decreased PAC in a subset of patients with dystonia who were studied before and during intraoperative test stimulation (n = 4). At rest, broadband gamma (50-200 Hz) power in the primary motor cortex was greater in the DYST-ARM and PD groups compared with the DYST group, whereas alpha (8-13 Hz) and beta (13-30 Hz) power was comparable in all 3 groups. During movement, the DYST-ARM group had impaired beta and low gamma desynchronization in the primary motor cortex. CONCLUSIONS AND RELEVANCE Isolated dystonia and PD have physiologic overlap with respect to high levels of motor cortex synchronization and reduction of cortical synchronization by subthalamic DBS, providing an explanation for their similar therapeutic response to basal ganglia stimulation.
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Affiliation(s)
- Svjetlana Miocinovic
- Movement Disorder and Neuromodulation Center, Department of Neurology, University of California, San Francisco
| | | | - Salman Qasim
- Department of Neurological Surgery, University of California, San Francisco
| | - Jill L Ostrem
- Movement Disorder and Neuromodulation Center, Department of Neurology, University of California, San Francisco
| | - Philip A Starr
- Department of Neurological Surgery, University of California, San Francisco
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21
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Siddiqi SH, Abraham NK, Geiger CL, Karimi M, Perlmutter JS, Black KJ. The Human Experience with Intravenous Levodopa. Front Pharmacol 2016; 6:307. [PMID: 26779024 PMCID: PMC4701937 DOI: 10.3389/fphar.2015.00307] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 12/11/2015] [Indexed: 11/24/2022] Open
Abstract
Objective: To compile a comprehensive summary of published human experience with levodopa given intravenously, with a focus on information required by regulatory agencies. Background: While safe intravenous (IV) use of levodopa has been documented for over 50 years, regulatory supervision for pharmaceuticals given by a route other than that approved by the U.S. Food and Drug Administration (FDA) has become increasingly cautious. If delivering a drug by an alternate route raises the risk of adverse events, an investigational new drug (IND) application is required, including a comprehensive review of toxicity data. Methods: Over 200 articles referring to IV levodopa were examined for details of administration, pharmacokinetics, benefit, and side effects. Results: We identified 142 original reports describing IVLD use in humans, beginning with psychiatric research in 1959–1960 before the development of peripheral decarboxylase inhibitors. At least 2760 subjects have received IV levodopa, and reported outcomes include parkinsonian signs, sleep variables, hormone levels, hemodynamics, CSF amino acid composition, regional cerebral blood flow, cognition, perception and complex behavior. Mean pharmacokinetic variables were summarized for 49 healthy subjects and 190 with Parkinson's disease. Side effects were those expected from clinical experience with oral levodopa and dopamine agonists. No articles reported deaths or induction of psychosis. Conclusion: At least 2760 patients have received IV levodopa with a safety profile comparable to that seen with oral administration.
