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Luo Y, Chen H, Gui M. Radiomics and Hybrid Models Based on Machine Learning to Predict Levodopa-Induced Dyskinesia of Parkinson's Disease in the First 6 Years of Levodopa Treatment. Diagnostics (Basel) 2023; 13:2511. [PMID: 37568874 PMCID: PMC10417024 DOI: 10.3390/diagnostics13152511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/23/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Current research on the prediction of movement complications associated with levodopa therapy in Parkinson's disease (PD) is limited. levodopa-induced dyskinesia (LID) is a movement complication that seriously affects the life quality of PD patients. One-third of PD patients develop LID within 1 to 6 years of levodopa treatment. This study aimed to construct models based on radiomics and machine learning to predict early LID in PD. METHODS We extracted radiomics features from the T1-weighted MRI obtained in the baseline of 49 PD control and 54 PD with LID in the first 6 years of levodopa therapy. Six brain regions related to the onset of PD were segmented as regions of interest (ROIs). The least absolute shrinkage and selection operator (LASSO) was used for feature selection. Using the machine learning methods of support vector machine (SVM), random forest (RF), and AdaBoost, we constructed radiomics models and hybrid models. The hybrid models combined the radiomics features and the Unified Parkinson's Disease Rating Scale part III (UPDRS III) total score. The five-fold cross-validation was performed and repeated 20 times to validate the stability of the classifiers. We used sensitivity, specificity, accuracy, receiver operating characteristic (ROC) curves, and area under the ROC curve (AUC) for model validation. RESULTS We selected 33 out of 6138 radiomics features. In the testing set of the radiomics model, the AUC values of the SVM, RF, and AdaBoost classifiers were 0.905, 0.808, and 0.778, respectively, and the accuracies were 0.839, 0.742, and 0.710. The hybrid models had better prediction performance. In the testing set, the AUC values of SVM, RF, and AdaBoost classifiers were 0.958, 0.861, and 0.832, respectively, and the accuracies were 0.903, 0.806, and 0.774. CONCLUSIONS Our results indicate that T1-weighted MRI is valuable in predicting early LID in PD. This work demonstrates that the combination of radiomics features and clinical features has good potential and value for identifying early LID in PD.
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Affiliation(s)
- Yang Luo
- Department of Neurology, Xiangya Hospital, Central South University, Changsha 410083, China;
| | - Huiqin Chen
- Department of Radiology, Xiangya Hospital, Central South University, Changsha 410083, China;
| | - Mingzhen Gui
- School of Automation, Central South University, Changsha 410083, China
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Palermo S, Stanziano M, Nigri A, Civilotti C, Celeghin A. Parkinson's Disease, SARS-CoV-2, and Frailty: Is There a Vicious Cycle Related to Hypovitaminosis D? Brain Sci 2023; 13:brainsci13040528. [PMID: 37190492 DOI: 10.3390/brainsci13040528] [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: 02/27/2023] [Revised: 03/17/2023] [Accepted: 03/21/2023] [Indexed: 05/17/2023] Open
Abstract
The literature has long established the association between aging and frailty, with emerging evidence pointing to a relationship between frailty and SARS-CoV-2 contagion. The possible neurological consequences of SARS-CoV-2 infection, associated with physical and cognitive frailty, could lead to a worsening of Parkinson's disease (PD) in infected patients or-more rarely-to an increase in the Parkinsonian symptomatology. A possible link between those clinical pictures could be identified in vitamin D deficiency, while the whole process would appear to be associated with alterations in the microbiota-intestine-brain axis that fall within the α-Synuclein Origin site and Connectome (SOC) model, and allow for the identification of a body-first PD and a brain-first PD. The model of care for this condition must consider intrinsic and extrinsic variables so that care by a multidisciplinary team can be successfully predicted. A multidimensional screening protocol specifically designed to identify people at risk or in the early stages of the disease should begin with the investigation of indices of frailty and microbiota-intestine-brain axis alterations, with a new focus on cases of hypovitaminosis D.
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Affiliation(s)
- Sara Palermo
- Department of Psychology, University of Turin, 10124 Turin, Italy
- Neuroradiology Unit, Diagnostic and Technology Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, 20133 Milan, Italy
| | - Mario Stanziano
- Neuroradiology Unit, Diagnostic and Technology Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, 20133 Milan, Italy
- Neurosciences Department "Rita Levi Montalcini", University of Turin, 10126 Turin, Italy
| | - Anna Nigri
- Neuroradiology Unit, Diagnostic and Technology Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, 20133 Milan, Italy
| | | | - Alessia Celeghin
- Department of Psychology, University of Turin, 10124 Turin, Italy
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3
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Buchwitz TM, Ruppert-Junck MC, Greuel A, Maier F, Thieken F, Jakobs V, Eggers C. Exploring impaired self-awareness of motor symptoms in Parkinson's disease: Resting-state fMRI correlates and the connection to mindfulness. PLoS One 2023; 18:e0279722. [PMID: 36827321 PMCID: PMC9955618 DOI: 10.1371/journal.pone.0279722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 12/13/2022] [Indexed: 02/25/2023] Open
Abstract
OBJECTIVE To further explore the phenomenon of impaired self-awareness of motor symptoms in patients with Parkinson's Disease by using an evaluated measurement approach applied in previous studies, while also examining its connection with dispositional mindfulness and possible correlates of functional connectivity. BACKGROUND Recently, the phenomenon of impaired self-awareness has been studied more intensively by applying different measurement and imaging methods. Existing literature also points towards a possible connection with mindfulness, which has not been examined in a cross-sectional study. There is no data available concerning correlates of functional connectivity. METHODS Non-demented patients with idiopathic Parkinson's Disease without severe depression were tested for impaired self-awareness for motor symptoms following a psychometrically evaluated approach. Mindfulness was measured by applying the German version of the Five Facet Mindfulness Questionnaire. A subset of eligible patients underwent functional MRI scanning. Spearman correlation analyses were performed to examine clinical data. Whole-brain voxelwise regressions between seed-based connectivity and behavioral measures were calculated to identify functional connectivity correlates of impaired self-awareness scores. RESULTS A total of 41 patients with Parkinson's Disease were included. 15 patients successfully underwent resting-state fMRI scanning. Up to 88% of patients showed signs of impaired self-awareness. Awareness for hypokinetic movements correlated with total mindfulness values and three facets, while awareness for dyskinetic movements did not. Three significant clusters between scores of impaired self-awareness in general and for dyskinetic movements were identified linking behavioral measures with the functional connectivity of the inferior frontal gyrus, the right insular cortex, the supplementary motor area, and the precentral gyrus among others. Impaired self-awareness for hypokinetic movements did not have any neural correlate. CONCLUSIONS Clinical data is comparable with results from previous studies applying the same structured approach to measure impaired self-awareness in Parkinson's Disease. Functional connectivity analyses were conducted for the first time to evaluate neural correlates thereof. This data does not support a connection between impaired self-awareness of motor symptoms and dispositional mindfulness.
