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Chen C, Zhang D, Chen F, Wu D, Chen W, Qin H, Hu Y. A retrospective study of Parkinson's disease in Southwest China 2021-2024: An age-based approach. Exp Gerontol 2024; 195:112532. [PMID: 39068693 DOI: 10.1016/j.exger.2024.112532] [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: 05/16/2024] [Revised: 07/17/2024] [Accepted: 07/26/2024] [Indexed: 07/30/2024]
Abstract
BACKGROUND Globally, Parkinson's disease (PD) is one of the common neurodegenerative diseases in the elderly with increasing morbidity and disability, and its clinical pathogenesis is not clear. OBJECTIVE To compare the differences in disease severity and blood biomarkers levels and their correlation between patients with early-onset Parkinson's disease (EOPD) and late-onset Parkinson's disease (LOPD). METHODS A total of 342 patients diagnosed with PD were retrospectively collected. PD patients were categorized into EOPD (24 patients) and LOPD (318 patients) according to the age of onset of the disease. The Hoehn-Yahr (HY) staging was used to assess the severity of the disease in PD patients. Subjective rating scales such as the Mini-mental State Examination (MMSE) were used to assess the motor and non-motor functions of the patients. The differences of objective blood biomarkers such as triglyceride (TG) between the two groups were investigated. The correlation between them and PD was explored by logistic analysis. RESULTS Percentage of EOPD group with HY staged as intermediate to late and Scales for Outcomes in Parkinson's Disease-Autonomic (SCOPA-AUT), Movement Disorder Society-Unified Parkinson's disease Rating Scale-III (MDS-UPDRS-III), Montreal Cognitive Assessment (MoCA) score and TG, non-high-density lipoprotein-cholesterol (N-HDL-C), homocysteine (HCY), apolipoprotein B (Apo-B), free triiodothyronine (FT3), free thyroxine (FT4), high-sensitivity C-reactive protein (hs-CRP) levels were lower than those in the LOPD group (P < 0.05); and the proportion of HY staged as early stage, Hamilton Anxiety Scale (HAMA) and Fatigue severity scale (FSS) scores and the levels of vitamin B12 were higher than those in the LOPD group (P < 0.05). The results of Multifactorial Logistic regression analysis showed that N-HDL-C [OR = 1.409, 95 % CI (1.063, 1.868)], Apo-B [OR = 0.797, 95 % CI (0.638, 0.997)], Vitamin B12 [OR = 0.992, 95 % CI (0.987, 0.998)] and hs-CRP [OR = 1.124, 95 % CI (1.070, 1.182)] were independent factors affecting the severity of PD, with significant differences between groups (P < 0.05). CONCLUSION N-HDL-C, Apo-B, Vitamin B12, and hs-CRP levels play an important role in the progression of PD.
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Affiliation(s)
- Canrong Chen
- Guangxi University of Chinese Medicine, Nanning, 530200, China
| | - Ding Zhang
- Guangxi University of Chinese Medicine, Nanning, 530200, China
| | - Feiyu Chen
- Yongning District Traditional Chinese Medicine Hospital, Nanning, 530299, China
| | - Donglin Wu
- Guangxi University of Chinese Medicine, Nanning, 530200, China
| | - Wei Chen
- The First Affiliated Hospital of Guangxi University of Chinese Medicine, Guangxi University of Chinese Medicine, Nanning 530023, China
| | - Hongling Qin
- The First Affiliated Hospital of Guangxi University of Chinese Medicine, Guangxi University of Chinese Medicine, Nanning 530023, China
| | - Yueqiang Hu
- The First Affiliated Hospital of Guangxi University of Chinese Medicine, Guangxi University of Chinese Medicine, Nanning 530023, China.
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Jin K, Teng Z, Li J, Qiu Y, Li S, Xu X, Wang L, Chen J, Huang J, Xiang H, Wu H, Tang H. Differences in cognitive impairment and its correlation with circulating cell-free mitochondrial DNA in medication-free depression and bipolar depression patients. J Affect Disord 2024:S0165-0327(24)01653-7. [PMID: 39343310 DOI: 10.1016/j.jad.2024.09.164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 08/25/2024] [Accepted: 09/25/2024] [Indexed: 10/01/2024]
Abstract
OBJECTIVE This study aimed to investigate whether there are differences in cognitive impairment between medication-free patients with bipolar depression (BD) and major depressive disorder (MDD) and whether these differences are related to circulating cell-free mtDNA (ccf-mtDNA). METHODS For this cross-sectional study, 76 outpatients with BD, 86 outpatients with MDD and 70 healthy controls (HCs) were enrolled. Sociodemographic and clinical data were collected. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and the Stroop Color-Word Test were used to assess cognitive function. Plasma ccf-mtDNA levels were measured via qPCR. RESULTS BD and MDD patients had similar scores for immediate memory, language, attention, delayed memory, the RBANS total score, Stroop color, Stroop word, and Stroop total score, which were significantly lower than the HCs. The visuospatial/constructive scores of the BD patients were significantly lower than those of the HCs (p < 0.001) and MDD patients (p = 0.008), but there was no difference between the HCs and MDD patients. The ccf-mtDNA levels in the BD and MDD patient groups were significantly higher than those in the HC group, and those in the MDD group were higher than those in the BD group (p = 0.016). Multiple stepwise regression analysis showed that ccf-mtDNA was negatively correlated with language in patients with depression (t = -2.11, p = 0.039). CONCLUSION There were differences in specific cognitive dimensions between patients with BD and MDD. Increased ccf-mtDNA levels were found in BD and MDD patients, suggesting ccf-mtDNA may be involved in the pathophysiology of MDD and BD.