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Affiliation(s)
- Shan H Siddiqi
- Department of Psychiatry, Washington University School of Medicine St. Louis, MO, USA
| | - Natalia K Abraham
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa Ottawa, ON, Canada
| | | | - Morvarid Karimi
- Department of Neurology, Washington University School of Medicine St. Louis, MO, USA
| | - Joel S Perlmutter
- Programs in Occupational Therapy and Physical Therapy, Division of Biology and Biomedical Sciences, Departments of Neurology, Radiology, and Anatomy and Neurobiology, Washington University School of Medicine St. Louis, MO, USA
| | - Kevin J Black
- Division of Biology and Biomedical Sciences, Departments of Psychiatry, Neurology, Radiology, and Anatomy and Neurobiology, Washington University School of Medicine St. Louis, MO, USA
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Weingarten CP, Sundman MH, Hickey P, Chen NK. Neuroimaging of Parkinson's disease: Expanding views. Neurosci Biobehav Rev 2015; 59:16-52. [PMID: 26409344 PMCID: PMC4763948 DOI: 10.1016/j.neubiorev.2015.09.007] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 09/07/2015] [Accepted: 09/15/2015] [Indexed: 12/14/2022]
Abstract
Advances in molecular and structural and functional neuroimaging are rapidly expanding the complexity of neurobiological understanding of Parkinson's disease (PD). This review article begins with an introduction to PD neurobiology as a foundation for interpreting neuroimaging findings that may further lead to more integrated and comprehensive understanding of PD. Diverse areas of PD neuroimaging are then reviewed and summarized, including positron emission tomography, single photon emission computed tomography, magnetic resonance spectroscopy and imaging, transcranial sonography, magnetoencephalography, and multimodal imaging, with focus on human studies published over the last five years. These included studies on differential diagnosis, co-morbidity, genetic and prodromal PD, and treatments from L-DOPA to brain stimulation approaches, transplantation and gene therapies. Overall, neuroimaging has shown that PD is a neurodegenerative disorder involving many neurotransmitters, brain regions, structural and functional connections, and neurocognitive systems. A broad neurobiological understanding of PD will be essential for translational efforts to develop better treatments and preventive strategies. Many questions remain and we conclude with some suggestions for future directions of neuroimaging of PD.
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Affiliation(s)
- Carol P Weingarten
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, United States.
| | - Mark H Sundman
- Brain Imaging and Analysis Center, Duke University Medical Center, United States
| | - Patrick Hickey
- Department of Neurology, Duke University School of Medicine, United States
| | - Nan-kuei Chen
- Brain Imaging and Analysis Center, Duke University Medical Center, United States; Department of Radiology, Duke University School of Medicine, United States
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23
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Rowland NC, De Hemptinne C, Swann NC, Qasim S, Miocinovic S, Ostrem JL, Knight RT, Starr PA. Task-related activity in sensorimotor cortex in Parkinson's disease and essential tremor: changes in beta and gamma bands. Front Hum Neurosci 2015; 9:512. [PMID: 26441609 PMCID: PMC4585033 DOI: 10.3389/fnhum.2015.00512] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Accepted: 09/03/2015] [Indexed: 11/25/2022] Open
Abstract
In Parkinson's disease patients in the OFF medication state, basal ganglia local field potentials exhibit changes in beta and gamma oscillations that correlate with reduced voluntary movement, manifested as rigidity and akinesia. However, magnetoencephalography and low-resolution electrocorticography (ECoG) studies in Parkinson's patients suggest that changes in sensorimotor cortical oscillations differ from those of the basal ganglia. To more clearly define the role of sensorimotor cortex oscillatory activity in Parkinson's, we performed intraoperative, high-resolution (4 mm spacing) ECoG recordings in 10 Parkinson's patients (2 females, ages 47–72) undergoing deep brain stimulation (DBS) lead placement in the awake, OFF medication state. We analyzed ECoG potentials during a computer-controlled reaching task designed to separate movement preparation from movement execution and compared findings to similar invasive recordings in eight patients with essential tremor (3 females, ages 59–78), a condition not associated with rigidity or akinesia. We show that (1) cortical beta spectral power at rest does not differ between Parkinson's and essential tremor patients (p = 0.85), (2) early motor preparation in Parkinson's patients in the OFF medication state is associated with a larger beta desynchronization compared to patients with essential tremor (p = 0.0061), and (3) cortical broadband gamma power is elevated in Parkinson's patients compared to essential tremor patients during both rest and task recordings (p = 0.004). Our findings suggest an oscillatory profile in sensorimotor cortex of Parkinson's patients that, in contrast to the basal ganglia, may act to promote movement to oppose the anti-kinetic bias of the dopamine-depleted state.
