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Brisson RT, Fernandes RDCL, Arruda JFDL, Rocha TCCDSM, Santos NDGD, Silva LD, de Lima MASD, de Rosso ALZ. Altered Cerebral Vasoreactivity on Transcranial Color-Coded Sonography Related to Akinetic-Rigid Phenotype of Parkinson's Disease: Interim Analysis of a Cross-Sectional Study. Brain Sci 2023; 13:brainsci13050709. [PMID: 37239181 DOI: 10.3390/brainsci13050709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 04/13/2023] [Accepted: 04/19/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND A correlation between worse functional outcomes in Parkinson's disease (PD) patients with cerebrovascular disease (CVD) or the Akinetic-rigid phenotype has been argued in recent studies. We aimed to evaluate the association of cerebral hemodynamics impairments, assessed by Transcranial Color-coded Doppler sonography (TCCS), on PD patients with different phenotypes of the disease and with risk factors for CVD. METHODOLOGY Idiopathic PD patients (n = 51) were divided into motor subtypes: Akinetic-rigid (AR) (n = 27) and Tremor-dominant (TD) (n = 24) and into two groups regarding vascular risk factors: when ≥2 were present (PDvasc) (n = 18) and <2 (PDnvasc) (n = 33). In a parallel analysis, the Fazekas scale on brain magnetic resonance imaging (MRI) was applied to a sample to assess the degree of leukoaraiosis. TCCS examinations were prospectively performed obtaining middle cerebral artery Mean Flow Velocities (Vm), Resistance Index (RI), and Pulsatility Index (PI). The Breath-Holding Index (BHI) was calculated to assess cerebrovascular reactivity (cVR). Standardized functional scales were administered (UPDRS III and Hoehn&Yahr). RESULTS The phenotype groups were similar in age, disease duration and demographic parameters, but there were significantly higher H&Y scores than TD group. cVR was impaired in 66.7% of AR vs. 37.5% of TD. AR group exhibited lower BHI (0.53 ± 0.31 vs. 0.91 ± 0.62; p = 0.000), lower Vm after apnea (44.3 ± 9.0 cm/s vs. 53.4 ± 11.4 cm/s; p = 0.003), higher PI (0.91 ± 0.26 vs. 0.76 ± 0.12; p = 0.000) and RI (0.58 ± 0.11 vs. 0.52 ± 0.06; p = 0.021). PDvasc group showed higher PI (0.98 vs. 0.76; p = 0.001) and higher frequency of altered cVR (72.2% vs. 42.2%; p = 0.004). There was a significant predominance of higher values on Fazekas scale in the PDvasc group. We found no difference between the Fazekas scale when comparing motor subtypes groups but there was a trend toward higher scores in the AR phenotype. CONCLUSIONS TCCS, a cost-effective method, displayed impaired cVR in Parkinsonian patients with risk factors for CVD with higher degree of MRI leukoaraiosis. PD patients with the AR disease phenotype also presented impaired cVR on TCCS and greater functional impairment, although with just a trend to higher scores on MRI Fazekas.
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Affiliation(s)
- Rodrigo Tavares Brisson
- Department of Neurology, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-617, Brazil
| | - Rita de Cássia Leite Fernandes
- Department of Neurology, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-617, Brazil
| | - Josevânia Fulgêncio de Lima Arruda
- Department of Neurology, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-617, Brazil
| | | | - Nathália de Góes Duarte Santos
- Department of Neurology, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-617, Brazil
| | - Liene Duarte Silva
- Department of Neurology, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-617, Brazil
| | - Marco Antônio Sales Dantas de Lima
- Department of Neurology, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-617, Brazil
| | - Ana Lucia Zuma de Rosso
- Department of Neurology, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-617, Brazil
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Fatokun I, Gee M, Nelles K, Ba F, Dadar M, Duchesne S, Sharma B, Masellis M, Black SE, Almeida QJ, Smith EE, Pieruccini-Faria F, Montero-Odasso M, Camicioli R. Dual-task gait and white matter hyperintensities in Lewy body diseases: An exploratory analysis. Front Aging Neurosci 2023; 15:1088050. [PMID: 37091522 PMCID: PMC10113527 DOI: 10.3389/fnagi.2023.1088050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 03/13/2023] [Indexed: 04/08/2023] Open
Abstract
BackgroundParkinson’s disease (PD) and dementia with Lewy bodies (DLB) are part of a spectrum of Lewy body disorders, who exhibit a range of cognitive and gait impairments. Cognitive-motor interactions can be examined by performing a cognitive task while walking and quantified by a dual task cost (DTC). White matter hyperintensities (WMH) on magnetic resonance imaging have also been associated with both gait and cognition. Our goal was to examine the relationship between DTC and WMH in the Lewy body spectrum, hypothesizing DTC would be associated with increased WMH volume.MethodsSeventy-eight participants with PD, PD with mild cognitive impairment (PD-MCI), PD with dementia or DLB (PDD/DLB), and 20 cognitively unimpaired participants were examined in a multi-site study. Gait was measured on an electronic walkway during usual gait, counting backward, animal fluency, and subtracting sevens. WMH were quantified from magnetic resonance imaging using an automated pipeline and visual rating. A median split based on DTC was performed. Models included age as well as measures of global cognition and cardiovascular risk.ResultsCompared to cognitively unimpaired participants, usual gait speed was lower and DTC was higher in PD-MCI and PDD/DLB. Low DTC participants had higher usual gait speed. WMH burden was greater in high counting DTC participants. Frontal WMH burden remained significant after adjusting for age, cardiovascular risk and global cognition.ConclusionIncreased DTC was associated with higher frontal WMH burden in Lewy body disorders after adjusting for age, cardiovascular risk, and global cognition. Higher DTC was associated with age.
