Altered brain activation and connectivity in early Parkinson disease tactile perception

The cerebellum directly modulates the substantia nigra dopaminergic activity

Evidence of direct reciprocal connections between the cerebellum and basal ganglia has challenged the long-held notion that these structures function independently. While anatomical studies have suggested the presence of cerebellar projections to the substantia nigra pars compacta (SNc), the nature and function of these connections (Cb-SNc) is unknown. Here we show, in mice, that Cb-SNc projections form monosynaptic glutamatergic synapses with dopaminergic and non-dopaminergic neurons in the SNc. Optogenetic activation of Cb-SNc axons in the SNc is associated with increased SNc activity, elevated striatal dopamine levels and increased locomotion. During behavior, Cb-SNc projections are bilaterally activated before ambulation and unilateral lever manipulation. Cb-SNc projections show prominent activation for water reward and higher activation for sweet water, suggesting that the pathway also encodes reward value. Thus, the cerebellum directly, rapidly and effectively modulates basal ganglia dopamine levels and conveys information related to movement initiation, vigor and reward processing.

The central role of the Thalamus in psychosis, lessons from neurodegenerative diseases and psychedelics

The PD-DLB psychosis complex found in Parkinson's disease (PD) and Dementia with Lewy Bodies (DLB) includes hallucinations, Somatic Symptom/Functional Disorders, and delusions. These disorders exhibit similar presentation patterns and progression. Mechanisms at the root of these symptoms also share similarities with processes promoting altered states of consciousness found in Rapid Eye Movement sleep, psychiatric disorders, or the intake of psychedelic compounds. We propose that these mechanisms find a crucial driver and trigger in the dysregulated activity of high-order thalamic nuclei set in motion by ThalamoCortical Dysrhythmia (TCD). TCD generates the loss of finely tuned cortico-cortical modulations promoted by the thalamus and unleashes the aberrant activity of the Default Mode Network (DMN). TCD moves in parallel with altered thalamic filtering of external and internal information. The process produces an input overload to the cortex, thereby exacerbating DMN decoupling from task-positive networks. These phenomena alter the brain metastability, creating dreamlike, dissociative, or altered states of consciousness. In support of this hypothesis, mind-altering psychedelic drugs also modulate thalamic-cortical pathways. Understanding the pathophysiological background of these conditions provides a conceptual bridge between neurology and psychiatry, thereby helping to generate a promising and converging area of investigation and therapeutic efforts.

Action and emotion perception in Parkinson's disease: A neuroimaging meta-analysis

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The neural substrates for action and emotion perception deficits in PD are still unclear.

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We addressed this issue via coordinate-based meta-analyses of previous fMRI data.

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PD patients exhibit decreased response in the basal ganglia.

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PD patients exhibit a trend toward decreased response in the parietal areas.

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PD patients exhibit a trend toward increased activation in the posterior cerebellum.

Patients with Parkinson disease (PD) may show impairments in the social perception. Whether these deficits have been consistently reported, it remains to be clarified which brain alterations subtend them. To this aim, we conducted a neuroimaging meta-analysis to compare the brain activity during social perception in patients with PD versus healthy controls. Our results show that PD patients exhibit a significantly decreased response in the basal ganglia (putamen and pallidum) and a trend toward decreased activity in the mirror system, particularly in the left parietal cortex (inferior parietal lobule and intraparietal sulcus). This reduced activation may be tied to a disruption of cognitive resonance mechanisms and may thus constitute the basis of impaired others’ representations underlying action and emotion perception. We also found increased activation in the posterior cerebellum in PD, although only in a within-group analysis and not in comparison with healthy controls. This cerebellar activation may reflect compensatory mechanisms, an aspect that deserves further investigation. We discuss the clinical implications of our findings for the development of novel social skill training programs for PD patients.

