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Wu J, Jin H, Shao Y, Mao C, Chen J, Liu C. Cognition and transcranial sonography in Parkinson's disease patients with or without orthostatic hypotension. Brain Behav 2021; 11:e2252. [PMID: 34291604 PMCID: PMC8413744 DOI: 10.1002/brb3.2252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 04/26/2021] [Accepted: 06/01/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Orthostatic hypotension (OH) is a common nonmotor symptom in patients with Parkinson's disease (PD), with an incidence ranging from 14% to 54%. AIMS This study explored changes in cognition and transcranial sonography (TCS) findings in patients with PD and OH. METHODS We enrolled PD patients who visited the outpatient or inpatient department from 2017 to 2020. Blood pressure was measured in different positions, and demographic data were collected. Motor and nonmotor symptoms were evaluated using standard scales. A subset of 107 patients underwent TCS. RESULTS We enrolled 66 PD-OH patients and 92 PD-no orthostatic hypotension (NOH) patients. There were no significant differences in gender, age, disease duration, or Hoehn and Yahr stage between groups. Binary logistic regression revealed age as an independent risk factor for OH in PD patients. There were statistically significant group differences in visuospatial and executive function and Unified Parkinson's Disease Rating Scale (UPDRS) I and II scores (p < .05). Among PD-OH patients, there was a statistically significant difference in UPDRS II and III scores between patients with or without clinical symptoms (p < .05). The substantia nigra (SN) area was significantly larger in PD-NOH patients (0.45 ± 0.18 cm2 ) than PD-OH patients (0.34 ± 0.16 cm2 ) (p < .05). CONCLUSIONS PD-OH patients had poorer visuospatial and executive function and lower UPDRS I and II scores compared with PD-NOH patients. Within the PD-OH group, there was no significant difference in cognition between patients with or without clinical symptoms. The difference in the SN area may indicate different subtypes of PD or a tendency to develop parkinsonism syndrome.
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Affiliation(s)
- Jia‐jing Wu
- Department of NeurologyThe Second Affiliated Hospital of Soochow UniversitySuzhouChina
| | - Hong Jin
- Department of NeurologyThe Second Affiliated Hospital of Soochow UniversitySuzhouChina
| | - Ying‐qi Shao
- Department of NeurologyThe Second Affiliated Hospital of Soochow UniversitySuzhouChina
| | - Cheng‐jie Mao
- Department of NeurologyThe Second Affiliated Hospital of Soochow UniversitySuzhouChina
| | - Jing Chen
- Department of NeurologyThe Second Affiliated Hospital of Soochow UniversitySuzhouChina
- Department of NeurologySuqian First HospitalSuqianChina
| | - Chun‐feng Liu
- Department of NeurologyThe Second Affiliated Hospital of Soochow UniversitySuzhouChina
- Department of NeurologySuqian First HospitalSuqianChina
- Jiangsu Key Laboratory of Neuropsychiatric Diseases and Institute of NeuroscienceSoochow UniversitySuzhouChina
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Crespo-Cuevas AM, López-Cancio E, Cáceres C, González A, Ispierto L, Hernández-Pérez M, Mataró M, Planas A, Canento T, Martín L, Arenillas JF, Alvarez R, Vilas D. Third Ventricle Width Assessed by Transcranial Sonography as Predictor of Long-Term Cognitive Impairment. J Alzheimers Dis 2020; 73:741-749. [DOI: 10.3233/jad-190949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Ane Miren Crespo-Cuevas
- Department of Neurosciences, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Elena López-Cancio
- Department of Neurosciences, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
- Department of Neurology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Cynthia Cáceres
- Department of Neurosciences, Neuropsychology Unit, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Anna González
- Department of Neurosciences, Neuropsychology Unit, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Lourdes Ispierto
- Department of Neurosciences, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - María Hernández-Pérez
- Department of Neurosciences, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - María Mataró
- Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain
- Institut de Neurociències, University of Barcelona, Barcelona, Spain
- Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Anna Planas
- Department of Neurosciences, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Tamara Canento
- Department of Neurosciences, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Lorena Martín
- Department of Neurosciences, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | | | - Ramiro Alvarez
- Department of Neurosciences, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Dolores Vilas
- Department of Neurosciences, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
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Mancuso L, Costa T, Nani A, Manuello J, Liloia D, Gelmini G, Panero M, Duca S, Cauda F. The homotopic connectivity of the functional brain: a meta-analytic approach. Sci Rep 2019; 9:3346. [PMID: 30833662 PMCID: PMC6399443 DOI: 10.1038/s41598-019-40188-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 02/05/2019] [Indexed: 01/21/2023] Open
Abstract
Homotopic connectivity (HC) is the connectivity between mirror areas of the brain hemispheres. It can exhibit a marked and functionally relevant spatial variability, and can be perturbed by several pathological conditions. The voxel-mirrored homotopic connectivity (VMHC) is a technique devised to enquire this pattern of brain organization, based on resting state functional connectivity. Since functional connectivity can be revealed also in a meta-analytical fashion using co-activations, here we propose to calculate the meta-analytic homotopic connectivity (MHC) as the meta-analytic counterpart of the VMHC. The comparison between the two techniques reveals their general similarity, but also highlights regional differences associated with how HC varies from task to rest. Two main differences were found from rest to task: (i) regions known to be characterized by global hubness are more similar than regions displaying local hubness; and (ii) medial areas are characterized by a higher degree of homotopic connectivity, while lateral areas appear to decrease their degree of homotopic connectivity during task performance. These findings show that MHC can be an insightful tool to study how the hemispheres functionally interact during task and rest conditions.