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Affiliation(s)
- Ipinuoluwakiye Fatokun
- Department of Medicine, Division of Neurology, University of Alberta, Edmonton, AB, Canada
| | - Myrlene Gee
- Department of Medicine, Division of Neurology, University of Alberta, Edmonton, AB, Canada
| | - Krista Nelles
- Department of Medicine, Division of Neurology, University of Alberta, Edmonton, AB, Canada
| | - Fang Ba
- Department of Medicine, Division of Neurology, University of Alberta, Edmonton, AB, Canada
- Neuroscience and Mental Health Institute (NMHI), University of Alberta, Edmonton, AB, Canada
| | - Mahsa Dadar
- Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montréal, QC, Canada
| | - Simon Duchesne
- Department of Radiology and Nuclear Medicine, Faculty of Medicine, Laval University, Québec City, QC, Canada
- CERVO Brain Research Centre, Québec City, QC, Canada
| | - Breni Sharma
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Mario Masellis
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Sandra E. Black
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Quincy J. Almeida
- Movement Disorders Research and Rehabilitation Consortium, Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Eric E. Smith
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
- Seaman Family MR Research Centre, University of Calgary, Calgary, AB, Canada
| | - Frederico Pieruccini-Faria
- Gait and Brain Lab, Parkwood Institute Research and Lawson Health Research Institute, London, ON, Canada
- Division of Geriatric Medicine, Department of Medicine, Schulich School of Medicine and Dentistry, London, ON, Canada
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Manuel Montero-Odasso
- Gait and Brain Lab, Parkwood Institute Research and Lawson Health Research Institute, London, ON, Canada
- Division of Geriatric Medicine, Department of Medicine, Schulich School of Medicine and Dentistry, London, ON, Canada
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Richard Camicioli
- Department of Medicine, Division of Neurology, University of Alberta, Edmonton, AB, Canada
- Neuroscience and Mental Health Institute (NMHI), University of Alberta, Edmonton, AB, Canada
- *Correspondence: Richard Camicioli,
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Magnante AT, Ord AS, Holland JA, Sautter SW. Neurocognitive functioning of patients with early-stage Parkinson's disease. APPLIED NEUROPSYCHOLOGY. ADULT 2022:1-12. [PMID: 35931087 DOI: 10.1080/23279095.2022.2106865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Parkinson's disease (PD) is a neurological disorder commonly associated with motor deficits. However, cognitive impairment is also common in patients with PD. Cognitive concerns in PD may affect multiple domains of neurocognition and vary across different stages of the disease. Extant research has focused mainly on cognitive deficits in middle to late stages of PD, whereas few studies have examined the unique cognitive profiles of patients with early-stage PD. This study addressed this gap in the published literature and examined neurocognitive functioning and functional capacity of patients with de novo PD, focusing on the unique pattern of cognitive deficits specific to the early stage of the disease. Results indicated that the pattern of cognitive deficits in patients with PD (n = 55; mean age = 72.93) was significantly different from healthy controls (n = 59; mean age = 71.88). Specifically, tasks related to executive functioning, attention, and verbal memory demonstrated the most pronounced deficits in patients with early-stage PD. Clinical implications of these findings are discussed.