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Affiliation(s)
- Kun Jin
- Department of Psychiatry, National Clinical Research Center for Mental Disorders and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Ziwei Teng
- Department of Psychiatry, National Clinical Research Center for Mental Disorders and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Jiaxin Li
- Department of Psychiatry, National Clinical Research Center for Mental Disorders and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Yan Qiu
- Xiamen Xianyue Hospital, Xianyue Hospital Affiliated with Xiamen Medical College, Fujian Psychiatric Center, Fujian Clinical Research Center for Mental Disorders, Xiamen 361012, Fujian, China
| | - Sujuan Li
- Department of Psychiatry, National Clinical Research Center for Mental Disorders and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Xuelei Xu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Lu Wang
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China
| | - Jindong Chen
- Department of Psychiatry, National Clinical Research Center for Mental Disorders and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Jing Huang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Hui Xiang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Haishan Wu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Hui Tang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
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Multiscale co-simulation of deep brain stimulation with brain networks in neurodegenerative disorders. BRAIN MULTIPHYSICS 2022. [DOI: 10.1016/j.brain.2022.100058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Yu J, Chen L, Cai G, Wang Y, Chen X, Hong W, Ye Q. Evaluating white matter alterations in Parkinson's disease-related parkin S/N167 mutation carriers using tract-based spatial statistics. Quant Imaging Med Surg 2022; 12:4272-4285. [PMID: 35919057 PMCID: PMC9338378 DOI: 10.21037/qims-21-1007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 05/05/2022] [Indexed: 11/30/2022]
Abstract
Background Genetic susceptibility plays an important role in the pathogenesis of Parkinson’s disease (PD). parkin S/N167 mutations may increase the risk of PD and affect white matter fibers in the brain. This cross-sectional study explored the effects of gene polymorphisms on white matter fiber damage in PD. Methods In all, 54 cases were enrolled in the study, including PD patients carrying parkin gene S/N167 mutations (G/A), PD patients without gene S/N167 mutations (G/G), and healthy controls (HC). The whole-brain white matter fiber skeleton was analyzed using the tract-based spatial statistics (TBSS) method. Two-way analysis of variance (ANOVA) and post hoc tests were used for data analyses. Results Two classification methods were used; one was based on disease classification, with 26 patients in the PD group (n=12 G/G, n=14 G/A) and 28 in the HC group (n=15 G/G, n=13 G/A), and the other was based on genetic classification, with 27 patients in the G/G group and 27 in the G/A group. In the G/A group, there was a wide range of significant changes in fractional anisotropy (FA), radial diffusivity (RD), and mean diffusivity (MD) values (P<0.05). There was also a significant decrease in FA in the PD-G/A group compared with the PD-G/G and HC-G/A groups (P<0.05). Conclusions There were more extensive brain white matter fiber damage and changes in PD patients; the G/A polymorphism may cause more extensive brain white matter damage.
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Affiliation(s)
- Jinqiu Yu
- Department of Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China.,Department of Neurology, Affiliated Sanming First Hospital, Fujian Medical University, Sanming, China.,Institute of Neuroscience, Fujian Key Laboratory of Molecular Neurology, Fuzhou, China.,Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China
| | - Lina Chen
- Department of Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China.,Institute of Neuroscience, Fujian Key Laboratory of Molecular Neurology, Fuzhou, China.,Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China
| | - Guoen Cai
- Department of Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China.,Institute of Neuroscience, Fujian Key Laboratory of Molecular Neurology, Fuzhou, China.,Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China
| | - Yingqing Wang
- Department of Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China.,Institute of Neuroscience, Fujian Key Laboratory of Molecular Neurology, Fuzhou, China.,Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China
| | - Xiaochun Chen
- Department of Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China.,Institute of Neuroscience, Fujian Key Laboratory of Molecular Neurology, Fuzhou, China.,Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China
| | - Weimin Hong
- Department of Neurology, Affiliated Sanming First Hospital, Fujian Medical University, Sanming, China
| | - Qinyong Ye
- Department of Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China.,Institute of Neuroscience, Fujian Key Laboratory of Molecular Neurology, Fuzhou, China.,Institute of Clinical Neurology, Fujian Medical University, Fuzhou, China
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Ji L, Jiang W, Liu D, Hou K. Effect of SIRT1 on white matter neural network in adolescent patients with depression. Front Psychiatry 2022; 13:966315. [PMID: 36177213 PMCID: PMC9513552 DOI: 10.3389/fpsyt.2022.966315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 08/19/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND This study aimed to explore the correlation between the rs12415800 polymorphism of the silent information regulator 1 (SIRT1) gene and the white matter neural circuit in adolescent patients with depression. METHODS We enrolled 119 participants, comprising 59 adolescent patients with depression and 60 matched healthy controls for analysis. Patients were further subdivided based on genotype; GG, AG, and AA, with G representing the wild type gene, and A representing the A allele at rs12415800. RESULTS We found that: (1) lower anisotropy fraction (FA) values in the left cingulate fasciculus and left anterior thalamus radiation in the AG/AA genotype were more likely to be affected by depression. (2) The FA values of the right inferior occipital-frontal fasciculus, right corticospinal tract, right inferior longitudinal fasciculus, and right superior longitudinal fasciculus regions in the depression (AG/AA) group were lower than in the depression (GG) group. (3) FA values of the right inferior occipital-frontal fasciculus left corticospinal tract, right inferior longitudinal fasciculus, left anterior thalamus radiation, right superior longitudinal fasciculus, left inferior longitudinal fasciculus, left uncinate fasciculus, and right anterior thalamus radiation in the depression (GG) group were lower than the control (GG) group. CONCLUSIONS The polymorphism locus of the SIRT1 gene rs12415800 may be related to changes in the microstructure of white matter fiber tracts, and patients carrying the A allele (AG/AA) have more changes in the white matter than those with the non-A allele (GG).
