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Marras C, Fereshtehnejad SM, Berg D, Bohnen NI, Dujardin K, Erro R, Espay AJ, Halliday G, Van Hilten JJ, Hu MT, Jeon B, Klein C, Leentjens AFG, Mollenhauer B, Postuma RB, Rodríguez-Violante M, Simuni T, Weintraub D, Lawton M, Mestre TA. Transitioning from Subtyping to Precision Medicine in Parkinson's Disease: A Purpose-Driven Approach. Mov Disord 2024; 39:462-471. [PMID: 38243775 DOI: 10.1002/mds.29708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/29/2023] [Accepted: 12/18/2023] [Indexed: 01/21/2024] Open
Abstract
The International Parkinson and Movement Disorder Society (MDS) created a task force (TF) to provide a critical overview of the Parkinson's disease (PD) subtyping field and develop a guidance on future research in PD subtypes. Based on a literature review, we previously concluded that PD subtyping requires an ultimate alignment with principles of precision medicine, and consequently novel approaches were needed to describe heterogeneity at the individual patient level. In this manuscript, we present a novel purpose-driven framework for subtype research as a guidance to clinicians and researchers when proposing to develop, evaluate, or use PD subtypes. Using a formal consensus methodology, we determined that the key purposes of PD subtyping are: (1) to predict disease progression, for both the development of therapies (use in clinical trials) and prognosis counseling, (2) to predict response to treatments, and (3) to identify therapeutic targets for disease modification. For each purpose, we describe the desired product and the research required for its development. Given the current state of knowledge and data resources, we see purpose-driven subtyping as a pragmatic and necessary step on the way to precision medicine. © 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Connie Marras
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | | | - Daniela Berg
- Department of Neurology, Christian-Albrechts-University, Kiel, Germany
| | - Nicolaas I Bohnen
- Departments of Radiology & Neurology, University of Michigan, University of Michigan Udall Center, Ann Arbor, Michigan, USA
| | - Kathy Dujardin
- Center of Excellence for Parkinson's Disease, CHU Lille, Univ Lille, Inserm, Lille Neuroscience & Cognition, Lille, France
| | - Roberto Erro
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience Section, University of Salerno, Baronissi, Italy
| | - Alberto J Espay
- James J. and Joan A. Gardner Family Center for Parkinson's Disease and Movement Disorders, Department of Neurology, University of Cincinnati, Cincinnati, Ohio, USA
| | - Glenda Halliday
- Brain and Mind Centre and Faculty of Medicine and Health School of Medical Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - Jacobus J Van Hilten
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Michele T Hu
- Nuffield Department of Clinical Neurosciences, Oxford University and John Radcliffe Hospital, West Wing, Neurology Department, Level 3, Oxford, United Kingdom
| | - Beomseok Jeon
- Department of Neurology, Seoul National University Hospital, Seoul, South Korea
| | - Christine Klein
- Institute of Neurogenetics, University of Luebeck, Luebeck, Germany
| | - Albert F G Leentjens
- Department of Psychiatry, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Brit Mollenhauer
- Paracelsus-Elena-Klinik, Kassel, Department of Neurology, University Medical Center Goettingen, Kassel, Germany
| | - Ronald B Postuma
- Department of Neurology, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | | | - Tanya Simuni
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Daniel Weintraub
- Departments of Psychiatry and Neurology, Perelman School of Medicine at the University of Pennsylvania; Parkinson's Disease Research, Education and Clinical Center (PADRECC), Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
| | - Michael Lawton
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Tiago A Mestre
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
- Parkinson's Disease and Movement Disorders Center, Division of Neurology, Department of Medicine, The Ottawa Hospital Research Institute, The University of Ottawa Brain and Research Institute, Ottawa, Ontario, Canada
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Wawrziczny E, Flinois B, Constant E, Brugallé E, Sokolowski C, Manceau C, Baille G, Defebvre L, Dujardin K, Antoine P. Dealing with the diagnosis of Parkinson's disease and its implications for couple functioning in the early stage: An interpretative phenomenological analysis. PLoS One 2024; 19:e0294240. [PMID: 38381728 PMCID: PMC10880977 DOI: 10.1371/journal.pone.0294240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 10/27/2023] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND For couples facing Parkinson's disease, marital relationships are significantly impacted, even at the early stages of the disease. However, very few studies have explicitly explored the functioning of the couple and how both partners deal with Parkinson's disease. The aim of this study was to explore the experiences and strategies of couples facing Parkinson's disease in the early stage using dyadic interpretative phenomenological analysis. METHODS Fifteen couples agreed to participate in the study. Semistructured interviews were conducted with each partner separately regarding his or her individual experience with Parkinson's disease, the couple's history, the impact of the diagnosis on the functioning of the couple, and his or her projections for the future. RESULTS Three higher-order themes emerged from the analyses. The first theme, "Being tested by the diagnosis", highlights 4 dyadic configurations according to the individual's and the couple's capacity for adjustment following the diagnosis: "noncongruent", "collapsed", "relieved" and "avoidant". The second theme, "Talking about everything except the disease", underlines that communication about the disease is often avoided both within the couple and with relatives to protect the persons with Parkinson's disease or respect their wishes. The third theme, "Supporting each other", describes the different levels of harmony between the two partners in the management of daily life and symptoms and their relational impacts. CONCLUSION These results allow us to better understand the experiences of both partners and to highlight the importance of promoting better acceptance of the diagnosis by persons with Parkinson's disease to allow better communication between partners and with relatives. Such support prevents disease-specific distress and facilitates better adjustment in the later stages of the disease.