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Affiliation(s)
- Anna Theresa Magnante
- College of Health and Behavioral Sciences, Regent University, Virginia Beach, VA, USA
| | - Anna Shirokova Ord
- College of Health and Behavioral Sciences, Regent University, Virginia Beach, VA, USA
| | - Jamie A Holland
- College of Health and Behavioral Sciences, Regent University, Virginia Beach, VA, USA
| | - Scott W Sautter
- College of Health and Behavioral Sciences, Regent University, Virginia Beach, VA, USA
- Hampton Roads Neuropsychology Inc., Virginia Beach, VA, USA
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Kim H, Fraser S. Neural correlates of dual-task walking in people with central neurological disorders: a systematic review. J Neurol 2022; 269:2378-2402. [PMID: 34989867 DOI: 10.1007/s00415-021-10944-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND People with central neurological disorders experience difficulties with dual-task walking due to disease-related impairments. The objective of this review was to provide a comprehensive examination of the neural correlates (structural/functional brain changes) of dual-task walking in people with Parkinson's disease (PD), multiple sclerosis (MS), stroke, and Alzheimer's disease (AD). METHODS A systematic review of the literature was conducted, following PRISMA guidelines, on Medline, Embase, and Scopus. Included studies examined the relationship between structural and functional brain imaging and dual-task walking performance in people with PD, MS, stroke, and AD. Articles that met the inclusion criteria had baseline characteristics, study design, and behavioral and brain outcomes extracted. Twenty-three studies were included in this review. RESULTS Most structural imaging studies (75%) found an association between decreased brain integrity and poor dual-task performance. Specific brain regions that showed this association include the striatum regions and hippocampus in PD and supplementary motor area in MS. Functional imaging studies reported an association between increased prefrontal activity and maintained (compensatory recruitment) or decreased dual-task walking performance in PD and stroke. A subset (n = 2) of the stroke papers found no significant correlations. Increased supplementary motor area activity was associated with decreased performance in MS and stroke. No studies on AD were identified. CONCLUSION In people with PD, MS, and stroke, several neural correlates of dual-task walking have been identified, however, the direction of the association between neural and performance outcomes varied across the studies. The type of cognitive task used and presentation modality (e.g., visual) may have contributed to these mixed findings.
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Affiliation(s)
- Hyejun Kim
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, 125 University Private, Ottawa, ON, K1N 6N5, Canada
| | - Sarah Fraser
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, 25 University Private, Ottawa, ON, K1N 7K4, Canada.
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Butt A, Kamtchum-Tatuene J, Khan K, Shuaib A, Jickling GC, Miyasaki JM, Smith EE, Camicioli R. White matter hyperintensities in patients with Parkinson's disease: A systematic review and meta-analysis. J Neurol Sci 2021; 426:117481. [PMID: 33975191 DOI: 10.1016/j.jns.2021.117481] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 04/25/2021] [Accepted: 05/02/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Mechanisms driving neurodegeneration in Parkinson's disease (PD) are unclear and neurovascular dysfunction may be a contributing factor. White matter hyperintensities (WMH) are commonly found on brain MRI in patients with PD. It is controversial if they are more prevalent or more severe in PD compared with controls. This systematic review aims to answer this question. METHODS A systematic search of electronic databases was conducted for studies of WMH in patients with PD. A qualitative synthesis was done for studies reporting WMH prevalence or WMH scores on a visual rating scale (VRS). In studies reporting total WMH volume, the difference between patients with PD and controls was pooled using random effects meta-analysis. RESULTS Among 3860 subjects from 24 studies, 2360 were cases and 1500 controls. Fifteen studies reported WMH scores and four studies reported the prevalence of WMH. On VRS, five studies reported no difference in WMH scores, three found higher WMH scores in PD compared to controls, three reported increased WMH scores either in periventricular or deep white matter, and four reported higher scores only in PD with dementia. In studies reporting WMH volume, there was no difference between patients with PD and controls (pooled standardized mean difference = 0.1, 95%CI: -0.1-0.4, I2 = 81%). CONCLUSION WMH are not more prevalent or severe in patients with PD than in age-matched controls. PD dementia may have more severe WMH compared to controls and PD with normal cognition. Prospective studies using standardized methods of WMH assessment are needed.