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Affiliation(s)
| | - Marina Christine Ruppert-Junck
- Department of Neurology, University Hospital Marburg, Marburg, Germany
- Center for Mind, Brain, and Behavior (CMBB), Universities Marburg and Gießen, Marburg, Germany
| | - Andrea Greuel
- Department of Neurology, University Hospital Marburg, Marburg, Germany
| | - Franziska Maier
- Department of Psychiatry, University Hospital Cologne, Medical Faculty, Cologne, Germany
| | - Franziska Thieken
- Department of Neurology, University Hospital Marburg, Marburg, Germany
| | - Viktoria Jakobs
- Department of Neurology, University Hospital Marburg, Marburg, Germany
| | - Carsten Eggers
- Department of Neurology, University Hospital Marburg, Marburg, Germany
- Center for Mind, Brain, and Behavior (CMBB), Universities Marburg and Gießen, Marburg, Germany
- Department of Neurology, Knappschaftskrankenhaus Bottrop GmbH, Bottrop, Germany
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4
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Pacella V, Moro V. Motor awareness: a model based on neurological syndromes. Brain Struct Funct 2022; 227:3145-3160. [PMID: 36064864 DOI: 10.1007/s00429-022-02558-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 08/24/2022] [Indexed: 12/20/2022]
Abstract
Motor awareness is a complex, multifaceted construct involving the awareness of both (i) one's motor state while executing a movement or remaining still and (ii) one's motor abilities. The analysis of neurological syndromes associated with motor disorders suggests the existence of various different components which are, however, integrated into a model of motor awareness. These components are: (i) motor intention, namely, a conscious desire to perform an action; (ii) motor monitoring and error recognition, that is, the capacity to check the execution of the action and identify motor errors; and (iii) a general awareness of one's own motor abilities and deficits, that is, the capacity to recognize the general state of one's motor abilities about the performance of specific actions and the potential consequences of motor impairment. Neuroanatomical correlates involving the parietal and insular cortices, the medial and lateral frontal regions, and subcortical structures (basal ganglia and limbic system) support this multi-component model. Specific damage (or disconnections) to these structures results in a number of different disorders in motor awareness, such as anosognosia for hemiplegia and apraxia, and a number of symptoms which are specific to motor intention disorders (e.g., the Anarchic Hand Syndrome and Tourette's Syndrome) or motor monitoring (e.g., Parkinson's and Huntington's diseases). All of these clinical conditions are discussed in the light of a motor awareness model.
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Affiliation(s)
- Valentina Pacella
- Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives-UMR 5293, CNRS, CEA University of Bordeaux, 33076, Bordeaux, CS, France. .,Brain Connectivity and Behaviour Laboratory, Sorbonne Universities, Paris, France.
| | - Valentina Moro
- NPSY.Lab-VR, Department of Human Sciences, University of Verona, Lungadige Porta Vittoria 17, 37129, Verona, Italy.
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Razzaq FA, Bringas Vega ML, Ontiveiro-Ortega M, Riaz U, Valdes-Sosa PA. Causal effects of cingulate morphology on executive functions in healthy young adults. Hum Brain Mapp 2022; 43:4370-4382. [PMID: 35665983 PMCID: PMC9435009 DOI: 10.1002/hbm.25960] [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: 06/30/2021] [Revised: 04/11/2022] [Accepted: 05/08/2022] [Indexed: 11/11/2022] Open
Abstract
In this study, we want to explore evidence for the causal relationship between the anatomical descriptors of the cingulate cortex (surface area, mean curvature-corrected thickness, and volume) and the performance of cognitive tasks such as Card Sort, Flanker, List Sort used as instruments to measure the executive functions of flexibility, inhibitory control, and working memory. We have performed this analysis in a cross-sectional sample of 899 healthy young subjects of the Human Connectome Project. To the best of our knowledge, this is the first study using causal inference to explain the relationship between cingulate morphology and the performance of executive tasks in healthy subjects. We have tested the causal model under a counterfactual framework using stabilized inverse probability of treatment weighting and marginal structural models. The results showed that the posterior cingulate surface area has a positive causal effect on inhibition (Flanker task) and cognitive flexibility (Card Sort). A unit increase (+1 mm2 ) in the posterior cingulate surface area will cause a 0.008% and 0.009% increase from the National Institute of Health (NIH) normative mean in Flankers (p-value <0.001), and Card Sort (p-value 0.005), respectively. Furthermore, a unit increase (+1 mm2 ) in the anterior cingulate surface area will cause a 0.004% (p-value <0.001) and 0.005% (p-value 0.001) increase from the NIH normative mean in Flankers and Card Sort. In contrast, the curvature-corrected-mean thickness only showed an association for anterior cingulate with List Sort (p = 0.034) but no causal effect.