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Affiliation(s)
- Lorenzo Mancuso
- Focus Lab, Department of Psychology, University of Turin, Turin, Italy
| | - Tommaso Costa
- GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy.
- Focus Lab, Department of Psychology, University of Turin, Turin, Italy.
| | - Andrea Nani
- GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy
- Focus Lab, Department of Psychology, University of Turin, Turin, Italy
| | - Jordi Manuello
- GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy
- Focus Lab, Department of Psychology, University of Turin, Turin, Italy
| | - Donato Liloia
- GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy
- Focus Lab, Department of Psychology, University of Turin, Turin, Italy
| | - Gabriele Gelmini
- Focus Lab, Department of Psychology, University of Turin, Turin, Italy
| | - Melissa Panero
- Focus Lab, Department of Psychology, University of Turin, Turin, Italy
| | - Sergio Duca
- GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy
| | - Franco Cauda
- GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy
- Focus Lab, Department of Psychology, University of Turin, Turin, Italy
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Heldmann M, Heeren J, Klein C, Rauch L, Hagenah J, Münte TF, Kasten M, Brüggemann N. Neuroimaging abnormalities in individuals exhibiting Parkinson's disease risk markers. Mov Disord 2018; 33:1412-1422. [PMID: 29756356 DOI: 10.1002/mds.27313] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 12/23/2017] [Accepted: 12/31/2017] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The concept of prodromal Parkinson's disease (PD) involves variable combinations of nonmotor features and subtle motor abnormalities as a result of ongoing neurodegeneration in the brain stem including substantia nigra (SN) and abnormal findings upon transcranial sonography and nuclear imaging. Except for nuclear imaging, the predictive value of risk markers for the conversion to overt PD is low. OBJECTIVE The objective of this study was to determine whether PD risk markers are associated with changes in brain structure and to what extent cognitive changes are risk markers for PD. METHODS Diffusion-weighted imaging, voxel-based morphometry, and cortical thickness analysis was performed in 29 individuals with hyposmia and/or an increased SN hyperechogenicity (SN+) upon transcranial sonography and 28 controls without these 2 risk markers. Classical parkinsonian signs were an exclusion criterion. All of the participants underwent a neuropsychological test battery addressing executive functions, learning ability, and verbal fluency. RESULTS In the PD risk group, diffusion-weighted imaging mean diffusivity was increased in 4 left hemisphere clusters (posterior thalamus, inferior longitudinal fasciculus, fornix, corticospinal tract). A negative relationship of mean diffusivity and smell function was present for the posterior thalamus and the corticospinal tract. There was a significant correlation of mean diffusivity values and SN+ in all clusters. Neither voxel-based morphometry nor cortical thickness analysis revealed any group differences. No relevant group differences were observed for cognitive tests included. CONCLUSION PD-free individuals with PD risk markers show microstructural changes of the white matter, including areas relevant for motor and limbic processes. In addition, our study provides for the first time a neuroanatomical correlate for SN hyperechogenicity. © 2018 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Marcus Heldmann
- Department of Neurology, University of Lübeck, Lübeck, Germany
| | - Janna Heeren
- Department of Neurology, University of Lübeck, Lübeck, Germany.,Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Christine Klein
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Linus Rauch
- Department of Neurology, University of Lübeck, Lübeck, Germany.,Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Johann Hagenah
- Department of Neurology, Westküstenklinikum Heide, Heide, Germany
| | - Thomas F Münte
- Department of Neurology, University of Lübeck, Lübeck, Germany
| | - Meike Kasten
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany.,Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Norbert Brüggemann
- Department of Neurology, University of Lübeck, Lübeck, Germany.,Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