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Affiliation(s)
- Ling Ji
- Department of Clinical Psychology, Southwest Hospital, Army Medical University, Chongqing, China
| | - Wen Jiang
- Outpatient Department, The General Hospital of Western Theater Command, Chengdu, China
| | - Daiyan Liu
- People's Liberation Army of China (PLA) Strategic Support Force Characteristic Medical Center, Beijing, China
| | - Kaiwen Hou
- Outpatient Department, The General Hospital of Western Theater Command, Chengdu, China
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Gu L, Guan X, Gao T, Zhou C, Yang W, Lv D, Wu J, Fang Y, Guo T, Song Z, Xu X, Tian J, Yin X, Zhang M, Zhang B, Pu J, Yan Y. The effect of polygenic risk on white matter microstructural degeneration in Parkinson's disease: A longitudinal Diffusion Tensor Imaging study. Eur J Neurol 2021; 29:1000-1010. [PMID: 34882309 DOI: 10.1111/ene.15201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 11/29/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE This study was undertaken to investigate the effect of genetic risk on whole brain white matter (WM) integrity in patients with Parkinson disease (PD). METHODS Data were acquired from the Parkinson's Progression Markers Initiative (PPMI) database. Polygenic load was estimated by calculating weighted polygenic risk scores (PRS) using (i) all available 26 PD-risk single nucleotide polymorphisms (SNPs) (PRS1) and (ii) 23 SNPs with minor allele frequency (MAF) > 0.05 (PRS2). According to the PRS2, and combined with clinical and diffusion tensor imaging (DTI) data over 3-year follow-up, 60 PD patients were screened and assigned to the low-PRS group (n = 30) and high-PRS group (n = 30) to investigate intergroup differences in clinical profiles and WM microstructure measured by DTI cross-sectionally and longitudinally. RESULTS PRS were associated with younger age at onset in patients with PD (PRS1, Spearman ρ = -0.190, p = 0.003; PRS2, Spearman ρ = -0.189, p = 0.003). The high-PRS group showed more extensive WM microstructural degeneration compared with the low-PRS group, mainly involving the anterior thalamic radiation (AThR) and inferior fronto-occipital fasciculus (IFOF) (p < 0.05). Furthermore, WM microstructural changes in AThR correlated with declining cognitive function (r = -0.401, p = 0.028) and increasing dopaminergic deficits in caudate (r = -0.405, p = 0.030). CONCLUSIONS These findings suggest that PD-associated polygenic load aggravates the WM microstructural degeneration and these changes may lead to poor cognition with continuous dopamine depletion. This study provides advanced evidence that combined with a cumulative PRS and DTI methods may predict disease progression in PD patients.
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Affiliation(s)
- Luyan Gu
- Department of Neurology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Xiaojun Guan
- Department of Radiology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Ting Gao
- Department of Neurology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Cheng Zhou
- Department of Radiology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Wenyi Yang
- Department of Neurology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Dayao Lv
- Department of Neurology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Jingjing Wu
- Department of Radiology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yi Fang
- Department of Neurology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Tao Guo
- Department of Radiology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Zhe Song
- Department of Neurology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Xiaojun Xu
- Department of Radiology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Jun Tian
- Department of Neurology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Xinzhen Yin
- Department of Neurology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Minming Zhang
- Department of Radiology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Baorong Zhang
- Department of Neurology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Jiali Pu
- Department of Neurology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yaping Yan
- Department of Neurology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
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The Potential Effects of Oxidative Stress-Related Plasma Abnormal Protein Aggregate Levels on Brain Volume and Its Neuropsychiatric Consequences in Parkinson's Disease. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:3666327. [PMID: 34434484 PMCID: PMC8382529 DOI: 10.1155/2021/3666327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 07/05/2021] [Accepted: 07/30/2021] [Indexed: 11/17/2022]
Abstract
Background Oxidative stress has been implicated in the pathogenesis of many diseases, including Parkinson's disease. Large protein aggregates may be produced after the breakdown of the proteostasis network due to overt oxidative stress. Meanwhile, brain volume loss and neuropsychiatric deficits are common comorbidities in Parkinson's disease patients. In this study, we applied a mediation model to determine the potential influences of oxidative stress-related plasma abnormal protein aggregate levels on brain volume and neuropsychiatric consequences in Parkinson's disease. Method 31 patients with PD and 24 healthy controls participated in this study. The PD patients were further grouped according to the presentation of cognitive decline or not. All participants received complete examinations to determine plasma abnormal protein aggregates levels, brain volume, and neuropsychiatric performance. The results were collected and analyzed in a single-level three-variable mediation model. Results Patients with PD cognitive decline exhibited higher plasma NfL levels, decreased regional brain volume, and poor neuropsychiatric subtest results compared with PD patients with normal cognition, with several correlations among these clinical presentations. The mediation model showed that the superior temporal gyrus completely mediated the effects of elevated plasma NfL levels due to the poor psychiatric performance of picture completion and digit span. Conclusion This study provides insight into the effects of oxidative stress-related plasma abnormal protein aggregate levels on regional brain volume and neuropsychiatric consequences in Parkinson's disease patients.
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Lin WC, Lee PL, Lu CH, Lin CP, Chou KH. Linking Stage-Specific Plasma Biomarkers to Gray Matter Atrophy in Parkinson Disease. AJNR Am J Neuroradiol 2021; 42:1444-1451. [PMID: 34045303 DOI: 10.3174/ajnr.a7171] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 03/17/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The shortcomings of synucleinopathy-based Parkinson disease staging highlight the need for systematic clinicopathologic elucidation and biomarkers. In this study, we investigated associations of proteinopathy and inflammation markers with changes in gray matter volume that accompany Parkinson disease progression. MATERIALS AND METHODS We prospectively enrolled 42 patients with idiopathic Parkinson disease, subdivided into early-/late-stage groups and 27 healthy controls. Parkinson disease severity and participants' functional and cognitive performance were evaluated. Peripheral plasma α-synuclein, β-amyloid42, and tau were quantified with immunomagnetic reduction assays, and nuclear DNA by polymerase chain reaction, and regional gray matter volumes were determined by MR imaging. Statistical tests identified stage-specific biomarkers and gray matter volume patterns in the early-stage Parkinson disease, late-stage Parkinson disease, and control groups. Correlations between gray matter volume atrophy, plasma biomarkers, Parkinson disease severity, and cognitive performance were analyzed. RESULTS Patients with Parkinson disease had significantly elevated α-synuclein, tau, and β-amyloid42 levels compared with controls; nuclear DNA levels were similar in early-stage Parkinson disease and controls, but higher in late-stage Parkinson disease (all P < .01). We identified 3 stage-specific gray matter volume atrophy patterns: 1) control > early-stage Parkinson disease = late-stage Parkinson disease: right midfrontal, left lingual, and fusiform gyri, left hippocampus, and cerebellum; 2) control > early-stage Parkinson disease > late-stage Parkinson disease: precentral, postcentral, parahippocampal, left superior-temporal, right temporal, right superior-frontal, and left cingulate gyri, occipital lobe, and bilateral parts of the cerebellum; 3) control = early-stage Parkinson disease > late-stage Parkinson disease: left midfrontal, superior-frontal and temporal, amygdala, and posterior cingulate gyri, caudate nucleus, and putamen. We discovered stage-specific correlations among proteinopathy, inflammation makers, topographic gray matter volume patterns, and cognitive performance that accompanied Parkinson disease progression. CONCLUSIONS Identifying associations linking peripheral plasma biomarkers, gray matter volume, and clinical status in Parkinson disease may facilitate earlier diagnosis and improve prognostic accuracy.