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Affiliation(s)
- Fuleah A Razzaq
- The Clinical Hospital of Chengdu Brain Sciences, University of Electronic Science and Technology of China, Chengdu, China
| | - Maria L Bringas Vega
- The Clinical Hospital of Chengdu Brain Sciences, University of Electronic Science and Technology of China, Chengdu, China
| | | | - Usama Riaz
- The Clinical Hospital of Chengdu Brain Sciences, University of Electronic Science and Technology of China, Chengdu, China
| | - Pedro A Valdes-Sosa
- The Clinical Hospital of Chengdu Brain Sciences, University of Electronic Science and Technology of China, Chengdu, China.,Cuban Neuroscience Center, Havana, Cuba
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Stanziano M, Golfrè Andreasi N, Messina G, Rinaldo S, Palermo S, Verri M, Demichelis G, Medina JP, Ghielmetti F, Bonvegna S, Nigri A, Frazzetta G, D'Incerti L, Tringali G, DiMeco F, Eleopra R, Bruzzone MG. Resting State Functional Connectivity Signatures of MRgFUS Vim Thalamotomy in Parkinson's Disease: A Preliminary Study. Front Neurol 2022; 12:786734. [PMID: 35095731 PMCID: PMC8791196 DOI: 10.3389/fneur.2021.786734] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/02/2021] [Indexed: 12/03/2022] Open
Abstract
Magnetic Resonance-guided high-intensity Focused Ultrasound (MRgFUS) of the thalamic ventral intermediate nucleus (Vim) for tremor has increasingly gained interest as a new non-invasive alternative to standard neurosurgery. Resting state functional connectivity (rs-FC) correlates of MRgFUS have not been extensively investigated yet. A region of interest (ROI)-to-ROI rs-FC MRI “connectomic” analysis focusing on brain regions relevant for tremor was conducted on 15 tremor-dominant patients with Parkinson's disease who underwent MRgFUS. We tested whether rs-FC between tremor-related areas was modulated by MRgFUS at 1 and 3 months post-operatively, and whether such changes correlated with individual clinical outcomes assessed by the MDS-UPDRS-III sub items for tremor. Significant increase in FC was detected within bilateral primary motor (M1) cortices, as well as between bilateral M1 and crossed primary somatosensory cortices, and also between pallidum and the dentate nucleus of the untreated hemisphere. Correlation between disease duration and FC increase at 3 months was found between the putamen of both cerebral hemispheres and the Lobe VI of both cerebellar hemispheres, as well as between the Lobe VI of untreated cerebellar hemisphere with bilateral supplementary motor area (SMA). Drop-points value of MDS-UPDRS at 3 months correlated with post-treatment decrease in FC, between the anterior cingulate cortex and bilateral SMA, as well as between the Lobe VI of treated cerebellar hemisphere and the interpositus nucleus of untreated cerebellum. Tremor improvement at 3 months, expressed as percentage of intra-subject MDS-UPDRS changes, correlated with FC decrease between bilateral occipital fusiform gyrus and crossed Lobe VI and Vermis VI. Good responders (≥50% of baseline tremor improvement) showed reduced FC between bilateral SMA, between the interpositus nucleus of untreated cerebellum and the Lobe VI of treated cerebellum, as well as between the untreated SMA and the contralateral putamen. Good responders were characterized at baseline by crossed hypoconnectivity between bilateral putamen and M1, as well as between the putamen of the treated hemisphere and the contralateral SMA. We conclude that MRgFUS can effectively modulate brain FC within the tremor network. Such changes are associated with clinical outcome. The shifting mode of integration among the constituents of this network is, therefore, susceptible to external redirection despite the chronic nature of PD.