Altered microstructural properties of superficial white matter in patients with Parkinson's disease

Parkinson's disease (PD), a chronic neurodegenerative disease, is characterized by sensorimotor and cognitive deficits. Previous diffusion tensor imaging (DTI) studies found abnormal DTI metrics in white matter bundles, such as the corpus callosum, cingulate, and frontal-parietal bundles, in PD patients. These studies mainly focused on alterations in microstructural features of long-range bundles within the deep white matter (DWM) that connects pairs of distant cortical regions. However, less is known about the DTI metrics of the superficial white matter (SWM) that connects local cortical regions in PD patients. To determine whether the DTI metrics of the SWM were different between the PD patients and the healthy controls, we recruited DTI data from 34 PD patients and 29 gender- and age-matched healthy controls. Using a probabilistic tractographic approach, we first defined a population-based SWM mask across all the subjects. Using a tract-based spatial statistical (TBSS) analytic approach, we then identified the SWM bundles showing abnormal DTI metrics in the PD patients. We found that the PD patients showed significantly lower DTI metrics in the SWM bundles connecting the sensorimotor cortex, cingulate cortex, posterior parietal cortex (PPC), and parieto-occipital cortex than the healthy controls. We also found that the clinical measures in the PD patients was significantly negatively correlated with the fractional anisotropy in the SWM (FA_SWM) that connects core regions in the default mode network (DMN). The FA_SWM in the bundles that connected the PPC was significantly positively correlated with cognitive performance in the PD patients. Our findings suggest that SWM may serve as the brain structural basis underlying the sensorimotor deficits and cognitive degeneration in PD patients.

Analysis of the effects of subthalamic nucleus deep brain stimulation on somatosensation in Parkinson's disease patients

OBJECTIVE

Despite the subthalamic nucleus (STN) deep brain stimulation (DBS) is a treatment commonly used to ameliorate the motor symptoms of Parkinson's disease (PD), its effects on somatosensation is unclear. The purpose of this study was to investigate the potential effects of DBS on temperature, proprioceptive, tactile, exteroceptive, pain and cortical sensations, and odor identification in PD patients.

METHODS

The study included 14 patients (with a mean age of 59.78 ± 11.03 years; range, 44-70 years) with idiopathic PD who underwent DBS surgery for movement disorders caused by PD at the same Neurosurgery Department. All patients were tested while DBS was turned on (DBS-ON) and off (DBS-OFF). To clearly observe the effect of removing stimulation off, DBS devices were turned off by experimental clinical personnel for a minimum duration of 30 min prior to examination. Temperature, proprioceptive, tactile, exteroceptive, pain and cortical sensations, and odor identification were examined.

RESULTS

We found that two-point discrimination was significantly lower during DBS-ON than DBS-OFF (p = 0.031). Tactile sensation and kinesthesia deviation degree were lower during DBS-ON than DBS-OFF, but were non-significant (p > 0.05). The number of correct answers on an assessment of graphesthesia was higher during DBS-ON, but was non-significant as well (p > 0.05). Odor identification was better during DBS-OFF.

CONCLUSIONS

DBS may have an effective role to improve somatosensation and DBS-related benefits may not be explained by improvements in motor function alone, but rather by enhanced somatosensory processing. Further studies with larger study groups are needed.

[Changes in regional homogeneity of brain activity in patients with diabetic peripheral]

OBJECTIVE

To investigate the abnormalities in regional homogeneity of brain activity in patients with diabetic peripheral neuropathy (DPN) using resting-state functional magnetic resonance imaging (rs-fMRI) and explore the association between brain activity changes and DPN.

METHODS

A regional homogeneity (ReHo) approach was used to compare the local synchronization of rs-fMRI signals among 20 patients with painful DPN, 16 patients with painless DPN, and 16 type 2 diabetic patients without DPN (non-DPN group).

RESULTS

Compared with the those without DPN, the patients with painful DPN showed high ReHo in the left inferior temporal gyrus and the right central posterior gyrus, and low ReHo in the posterior cingulate gyrus, right inferior parietal gyrus, and the left superior parietal gyrus (P < 0.05);the patients with painless DPN group showed high ReHo in the left inferior temporal gyrus, the right middle temporal gyrus, and the right superior frontal gyrus, and low ReHo in the left thalamus (P < 0.05).No significant differences in ReHo were found between the patients with painful DPN and painless DPN (P>0.05).

CONCLUSIONS

The patients with DPN have altered ReHo in multiple brain regions and impairment of a default mode network, for which the left temporal gyrus may serve as a functional compensatory brain area. ReHo disturbance in the central right posterior gyrus may play a central role in the pain symptoms associated with painful DPN.