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Affiliation(s)
- W-C Lin
- From the Department of Diagnostic Radiology (W.-C.L.), Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - P-L Lee
- Institute of Neuroscience (P.-L.L., C.-P.L., K.-H.C.), National Yang-Ming University, Taipei, Taiwan
| | - C-H Lu
- Department of Neurology (C.-H.L.), Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - C-P Lin
- Institute of Neuroscience (P.-L.L., C.-P.L., K.-H.C.), National Yang-Ming University, Taipei, Taiwan
- Department of Biomedical Imaging and Radiological Sciences (C.-P.L.), National Yang-Ming University, Taipei, Taiwan
- Brain Research Center (C.-P.L., K.-H.C.), National Yang-Ming University, Taipei, Taiwan
| | - K-H Chou
- Institute of Neuroscience (P.-L.L., C.-P.L., K.-H.C.), National Yang-Ming University, Taipei, Taiwan
- Brain Research Center (C.-P.L., K.-H.C.), National Yang-Ming University, Taipei, Taiwan
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Associations among Cognitive Functions, Plasma DNA, and Diffusion Tensor Image along the Perivascular Space (DTI-ALPS) in Patients with Parkinson's Disease. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:4034509. [PMID: 33680283 PMCID: PMC7904342 DOI: 10.1155/2021/4034509] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 01/30/2021] [Indexed: 01/24/2023]
Abstract
Background Parkinson's disease (PD) is a common neurodegenerative disease associated with accumulation of misfolding proteins and increased neuroinflammation, which may further impair the glymphatic system. The purpose of this study was to utilize diffusion tensor image analysis along the perivascular space (DTI-ALPS) to evaluate glymphatic system activity and its relationship with systemic oxidative stress status in PD patients. Methods Magnetic resonance imaging and neuropsychological tests were conducted on 25 PD patients with normal cognition (PDN), 25 PD patients with mild cognitive impairment (PD-MCI), 38 PD patients with dementia (PDD), and 47 normal controls (NC). Oxidative stress status was assessed by plasma DNA level. Differences in ALPS-index among the subgroups were assessed and further correlated with cognitive functions and plasma DNA levels. Results The PD-MCI and PDD groups showed significantly lower ALPS-index compared to normal controls. The ALPS-index was inversely correlated with plasma nuclear DNA, mitochondrial DNA levels, and cognitive scores. Conclusions Lower diffusivity along the perivascular space, represented by lower ALPS-index, indicates impairment of the glymphatic system in PD patients. The correlation between elevated plasma nuclear DNA levels and lower ALPS-index supports the notion that PD patients may exhibit increased oxidative stress associated with glymphatic system microstructural alterations.
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Wei X, Luo C, Li Q, Hu N, Xiao Y, Liu N, Lui S, Gong Q. White Matter Abnormalities in Patients With Parkinson's Disease: A Meta-Analysis of Diffusion Tensor Imaging Using Tract-Based Spatial Statistics. Front Aging Neurosci 2021; 12:610962. [PMID: 33584244 PMCID: PMC7876070 DOI: 10.3389/fnagi.2020.610962] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 12/28/2020] [Indexed: 02/05/2023] Open
Abstract
Background: Tract-based spatial statistics (TBSS) studies based on diffusion tensor imaging (DTI) have revealed extensive abnormalities in white matter (WM) fibers of Parkinson's disease (PD); however, the results were inconsistent. Therefore, a meta-analytical approach was used in this study to find the most prominent and replicable WM abnormalities of PD. Methods: Online databases were systematically searched for all TBSS studies comparing fractional anisotropy (FA) between patients with PD and controls. Subsequently, we performed the meta-analysis using a coordinate-based meta-analytic software called seed-based d mapping. Meanwhile, meta-regression was performed to explore the potential correlation between the alteration of FA and the clinical characteristics of PD. Results: Out of a total of 1,701 studies that were identified, 23 studies were included. Thirty datasets, including 915 patients (543 men) with PD and 836 healthy controls (449 men), were included in the current study. FA reduction was identified in the body of the corpus callosum (CC; 245 voxels; z = -1.739; p < 0.001) and the left inferior fronto-occipital fasciculus (IFOF) 118 voxels; z = -1.182; p < 0.001). Both CC and IFOF maintained significance in the sensitivity analysis. No increase in FA was identified, but the percentage of male patients with PD was positively associated with the value of FA in the body of the CC. Conclusions: Although some limitations exist, DTI is regarded as a valid way to identify the pathophysiology of PD. It could be more beneficial to integrate DTI parameters with other MRI techniques to explore brain degeneration in PD.