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Affiliation(s)
- Mario Stanziano
- Neuroradiology Unit, Diagnostic and Technology Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy.,Neurosciences Department "Rita Levi Montalcini, " University of Turin, Turin, Italy
| | - Nico Golfrè Andreasi
- Parkinson and Movement Disorders Unit, Clinical Neurosciences Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy
| | - Giuseppe Messina
- Functional Neurosurgery Unit, Neurosurgery Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy
| | - Sara Rinaldo
- Parkinson and Movement Disorders Unit, Clinical Neurosciences Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy
| | - Sara Palermo
- Neuroradiology Unit, Diagnostic and Technology Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy.,European Innovation Partnership on Active and Healthy Ageing, Brussels, Belgium
| | - Mattia Verri
- Neuroradiology Unit, Diagnostic and Technology Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy
| | - Greta Demichelis
- Neuroradiology Unit, Diagnostic and Technology Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy
| | - Jean Paul Medina
- Neuroradiology Unit, Diagnostic and Technology Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy
| | - Francesco Ghielmetti
- Health Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy
| | - Salvatore Bonvegna
- Parkinson and Movement Disorders Unit, Clinical Neurosciences Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy
| | - Anna Nigri
- Neuroradiology Unit, Diagnostic and Technology Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy
| | | | - Ludovico D'Incerti
- Neuroradiology Unit, Diagnostic and Technology Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy
| | - Giovanni Tringali
- Functional Neurosurgery Unit, Neurosurgery Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy
| | - Francesco DiMeco
- Neurosurgery Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy.,Pathophysiology and Transplantation Department, University of Milan, Milan, Italy.,Neurological Surgery Department, Johns Hopkins Medical School, Baltimore, MD, United States
| | - Roberto Eleopra
- Parkinson and Movement Disorders Unit, Clinical Neurosciences Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy
| | - Maria Grazia Bruzzone
- Neuroradiology Unit, Diagnostic and Technology Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Neurologico Carlo Besta, Milan, Italy
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Brockett AT, Roesch MR. Reactive and Proactive Adaptation of Cognitive and Motor Neural Signals during Performance of a Stop-Change Task. Brain Sci 2021; 11:617. [PMID: 34064876 PMCID: PMC8151620 DOI: 10.3390/brainsci11050617] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/04/2021] [Accepted: 05/06/2021] [Indexed: 11/25/2022] Open
Abstract
The ability to inhibit or suppress unwanted or inappropriate actions, is an essential component of executive function and cognitive health. The immense selective pressure placed on maintaining inhibitory control processes is exemplified by the relatively small number of instances in which these systems completely fail in the average person's daily life. Although mistakes and errors do inevitably occur, inhibitory control systems not only ensure that this number is low, but have also adapted behavioral strategies to minimize future failures. The ability of our brains to adapt our behavior and appropriately engage proper motor responses is traditionally depicted as the primary domain of frontal brain areas, despite evidence to the fact that numerous other brain areas contribute. Using the stop-signal task as a common ground for comparison, we review a large body of literature investigating inhibitory control processes across frontal, temporal, and midbrain structures, focusing on our recent work in rodents, in an effort to understand how the brain biases action selection and adapts to the experience of conflict.
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Affiliation(s)
- Adam T. Brockett
- Department of Psychology, University of Maryland, College Park, MD 20742, USA;
- Program in Neuroscience and Cognitive Science, University of Maryland, College Park, MD 20742, USA
| | - Matthew R. Roesch
- Department of Psychology, University of Maryland, College Park, MD 20742, USA;
- Program in Neuroscience and Cognitive Science, University of Maryland, College Park, MD 20742, USA
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Siquier A, Andrés P. Cognitive and Behavioral Inhibition Deficits in Parkinson's Disease: The Hayling Test as a Reliable Marker. Front Aging Neurosci 2021; 12:621603. [PMID: 33519424 PMCID: PMC7843521 DOI: 10.3389/fnagi.2020.621603] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 12/15/2020] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE The present study seeks to provide an overview of executive (inhibition and flexibility) deficits in Parkinson's disease (PD) by combining a cognitive and behavioral approach. METHODS Fifteen PD patients and 15 healthy controls underwent a neuropsychological and behavioral assessment including the Hayling and Trails Tests, the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease (QUIP-RS), the Behavior Rating Inventory of Executive Function (BRIEF-A), and the Short Form-36 Health Survey (SF-36). The level of awareness of executive functioning was also analyzed. We finally explored how these neuropsychological and clinical outcomes could relate to each other. RESULTS PD patients performed significantly worse in both neuropsychological tasks designed to evaluate inhibition abilities. They also reported more inhibition difficulties in everyday life and poorer quality of life. Associations between neuropsychological measures and self-reports were found. Moreover, as indicated by the discrepancy score, PD patients were as accurate as their relatives in self-reporting their executive daily difficulties. CONCLUSION Inhibition and cognitive flexibility impairments assessed by the neuropsychological tests (Hayling and Trails tests) seem to capture daily life executive problems in PD. Furthermore, our study provides a deeper understanding of PD patients' and their relatives' experience of these executive dysfunctions.
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Affiliation(s)
- Antònia Siquier
- Neuropsychology and Cognition Research Group, Department of Psychology, Research Institute of Health Sciences (IUNICS), University of the Balearic Islands, Palma, Spain
- Balearic Islands Health Research Institute (IdISBa), Palma, Spain
| | - Pilar Andrés
- Neuropsychology and Cognition Research Group, Department of Psychology, Research Institute of Health Sciences (IUNICS), University of the Balearic Islands, Palma, Spain
- Balearic Islands Health Research Institute (IdISBa), Palma, Spain