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Miskowiak KW, Burdick KE, Martinez‐Aran A, Bonnin CM, Bowie CR, Carvalho AF, Gallagher P, Lafer B, López‐Jaramillo C, Sumiyoshi T, McIntyre RS, Schaffer A, Porter RJ, Torres IJ, Yatham LN, Young AH, Kessing LV, Vieta E. Methodological recommendations for cognition trials in bipolar disorder by the International Society for Bipolar Disorders Targeting Cognition Task Force. Bipolar Disord 2017; 19:614-626. [PMID: 28895274 PMCID: PMC6282834 DOI: 10.1111/bdi.12534] [Citation(s) in RCA: 140] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 07/20/2017] [Indexed: 12/18/2022]
Abstract
OBJECTIVES To aid the development of treatment for cognitive impairment in bipolar disorder, the International Society for Bipolar Disorders (ISBD) convened a task force to create a consensus-based guidance paper for the methodology and design of cognition trials in bipolar disorder. METHODS The task force was launched in September 2016, consisting of 18 international experts from nine countries. A series of methodological issues were identified based on literature review and expert opinion. The issues were discussed and expanded upon in an initial face-to-face meeting, telephone conference call and email exchanges. Based upon these exchanges, recommendations were achieved. RESULTS Key methodological challenges are: lack of consensus on how to screen for entry into cognitive treatment trials, define cognitive impairment, track efficacy, assess functional implications, and manage mood symptoms and concomitant medication. Task force recommendations are to: (i) enrich trials with objectively measured cognitively impaired patients; (ii) generally select a broad cognitive composite score as the primary outcome and a functional measure as a key secondary outcome; and (iii) include remitted or partly remitted patients. It is strongly encouraged that trials exclude patients with current substance or alcohol use disorders, neurological disease or unstable medical illness, and keep non-study medications stable. Additional methodological considerations include neuroimaging assessments, targeting of treatments to illness stage and using a multimodal approach. CONCLUSIONS This ISBD task force guidance paper provides the first consensus-based recommendations for cognition trials in bipolar disorder. Adherence to these recommendations will likely improve the sensitivity in detecting treatment efficacy in future trials and increase comparability between studies.
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Affiliation(s)
- KW Miskowiak
- Copenhagen Affective Disorder Research CentrePsychiatric Centre CopenhagenCopenhagen University HospitalRigshospitaletCopenhagenDenmark
- Department of PsychologyUniversity of CopenhagenCopenhagenDenmark
| | - KE Burdick
- Department of PsychiatryBrigham and Women's HospitalHarvard Medical SchoolBostonMAUSA
| | - A Martinez‐Aran
- Clinical Institute of NeuroscienceHospital ClinicUniversity of BarcelonaIDIBAPSCIBERSAMBarcelonaCataloniaSpain
| | - CM Bonnin
- Clinical Institute of NeuroscienceHospital ClinicUniversity of BarcelonaIDIBAPSCIBERSAMBarcelonaCataloniaSpain
| | - CR Bowie
- Department of PsychologyQueen's UniversityKingstonCanada
| | - AF Carvalho
- Department of Clinical MedicineFederal University of CearáFortalezaBrazil
| | - P Gallagher
- Institute of NeuroscienceNewcastle UniversityNewcastle upon TyneUK
| | - B Lafer
- Bipolar Disorder Research ProgramInstitute of PsychiatryUniversity of São Paulo Medical SchoolSão PauloBrazil
| | - C López‐Jaramillo
- Research Group in PsychiatryDepartment of PsychiatryUniversidad de AntioquiaMedellínColombia
| | - T Sumiyoshi
- Department of Clinical EpidemiologyNational Center of Neurology and PsychiatryTokyoJapan
| | - RS McIntyre
- Mood Disorders Psychopharmacology Unit, Brain and Cognition Discovery Foundation, University of TorontoTorontoCanada
| | - A Schaffer
- Department of PsychiatryUniversity of TorontoTorontoCanada
| | - RJ Porter
- Department of Psychological MedicineUniversity of OtagoChristchurchNew Zealand
| | - IJ Torres
- Department of PsychiatryUniversity of British ColumbiaVancouverCanada
| | - LN Yatham
- Department of PsychiatryUniversity of British ColumbiaVancouverCanada
| | - AH Young
- Department of Psychological MedicineInstitute of PsychiatryPsychology and NeuroscienceKing's College LondonLondonUK
| | - LV Kessing
- Copenhagen Affective Disorder Research CentrePsychiatric Centre CopenhagenCopenhagen University HospitalRigshospitaletCopenhagenDenmark
| | - E Vieta
- Clinical Institute of NeuroscienceHospital ClinicUniversity of BarcelonaIDIBAPSCIBERSAMBarcelonaCataloniaSpain
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