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Affiliation(s)
- Nathan C Rowland
- Department of Neurological Surgery, University of California, San Francisco San Francisco, CA, USA
| | - Coralie De Hemptinne
- Department of Neurological Surgery, University of California, San Francisco San Francisco, CA, USA
| | - Nicole C Swann
- Department of Neurological Surgery, University of California, San Francisco San Francisco, CA, USA
| | - Salman Qasim
- Department of Neurological Surgery, University of California, San Francisco San Francisco, CA, USA
| | - Svjetlana Miocinovic
- Department of Neurology, University of California, San Francisco San Francisco, CA, USA
| | - Jill L Ostrem
- Department of Neurology, University of California, San Francisco San Francisco, CA, USA
| | - Robert T Knight
- Department of Neurological Surgery, University of California, San Francisco San Francisco, CA, USA ; Department of Neurology, University of California, San Francisco San Francisco, CA, USA ; Helen Wills Neuroscience Institute, University of California, Berkeley Berkeley, CA, USA ; Department of Psychology, University of California, Berkeley Berkeley, CA, USA
| | - Philip A Starr
- Department of Neurological Surgery, University of California, San Francisco San Francisco, CA, USA
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Trujillo JP, Gerrits NJHM, Vriend C, Berendse HW, van den Heuvel OA, van der Werf YD. Impaired planning in Parkinson's disease is reflected by reduced brain activation and connectivity. Hum Brain Mapp 2015; 36:3703-15. [PMID: 26096737 PMCID: PMC5033031 DOI: 10.1002/hbm.22873] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 05/18/2015] [Accepted: 05/27/2015] [Indexed: 11/21/2022] Open
Abstract
Objective Parkinson's disease (PD) often entails impairments of executive functions, such as planning. Although widely held that these impairments arise from dopaminergic denervation of the striatum, not all executive functions are affected early on, and the underlying neural dynamics are not fully understood. In a combined longitudinal and cross‐sectional study, we investigated how planning deficits progress over time in the early stages of PD compared to matched healthy controls. We used functional magnetic resonance imaging (fMRI) to identify accompanying neural dynamics. Methods Seventeen PD patients and 20 healthy controls performed a parametric Tower of London task at two time points separated by ∼3 years (baseline and follow‐up). We assessed task performance longitudinally in both groups; at follow‐up, a subset of participants (14 patients, 19 controls) performed a parallel version of the task during fMRI. We performed meta‐analyses to localize regions‐of‐interest (ROIs), that is, the bilateral dorsolateral prefrontal cortex (DLPFC), inferior parietal cortex, and caudate nucleus, and performed group‐by‐task analyses and within‐group regression analyses of planning‐related neural activation. We studied task‐related functional connectivity of seeds in the DLPFC and caudate nucleus. Results PD patients, compared with controls, showed impaired task performance at both time‐points, while both groups showed similar performance reductions from baseline to follow‐up. Compared to controls, patients showed lower planning‐related brain activation together with decreased functional connectivity. Conclusion These findings support the notion that planning is affected early in the PD disease course, and that this impairment in planning is accompanied by decreases in both task‐related brain activity and connectivity. Hum Brain Mapp 36:3703–3715, 2015. © 2015 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc.