Somatosensory Training Improves Proprioception and Untrained Motor Function in Parkinson's Disease

Background: Proprioceptive impairment is a common feature of Parkinson's disease (PD). Proprioceptive function is only partially restored with anti-parkinsonian medication or deep brain stimulation. Behavioral exercises focusing on somatosensation have been promoted to overcome this therapeutic gap. However, conclusive evidence on the effectiveness of such somatosensory-focused behavioral training for improving somatosensory function is lacking. Moreover, it is unclear, if such training has any effect on motor performance in PD.

Objective: To investigate, whether proprioception improves with a somatosensory focused, robot-aided training in people with PD (PWPs), and whether enhanced proprioception translates to improved motor performance.

Method: Thirteen PWPs of mild-moderate clinical severity were assessed and trained ON medication using a robotic wrist exoskeleton. Thirteen healthy elderly participants served as controls. Training involved making increasingly accurate, continuous, precise small amplitude wrist flexion/extension movements. Wrist position sense acuity, as a marker of proprioception function, and spatial error during wrist pointing, as a marker of untrained motor performance, were recorded twice before and once after training. Functional hand writing kinematics exhibited during training were evaluated in the PD group for determining training-induced changes.

Results: Training improved position sense acuity in all PWPs (mean change: 28%; p < 0.001) and healthy controls (mean change: 23%; p < 0.01). Second, 10/13 PD participants and 10/13 healthy control participants had reduced spatial movement error in the untrained wrist pointing task after training. Third, spatial error for the functional handwriting tasks (line tracing and tracking) did not improve with training in the PD group.

Conclusion: Proprioceptive function in mild to moderate PD is trainable and improves with a somatosensory-focused motor training. Learning showed a local transfer within the trained joint degree-of-freedom as improved spatial accuracy in an unpracticed motor task. No learning gains were observed for the untrained functional handwriting task, indicating that training may be specific to the trained joint degree-of-freedom.

Creatine Protects Against Cytosolic Calcium Dysregulation, Mitochondrial Depolarization and Increase of Reactive Oxygen Species Production in Rotenone-Induced Cell Death of Cerebellar Granule Neurons

Rotenone is a neurotoxin that is an active component of many pesticides which has been shown to induce Parkinsonism in animal models. We show that the cytotoxicity of exposure to nanomolar concentrations of rotenone in cultures of mature cerebellar granule neurons (CGN) in serum-free medium is not due to phagocytosis by glial contamination. A concentration as low as 5.65 ± 0.51 nM of rotenone was enough to trigger 50% cell death of mature CGN in culture after 12 h. The addition of serum proteins to the culture medium attenuated rotenone neurotoxicity, and this can account at least in part for the requirement of higher rotenone concentrations to elicit neuronal cytotoxicity reported in previous works. Creatine partial protection against CGN death promoted by 5 nM rotenone correlated with creatine protection against rotenone-induced mitochondrial depolarization and oxidative stress. Furthermore, creatine largely attenuated the early dysregulation of cytosolic Ca²⁺ concentration after acute rotenone treatment. Noteworthy, our results also revealed that the sustained alteration of Ca²⁺ homeostasis induced by rotenone takes place at the onset of the enhancement of intracellular oxidative stress and before mitochondrial depolarization, pointing out that cytosolic Ca²⁺ dysregulation is a very early event in the rotenone toxicity to CGN.

Longitudinal white matter microstructural change in Parkinson's disease

Postmortem studies of Parkinson's disease (PD) suggest that Lewy body pathology accumulates in a predictable topographical sequence, beginning in the olfactory bulb, followed by caudal brainstem, substantia nigra, limbic cortex, and neocortex. Diffusion-weighted imaging (DWI) is sensitive, if not specific, to early disease-related white matter (WM) change in a variety of traumatic and degenerative brain diseases. Although numerous cross-sectional studies have reported DWI differences in cerebral WM in PD, only a few longitudinal studies have investigated whether DWI change exceeds that of normal aging or coincides with regional Lewy body accumulation. This study mapped regional differences in the rate of DWI-based microstructural change between 29 PD patients and 43 age-matched controls over 18 months. Iterative within- and between-subject tensor-based registration was completed on motion- and eddy current-corrected DWI images, then baseline versus follow-up difference maps of fractional anisotropy, mean, radial, and axial diffusivity were analyzed in the Biological Parametric Mapping toolbox for MATLAB. This analysis showed that PD patients had a greater decline in WM integrity in the rostral brainstem, caudal subcortical WM, and cerebellar peduncles, compared with controls. In addition, patients with unilateral clinical signs at baseline experienced a greater rate of WM change over the 18-month study than patients with bilateral signs. These findings suggest that rate of WM microstructural change in PD exceeds that of normal aging and is maximal during early stage disease. In addition, the neuroanatomic locations (rostral brainstem and subcortical WM) of accelerated WM change fit with current theories of topographic disease progression.