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Affiliation(s)
- Xia Wei
- Department of Radiology, Functional and Molecular Imaging Key Laboratory of Sichuan Province, Huaxi MR Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China.,Psychoradiology Research Unit of the Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, China.,Department of Radiology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Chunyan Luo
- Department of Radiology, Functional and Molecular Imaging Key Laboratory of Sichuan Province, Huaxi MR Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China.,Psychoradiology Research Unit of the Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, China.,Department of Radiology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Qian Li
- Department of Radiology, Functional and Molecular Imaging Key Laboratory of Sichuan Province, Huaxi MR Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China.,Psychoradiology Research Unit of the Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, China.,Department of Radiology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Na Hu
- Department of Radiology, Functional and Molecular Imaging Key Laboratory of Sichuan Province, Huaxi MR Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China.,Psychoradiology Research Unit of the Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, China.,Department of Radiology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Yuan Xiao
- Department of Radiology, Functional and Molecular Imaging Key Laboratory of Sichuan Province, Huaxi MR Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China.,Psychoradiology Research Unit of the Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, China.,Department of Radiology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Nian Liu
- Department of Radiology, Functional and Molecular Imaging Key Laboratory of Sichuan Province, Huaxi MR Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China.,Psychoradiology Research Unit of the Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, China.,Department of Radiology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Su Lui
- Department of Radiology, Functional and Molecular Imaging Key Laboratory of Sichuan Province, Huaxi MR Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China.,Psychoradiology Research Unit of the Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, China.,Department of Radiology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Qiyong Gong
- Department of Radiology, Functional and Molecular Imaging Key Laboratory of Sichuan Province, Huaxi MR Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China.,Psychoradiology Research Unit of the Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, China.,Department of Radiology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
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11
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Chang TC, Chen YC, Huang YC, Lin WC, Lu CH. Systemic oxidative stress and cognitive function in Parkinson's disease with different PWMH or DWMH lesions. BMC Neurol 2021; 21:16. [PMID: 33430806 PMCID: PMC7798238 DOI: 10.1186/s12883-020-02037-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 12/26/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Parkinson's disease (PD), frequently accompanied by cognitive impairments, is associated with systemic oxidative stress and abnormal structural changes on brain images. We aimed to identify the correlation between systemic oxidative stress and cognitive function in PD patients with different periventricular white matter hyperintensities (PWMH) and deep white matter hyperintensities (DWMH). METHODS A total of 146 participants with idiopathic PD underwent brain MRI, which revealed PWMH and DWMH. The number of lesions were evaluated using the Fazekas criteria. Systemic oxidative stress was determined as early or late phase changes in leukocyte apoptosis and its subsets by flow cytometry. Cognitive functions, including attention, executive function, memory, language, and visual space, were assessed. RESULTS For different DWMH, the leukocyte apoptosis and its subsets were significantly different.. However, there were no significant differences in oxidative stress biomarkers in PD patients with different PWMH. Attention and memory were significantly decreased in patients with more advanced DWMH injuries. Attention, memory, and language were significantly impaired in patients with worse PWMH lesions. CONCLUSION Significant oxidative stress biomarker alternations in PD patients with DWMH, but not PWMH, might be associated with white matter injury. Systemic inflammatory responses may contribute to deep white matter damage in PD. Further, more cognitive deficits were seen in PD patients with worse deep white matter lesions, especially in moderate to severe periventricular white matter injury. TRIAL REGISTRATION Retrospective study.
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Affiliation(s)
- Ta-Chih Chang
- Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yi-Cun Chen
- Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yu-Chi Huang
- Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
| | - Wei-Che Lin
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
| | - Cheng-Hsien Lu
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
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12
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Sánchez-Dinorín G, Rodríguez-Violante M, Cervantes-Arriaga A, Navarro-Roa C, Ricardo-Garcell J, Rodríguez-Camacho M, Solís-Vivanco R. Frontal functional connectivity and disease duration interactively predict cognitive decline in Parkinson's disease. Clin Neurophysiol 2020; 132:510-519. [PMID: 33450572 DOI: 10.1016/j.clinph.2020.11.035] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 09/25/2020] [Accepted: 11/16/2020] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Cognitive decline does not always follow a predictable course in Parkinson's disease (PD), with some patients remaining stable while others meet criteria for dementia from early stages. Functional connectivity has been proposed as a good correlate of cognitive decline in PD, although it has not been explored whether the association between this connectivity and cognitive ability is influenced by disease duration, which was our objective. METHODS We included 30 patients with PD and 15 healthy controls (HC). Six cognitive domains were estimated based on neuropsychological assessment. Phase-based connectivity at frontal and posterior cortical regions was estimated from a resting EEG. RESULTS The PD group showed significant impairment for the executive, visuospatial, and language domains compared with HC. Increased connectivity at frontal regions was also found in the PD group. Frontal delta and theta connectivity negatively influenced general cognition and visuospatial performance, but this association was moderated by disease duration, with increased connectivity predicting worse performance after 8 years of disease duration. CONCLUSION Subtle neurophysiological changes underlie cognitive decline along PD progression, especially around a decade after motor symptoms onset. SIGNIFICANCE Connectivity of EEG slow waves at frontal regions might be used as a predictor of cognitive decline in PD.
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Affiliation(s)
- Gerardo Sánchez-Dinorín
- Neuropsychology Laboratory, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez (INNN), Mexico City, Mexico; Faculty of Psychology, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
| | | | | | | | | | | | - Rodolfo Solís-Vivanco
- Neuropsychology Laboratory, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez (INNN), Mexico City, Mexico; Faculty of Psychology, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico.
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13
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Zhang Y, Burock MA. Diffusion Tensor Imaging in Parkinson's Disease and Parkinsonian Syndrome: A Systematic Review. Front Neurol 2020; 11:531993. [PMID: 33101169 PMCID: PMC7546271 DOI: 10.3389/fneur.2020.531993] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 08/18/2020] [Indexed: 12/21/2022] Open
Abstract
Diffusion tensor imaging (DTI) allows measuring fractional anisotropy and similar microstructural indices of the brain white matter. Lower than normal fractional anisotropy as well as higher than normal diffusivity is associated with loss of microstructural integrity and neurodegeneration. Previous DTI studies in Parkinson's disease (PD) have demonstrated abnormal fractional anisotropy in multiple white matter regions, particularly in the dopaminergic nuclei and dopaminergic pathways. However, DTI is not considered a diagnostic marker for the earliest Parkinson's disease since anisotropic alterations present a temporally divergent pattern during the earliest Parkinson's course. This article reviews a majority of clinically employed DTI studies in PD, and it aims to prove the utilities of DTI as a marker of diagnosing PD, correlating clinical symptomatology, tracking disease progression, and treatment effects. To address the challenge of DTI being a diagnostic marker for early PD, this article also provides a comparison of the results from a longitudinal, early stage, multicenter clinical cohort of Parkinson's research with previous publications. This review provides evidences of DTI as a promising marker for monitoring PD progression and classifying atypical PD types, and it also interprets the possible pathophysiologic processes under the complex pattern of fractional anisotropic changes in the first few years of PD. Recent technical advantages, limitations, and further research strategies of clinical DTI in PD are additionally discussed.