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Affiliation(s)
- Emilie Wawrziczny
- University of Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives, Lille, France
| | | | - Emilie Constant
- University of Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives, Lille, France
| | - Elodie Brugallé
- University of Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives, Lille, France
| | - Céline Sokolowski
- University of Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives, Lille, France
| | - Charlotte Manceau
- University of Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives, Lille, France
| | | | - Luc Defebvre
- Regional and University Hospital Centre of Lille, Lille, France
| | - Kathy Dujardin
- Regional and University Hospital Centre of Lille, Lille, France
| | - Pascal Antoine
- University of Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives, Lille, France
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Béreau M, Kibleur A, Servant M, Clément G, Dujardin K, Rolland AS, Wirth T, Lagha-Boukbiza O, Voirin J, Santin MDN, Hainque E, Grabli D, Comte A, Drapier S, Durif F, Marques A, Eusebio A, Azulay JP, Giordana C, Houeto JL, Jarraya B, Maltete D, Rascol O, Rouaud T, Tir M, Moreau C, Danaila T, Prange S, Tatu L, Tranchant C, Corvol JC, Devos D, Thobois S, Desmarets M, Anheim M. Motivational and cognitive predictors of apathy after subthalamic nucleus stimulation in Parkinson's disease. Brain 2024; 147:472-485. [PMID: 37787488 DOI: 10.1093/brain/awad324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 07/13/2023] [Accepted: 08/21/2023] [Indexed: 10/04/2023] Open
Abstract
Postoperative apathy is a frequent symptom in Parkinson's disease patients who have undergone bilateral deep brain stimulation of the subthalamic nucleus. Two main hypotheses for postoperative apathy have been suggested: (i) dopaminergic withdrawal syndrome relative to postoperative dopaminergic drug tapering; and (ii) direct effect of chronic stimulation of the subthalamic nucleus. The primary objective of our study was to describe preoperative and 1-year postoperative apathy in Parkinson's disease patients who underwent chronic bilateral deep brain stimulation of the subthalamic nucleus. We also aimed to identify factors associated with 1-year postoperative apathy considering: (i) preoperative clinical phenotype; (ii) dopaminergic drug management; and (iii) volume of tissue activated within the subthalamic nucleus and the surrounding structures. We investigated a prospective clinical cohort of 367 patients before and 1 year after chronic bilateral deep brain stimulation of the subthalamic nucleus. We assessed apathy using the Lille Apathy Rating Scale and carried out a systematic evaluation of motor, cognitive and behavioural signs. We modelled the volume of tissue activated in 161 patients using the Lead-DBS toolbox and analysed overlaps within motor, cognitive and limbic parts of the subthalamic nucleus. Of the 367 patients, 94 (25.6%) exhibited 1-year postoperative apathy: 67 (18.2%) with 'de novo apathy' and 27 (7.4%) with 'sustained apathy'. We observed disappearance of preoperative apathy in 22 (6.0%) patients, who were classified as having 'reversed apathy'. Lastly, 251 (68.4%) patients had neither preoperative nor postoperative apathy and were classified as having 'no apathy'. We identified preoperative apathy score [odds ratio (OR) 1.16; 95% confidence interval (CI) 1.10, 1.22; P < 0.001], preoperative episodic memory free recall score (OR 0.93; 95% CI 0.88, 0.97; P = 0.003) and 1-year postoperative motor responsiveness (OR 0.98; 95% CI 0.96, 0.99; P = 0.009) as the main factors associated with postoperative apathy. We showed that neither dopaminergic dose reduction nor subthalamic stimulation were associated with postoperative apathy. Patients with 'sustained apathy' had poorer preoperative fronto-striatal cognitive status and a higher preoperative action initiation apathy subscore. In these patients, apathy score and cognitive status worsened postoperatively despite significantly lower reduction in dopamine agonists (P = 0.023), suggesting cognitive dopa-resistant apathy. Patients with 'reversed apathy' benefited from the psychostimulant effect of chronic stimulation of the limbic part of the left subthalamic nucleus (P = 0.043), suggesting motivational apathy. Our results highlight the need for careful preoperative assessment of motivational and cognitive components of apathy as well as executive functions in order to better prevent or manage postoperative apathy.