Central pain processing in "drug-naïve" pain-free patients with Parkinson's disease

BACKGROUND

Despite its clinical relevance, the pathophysiology of pain in Parkinson's disease (PD) is still largely unknown, and both central and peripheral mechanisms have been invoked.

OBJECTIVES

To investigate whether central pain processing is altered in "drug-naive" pain-free PD (dnPD) patients.

METHODS

Using event-related functional MRI (fMRI), functional response to forearm heat stimulation (FHS) at two different intensities (41°C and 53°C) was investigated in 20 pain-free dnPD patients, compared with 18 healthy controls (HCs). Secondary analyses were performed to evaluate associations between BOLD signal changes and PD clinical features and behavioral responses.

RESULTS

During low-innocuous FHS (41°C), no activation differences were found between dnPD patients and HCs. During high-noxious FHS (53°C) a significantly increased activation in the left somatosensory cortex, left cerebellum, and right low pons was observed in dnPD patients compared to HCs. In the latter experimental condition, fMRI BOLD signal changes in the right low pons (p < .0001; R = -0.8) and in the cerebellum (p = .004; R = -0.7) were negatively correlated with pain intensity ratings only in dnPD patients. No statistically significant difference in experimental pain perception was detected between dnPD patients and HCs.

CONCLUSIONS

Our findings suggest that a functional remodulation of pain processing pathways occurs even in the absence of clinically overt pain symptoms in dnPD patients. These mechanisms may eventually become dysfunctional over time, contributing to the emergence of pain symptoms in more advanced PD stages. The comprehension of pain-related mechanisms may improve the clinical approach and therapeutic management of this disabling nonmotor symptom.

Spatiotemporal characteristics of the pharyngeal event-related potential in healthy subjects and older patients with oropharyngeal dysfunction

BACKGROUND

Oropharyngeal dysphagia (OD) is a highly prevalent symptom in older people. Appropriate oropharyngeal sensory feedback is essential for safe and efficient swallowing. However, pharyngeal sensitivity decreases with advancing age and could play a fundamental role in the physiopathology of swallowing dysfunction associated with aging. We aimed to characterize pharyngeal sensitivity and cortical response to a pharyngeal electrical stimulus in healthy volunteers (HV) and older patients with and without OD.

METHODS

Eight young HV, eight older HV without OD, and 14 older patients with OD were studied by electroencephalography through 32 scalp electrodes. Pharyngeal event-related potentials (ERP) were assessed following electrical stimulation of the pharynx. Sensory and tolerance thresholds to the electrical stimulus and latency, amplitude, and scalp current density of each ERP component were analyzed and compared. An ERP source localization study was also performed using the sLORETA software.

KEY RESULTS

Older participants (with and without OD) presented an increased sensory threshold to pharyngeal electrical stimulation (10.2 ± 1.7 mA and 11.5 ± 1.9 mA respectively), compared with young HV (6.0 ± 1.2 mA). The cortical activation of older HV in response to pharyngeal electrical stimulus was reduced compared with young HV (N2 amplitude: 0.22 ± 0.79 vs -3.10 ± 0.59, P<.05). Older patients with OD also presented disturbances to the pharyngo-cortical connection together with disrupted pattern of cortical activation.

CONCLUSIONS AND INFERENCES

Older people present a decline in pharyngeal sensory function, more severe in older patients with OD. This sensory impairment might be a critical pathophysiological element and a potential target for treatment of swallowing dysfunction in older patients.

Bipolar disorder, a precursor of Parkinson's disease?

Parkinson's disease is a neurodegenerative disorder predominantly resulting from dopamine depletion in the substantia nigra pars compacta. Some psychiatric disorders may have dopaminergic dysfunction as their substrate. We describe a well-documented case of Parkinson's disease associated with Bipolar Disorder. Although there is some knowledge about the association between these diseases, little is known about its pathophysiology and correlation. We believe that among various hypotheses, many neurotransmitters are linked to this pathophysiology.