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Amanzio M, Palermo S. Editorial: Unawareness of Illness in Neurological Disorders: A Focussed Neurocognitive Approach Shedding Light on Neuropsychological Deficits and Neural Underpinnings Potential Association. Front Psychol 2020; 11:622576. [PMID: 33365009 PMCID: PMC7750403 DOI: 10.3389/fpsyg.2020.622576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 11/10/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Martina Amanzio
- Department of Psychology, University of Turin, Turin, Italy.,Department of Neuroscience, Center for the Study of Movement Disorders, University of Turin, Turin, Italy
| | - Sara Palermo
- Department of Neuroscience, Center for the Study of Movement Disorders, University of Turin, Turin, Italy.,European Innovation Partnership on Active and Healthy Aging, Brussels, Belgium
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Palermo S, Carassa A, Morese R. Editorial: Perspective-Taking, Self-Awareness and Social Cognition in Neurodegenerative Disorders, Cerebral Abnormalities and Acquired Brain Injuries (ABI): A Neurocognitive Approach. Front Psychol 2020; 11:614609. [PMID: 33329288 PMCID: PMC7733928 DOI: 10.3389/fpsyg.2020.614609] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 11/09/2020] [Indexed: 11/17/2022] Open
Affiliation(s)
- Sara Palermo
- Department of Neuroscience, Center for the Study of Movement Disorders, University of Turin, Turin, Italy.,European Innovation Partnership on Active and Healthy Ageing, Bruxelles, Belgium
| | - Antonella Carassa
- Faculty of Communication, Culture and Society, Università della Svizzera Italiana, Lugano, Switzerland
| | - Rosalba Morese
- Faculty of Communication, Culture and Society, Università della Svizzera Italiana, Lugano, Switzerland.,Faculty of Biomedical Sciences, Institute of Public Health, Università della Svizzera Italiana, Lugano, Switzerland
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Scarpina F, Bruno V, Rabuffetti M, Priano L, Tagini S, Gindri P, Mauro A, Garbarini F. Drawing lines and circles in Parkinson's Disease: The lateralized symptoms interfere with the movements of the unaffected hand. Neuropsychologia 2020; 151:107718. [PMID: 33309678 DOI: 10.1016/j.neuropsychologia.2020.107718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 11/26/2020] [Accepted: 12/04/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Evidence about altered bimanual coordination has been reported in Parkinson's Disease. However, no previous study has explored such an alteration quantifying the interference effect that the trajectory of each hand might impose on the other one. Thus, in the present research, we applied the traditional Circles-Lines Coupling Task, which allowed assessing the motor coordination of the two hands, in the context of Parkinson's Disease. METHODS Thirty-six individuals affected by Parkinson's Disease were consecutively recruited and assigned to two groups according to their symptoms' lateralization. Moreover, eighteen age-matched healthy controls participated in the study. We capitalized on the Circles-Lines Coupling Task, in which the performance during incongruent movements (drawing lines with one hand and circles with the other hand) was compared with the performance during congruent movements (drawing lines with both hands). A bimanual coupling index was computed to compare the interference effect of each hand on the other one. RESULTS In healthy controls, the bimanual coupling index did not differ between the two hands. Crucially, in both groups of individuals affected by Parkinson's Disease, the less affected hand showed a significantly higher bimanual coupling index, due to the abnormal interference exerted by the most affected one, than vice versa. CONCLUSIONS Our results highlighted an altered spatial bimanual coupling in Parkinson's disease, depending on the symptoms' lateralization. We offered different explanations of our results according to the theoretical frameworks about the mechanisms subserving bimanual coordination.
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Affiliation(s)
- Federica Scarpina
- "Rita Levi Montalcini" Department of Neurosciences, University of Turin, Italy; Istituto Auxologico Italiano, IRCCS, U.O. di Neurologia e Neuroriabilitazione, Piancavallo, VCO, Italy.
| | - Valentina Bruno
- MANIBUS Lab, Department of Psychology, University of Turin, Italy
| | | | - Lorenzo Priano
- "Rita Levi Montalcini" Department of Neurosciences, University of Turin, Italy; Istituto Auxologico Italiano, IRCCS, U.O. di Neurologia e Neuroriabilitazione, Piancavallo, VCO, Italy
| | - Sofia Tagini
- Istituto Auxologico Italiano, IRCCS, U.O. di Neurologia e Neuroriabilitazione, Piancavallo, VCO, Italy
| | | | - Alessandro Mauro
- "Rita Levi Montalcini" Department of Neurosciences, University of Turin, Italy; Istituto Auxologico Italiano, IRCCS, U.O. di Neurologia e Neuroriabilitazione, Piancavallo, VCO, Italy
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12
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Morese R, Palermo S. Altruistic Punishment and Impulsivity in Parkinson's Disease: A Social Neuroscience Perspective. Front Behav Neurosci 2020; 14:102. [PMID: 32792921 PMCID: PMC7385270 DOI: 10.3389/fnbeh.2020.00102] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 05/25/2020] [Indexed: 12/28/2022] Open
Abstract
Non-motor symptoms of Parkinson's disease (PD) are of increasing interest in clinical and psychological research. Disinhibition-the inability to inhibit inappropriate behavior-leads to social and emotional impairments, including impulsive behavior and disregard for social conventions and decision-making behavior. In recent years, the latter has been investigated using economic exchanges during social interactions. Altruistic punishment-to punish someone who violates group norms even if it foresees a personal cost-is one of the most useful and fruitful paradigms; it allows to maintain a cooperation system within social groups. Alterations of this cognitive ability negatively impact the quality of life of the individual and social stability. Social neuroscience has suggested association between impulsive behaviors and altruistic punishment. Neuroimaging research aimed at exploring functional networks and intrinsic functional connectivity went in this direction. To date, little is known about these issues in neurodegenerative diseases such as PD. Dopamine replacement treatment and dopamine-agonists have been associated with impulse-control disorder and impulsive-compulsive behavior able to affect social decision-making. Frontal-executive dysfunction determines an alteration of social functioning through a mechanism of subversion of online action-monitoring, which associates disinhibition with volition. Genetic polymorphisms, alterations of the nigro-striatal substance, and impairment in the medial prefrontal cortex and in the Default mode network (DMN) seem to be able to explain these mechanisms. This theoretical perspective article aims to present these topics in order to encourage an interdisciplinary discussion capable of generating new research and developing rehabilitative intervention to improve social decision-making in PD patients.