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Affiliation(s)
- Asif Butt
- Department of Medicine, Division of Neurology, University of Alberta, 116 St & 85 Ave, Edmonton, AB T6G 2R3, Canada.
| | - Joseph Kamtchum-Tatuene
- Neuroscience and Mental Health Institute, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Khurshid Khan
- Department of Medicine, Division of Neurology, University of Alberta, 116 St & 85 Ave, Edmonton, AB T6G 2R3, Canada
| | - Ashfaq Shuaib
- Department of Medicine, Division of Neurology, University of Alberta, 116 St & 85 Ave, Edmonton, AB T6G 2R3, Canada
| | - Glen C Jickling
- Department of Medicine, Division of Neurology, University of Alberta, 116 St & 85 Ave, Edmonton, AB T6G 2R3, Canada
| | - Janis M Miyasaki
- Department of Medicine, Division of Neurology, University of Alberta, 116 St & 85 Ave, Edmonton, AB T6G 2R3, Canada
| | - Eric E Smith
- Department of Clinical Neurosciences and Hotchkiss Brain Institute, University of Calgary, 2500 University Dr NW, Calgary, AB T2N 1N4, Canada
| | - Richard Camicioli
- Department of Medicine, Division of Neurology, University of Alberta, 116 St & 85 Ave, Edmonton, AB T6G 2R3, Canada
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Rane S, Owen J, Hippe DS, Cholerton B, Zabetian CP, Montine T, Grabowski TJ. White Matter Lesions in Mild Cognitive Impairment and Idiopathic Parkinson's Disease: Multimodal Advanced MRI and Cognitive Associations. J Neuroimaging 2020; 30:843-850. [PMID: 32937003 DOI: 10.1111/jon.12778] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 08/13/2020] [Indexed: 01/08/2023] Open
Abstract
Cerebrovascular disease is a common comorbidity in older adults, typically assessed in terms of white matter hyperintensities (WMHs) on MRI. While it is well known that WMHs exacerbate cognitive symptoms, the exact relation of WMHs with cognitive performance and other degenerative diseases is unknown. Furthermore, based on location, WMHs are often classified into periventricular and deep WMHs and are believed to have different pathological origins. Whether the two types of WMHs influence cognition differently is unclear. Using regression models, we assessed the independent association of these two types of WMHs with cognitive performance in two separate studies focused on distinct degenerative diseases, early Alzheimer's (mild cognitive impairment), and Parkinson's disease. We further tested if the two types of WMHs were differentially associated with reduced cortical cerebral blood flow (CBF) as measured by arterial spin labeling and increased mean diffusivity (MD, a marker of tissue injury) as measured by diffusion imaging. Our approach revealed that both deep and periventricular WMHs were associated with poor performance on tests of global cognition (Montreal cognitive Assessment, MoCA), task processing (Trail making test), and category fluency in the study of mild cognitive impairment. They were associated with poor performance in global cognition (MoCA) and category fluency in the Parkinson's disease study. Of note, more associations were detected between cognitive performance and deep WMHs than between cognitive performance and periventricular WMHs. Mechanistically, both deep and periventricular WMHs were associated with increased MD. Both deep and periventricular WMHs were also associated with reduced CBF in the gray matter.
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Affiliation(s)
- Swati Rane
- Department of Radiology, Integrated Brain Imaging Center, University of Washington Medical Center, Seattle, WA
| | - Julia Owen
- Department of Radiology, Integrated Brain Imaging Center, University of Washington Medical Center, Seattle, WA
| | - Daniel S Hippe
- Department of Radiology, Integrated Brain Imaging Center, University of Washington Medical Center, Seattle, WA
| | | | - Cyrus P Zabetian
- Veterans Affairs Puget Sound Health Care System, Seattle, WA.,Department of Neurology, University of Washington Medical Center, Seattle, WA
| | - Tom Montine
- Department of Pathology, Stanford University, Stanford, CA
| | - Thomas J Grabowski
- Department of Radiology, Integrated Brain Imaging Center, University of Washington Medical Center, Seattle, WA.,Department of Neurology, University of Washington Medical Center, Seattle, WA
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Age- and disease-related cerebral white matter changes in patients with Parkinson's disease. Neurobiol Aging 2019; 80:203-209. [DOI: 10.1016/j.neurobiolaging.2019.05.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 04/26/2019] [Accepted: 05/06/2019] [Indexed: 11/18/2022]
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Wagshul ME, Lucas M, Ye K, Izzetoglu M, Holtzer R. Multi-modal neuroimaging of dual-task walking: Structural MRI and fNIRS analysis reveals prefrontal grey matter volume moderation of brain activation in older adults. Neuroimage 2019; 189:745-754. [PMID: 30710680 DOI: 10.1016/j.neuroimage.2019.01.045] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 01/17/2019] [Accepted: 01/21/2019] [Indexed: 11/28/2022] Open