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Affiliation(s)
- Matthieu Béreau
- Department of Neurology, NS-PARK/F-CRIN network, University Hospital of Besançon, 25030 Besançon Cedex, France
- UR LINC 481, Université de Franche-Comté, F-2500 Besançon, France
| | - Astrid Kibleur
- LIP/PC2S, Université Grenoble Alpes, Université Savoie Mont Blanc, 38040 Grenoble Cedex 9, France
| | - Mathieu Servant
- UR LINC 481, Université de Franche-Comté, F-2500 Besançon, France
| | - Gautier Clément
- Department of Neurology, NS-PARK/F-CRIN network, University Hospital of Besançon, 25030 Besançon Cedex, France
| | - Kathy Dujardin
- Lille Neurosciences and Cognition, CHU-Lille, Neurology and Movement Disorders department, NS-Park/F-CRIN network, Univ. Lille, 59037 Lille, France
| | - Anne-Sophie Rolland
- Lille Neurosciences and Cognition, CHU-Lille, Department of Medical Pharmacology, NS-Park/F-CRIN, Univ. Lille, Inserm, 59045 Lille, France
| | - Thomas Wirth
- Service de Neurologie, NS-Park/F-CRIN network, Hôpitaux Universitaires de Strasbourg et Fédération de Médecine Translationnelle de Médecine de Strasbourg, 67200 Strasbourg, France
- Institut de Génétique et de Biologie Moléculaire et Cellulaire, INSERM-U964/CNRS-UMR7104/Université de Strasbourg, 67400 Illkirch, France
| | - Ouhaid Lagha-Boukbiza
- Service de Neurologie, NS-Park/F-CRIN network, Hôpitaux Universitaires de Strasbourg et Fédération de Médecine Translationnelle de Médecine de Strasbourg, 67200 Strasbourg, France
| | - Jimmy Voirin
- Department of Neurosurgery, NS-PARK/F-CRIN network, Strasbourg University Hospital, 67200 Strasbourg, France
| | - Marie des Neiges Santin
- Department of Neurosurgery, NS-PARK/F-CRIN network, Strasbourg University Hospital, 67200 Strasbourg, France
| | - Elodie Hainque
- Assistance publique Hôpitaux de Paris, Inserm, CNRS, Hôpital Pitié-Salpêtrière, Department of Neurology, NS-Park/F-CRIN network, Sorbonne Université, Paris Brain Institute-ICM, 75014 Paris, France
| | - David Grabli
- Assistance publique Hôpitaux de Paris, Inserm, CNRS, Hôpital Pitié-Salpêtrière, Department of Neurology, NS-Park/F-CRIN network, Sorbonne Université, Paris Brain Institute-ICM, 75014 Paris, France
| | - Alexandre Comte
- UR LINC 481, Université de Franche-Comté, F-2500 Besançon, France
- Centre d'investigation clinique Inserm CIC 1431, CHU Besançon, F-25000 Besançon, France
| | - Sophie Drapier
- Department of Neurology, NS-PARK/F-CRIN network, University Hospital of Rennes, 35000 Rennes, France
| | - Franck Durif
- CNRS, Clermont Auvergne INP, Institut Pascal, Clermont-Ferrand University Hospital, Neurology department, NS-Park/F-CRIN network, Université Clermont Auvergne, 63000 Clermont-Ferrand, France
| | - Ana Marques
- CNRS, Clermont Auvergne INP, Institut Pascal, Clermont-Ferrand University Hospital, Neurology department, NS-Park/F-CRIN network, Université Clermont Auvergne, 63000 Clermont-Ferrand, France
| | - Alexandre Eusebio
- Department of Neurology and Movement Disorders, APHM, Hôpital Universitaire Timone, 13005 Marseille, France
- CNRS, Institut de Neurosciences de la Timone, Aix Marseille Univ., 13005 Marseille, France
| | - Jean-Philippe Azulay
- Department of Neurology and Movement Disorders, APHM, Hôpital Universitaire Timone, 13005 Marseille, France
- CNRS, Institut de Neurosciences de la Timone, Aix Marseille Univ., 13005 Marseille, France
| | - Caroline Giordana
- Department of Neurology, NS-Park/F-CRIN network, Centre Hospitalier Universitaire de Nice, 06002 Nice, France
| | - Jean-Luc Houeto
- Department of Neurology, NS-Park/F-CRIN network, Limoges University Hospital, Inserm, U1094, EpiMaCT-Epidemiology of chronic diseases in tropical zone, Limoges University Hospital,87042 Limoges, France
| | - Béchir Jarraya
- Neuroscience Pole, NS-Park/F-CRIN network, Hôpital Foch, Suresnes, University of Versailles Paris-Saclay, INSERM-CEA NeuroSpin, 91191 Gif-sur-Yvette, France
| | - David Maltete