The novel adaptive rotating beam test unmasks sensorimotor impairments in a transgenic mouse model of Parkinson's disease

Development of disease modifying therapeutics for Parkinson's disease (PD), the second most common neurodegenerative disorder, relies on availability of animal models which recapitulate the disease hallmarks. Only few transgenic mouse models, which mimic overexpression of alpha-synuclein, show dopamine loss, behavioral impairments and protein aggregation. Mice overexpressing human wildtype alpha-synuclein under the Thy-1 promotor (Thy1-aSyn) replicate these features. However, female mice do not exhibit a phenotype. This was attributed to a potentially lower transgene expression located on the X chromosome. Here we support that female mice overexpress human wildtype alpha-synuclein only about 1.5 fold in the substantia nigra, compared to about 3 fold in male mice. Since female Thy1-aSyn mice were shown previously to exhibit differences in corticostriatal communication and synaptic plasticity similar to their male counterparts we hypothesized that female mice use compensatory mechanisms and strategies to not show overt motor deficits despite an underlying endophenotype. In order to unmask these deficits we translated recent findings in PD patients that sensory abnormalities can enhance motor dysfunction into a novel behavioral test, the adaptive rotating beam test. We found that under changing sensory input female Thy1-aSyn mice showed an overt phenotype. Our data supports that the integration of sensorimotor information is likely a major contributor to symptoms of movement disorders and that even low levels of overexpression of human wildtype alpha-synuclein has the potential to disrupt processing of these information. The here described adaptive rotating beam test represents a sensitive behavioral test to detect moderate sensorimotor alterations in mouse models.

Gray matter correlates of dopaminergic degeneration in Parkinson's disease: A hybrid PET/MR study using (18) F-FP-CIT

Dopaminergic degeneration is a hallmark of Parkinson's disease (PD), which causes various symptoms affected by corticostriatal circuits. So far, the relationship between cortical changes and dopamine loss in the striatum is unclear. Here, we evaluate the gray matter (GM) changes in accordance with striatal dopaminergic degeneration in PD using hybrid PET/MR. Sixteen patients with idiopathic PD underwent (18) F-FP-CIT PET/MR. To measure dopaminergic degeneration in PD, binding ratio (BR) of dopamine transporter in striatum was evaluated by (18) F-FP-CIT. Voxel-based morphometry (VBM) was used to evaluate GM density. We obtained voxelwise correlation maps of GM density according to the striatal BR. Voxel-by-voxel correlation between BR maps and GM density maps was done to evaluate region-specific correlation of striatal dopaminergic degeneration. There was a trend of positive correlation between striatal BR and GM density in the cerebellum, parahippocampal gyri, and frontal cortex. A trend of negative correlation between striatal BR and GM density in the medial occipital cortex was found. Voxel-by-voxel correlation revealed that the positive correlation was mainly dependent on anterior striatal BR, while posterior striatal BR mostly showed negative correlation with GM density in occipital and temporal cortices. Decreased GM density related to anterior striatal dopaminergic degeneration might demonstrate degeneration of dopaminergic nonmotor circuits. Furthermore, the negative correlation could be related to the motor circuits of posterior striatum. Our integrated PET/MR study suggests that the widespread structural progressive changes in PD could denote the cortical functional correlates of the degeneration of striatal dopaminergic circuits. Hum Brain Mapp 37:1710-1721, 2016. © 2016 Wiley Periodicals, Inc.

Exercise alters resting-state functional connectivity of motor circuits in parkinsonian rats

Few studies have examined changes in functional connectivity after long-term aerobic exercise. We examined the effects of 4 weeks of forced running wheel exercise on the resting-state functional connectivity (rsFC) of motor circuits of rats subjected to bilateral 6-hydroxydopamine lesion of the dorsal striatum. Our results showed substantial similarity between lesion-induced changes in rsFC in the rats and alterations in rsFC reported in Parkinson's disease subjects, including disconnection of the dorsolateral striatum. Exercise in lesioned rats resulted in: (1) normalization of many of the lesion-induced alterations in rsFC, including reintegration of the dorsolateral striatum into the motor network; (2) emergence of the ventrolateral striatum as a new broadly connected network hub; and (3) increased rsFC among the motor cortex, motor thalamus, basal ganglia, and cerebellum. Our results showed for the first time that long-term exercise training partially reversed lesion-induced alterations in rsFC of the motor circuits, and in addition enhanced functional connectivity in specific motor pathways in the parkinsonian rats, which could underlie recovery in motor functions observed in these animals.