Abstract
It has been well established over the last two decades that walking is not merely an automatic, motoric activity; it also utilizes executive function circuits, which play an increasingly important role in walking for older people and those with mobility and cognitive deficits. Dual-task walking, such as walking while performing a cognitive task, is a necessary skill for everyday functioning, and has been shown to activate prefrontal lobe areas in healthy older people. Another well-established point in healthy aging is the loss of grey matter, and in particular loss of frontal lobe grey matter volume. However, the relationship between increased frontal lobe activity during dual-task walking and loss of frontal grey matter in healthy aging remains unknown. In the current study, we combined oxygenated hemoglobin (HbO2) data from functional near-infrared spectroscopy (fNIRS), taken during dual-task walking, with structural MRI volumetrics in a cohort of healthy older subjects to identify this relationship. We studied fifty-five relatively healthy, older participants (≥65 years) during two separate sessions: fNIRS to measure HbO2 changes between single-task (i.e., normal walking) and dual-task walking-while-talking, and high-resolution, structural MRI to measure frontal lobe grey matter volumes. Linear mixed effects modeling was utilized to determine the moderation effect of grey matter volume on the change in prefrontal oxygenated hemoglobin between the two walking tasks, while controlling for covariates including task performance. We found a highly significant interaction effect between frontal grey matter volume and task on HbO2 levels (p < 0.0001). Specifically, increased HbO2 levels during dual-task compared to single-task walking were associated with reduced frontal grey matter volume. Regional analysis identified bilateral superior and rostral middle gyri as the primary areas driving these results. The findings provide support for the concept of neural inefficiency: in the absence of behavioral gains, grey matter loss in relatively healthy, older individuals leads to over-activation of frontal lobe during a cognitively demanding walking task with established clinical and predictive utility.
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Affiliation(s)
- Mark E Wagshul
- Department of Radiology, Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine, Bronx, NY, USA; Physiology and Biophysics, Albert Einstein College of Medicine, Bronx, NY, USA.
| | - Melanie Lucas
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
| | - Kenny Ye
- Department of Epidemiology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Meltem Izzetoglu
- Villanova University, Electrical and Computer Engineering, Villanova, PA, USA
| | - Roee Holtzer
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA; Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
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Allali G, Blumen HM, Devanne H, Pirondini E, Delval A, Van De Ville D. Brain imaging of locomotion in neurological conditions. Neurophysiol Clin 2018; 48:337-359. [PMID: 30487063 PMCID: PMC6563601 DOI: 10.1016/j.neucli.2018.10.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 10/05/2018] [Accepted: 10/09/2018] [Indexed: 01/20/2023] Open
Abstract
Impaired locomotion is a frequent and major source of disability in patients with neurological conditions. Different neuroimaging methods have been used to understand the brain substrates of locomotion in various neurological diseases (mainly in Parkinson's disease) during actual walking, and while resting (using mental imagery of gait, or brain-behavior correlation analyses). These studies, using structural (i.e., MRI) or functional (i.e., functional MRI or functional near infra-red spectroscopy) brain imaging, electrophysiology (i.e., EEG), non-invasive brain stimulation (i.e., transcranial magnetic stimulation, or transcranial direct current stimulation) or molecular imaging methods (i.e., PET, or SPECT) reveal extended brain networks involving both grey and white matters in key cortical (i.e., prefrontal cortex) and subcortical (basal ganglia and cerebellum) regions associated with locomotion. However, the specific roles of the various pathophysiological mechanisms encountered in each neurological condition on the phenotype of gait disorders still remains unclear. After reviewing the results of individual brain imaging techniques across the common neurological conditions, such as Parkinson's disease, dementia, stroke, or multiple sclerosis, we will discuss how the development of new imaging techniques and computational analyses that integrate multivariate correlations in "large enough datasets" might help to understand how individual pathophysiological mechanisms express clinically as an abnormal gait. Finally, we will explore how these new analytic methods could drive our rehabilitative strategies.