- Department of Neurology, NS-Park/F-CRIN network, Rouen University Hospital and University of Rouen, 76000 Rouen, France
- INSERM U1239, Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, 76130 Mont-Saint-Aignan, France
| | - Olivier Rascol
- Department of Clinical Pharmacology and Neuroscience, CIC1436, NS-Park/F-CRIN network, NeuroToul Center of Excellence, Toulouse University Hospital, INSERM, CHU of Toulouse, 31000 Toulouse, France
| | - Tiphaine Rouaud
- Department of Neurology, Centre Expert Parkinson, NS-Park/F-CRIN network, CHU Nantes, 44093 Nantes, France
| | - Mélissa Tir
- Department of Neurology, NS-Park/F-CRIN network, Amiens University Hospital, 80000 Amiens, France
| | - Caroline Moreau
- Lille Neurosciences and Cognition, CHU-Lille, Neurology and Movement Disorders department, NS-Park/F-CRIN network, Univ. Lille, 59037 Lille, France
| | - Teodor Danaila
- Department of Neurology, NS-Park/F-CRIN network, Amiens University Hospital, 80000 Amiens, France
| | - Stéphane Prange
- Department of Neurology, NS-Park/F-CRIN network, Amiens University Hospital, 80000 Amiens, France
- Service de Neurologie C, NS-Park/F-CRIN network, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, 69500 Bron, France
| | - Laurent Tatu
- Department of Neurology, NS-PARK/F-CRIN network, University Hospital of Besançon, 25030 Besançon Cedex, France
| | - Christine Tranchant
- Service de Neurologie, NS-Park/F-CRIN network, Hôpitaux Universitaires de Strasbourg et Fédération de Médecine Translationnelle de Médecine de Strasbourg, 67200 Strasbourg, France
| | - Jean-Christophe Corvol
- Assistance publique Hôpitaux de Paris, Inserm, CNRS, Hôpital Pitié-Salpêtrière, Department of Neurology, NS-Park/F-CRIN network, Sorbonne Université, Paris Brain Institute-ICM, 75014 Paris, France
| | - David Devos
- Lille Neurosciences and Cognition, CHU-Lille, Neurology and Movement Disorders department, NS-Park/F-CRIN network, Univ. Lille, 59037 Lille, France
- Lille Neurosciences and Cognition, CHU-Lille, Department of Medical Pharmacology, NS-Park/F-CRIN, Univ. Lille, Inserm, 59045 Lille, France
| | - Stephane Thobois
- Service de Neurologie C, NS-Park/F-CRIN network, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, 69500 Bron, France
- Institut des Sciences Cognitives Marc Jeannerot, CNRS, UMR5229, 69675 Bron, France
| | - Maxime Desmarets
- Centre d'investigation clinique Inserm CIC 1431, CHU Besançon, F-25000 Besançon, France
- Université de Franche-Comté, EFS, INSERM, UMR RIGHT, 25000 Besançon, France
| | - Mathieu Anheim
- Service de Neurologie, NS-Park/F-CRIN network, Hôpitaux Universitaires de Strasbourg et Fédération de Médecine Translationnelle de Médecine de Strasbourg, 67200 Strasbourg, France
- Institut de Génétique et de Biologie Moléculaire et Cellulaire, INSERM-U964/CNRS-UMR7104/Université de Strasbourg, 67400 Illkirch, France
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Corveleyn X, Corbel C, Fabre R, Zeghari R, Dujardin K, Robert P, Manera V. Validation study of the apathy motivation index in French adults. Front Psychol 2023; 14:1252965. [PMID: 37928593 PMCID: PMC10624122 DOI: 10.3389/fpsyg.2023.1252965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 09/25/2023] [Indexed: 11/07/2023] Open
Abstract
Objective Apathy is present in many brain disorders, but it is also prevalent to varying degrees in healthy people. While many tools have been developed to assess levels of apathy in pathology, no standardized measure of apathy in healthy people exists. Method Therefore, this study aimed to validate the French version of the Apathy Motivation Index (f-AMI). The results of 729 participants were analyzed using an exploratory factorial analysis. Results Preliminary analyses suggested that the three domains of apathy extracted in the original AMI scale-behavioral activation (BA), social motivation (SM), and emotional sensitivity (ES)-could be found also in the f-AMI. A further