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Affiliation(s)
- Yu Zhang
- Department of Psychiatry, War Related Illness and Injury Study Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, United States
| | - Marc A Burock
- Department of Psychiatry, Mainline Health, Bryn Mawr Hospital, Bryn Mawr, PA, United States
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14
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Bruno DCF, Donatti A, Martin M, Almeida VS, Geraldis JC, Oliveira FS, Dogini DB, Lopes-Cendes I. Circulating nucleic acids in the plasma and serum as potential biomarkers in neurological disorders. ACTA ACUST UNITED AC 2020; 53:e9881. [PMID: 32813850 PMCID: PMC7446710 DOI: 10.1590/1414-431x20209881] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 06/12/2020] [Indexed: 12/12/2022]
Abstract
Neurological diseases are responsible for approximately 6.8 million deaths every year. They affect up to 1 billion people worldwide and cause significant disability and reduced quality of life. In most neurological disorders, the diagnosis can be challenging; it frequently requires long-term investigation. Thus, the discovery of better diagnostic methods to help in the accurate and fast diagnosis of neurological disorders is crucial. Circulating nucleic acids (CNAs) are defined as any type of DNA or RNA that is present in body biofluids. They can be found within extracellular vesicles or as cell-free DNA and RNA. Currently, CNAs are being explored as potential biomarkers for diseases because they can be obtained using non-invasive methods and may reflect unique characteristics of the biological processes involved in several diseases. CNAs can be especially useful as biomarkers for conditions that involve organs or structures that are difficult to assess, such as the central nervous system. This review presents a critical assessment of the most current literature about the use of plasma and serum CNAs as biomarkers for several aspects of neurological disorders: defining a diagnosis, establishing a prognosis, and monitoring the disease progression and response to therapy. We explored the biological origin, types, and general mechanisms involved in the generation of CNAs in physiological and pathological processes, with specific attention to neurological disorders. In addition, we present some of the future applications of CNAs as non-invasive biomarkers for these diseases.
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Affiliation(s)
- D C F Bruno
- Departamento de Genética Médica e Medicina Genômica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil
| | - A Donatti
- Departamento de Genética Médica e Medicina Genômica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil
| | - M Martin
- Departamento de Genética Médica e Medicina Genômica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil
| | - V S Almeida
- Departamento de Genética Médica e Medicina Genômica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil
| | - J C Geraldis
- Departamento de Genética Médica e Medicina Genômica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil
| | - F S Oliveira
- Departamento de Genética Médica e Medicina Genômica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil
| | - D B Dogini
- Departamento de Genética Médica e Medicina Genômica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil
| | - I Lopes-Cendes
- Departamento de Genética Médica e Medicina Genômica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil
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15
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Abbasi N, Fereshtehnejad SM, Zeighami Y, Larcher KMH, Postuma RB, Dagher A. Predicting severity and prognosis in Parkinson's disease from brain microstructure and connectivity. NEUROIMAGE-CLINICAL 2019; 25:102111. [PMID: 31855654 PMCID: PMC6926369 DOI: 10.1016/j.nicl.2019.102111] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 11/26/2019] [Accepted: 11/27/2019] [Indexed: 12/25/2022]
Abstract
White matter disruption occurs in Parkinson's disease across several brain regions. DTI properties could identify clinically distinct subtypes of Parkinson's disease. Structural neural disruption can predict clinical outcomes in Parkinson's disease.
Objectives: Investigating biomarkers to demonstrate progression of Parkinson's disease (PD) is of high priority. We investigated the association of brain structural properties with progression of clinical outcomes and their ability to differentiate clinical subtypes of PD. Methods: A comprehensive set of clinical features was evaluated at baseline and 4.5-year follow-up for 144 de-novo PD patients from the Parkinson's Progression Markers Initiative. We created a global composite outcome (GCO) by combining z-scores of non-motor and motor symptoms, motor signs, overall activities of daily living and global cognition, as a single numeric indicator of prognosis. We classified patients into three subtypes based on multi-domain clinical criteria: ‘mild motor-predominant’, ‘intermediate’ and ‘diffuse-malignant’. We analyzed diffusion-weighted scans at the early drug-naïve stage and extracted fractional anisotropy and mean diffusivity (MD) of basal ganglia and cortical sub-regions. Then, we employed graph theory to calculate network properties and used network-based statistic to investigate our primary hypothesis. Results: Baseline MD of globus pallidus was associated with worsening of motor severity, cognition, and GCO after 4.5 years of follow-up. Connectivity disruption at baseline was correlated with decline in cognition, and increase in GCO. Baseline MD of nucleus accumbens, globus pallidus and basal-ganglia were linked to clinical subtypes at 4.5-year of follow-up. Disruption in sub-cortical networks associated with being subtyped as ‘diffuse-malignant’ versus ‘mild motor-predominant’ after 4.5 years. Conclusions: Diffusion imaging analysis at the early de-novo stage of PD was able to differentiate clinical sub-types of PD after 4.5 years and was highly associated with future clinical outcomes of PD.
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Affiliation(s)
- Nooshin Abbasi
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, 3801 University St., Montreal, Quebec H3A 2B4, Canada.
| | - Seyed-Mohammad Fereshtehnejad
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada; Division of Neurology, Department of Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada; Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institute, Stockholm, Sweden
| | - Yashar Zeighami
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, 3801 University St., Montreal, Quebec H3A 2B4, Canada
| | | | - Ronald B Postuma
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada; Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada
| | - Alain Dagher
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, 3801 University St., Montreal, Quebec H3A 2B4, Canada
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16
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Lin WC, Huang YC, Leong CP, Chen MH, Chen HL, Tsai NW, Tso HH, Chen PC, Lu CH. Associations Between Cognitive Functions and Physical Frailty in Patients With Parkinson's Disease. Front Aging Neurosci 2019; 11:283. [PMID: 31736737 PMCID: PMC6831640 DOI: 10.3389/fnagi.2019.00283] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 10/03/2019] [Indexed: 11/25/2022] Open
Abstract
Background: Parkinson’s disease (PD) is a neurodegenerative disease manifested by both motor and non-motor dysfunctions and co-existence of cognitive impairment and physical frailty is common. Given that research in this area is limited, a better understanding of associated factors with physical frailty could provide a focused screening method and facilitate early intervention in PD. Methods: Seventy-six patients with idiopathic PD were recruited and Fried’s criteria of physical frailty were used to group all participants. Comprehensive cognitive tests and clinical characteristics were measured, and univariate and multivariate analysis was performed to explore the relationship between clinical factors or neuropsychological functions. Results: Twenty-nine patients with PD (38%) exhibited physical frailty. Compared to PD patients without frailty, PD patients with frailty were older in age and demonstrated worse disease severity and poorer cognitive functions, including attention, executive function, memory, speech and language, and visuospatial function (p < 0.05). Further, stepwise logistic regression analysis revealed that disease severity by the Unified Parkinson’s Disease Rating Scale (UPDRS) total score (OR: 1.065; 95% CI: 1.033–1.099) and executive function (OR: 0.724; 95% CI: 0.581–0.877) were independent risk factors for predicting physical frailty (p = 0.003 and 0.002). The best cut-off points are 46 in UPDRS (sensitivity: 62.1%; specificity: 91.5%). Conclusions: Executive function impairment is an independent risk factor for the development of physical frailty with disease progression. Awareness of such comorbidity might provide a screening tool to facilitate investigation in their underlying etiology and early intervention for frailty prevention.