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Affiliation(s)
- Rosalba Morese
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland.,Faculty of Communication, Culture and Society, Università della Svizzera italiana, Lugano, Switzerland
| | - Sara Palermo
- Center for the Study of Movement Disorders, Department of Neuroscience, University of Turin, Turin, Italy.,European Innovation Partnership on Active and Healthy Ageing, Brussels, Belgium
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13
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Palermo S, Morese R, Zibetti M, Romagnolo A, Carlotti EG, Zardi A, Valentini MC, Pontremoli A, Lopiano L. What Happens When I Watch a Ballet and I Am Dyskinetic? A fMRI Case Report in Parkinson Disease. Front Psychol 2020; 11:1999. [PMID: 32849162 PMCID: PMC7426453 DOI: 10.3389/fpsyg.2020.01999] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 07/20/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The identical sets of neurons - the mirror neuron system (MNS) - can be activated by simply observing specific, specific movements, decoded behaviors and even facial expressions performed by other people. The same neurons activated during observation are those recruited during the same movements and actions. Hence the mirror system plays a central role in observing and executing movements. Little is known about MNS in a neurodegenerative motor disorder, such as Parkinson's Disease (PD) is. METHODS We explored the neural correlates potentially involved in empathy and embodiment in PD through complex action observation of complex behaviors like the choreutical arts. An integrated multidisciplinary assessment (neurological, neuropsychiatric, and neuropsychological) was used for the selection of the PD candidate for the neuroimaging experimental acquisition. For the first time in literature the famous Calvo-Merino's paradigm was administered to a PD subject. KEY POINTS Functional magnetic resonance imaging (fMRI) exploratory analysis shows the recruitment of the left thalamus, the right dorsolateral prefrontal cortex, and the bilateral superior precentral gyrus (one of the main hubs of the MNS). If the observed choreic movement becomes part of the observer's motor repertoire experience, mirror neurons might activate stimulating affective empathy and making the understanding of movement an own proper body experience (cognitive embodiment). MAIN LESSONS Our study sheds light on a possible use of complex action observation to improve or slow the deterioration of motor abilities and levodopa-induced dyskinesias in PD patients. Indeed, the modulation of the neural area involved in complex action observation could be considered a promising target for neuro-rehabilitative intervention mediated by the elicitation of the MNS.
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Affiliation(s)
- Sara Palermo
- Department of Neuroscience, Center for the Study of Movement Disorders, University of Turin, Turin, Italy
- European Innovation Partnership on Active and Healthy Ageing, Bruxelles, Belgium
| | - Rosalba Morese
- Faculty of Communication, Culture and Society, Università della Svizzera italiana, Lugano, Switzerland
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
| | - Maurizio Zibetti
- Department of Neuroscience, Center for the Study of Movement Disorders, University of Turin, Turin, Italy
| | - Alberto Romagnolo
- Department of Neuroscience, Center for the Study of Movement Disorders, University of Turin, Turin, Italy
| | | | - Andrea Zardi
- Dipartimento di Studi Umanistici, University of Turin, Turin, Italy
| | - Maria Consuelo Valentini
- Neuroradiology Unit, Azienda Ospedaliera Universitaria “Città della Salute e della Scienza di Torino”, Turin, Italy
| | | | - Leonardo Lopiano
- Department of Neuroscience, Center for the Study of Movement Disorders, University of Turin, Turin, Italy
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14
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Amanzio M, Bartoli M, Cipriani GE, Palermo S. Executive Dysfunction and Reduced Self-Awareness in Patients With Neurological Disorders. A Mini-Review. Front Psychol 2020; 11:1697. [PMID: 32760331 PMCID: PMC7371941 DOI: 10.3389/fpsyg.2020.01697] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 06/22/2020] [Indexed: 11/13/2022] Open
Abstract
Awareness of deficits in patients with neurological disorders may be described as a theoretical unitary phenomenon, which has been analysed reaching interesting results in the last decades. Awareness of deficits manifests itself in a continuum ranging from full awareness to total absence. In line with a neurocognitive approach, a reduction in self-awareness could be explained considering executive dysfunction associated with prefrontal cortex anatomo-functional changes. Our mini-review will focus on reduced self-awareness in neurological disorders, such as Alzheimer’s disease, behavioural Frontotemporal Dementia and Acquired Brain Injuries. Results achieved thanks to an explanatory investigative approach combined with a theoretical reference model will be presented. Data suggest the key role of executive functions in supporting adequate self-awareness towards patients’ cognitive-behavioural profile and instrumental activity autonomy. The Cognitive Awareness Model seems to be one of the best theoretical model to better approach this phenomenon.