Function of basal ganglia in bridging cognitive and motor modules to perform an action

The basal ganglia (BG) are thought to be involved in the integration of multiple sources of information, and their dysfunction can lead to disorders such as Parkinson's disease (PD). PD patients show motor and cognitive dysfunction with specific impairments in the internal generation of motor actions and executive deficits, respectively. The role of the BG, then, would be to integrate information from several sources in order to make a decision on a resulting action adequate for the required task. Reanalyzing the data set from our previous study (Martinu et al., 2012), we investigated this hypothesis by applying a graph theory method to a series of fMRI data during the performance of self-initiated (SI) finger movement tasks obtained in healthy volunteers (HV) and early stage PD patients. Dorsally, connectivity strength between the medial prefrontal areas (mPFC) and cortical regions including the primary motor area (M1), the extrastriate visual cortex, and the associative cortex, was reduced in the PD patients. The connectivity strengths were positively correlated to activity in the striatum in both groups. Ventrally, all connectivity between the striatum, the thalamus, and the extrastriate visual cortex decreased in strength in the PD, as did the connectivity between the striatum and the ventrolateral PFC (VLPFC). Individual response time (RT) was negatively correlated to connectivity strength between the dorsolateral PFC (DLPFC) and the striatum and positively correlated to connectivity between the VLPFC and the striatum in the HV. These results indicate that the BG, with the mPFC and thalamus, are involved in integrating multiple sources of information from areas such as DLPFC, and VLPFC, connecting to M1, thereby determining a network that leads to the adequate decision and performance of the resulting action.

Aristotle's illusion in Parkinson's disease: evidence for normal interdigit tactile perception

Sensory alterations, a common feature of such movement disorders as Parkinson’s disease (PD) and dystonia, could emerge as epiphenomena of basal ganglia dysfunction. Recently, we found a selective reduction of tactile perception (Aristotle’s illusion, the illusory doubling sensation of one object when touched with crossed fingers) in the affected hand of patients with focal hand dystonia. This suggests that reduced tactile illusion might be a specific feature of this type of dystonia and could be due to abnormal somatosensory cortical activation. The aim of the current study was to investigate whether Aristotle’s illusion is reduced in the affected hand of patients with PD. We tested 15 PD patients, in whom motor symptoms were mainly localised to one side of the body, and 15 healthy controls. Three pairs of fingers were tested in crossed (evoking the illusion) or parallel position (not evoking the illusion). A sphere was placed in the contact point between the two fingers and the blindfolded participants had to say whether they felt one or two stimuli. Stimuli were applied on the affected and less or unaffected side of the PD patients. We found no difference in illusory perception between the PD patients and the controls, nor between the more affected and less/unaffected side, suggesting that Aristotle’s illusion is preserved in PD. The retained tactile illusion in PD and its reduction in focal hand dystonia suggest that the basal ganglia, which are dysfunctional in both PD and dystonia, may not be causally involved in this function. Instead, the level of activation between digits in the somatosensory cortex may be more directly involved. Finally, the similar percentage of illusion in the more affected and less or unaffected body sides indicates that the illusory perception is not influenced by the presence or amount of motor symptoms.

Groupwise whole-brain parcellation from resting-state fMRI data for network node identification

In this paper, we present a groupwise graph-theory-based parcellation approach to define nodes for network analysis. The application of network-theory-based analysis to extend the utility of functional MRI has recently received increased attention. Such analyses require first and foremost a reasonable definition of a set of nodes as input to the network analysis. To date many applications have used existing atlases based on cytoarchitecture, task-based fMRI activations, or anatomic delineations. A potential pitfall in using such atlases is that the mean timecourse of a node may not represent any of the constituent timecourses if different functional areas are included within a single node. The proposed approach involves a groupwise optimization that ensures functional homogeneity within each subunit and that these definitions are consistent at the group level. Parcellation reproducibility of each subunit is computed across multiple groups of healthy volunteers and is demonstrated to be high. Issues related to the selection of appropriate number of nodes in the brain are considered. Within typical parameters of fMRI resolution, parcellation results are shown for a total of 100, 200, and 300 subunits. Such parcellations may ultimately serve as a functional atlas for fMRI and as such three atlases at the 100-, 200- and 300-parcellation levels derived from 79 healthy normal volunteers are made freely available online along with tools to interface this atlas with SPM, BioImage Suite and other analysis packages.