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Affiliation(s)
- Wei-Che Lin
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yu-Chi Huang
- Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chau-Peng Leong
- Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Meng-Hsiang Chen
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Hsiu-Ling Chen
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Nai-Wen Tsai
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Hui-Hsin Tso
- Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Po-Cheng Chen
- Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Cheng-Hsien Lu
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
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17
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Ferris CF, Morrison TR, Iriah S, Malmberg S, Kulkarni P, Hartner JC, Trivedi M. Evidence of Neurobiological Changes in the Presymptomatic PINK1 Knockout Rat. JOURNAL OF PARKINSONS DISEASE 2019; 8:281-301. [PMID: 29710734 DOI: 10.3233/jpd-171273] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Genetic models of Parkinson's disease (PD) coupled with advanced imaging techniques can elucidate neurobiological disease progression, and can help identify early biomarkers before clinical signs emerge. PTEN-induced putative kinase 1 (PINK1) helps protect neurons from mitochondrial dysfunction, and a mutation in the associated gene is a risk factor for recessive familial PD. The PINK1 knockout (KO) rat is a novel model for familial PD that has not been neuroradiologically characterized for alterations in brain structure/function, alongside behavior, prior to 4 months of age. OBJECTIVE To identify biomarkers of presymptomatic PD in the PINK1 -/- rat at 3 months using magnetic resonance imaging techniques. METHODS At postnatal weeks 12-13; one month earlier than previously reported signs of motor and cognitive dysfunction, this study combined imaging modalities, including assessment of quantitative anisotropy across 171 individual brain areas using an annotated MRI rat brain atlas to identify sites of gray matter alteration between wild-type and PINK1 -/- rats. RESULTS The olfactory system, hypothalamus, thalamus, nucleus accumbens, and cerebellum showed differences in anisotropy between experimental groups. Molecular analyses revealed reduced levels of glutathione, ATP, and elevated oxidative stress in the substantia nigra, striatum and deep cerebellar nuclei. Mitochondrial genes encoding proteins in Complex IV, along with mRNA levels associated with mitochondrial function and genes involved in glutathione synthesis were reduced. Differences in brain structure did not align with any cognitive or motor impairment. CONCLUSIONS These data reveal early markers, and highlight novel brain regions involved in the pathology of PD in the PINK1 -/- rat before behavioral dysfunction occurs.
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Affiliation(s)
- Craig F Ferris
- Center for Translational NeuroImaging, Northeastern University, Boston, MA, USA.,Department of Psychology and Pharmaceutical Sciences, Northeastern University, Boston, MA, USA
| | - Thomas R Morrison
- Center for Translational NeuroImaging, Northeastern University, Boston, MA, USA
| | - Sade Iriah
- Center for Translational NeuroImaging, Northeastern University, Boston, MA, USA
| | - Samantha Malmberg
- Center for Translational NeuroImaging, Northeastern University, Boston, MA, USA
| | - Praveen Kulkarni
- Center for Translational NeuroImaging, Northeastern University, Boston, MA, USA
| | | | - Malav Trivedi
- NOVA Southeastern University, Ft. Lauderdale, FL, USA
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18
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Chiang PL, Chen HL, Lu CH, Chen YS, Chou KH, Hsu TW, Chen MH, Tsai NW, Li SH, Lin WC. Interaction of systemic oxidative stress and mesial temporal network degeneration in Parkinson's disease with and without cognitive impairment. J Neuroinflammation 2018; 15:281. [PMID: 30257698 PMCID: PMC6158841 DOI: 10.1186/s12974-018-1317-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 09/18/2018] [Indexed: 12/31/2022] Open
Abstract
Background To identify the vulnerable areas associated with systemic oxidative stress and further disruption of these vulnerable areas by measuring the associated morphology and functional network alterations in Parkinson’s disease (PD) patients with and without cognitive impairment. Methods This prospective study was approved by the institutional review board of KCGMH, and written informed consent was obtained. Between December 2010 and May 2015, 41 PD patients with different levels of cognitive functions and 29 healthy volunteers underwent peripheral blood sampling to quantify systemic oxidative stress, as well as T1W volumetric and resting state functional MRI (rs-fMRI) scans. Rs-fMRI was used to derive the healthy intrinsic connectivity patterns seeded by the vulnerable areas associated with any of the significant oxidative stress markers. The two groups were compared in terms of the functional connectivity correlation coefficient (fc-CC) and gray matter volume (GMV) of the network seeded by the vulnerable areas. Results The levels of oxidative stress markers, including leukocyte apoptosis and adhesion molecules, were significantly higher in the PD group. Using whole-brain VBM-based correlation analysis, the bilateral mesial temporal lobes (MTLs) were identified as the most vulnerable areas associated with lymphocyte apoptosis (P < 0.005). We found that the MTL network of healthy subjects resembled the PD-associated atrophy pattern. Furthermore, reduced fc-CC and GMV were further associated with the aggravated cognitive impairment. Conclusion The MTLs are the vulnerable areas associated with peripheral lymphocyte infiltration, and disruptions of the MTL functional network in both architecture and functional connectivity might result in cognitive impairments in Parkinson’s disease. Electronic supplementary material The online version of this article (10.1186/s12974-018-1317-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Pi-Ling Chiang
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung, Kaohsiung, 83305, Taiwan
| | - Hsiu-Ling Chen
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung, Kaohsiung, 83305, Taiwan
| | - Cheng-Hsien Lu
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yueh-Sheng Chen
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung, Kaohsiung, 83305, Taiwan
| | - Kun-Hsien Chou
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Tun-Wei Hsu
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Meng-Hsiang Chen
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung, Kaohsiung, 83305, Taiwan
| | - Nai-Wen Tsai
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Shau-Hsuan Li
- Department of Hematology and Oncology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Wei-Che Lin
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung, Kaohsiung, 83305, Taiwan.