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Affiliation(s)
- James P Trujillo
- Department of Emotion & Cognition, Netherlands Institute for Neuroscience, An Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands.,Department of Anatomy and Neurosciences, VU University Medical Center (VUmc), Amsterdam, The Netherlands
| | - Niels J H M Gerrits
- Department of Anatomy and Neurosciences, VU University Medical Center (VUmc), Amsterdam, The Netherlands.,Neuroscience Campus Amsterdam (NCA), Amsterdam, The Netherlands
| | - Chris Vriend
- Department of Anatomy and Neurosciences, VU University Medical Center (VUmc), Amsterdam, The Netherlands.,Neuroscience Campus Amsterdam (NCA), Amsterdam, The Netherlands.,Department of Psychiatry, VUmc, Amsterdam, The Netherlands
| | - Henk W Berendse
- Neuroscience Campus Amsterdam (NCA), Amsterdam, The Netherlands.,Department of Neurology, VUmc, Amsterdam, The Netherlands
| | - Odile A van den Heuvel
- Department of Anatomy and Neurosciences, VU University Medical Center (VUmc), Amsterdam, The Netherlands.,Neuroscience Campus Amsterdam (NCA), Amsterdam, The Netherlands.,Department of Psychiatry, VUmc, Amsterdam, The Netherlands
| | - Ysbrand D van der Werf
- Department of Emotion & Cognition, Netherlands Institute for Neuroscience, An Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands.,Department of Anatomy and Neurosciences, VU University Medical Center (VUmc), Amsterdam, The Netherlands.,Neuroscience Campus Amsterdam (NCA), Amsterdam, The Netherlands
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25
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Murrow RW. Penfield's Prediction: A Mechanism for Deep Brain Stimulation. Front Neurol 2014; 5:213. [PMID: 25368601 PMCID: PMC4202722 DOI: 10.3389/fneur.2014.00213] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 10/05/2014] [Indexed: 11/13/2022] Open
Abstract
CONTEXT Despite its widespread use, the precise mechanism of action of Deep Brain Stimulation (DBS) therapy remains unknown. The modern urgency to publish more and new data can obscure previously learned lessons by the giants who have preceded us and whose shoulders we now stand upon. Wilder Penfield extensively studied the effects of artificial electrical brain stimulation and his comments on the subject are still very relevant today. In particular, he noted two very different (and seemingly opposite) effects of stimulation within the human brain. In some structures, artificial electrical stimulation has an effect, which mimics ablation, while, in other structures, it produces a stimulatory effect on that tissue. HYPOTHESIS The hypothesis of this paper is fourfold. First, it proposes that some neural circuits are widely synchronized with other neural circuits, while some neural circuits are unsynchronized and operate independently. Second, it proposes that artificial high-frequency electrical stimulation of a synchronized neural circuit results in an ablative effect, but artificial high-frequency electrical stimulation of an unsynchronized neural circuit results in a stimulatory effect. Third, it suggests a part of the mechanism by which large-scale physiologic synchronization of widely distributed independently processed information streams may occur. This may be the neural mechanism underlying Penfield's "centrencephalic system," which he emphasized so many years ago. Fourth, it outlines the specific anatomic distribution of this physiologic synchronization, which Penfield has already clearly delineated as the distribution of his centrencephalic system. EVIDENCE This paper draws on a brief overview of previous theory regarding the mechanism of action of DBS and on historical, as well as widely known modern clinical data regarding the observed effects of stimulation delivered to various targets within the brain. Basic science investigations, which support the hypothesis are also cited. CONCLUSION This paper proposes a novel hypothesis for the mechanism of action of DBS, which was conceptually foreshadowed by Wilder Penfield decades ago.
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Affiliation(s)
- Richard W. Murrow
- Department of Neurology, University of North Carolina, Chapel Hill, NC, USA
- Department of Neurosurgery, University of North Carolina, Chapel Hill, NC, USA
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26
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Ko JH, Lerner RP, Eidelberg D. Effects of levodopa on regional cerebral metabolism and blood flow. Mov Disord 2014; 30:54-63. [PMID: 25296957 DOI: 10.1002/mds.26041] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 09/01/2014] [Indexed: 01/24/2023] Open
Abstract
Levodopa (L-dopa) has been at the forefront of antiparkinsonian therapy for a half century. Recent advances in functional brain imaging have contributed substantially to the understanding of the effects of L-dopa and other dopaminergic treatment on the activity of abnormal motor and cognitive brain circuits in Parkinson's disease patients. Progress has also been made in understanding the functional pathology of dyskinesias, a common side effect of l-dopa treatment, at both regional and network levels. Here, we review these studies, focusing mainly on the new mechanistic insights provided by metabolic brain imaging and network analysis.