Functional connectivity abnormalities during contextual processing in schizophrenia and in Parkinson's disease

Functional connectivity was evaluated in patients with schizophrenia (SC) and in patients with Parkinson's disease (PD) during the performance of a local contextual processing paradigm, to investigate the proposition that functional disconnection is involved with contextual processing deficits in these populations. To this end, we utilized event-related EEG signals, synchronization likelihood and graph theoretical analysis. Local context was defined as the occurrence of a predictive sequence of stimuli before the presentation of a target event. In the SC patients, we observed a decrease in path length (L) in the beta band, for the predictive sequence and for predicted and random targets, compared with controls. These abnormalities were associated with weaker frontal-temporal-parietal connections. In the PD patients we found longer L (theta band) for predicted targets, and higher cluster coefficients for both the predictive sequence (theta band) and predicted targets (alpha and theta bands), compared with controls. Detection of predicted targets was associated with weaker frontal-parietal connections in PD. No group differences were found for randomized standard stimuli in both SC and PD patients. These findings provide evidence of task-specific functional connectivity abnormalities within frontal networks during local contextual processing.

The cerebellum in Parkinson's disease

Parkinson’s disease is a chronic progressive neurodegenerative disorder characterized by resting tremor, slowness of movements, rigidity, gait disturbance and postural instability. Most investigations on Parkinson’s disease focused on the basal ganglia, whereas the cerebellum has often been overlooked. However, increasing evidence suggests that the cerebellum may have certain roles in the pathophysiology of Parkinson’s disease. Anatomical studies identified reciprocal connections between the basal ganglia and cerebellum. There are Parkinson’s disease–related pathological changes in the cerebellum. Functional or morphological modulations in the cerebellum were detected related to akinesia/rigidity, tremor, gait disturbance, dyskinesia and some non-motor symptoms. It is likely that the major roles of the cerebellum in Parkinson’s disease include pathological and compensatory effects. Pathological changes in the cerebellum might be induced by dopaminergic degeneration, abnormal drives from the basal ganglia and dopaminergic treatment, and may account for some clinical symptoms in Parkinson’s disease. The compensatory effect may help maintain better motor and non-motor functions. The cerebellum is also a potential target for some parkinsonian symptoms. Our knowledge about the roles of the cerebellum in Parkinson’s disease remains limited, and further attention to the cerebellum is warranted.

Automatic classification of early Parkinson's disease with multi-modal MR imaging

Background

In recent years, neuroimaging has been increasingly used as an objective method for the diagnosis of Parkinson's disease (PD). Most previous studies were based on invasive imaging modalities or on a single modality which was not an ideal diagnostic tool. In this study, we developed a non-invasive technology intended for use in the diagnosis of early PD by integrating the advantages of various modals.

Materials and Methods

Nineteen early PD patients and twenty-seven normal volunteers participated in this study. For each subject, we collected resting-state functional magnetic resonance imaging (rsfMRI) and structural images. For the rsfMRI images, we extracted the characteristics at three different levels: ALFF (amplitude of low-frequency fluctuations), ReHo (regional homogeneity) and RFCS (regional functional connectivity strength). For the structural images, we extracted the volume characteristics from the gray matter (GM), the white matter (WM) and the cerebrospinal fluid (CSF). A two-sample t-test was used for the feature selection, and then the remaining features were fused for classification. Finally a classifier for early PD patients and normal control subjects was identified from support vector machine training. The performance of the classifier was evaluated using the leave-one-out cross-validation method.

Results

Using the proposed methods to classify the data set, good results (accuracy  = 86.96%, sensitivity  = 78.95%, specificity  = 92.59%) were obtained.

Conclusions

This method demonstrates a promising diagnosis performance by the integration of information from a variety of imaging modalities, and it shows potential for improving the clinical diagnosis and treatment of PD.