exploratory analysis showed that a higher number of factors could be extracted, particularly for women. Specifically, both social and emotional factors could be divided into two sub-factors: (1) social motivation toward strangers or toward an acquaintance and (2) self-directed emotional sensitivity directed toward others. Regarding construct validity, the scores of f-AMI were correlated with the French Dimensional Apathy Scale results. Concerning the divergent validity, emotional sensitivity in apathy is different from depression, anhedonia, and fatigue levels. Conclusion These results suggest that the f-AMI can be used to assess levels of apathy in healthy adults.
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Affiliation(s)
- Xavier Corveleyn
- LAPCOS, Université Côte d'Azur, Nice, France
- MSHS Sud-Est, Maison des Sciences de l'Homme et de la Société Sud-Est, Nice, France
| | - Camille Corbel
- LAPCOS, Université Côte d'Azur, Nice, France
- MSHS Sud-Est, Maison des Sciences de l'Homme et de la Société Sud-Est, Nice, France
| | - Roxane Fabre
- CoBTeK Lab, Université Côte d'Azur, Nice, France
- Département de Santé Publique, Centre Hospitalier Universitaire de Nice (Public Health Department University Hospital of Nice), Nice, France
| | | | - Kathy Dujardin
- CHU Lille, Lille Neurosciences and Cognition, INSERM, Université Lille, Lille, France
| | - Philippe Robert
- CoBTeK Lab, Université Côte d'Azur, Nice, France
- Centre Hospitalier Universitaire de Nice, Centre mémoire CMRR, Nice, France
- Association Innovation Alzheimer, Nice, France
| | - Valeria Manera
- CoBTeK Lab, Université Côte d'Azur, Nice, France
- Centre Hospitalier Universitaire de Nice, Centre mémoire CMRR, Nice, France
- Association Innovation Alzheimer, Nice, France
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Bayot M, Dujardin K, Gérard M, Braquet A, Tard C, Betrouni N, Defebvre L, Delval A. The contribution of executive control dysfunction to freezing of gait in Parkinson's disease. Clin Neurophysiol 2023; 152:75-89. [PMID: 37356311 DOI: 10.1016/j.clinph.2023.05.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 03/16/2023] [Accepted: 05/06/2023] [Indexed: 06/27/2023]
Abstract
OBJECTIVE An executive dysfunction is supposed to contribute to freezing of gait (FoG) in Parkinson's disease. We aimed to investigate at a behavioral and cortical levels whether an attentional load (particularly, a conflicting situation) can specifically impact preparation and execution phases of step initiation in parkinsonian patients with FoG. METHODS Fifteen patients with FoG, 16 without and 15 controls performed an adapted version of the Attention Network Test, with step initiation as response instead of the standard manual keypress. Kinetic and kinematic features of gait initiation as well as high-resolution electroencephalography were recorded during the task. RESULTS Patients with FoG presented an impaired executive control. Step execution time was longer in parkinsonian patients. However, the executive control effect on step execution time was not different between all groups. Compared to patients, controls showed a shorter step initiation-locked alpha desynchronization, and an earlier, more intense and shorter beta desynchronization over the sensorimotor cortex. Even though controls were faster, the induced alpha and beta activity associated with the effect of executive control didn't differ between patients and controls. CONCLUSIONS Tasks of conflict resolution lead to a comparable alteration of step initiation and its underlying brain activity in all groups. Links between executive control, gait initiation and FoG seem more complex than expected. SIGNIFICANCE This study questions the cognitive hypothesis in the pathophysiology of freezing of gait. Executive dysfunction is associated with FoG but is not the main causal mechanism since the interaction between attention and motor preparation didn't provoke FoG.