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Affiliation(s)
- Martina Amanzio
- Department of Psychology, University of Turin, Turin, Italy.,European Innovation Partnership on Active and Healthy Ageing, Brussels, Belgium
| | | | | | - Sara Palermo
- Department of Psychology, University of Turin, Turin, Italy.,European Innovation Partnership on Active and Healthy Ageing, Brussels, Belgium
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15
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Shen Y, Hu J, Chen Y, Liu W, Li Y, Yan L, Xie C, Zhang W, Yu M, Liu W. Levodopa Changes Functional Connectivity Patterns in Subregions of the Primary Motor Cortex in Patients With Parkinson's Disease. Front Neurosci 2020; 14:647. [PMID: 32733186 PMCID: PMC7360730 DOI: 10.3389/fnins.2020.00647] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 05/25/2020] [Indexed: 12/12/2022] Open
Abstract
Background The primary motor cortex (M1) is a critical node in Parkinson’s disease (PD)-related motor circuitry; however, the functional roles of its subregions are poorly understood. In this study, we investigated changes in the functional connectivity patterns of M1 subregions and their relationships to improved clinical symptoms following levodopa administration. Methods Thirty-six PD patients and 37 healthy controls (HCs) were enrolled. A formal levodopa challenge test was conducted in the PD group, and the Unified Parkinson’s Disease Rating Scale motor section (UPDRS-III) was assessed before (off state) and 1 h after administration of levodopa (on state). The PD group underwent resting-state functional magnetic resonance imaging in both off and on states, whereas the HC group was scanned once. We used the Human Brainnetome Atlas template to subdivide M1 into twelve regions of interest (ROIs). Functional connectivity (FC) was compared between PD on and off states [paired t-test, voxel-level p < 0.001, cluster-level p < 0.05, Gaussian random field (GRF) correction] and between patients and HC (two-sample t-test voxel-level p < 0.001, cluster-level p < 0.05). Correlations between ΔFC (differences in FC between PD off and on states) and clinical symptom improvements were examined. Results There was decreased FC between the right caudal dorsolateral area 6 and the anterior cingulate gyrus (ACC), the right upper limb region and the left medial dorsal thalamus (mdTHA), as well as increased FC between the left tongue and larynx region and the left medial frontal gyrus. ΔFC between the right caudal dorsolateral area 6 and ACC was positively correlated with improvements in UPDRS-III total scores as well as the rigidity (item 22) and bradykinesia (items 23–26 and 31) subscores. ΔFC between the right upper limb region and left thalamus was positively correlated with improvements in the left upper limb tremor (items 20c and 21b) and postural tremor (item 21b) subscores. Conclusions Our results reveal novel information regarding the underlying mechanisms in the motor circuits in the M1 and a promising way to explore the internal function of the M1 in PD patients. Notably, M1 is a potential therapeutic target in PD, and the exploration of its subregions provides a basis and a source of new insights for clinical intervention and precise drug treatment.
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Affiliation(s)
- Yang Shen
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Jun Hu
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yong Chen
- Department of Laboratory Medicine, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Wan Liu
- Department of Rehabilitation, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yuqian Li
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Lei Yan
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Chunming Xie
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Wenbin Zhang
- Department of Functional Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Miao Yu
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Weiguo Liu
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
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16
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Cenci MA, Riggare S, Pahwa R, Eidelberg D, Hauser RA. Dyskinesia matters. Mov Disord 2019; 35:392-396. [PMID: 31872501 DOI: 10.1002/mds.27959] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 11/18/2019] [Accepted: 12/02/2019] [Indexed: 12/12/2022] Open
Abstract
Levodopa-induced dyskinesia (LID) represents a significant source of discomfort for people with Parkinson's disease (PD). It negatively affects quality of life, it is associated with both motor and nonmotor fluctuations, and it brings an increased risk of disability, balance problems, and falls. Although the prevalence of severe LID appears to be lower than in previous eras (likely owing to a more conservative use of oral levodopa), we have not yet found a way to prevent the development of this complication. Advanced surgical therapies, such as deep brain stimulation, ameliorate LID, but only a minority of PD patients qualify for these interventions. Although some have argued that PD patients would rather be ON with dyskinesia than OFF, the deeper truth is that patients would very much prefer to be ON without dyskinesia. As researchers and clinicians, we should aspire to make that goal a reality. To this end, translational research on LID is to be encouraged and persistently pursued. © 2019 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- M Angela Cenci
- Basal Ganglia Pathophysiology Unit, Dept. of Experimental Medical Science, Lund University, Lund, Sweden
| | - Sara Riggare
- Department for Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Rajesh Pahwa
- University of Kansas Medical Center, Movement Disorders Division, Kansas City, Kansas, USA
| | - David Eidelberg
- Center for Neurosciences, The Feinstein Institute for Medical Research, Manhasset, New York, USA
| | - Robert A Hauser
- University of South Florida, Department of Neurology, Tampa, Florida, USA
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17
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Gao Q, Jia G, Zhao J, Zhang D. Inhibitory Control in Excessive Social Networking Users: Evidence From an Event-Related Potential-Based Go-Nogo Task. Front Psychol 2019; 10:1810. [PMID: 31447743 PMCID: PMC6692436 DOI: 10.3389/fpsyg.2019.01810] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 07/22/2019] [Indexed: 12/18/2022] Open
Abstract
Inhibitory control is a core executive function module that monitors and suppresses inappropriate behavior. Inhibitory deficits have been observed in different addiction types (e.g., smoking, alcohol, drug and gambling). The excessive use of social networking sites (SNSs) has attracted increasing attention; however, it is unknown whether inhibitory control is impaired in excessive SNS users. This study used event-related potentials in an SNS-related Go-Nogo task to investigate inhibitory control in excessive SNS users. Although the behavioral data did not show any significant differences between groups, the N1 amplitude was larger following SNS images than control images in excessive SNS users. Furthermore, excessive users showed larger N2 amplitude and smaller Nogo-P3 amplitude than non-excessive users irrespective of stimuli. These findings suggested that excessive SNS users are inefficient in allocating monitoring resources in the Go-Nogo task (reflected by enhance N2) and show difficulty in late inhibitory control procedure (reflected by reduced Nogo-P3) compared to non-excessive users. Also, excessive SNS users pay more attention to SNS-related images compared to non-SNS-related images (reflected by the N1). Interventions for this specific population should focus on limiting exposure to SNS cues and enhancing inhibitory control.