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Affiliation(s)
- Gilles Allali
- Department of Clinical Neurosciences, Division of Neurology, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland; Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY, USA.
| | - Helena M Blumen
- Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY, USA; Department of Medicine, Division of Geriatrics, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY, USA
| | - Hervé Devanne
- Department of Clinical Neurophysiology, Lille University Medical Center, Lille, France; EA 7369, URePSSS, Unité de Recherche Pluridisciplinaire Sport Santé Société, Université du Littoral Côte d'Opale, Calais, France
| | - Elvira Pirondini
- Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland; Institute of Bioengineering, Center for Neuroprosthetics, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Arnaud Delval
- Department of Clinical Neurophysiology, Lille University Medical Center, Lille, France; Unité Inserm 1171, Faculté de Médecine, Université de Lille, Lille, France
| | - Dimitri Van De Ville
- Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland; Institute of Bioengineering, Center for Neuroprosthetics, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
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10
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[Validation of the Geriatric Check in a cohort of hospitalized neurological patients]. Z Gerontol Geriatr 2018; 52:172-178. [PMID: 30206742 DOI: 10.1007/s00391-018-1441-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Revised: 07/18/2018] [Accepted: 08/22/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND The Geriatrie-Check was developed as a screening tool for the identification of older patients with geriatric treatment requirements in hospitals. It was recommended by the Baden-Wuerttemberg Hospitals Association for routine use in hospitals in 2014 although no published validation studies are available. The test takes 3-5 min. AIM Validation of the Geriatrie-Check in a prospective cohort of hospitalized neurological patients with and without geriatric characteristics. METHODS In this prospective cross-sectional observational study at the University Hospital Tübingen, Germany the Geriatrie-Check was compared with a comprehensive geriatric assessment in 107 neurological inpatients aged 70 years and older (41% women, mean age 76.7 years). RESULTS The Geriatrie-Check classified 61 patients (57%) as geriatric patients. These patients with a positive result in the Geriatrie-Check had a higher percentage of frailty (according to Fried et al.), higher values in the Gérontopôle frailty screening tool, higher values in the geriatric screening according to Lachs et el., slower gait speed, lower grip force, needed longer for the timed up-and-go test, had a greater fear of falling in the Falls Efficacy Scale - International, lower scores in the Mini Mental State Examination, needed more time to perform the Trail Making Test A and B, had higher values in the Beck's Depressions Inventar II and lower values in the visual analogue scale of the EQ-5D. A higher percentage of patients took more than five different drugs. INTERPRETATION AND CONCLUSION The Geriatrie-Check has been shown to be a useful and valid tool for the identification of geriatric inpatients in neurological wards due to the good agreement with the results of the geriatric assessment.
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Ciliz M, Sartor J, Lindig T, Pilotto A, Schäffer E, Weiss M, Scheltens P, Becker S, Hobert MA, Berg D, Liepelt-Scarfone I, Maetzler W. Brain-Area Specific White Matter Hyperintensities: Associations to Falls in Parkinson’s Disease. JOURNAL OF PARKINSONS DISEASE 2018; 8:455-462. [DOI: 10.3233/jpd-181351] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Meltem Ciliz
- Department of Neurodegeneration, Center for Neurology and Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
- DZNE, German Center for Neurodegenerative Diseases, Tuebingen, Germany
| | - Jennifer Sartor
- Department of Neurodegeneration, Center for Neurology and Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
- DZNE, German Center for Neurodegenerative Diseases, Tuebingen, Germany
| | - Tobias Lindig
- Department of Diagnostic and Interventional Neuroradiology, University of Tuebingen, Tuebingen, Germany
| | - Andrea Pilotto
- Department of Neurodegeneration, Center for Neurology and Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
- DZNE, German Center for Neurodegenerative Diseases, Tuebingen, Germany
| | - Eva Schäffer
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Michael Weiss
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Philip Scheltens
- Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Sara Becker
- Department of Neurodegeneration, Center for Neurology and Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
- DZNE, German Center for Neurodegenerative Diseases, Tuebingen, Germany
| | - Markus A. Hobert
- Department of Neurodegeneration, Center for Neurology and Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
- DZNE, German Center for Neurodegenerative Diseases, Tuebingen, Germany
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Daniela Berg
- Department of Neurodegeneration, Center for Neurology and Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
- DZNE, German Center for Neurodegenerative Diseases, Tuebingen, Germany
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Inga Liepelt-Scarfone
- Department of Neurodegeneration, Center for Neurology and Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
- DZNE, German Center for Neurodegenerative Diseases, Tuebingen, Germany
| | - Walter Maetzler
- Department of Neurodegeneration, Center for Neurology and Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
- DZNE, German Center for Neurodegenerative Diseases, Tuebingen, Germany
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
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