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Affiliation(s)
- Madli Bayot
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Department of Clinical Neurophysiology, F-59000 Lille, France.
| | - Kathy Dujardin
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Department of Neurology and Movement Disorders, F-59000 Lille, France.
| | - Morgane Gérard
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Department of Clinical Neurophysiology, F-59000 Lille, France.
| | | | - Céline Tard
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Department of Neurology and Movement Disorders, F-59000 Lille, France.
| | - Nacim Betrouni
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Department of Clinical Neurophysiology, F-59000 Lille, France.
| | - Luc Defebvre
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Department of Neurology and Movement Disorders, F-59000 Lille, France.
| | - Arnaud Delval
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Department of Clinical Neurophysiology, F-59000 Lille, France.
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Carey G, Lopes R, Moonen AJ, Mulders AE, de Jong JJ, Kuchcinski G, Defebvre L, Kuijf ML, Dujardin K, Leentjens AF. Cognitive Behavioral Therapy for Anxiety in Parkinson's Disease Induces Functional Brain Changes. J Parkinsons Dis 2023; 13:93-103. [PMID: 36591659 PMCID: PMC9912714 DOI: 10.3233/jpd-223527] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Cognitive behavioral therapy (CBT) reduces anxiety symptoms in patients with Parkinson's disease (PD). OBJECTIVE The objective of this study was to identify changes in functional connectivity in the brain after CBT for anxiety in patients with PD. METHODS Thirty-five patients with PD and clinically significant anxiety were randomized over two groups: CBT plus clinical monitoring (10 CBT sessions) or clinical monitoring only (CMO). Changes in severity of anxiety symptoms were assessed with the Parkinson Anxiety Scale (PAS). Resting-state functional brain MRI was performed at baseline and after the intervention. Functional networks were extracted by an Independent Component Analysis (ICA). Functional connectivity (FC) changes between structures involved in the PD-related anxiety circuits, such as the fear circuit (involving limbic, frontal, and cingulate structures) and the cortico-striato-thalamo-cortical limbic circuit, and both within and between functional networks were compared between groups and regressed with anxiety symptoms changes. RESULTS Compared to CMO, CBT reduced the FC between the right thalamus and the bilateral orbitofrontal cortices and increased the striato-frontal FC. CBT also increased the fronto-parietal FC within the central executive network (CEN) and between the CEN and the salience network. After CBT, improvement of PAS-score was associated with an increased striato-cingulate and parieto-temporal FC, and a decreased FC within the default-mode network and between the dorsal attentional network and the language network. CONCLUSION CBT in PD-patients improves anxiety symptoms and is associated with functional changes reversing the imbalance between PD-related anxiety circuits and reinforcing cognitive control on emotional processing.