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Affiliation(s)
- Ji Hyun Ko
- Center for Neurosciences, The Feinstein Institute for Medical Research, Manhasset, New York, USA
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27
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Ko JH, Feigin A, Mattis PJ, Tang CC, Ma Y, Dhawan V, During MJ, Kaplitt MG, Eidelberg D. Network modulation following sham surgery in Parkinson's disease. J Clin Invest 2014; 124:3656-66. [PMID: 25036712 DOI: 10.1172/jci75073] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 05/08/2014] [Indexed: 02/01/2023] Open
Abstract
Patient responses to placebo and sham effects are a major obstacle to the development of therapies for brain disorders, including Parkinson's disease (PD). Here, we used functional brain imaging and network analysis to study the circuitry underlying placebo effects in PD subjects randomized to sham surgery as part of a double-blind gene therapy trial. Metabolic imaging was performed prior to randomization, then again at 6 and 12 months after sham surgery. In this cohort, the sham response was associated with the expression of a distinct cerebello-limbic circuit. The expression of this network increased consistently in patients blinded to treatment and correlated with independent clinical ratings. Once patients were unblinded, network expression declined toward baseline levels. Analogous network alterations were not seen with open-label levodopa treatment or during disease progression. Furthermore, sham outcomes in blinded patients correlated with baseline network expression, suggesting the potential use of this quantitative measure to identify "sham-susceptible" subjects before randomization. Indeed, Monte Carlo simulations revealed that a priori exclusion of such individuals substantially lowers the number of randomized participants needed to demonstrate treatment efficacy. Individualized subject selection based on a predetermined network criterion may therefore limit the need for sham interventions in future clinical trials.
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28
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Fling BW, Cohen RG, Mancini M, Carpenter SD, Fair DA, Nutt JG, Horak FB. Functional reorganization of the locomotor network in Parkinson patients with freezing of gait. PLoS One 2014; 9:e100291. [PMID: 24937008 PMCID: PMC4061081 DOI: 10.1371/journal.pone.0100291] [Citation(s) in RCA: 154] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Accepted: 05/21/2014] [Indexed: 01/12/2023] Open
Abstract
Freezing of gait (FoG) is a transient inability to initiate or maintain stepping that often accompanies advanced Parkinson’s disease (PD) and significantly impairs mobility. The current study uses a multimodal neuroimaging approach to assess differences in the functional and structural locomotor neural network in PD patients with and without FoG and relates these findings to measures of FoG severity. Twenty-six PD patients and fifteen age-matched controls underwent resting-state functional magnetic resonance imaging and diffusion tensor imaging along with self-reported and clinical assessments of FoG. After stringent movement correction, fifteen PD patients and fourteen control participants were available for analysis. We assessed functional connectivity strength between the supplementary motor area (SMA) and the following locomotor hubs: 1) subthalamic nucleus (STN), 2) mesencephalic and 3) cerebellar locomotor region (MLR and CLR, respectively) within each hemisphere. Additionally, we quantified structural connectivity strength between locomotor hubs and assessed relationships with metrics of FoG. FoG+ patients showed greater functional connectivity between the SMA and bilateral MLR and between the SMA and left CLR compared to both FoG− and controls. Importantly, greater functional connectivity between the SMA and MLR was positively correlated with i) clinical, ii) self-reported and iii) objective ratings of freezing severity in FoG+, potentially reflecting a maladaptive neural compensation. The current findings demonstrate a re-organization of functional communication within the locomotor network in FoG+ patients whereby the higher-order motor cortex (SMA) responsible for gait initiation communicates with the MLR and CLR to a greater extent than in FoG− patients and controls. The observed pattern of altered connectivity in FoG+ may indicate a failed attempt by the CNS to compensate for the loss of connectivity between the STN and SMA and may reflect a loss of lower-order, automatic control of gait by the basal ganglia.