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Affiliation(s)
- Qiufeng Gao
- Department of Sociology, Shenzhen University, Shenzhen, China
| | - Ge Jia
- Department of Sociology, Shenzhen University, Shenzhen, China
| | - Jun Zhao
- College of Psychology, Shenzhen University, Shenzhen, China
| | - Dandan Zhang
- College of Psychology, Shenzhen University, Shenzhen, China.,Shenzhen Key Laboratory of Affective and Social Cognitive Science, Shenzhen University, Shenzhen, China
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18
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Palermo S, Andò A, Salatino A, Sirgiovanni S, De Faveri L, Carassa A, Valentini MC, Morese R. Selective Emotional Dysregulation in Splenium Agenesis. A Case Report of a Patient With Normal Cognitive Profile. Front Psychol 2019; 10:631. [PMID: 30967819 PMCID: PMC6438861 DOI: 10.3389/fpsyg.2019.00631] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 03/06/2019] [Indexed: 11/13/2022] Open
Abstract
Objective: Patients with lesions of the corpus callosum are rare and may present different symptoms of the disconnection syndrome. However, to-date studies on callosotomized patients have not been conclusive, likely because of the non-uniform nature of clinical features, the extent of resection, and methods used to investigate specific and related deficits. Agenesis of the corpus callosum (AgCC) may be asymptomatic and discovered incidentally or associated with very slight deficits diagnosed during neurological examinations. In this study, we reported a case of an apparently completely asymptomatic 23-year-old woman with appreciable agenesis of the splenium of the corpus callosum. Methods: She underwent a neurological evaluation, a comprehensive battery of neuropsychological tests to identify any subclinical dysfunction that may affect the functionality of the subject in the daily life. Specifically, the possible presence of emotion dysregulation was examined by using a self-report questionnaire. Results: She showed normal neuropsychological and emotional functioning, performing efficiently on tests measuring acquired brain impairment. Discussion: The present case is discussed in terms of neuroplasticity - with a focus on putative compensatory mechanisms - emphasizing the variegated clinical feature patterns of brain defects present from birth.
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Affiliation(s)
- Sara Palermo
- Department of Psychology, University of Turin, Turin, Italy
- Neuroradiology Division, Azienda Ospedaliera-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Agata Andò
- Department of Psychology, University of Turin, Turin, Italy
| | | | - Stefano Sirgiovanni
- Neuroradiology Division, Azienda Ospedaliera-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Luana De Faveri
- Neuroradiology Division, Azienda Ospedaliera-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Antonella Carassa
- Faculty of Communication Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Maria C. Valentini
- Neuroradiology Division, Azienda Ospedaliera-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Rosalba Morese
- Faculty of Communication Sciences, Università della Svizzera Italiana, Lugano, Switzerland
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19
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Palermo S, Rainero I, Stanziano M, Vase L, D'Agata F, Rubino E, Fonio P, Sardanelli F, Amanzio M. A novel neurocognitive approach for placebo analgesia in neurocognitive disorders. Exp Gerontol 2019; 118:106-116. [PMID: 30658120 DOI: 10.1016/j.exger.2019.01.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 12/24/2018] [Accepted: 01/11/2019] [Indexed: 01/26/2023]
Abstract
Neural correlates of placebo analgesia (PA) in patients with neurocognitive disorders have not yet been elucidated. The present study aimed to evaluate how and to what extent executive (dys)functions of the medial prefrontal cortex (MPFC) may be related to PA. To this end, twenty-three subjects complaining of different cognitive deficits (from mild cognitive impairment likely due to Alzheimer's disease to mild AD) were recruited. PA was investigated by a well-known experimental venipuncture pain paradigm (open versus hidden [O-H] application of lidocaine). Patients also underwent a comprehensive neuropsychological evaluation and a functional magnetic resonance imaging (fMRI) GO/No-GO task for eliciting selective activation of the MPFC. Selected neuropsychological variables were correlated to the OH-PA paradigm. The association between the fMRI response on the "No-GO" versus "GO" contrast and PA was investigated over the whole-brain by regression analysis. We showed the existence of a relationship between a lower PA and MPFC dysfunctions through the neuropsychological and fMRI assessment. A separate voxel-based morphometry (VBM) analysis controlled for possible influence of grey matter (GM) volume reduction on both fMRI results and PA. fMRI results were not directly affected by, and therefore independent of, disease-specific GM atrophy, which was indeed located more anteriorly within the rostral anterior cingulate and inversely correlated with PA. Our findings shed new light on the underestimated contribution of executive (dys)functions mediated by the MPFC (response-inhibition, self-monitoring and set-shifting abilities) in PA pathogenesis, with a special purely (i.e. independently from brain structural alterations) functional role played by the MCC. Results are discussed in terms of possible clinical relevance in the management of patients with neurocognitive disorders.
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Affiliation(s)
- S Palermo
- Department of Psychology, University of Turin, Italy.
| | - I Rainero
- Neurology 1st Unit, Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy
| | - M Stanziano
- Postgraduate School in Radiodiagnostics, University of Milan, Milan, Italy; Brain Imaging Center, Neuroscience Institute of Turin (NIT), Turin, Italy
| | - L Vase
- Department of Psychology and Behavioural Sciences, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark
| | - F D'Agata
- Brain Imaging Center, Neuroscience Institute of Turin (NIT), Turin, Italy
| | - E Rubino
- Neurology 1st Unit, Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy
| | - P Fonio
- Department of Diagnostic and Interventional Imaging, Radiology Institute, University of Turin, A.O.U. "Città della Salute e della Scienza di Torino", Turin, Italy
| | - F Sardanelli
- Department of Biomedical Sciences for Health, University of Milan, San Donato Milanese, Italy; IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - M Amanzio
- Department of Psychology, University of Turin, Italy; European Innovation Partnership on Active and Healthy Ageing, Brussels, Belgium
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