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19
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Long Y, Ouyang X, Liu Z, Chen X, Hu X, Lee E, Chen EYH, Pu W, Shan B, Rohrbaugh RM. Associations Among Suicidal Ideation, White Matter Integrity and Cognitive Deficit in First-Episode Schizophrenia. Front Psychiatry 2018; 9:391. [PMID: 30210372 PMCID: PMC6121174 DOI: 10.3389/fpsyt.2018.00391] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 08/03/2018] [Indexed: 11/26/2022] Open
Abstract
Objective: The study was aimed to investigate the possible associations among suicidal ideation, brain white matter (WM) integrity and cognitive deficit in first-episode schizophrenia (FES) using diffusion tensor imaging. Methods: The sample contained 18 FES patients with suicidal ideation (SI+), 45 FES patients without suicidal ideation (SI-) and 44 healthy controls. The Calgary Depression Scale for Schizophrenia was used to measure the suicidal ideation and depression symptoms. The whole brain WM integrity and three domains of cognitive function: working memory, verbal comprehension as well as processing speed were compared between the three groups. Results: Compared with SI-, SI+ showed preserved WM integrity as indicated by significantly higher factional anisotropy (FA) or lower mean diffusivity (MD) in multiple WM tracts, and higher FA coupled with lower MD in bilateral posterior corona radiata. Compared with SI-, SI+ were more depressed and had less cognitive deficit in working memory and verbal comprehension. The fiber tracts in bilateral posterior corona radiata connect to the precuneus as shown by probabilistic tractography, and their WM integrity disruptions were found to be positively associated with the cognitive deficits in the FES patients. Discussion: Preserved WM integrity may be a risk factor for suicidal ideation in FES patients. One possible explanation is that it contributes to preserved cognitive function, especially in working memory and verbal comprehension, which may be associated with greater insight and could lead to increased depression and suicidal ideation. The posterior corona radiata and the precuneus may be linked to the related biological processes.
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Affiliation(s)
- Yicheng Long
- Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, China
| | - Xuan Ouyang
- Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, China.,Mental Health Institute, Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, Chinese National Clinical Research Center on Mental Health Disorders, National Technology Institute of Psychiatry, Changsha, China
| | - Zhening Liu
- Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, China.,Mental Health Institute, Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, Chinese National Clinical Research Center on Mental Health Disorders, National Technology Institute of Psychiatry, Changsha, China
| | - Xudong Chen
- Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, China
| | - Xinran Hu
- Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, China
| | - Edwin Lee
- Department of Psychiatry, University of Hong Kong, Hong Kong, Hong Kong
| | - Eric Y H Chen
- Department of Psychiatry, University of Hong Kong, Hong Kong, Hong Kong.,State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong, Hong Kong
| | - Weidan Pu
- Medical Psychological Center, Second Xiangya Hospital, Central South University, Changsha, China
| | - Baoci Shan
- Key Laboratory of Nuclear Analysis, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, China
| | - Robert M Rohrbaugh
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
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Chiang PL, Chen HL, Lu CH, Chen PC, Chen MH, Yang IH, Tsai NW, Lin WC. White matter damage and systemic inflammation in Parkinson's disease. BMC Neurosci 2017; 18:48. [PMID: 28595572 PMCID: PMC5465562 DOI: 10.1186/s12868-017-0367-y] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2016] [Accepted: 05/31/2017] [Indexed: 01/02/2023] Open
Abstract
Background Systemic inflammation and white matter (WM) alterations have been noted as effects of Parkinson’s disease (PD). This study sought to evaluate WM integrity in PD patients using diffusion tensor imaging (DTI) and to assess its relationship with systemic inflammation. Methods Sixty-six patients with PD (23 men and 43 women) and 67 healthy volunteers (29 men and 38 women) underwent blood sampling to quantify inflammatory markers and DTI scans to determine fiber integrity. The inflammatory markers included leukocyte apoptosis, as well as cellular and serum adhesion molecules, in each peripheral blood sample. DTI-related indices [including fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD), and mean diffusivity (MD)] were derived from DTI scans. The resulting FA maps were compared using voxel-based statistics to determine differences between the PD and control groups. The differences in the DTI indices, clinical severity, and inflammatory markers were correlated. Results Exploratory group-wise comparison between the two groups revealed that the PD patients exhibited extensive DTI index differences. Low FA accompanied by high RD and MD, without significant differences in AD, suggesting a demyelination process, were found in the parietal, occipital, cerebellar, and insular WM of the PD patients. The declined DTI indices were significantly correlated with increased clinical disease severity, adhesion molecules, and leukocyte apoptosis. Conclusions Patients with PD experience WM integrity damage in vulnerable regions, and these impairments are associated with increased disease severity and systemic inflammation. The possible interactions among them may represent variant neuronal injuries and their consequent processes in PD. Electronic supplementary material The online version of this article (doi:10.1186/s12868-017-0367-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Pi-Ling Chiang
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung, Kaohsiung, 83305, Taiwan
| | - Hsiu-Ling Chen
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung, Kaohsiung, 83305, Taiwan
| | - Cheng-Hsien Lu
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Department of Biological Science, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Pei-Chin Chen
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung, Kaohsiung, 83305, Taiwan
| | - Meng-Hsiang Chen
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung, Kaohsiung, 83305, Taiwan
| | - I-Hsiao Yang
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung, Kaohsiung, 83305, Taiwan
| | - Nai-Wen Tsai
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Wei-Che Lin
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung, Kaohsiung, 83305, Taiwan.
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