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Affiliation(s)
- Brett W. Fling
- Department of Neurology, School of Medicine, Oregon Health & Science University, Portland, Oregon, United States of America
- * E-mail:
| | - Rajal G. Cohen
- Department of Psychology and Communication Studies, University of Idaho Moscow, Idaho, United States of America
| | - Martina Mancini
- Department of Neurology, School of Medicine, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Samuel D. Carpenter
- Department of Behavioral Neuroscience, School of Medicine, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Damien A. Fair
- Department of Behavioral Neuroscience, School of Medicine, Oregon Health & Science University, Portland, Oregon, United States of America
- Department of Psychiatry, School of Medicine, Oregon Health & Science University, Portland, Oregon, United States of America
| | - John G. Nutt
- Department of Neurology, School of Medicine, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Fay B. Horak
- Department of Neurology, School of Medicine, Oregon Health & Science University, Portland, Oregon, United States of America
- Portland VA Medical Center, Portland, Oregon, United States of America
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29
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Abstract
The use of functional brain imaging techniques, including positron emission tomography (PET), single-photon emission computed tomography (SPECT), and functional magnetic resonance imaging (fMRI), has allowed for monitoring neuronal and neurochemical activities in the living human brain and identifying abnormal changes in various neurological and psychiatric diseases. Combining these methods with techniques such as deep brain stimulation (DBS) and transcranial magnetic stimulation (TMS) has greatly advanced our understanding of the effects of such treatment on brain activity at targeted regions as well as specific disease-related networks. Indeed, recent network-level analysis focusing on inter-regional covarying activities in data interpretation has unveiled several key mechanisms underlying the therapeutic effects of brain stimulation. However, non-negligible discrepancies have been reported in the literature, attributable in part to the heterogeneity of both imaging and brain stimulation techniques. This chapter summarizes recent studies that combine brain imaging and brain stimulation, and includes discussion of future direction in these lines of research.
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30
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Ko JH, Spetsieris P, Ma Y, Dhawan V, Eidelberg D. Quantifying significance of topographical similarities of disease-related brain metabolic patterns. PLoS One 2014; 9:e88119. [PMID: 24498250 PMCID: PMC3909315 DOI: 10.1371/journal.pone.0088119] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Accepted: 01/05/2014] [Indexed: 11/30/2022] Open
Abstract
Multivariate analytical routines have become increasingly popular in the study of cerebral function in health and in disease states. Spatial covariance analysis of functional neuroimaging data has been used to identify and validate characteristic topographies associated with specific brain disorders. Voxel-wise correlations can be used to assess similarities and differences that exist between covariance topographies. While the magnitude of the resulting topographical correlations is critical, statistical significance can be difficult to determine in the setting of large data vectors (comprised of over 100,000 voxel weights) and substantial autocorrelation effects. Here, we propose a novel method to determine the p-value of such correlations using pseudo-random network simulations.
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Affiliation(s)
- Ji Hyun Ko
- Center for Neurosciences, The Feinstein Institute for Medical Research, North Shore-Long Island Jewish Health System, Manhasset, New York, United States of America
- * E-mail:
| | - Phoebe Spetsieris
- Center for Neurosciences, The Feinstein Institute for Medical Research, North Shore-Long Island Jewish Health System, Manhasset, New York, United States of America
| | - Yilong Ma
- Center for Neurosciences, The Feinstein Institute for Medical Research, North Shore-Long Island Jewish Health System, Manhasset, New York, United States of America
| | - Vijay Dhawan
- Center for Neurosciences, The Feinstein Institute for Medical Research, North Shore-Long Island Jewish Health System, Manhasset, New York, United States of America
| | - David Eidelberg
- Center for Neurosciences, The Feinstein Institute for Medical Research, North Shore-Long Island Jewish Health System, Manhasset, New York, United States of America
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31
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Herz DM, Eickhoff SB, Løkkegaard A, Siebner HR. Functional neuroimaging of motor control in Parkinson's disease: a meta-analysis. Hum Brain Mapp 2013; 35:3227-37. [PMID: 24123553 DOI: 10.1002/hbm.22397] [Citation(s) in RCA: 131] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Revised: 08/07/2013] [Accepted: 08/13/2013] [Indexed: 12/13/2022] Open
Abstract
Functional neuroimaging has been widely used to study the activation patterns of the motor network in patients with Parkinson's disease (PD), but these studies have yielded conflicting results. This meta-analysis of previous neuroimaging studies was performed to identify patterns of abnormal movement-related activation in PD that were consistent across studies. We applied activation likelihood estimation (ALE) of functional neuroimaging studies probing motor function in patients with PD. The meta-analysis encompassed data from 283 patients with PD reported in 24 functional neuroimaging studies and yielded consistent alterations in neural activity in patients with PD. Differences in cortical activation between PD patients and healthy controls converged in a left-lateralized fronto-parietal network comprising the presupplementary motor area, primary motor cortex, inferior parietal cortex, and superior parietal lobule. Both, increases as well as decreases in motor cortical activity, which were related to differences in movement timing and selection in the applied motor tasks, were reported in these cortical areas. In the basal ganglia, PD patients expressed a decrease of motor activation in the posterior motor putamen, which improved with dopaminergic medication. The likelihood of detecting a decrease in putaminal activity increased with motor impairment. This reduced motor activation of the posterior putamen across previous neuroimaging studies indicates that nigrostriatal dopaminergic denervation affects neural processing in the denervated striatal motor territory. In contrast, fronto-parietal motor areas display both increases as well as decreases in movement related activation. This points to a more complex relationship between altered cortical physiology and nigrostriatal dopaminergic denervation in PD.
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Affiliation(s)
- Damian M Herz
- Danish Research Center for Magnetic Resonance, Center for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
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32
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LEE D, HENRIQUES DY, SNIDER J, SONG D, POIZNER H. Reaching to proprioceptively defined targets in Parkinson's disease: effects of deep brain stimulation therapy. Neuroscience 2013; 244:99-112. [PMID: 23590906 PMCID: PMC3780593 DOI: 10.1016/j.neuroscience.2013.04.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Revised: 04/04/2013] [Accepted: 04/05/2013] [Indexed: 11/26/2022]
Abstract
Deep brain stimulation of the subthalamic nucleus (STN DBS) provides a unique window into human brain function since it can reversibly alter the functioning of specific brain circuits. Basal ganglia-cortical circuits are thought to be excessively noisy in patients with Parkinson's disease (PD), based in part on the lack of specificity of proprioceptive signals in basal ganglia-thalamic-cortical circuits in monkey models of the disease. PD patients are known to have deficits in proprioception, but the effects are often subtle, with paradigms typically restricted to one or two joint movements in a plane. Moreover, the effects of STN DBS on proprioception are virtually unexplored. We tested the following hypotheses: first, that PD patients will show substantial deficits in unconstrained, multi-joint proprioception, and, second, that STN DBS will improve multi-joint proprioception. Twelve PD patients with bilaterally implanted electrodes in the subthalamic nucleus and 12 age-matched healthy subjects were asked to position the left hand at a location that was proprioceptively defined in 3D space with the right hand. In a second condition, subjects were provided visual feedback during the task so that they were not forced to rely on proprioception. Overall, with STN DBS switched off, PD patients showed significantly larger proprioceptive localization errors, and greater variability in endpoint localizations than the control subjects. Visual feedback partially normalized PD performance, and demonstrated that the errors in proprioceptive localization were not simply due to a difficulty in executing the movements or in remembering target locations. Switching STN DBS on significantly reduced localization errors from those of control subjects when patients moved without visual feedback relative to when they moved with visual feedback (when proprioception was not required). However, this reduction in localization errors without vision came at the cost of increased localization variability.
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Affiliation(s)
- D. LEE
- Institute for Neural Computation, University of California, San Diego, CA, United States
| | - D. Y. HENRIQUES
- School of Kinesiology & Health Science Centre for Vision Research, York University, Toronto, Canada
| | - J. SNIDER
- Institute for Neural Computation, University of California, San Diego, CA, United States
| | - D. SONG
- Department of Neurosciences, University of California, San Diego, CA, United States
| | - H. POIZNER
- Institute for Neural Computation, University of California, San Diego, CA, United States
- Graduate Program in Neurosciences, University of California, San Diego, CA, United States
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