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Affiliation(s)
- Guillaume Carey
- School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands,Lille Neuroscience & Cognition, University of Lille, Lille, France,Department of Neurology and Movement Disorders, Lille University Medical Centre, Lille, France,Correspondence to: Guillaume Carey, MD, CHU de Lille, Hôpital Roger Salengro, Avenue du Professeur Emile Laine, Service de Neurologie A, 59037, Lille, France. E-mail:
| | - Renaud Lopes
- Lille Neuroscience & Cognition, University of Lille, Lille, France,Plateformes Lilloises en Biologie & Santé, University of Lille, Lille, France
| | - Anja J.H. Moonen
- School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands,Department of Psychiatry, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Anne E.P. Mulders
- School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands,Department of Psychiatry, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Joost J.A. de Jong
- School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands,Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Gregory Kuchcinski
- Lille Neuroscience & Cognition, University of Lille, Lille, France,Department of Neuroradiology, Lille University Medical Centre, Lille, France,Plateformes Lilloises en Biologie & Santé, University of Lille, Lille, France
| | - Luc Defebvre
- Lille Neuroscience & Cognition, University of Lille, Lille, France,Department of Neurology and Movement Disorders, Lille University Medical Centre, Lille, France
| | - Mark L. Kuijf
- School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands,Department of Neurology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Kathy Dujardin
- Lille Neuroscience & Cognition, University of Lille, Lille, France,Department of Neurology and Movement Disorders, Lille University Medical Centre, Lille, France
| | - Albert F.G. Leentjens
- School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands,Department of Psychiatry, Maastricht University Medical Centre, Maastricht, The Netherlands
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Zwaenepoel B, Casteur L, Dujardin K. Image focus: central venous catheter tip location does matter. Eur Heart J Cardiovasc Imaging 2023; 24:e27. [PMID: 36464838 DOI: 10.1093/ehjci/jeac225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2022] Open
Affiliation(s)
- B Zwaenepoel
- Department of cardiology, AZ Delta, Roeselare, Belgium
| | - L Casteur
- Department of cardiology, AZ Delta, Roeselare, Belgium
| | - K Dujardin
- Department of cardiology, AZ Delta, Roeselare, Belgium
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Carey G, Viard R, Lopes R, Kuchcinski G, Defebvre L, Leentjens AF, Dujardin K. Anxiety in Parkinson's Disease Is Associated with Changes in Brain Structural Connectivity. J Parkinsons Dis 2023; 13:989-998. [PMID: 37599537 PMCID: PMC10578283 DOI: 10.3233/jpd-230035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/02/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND Anxiety in Parkinson's disease (PD) has been associated with grey matter changes and functional changes in anxiety-related neuronal circuits. So far, no study has analyzed white matter (WM) changes in patients with PD and anxiety. OBJECTIVE The aim of this study was to identify WM changes by comparing PD patients with and without anxiety, using diffusion-tensor imaging (DTI). METHODS 108 non-demented PD patients with (n = 31) and without (n = 77) anxiety as defined by their score on the Parkinson Anxiety Scale participated. DTI was used to determine the fractional anisotropy (FA) and mean diffusivity (MD) in specific tracts within anxiety-related neuronal circuits. Mean FA and MD were compared between groups and correlated with the severity of anxiety adjusted by sex, center, Hoehn & Yahr stage, levodopa equivalent daily dosage, and Hamilton depression rating scale. RESULTS Compared to patients without anxiety, PD patients with anxiety showed lower FA within the striato-orbitofrontal, striato-cingulate, cingulate-limbic, and caudate-thalamic tracts; higher FA within the striato-limbic and accumbens-thalamic tracts; higher MD within the striato-thalamic tract and lower MD within the striato-limbic tract. CONCLUSIONS Anxiety in PD is associated with microstructural alterations in anxiety-related neuronal circuits within the WM. This result reinforces the view that PD-related anxiety is linked to structural alteration within the anxiety-related brain circuits.
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Affiliation(s)
- Guillaume Carey
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France
- School for Mental Health and Neurosciences (MHeNS), Maastricht University, Maastricht, The Netherlands
- Department of Neurology and Movement Disorders, Lille University Medical Centre, Lille, France
| | - Romain Viard
- Univ Lille, UMS 2014 – US 41 – PLBS – Plateformes Lilloises en Biologie & Santé, Lille, France
| | - Renaud Lopes
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France
- Univ Lille, UMS 2014 – US 41 – PLBS – Plateformes Lilloises en Biologie & Santé, Lille, France
| | - Gregory Kuchcinski
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France
- Univ Lille, UMS 2014 – US 41 – PLBS – Plateformes Lilloises en Biologie & Santé, Lille, France
- Department of Neuroradiology, Lille University Medical Centre, Lille, France
| | - Luc Defebvre
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France
- Department of Neurology and Movement Disorders, Lille University Medical Centre, Lille, France
| | - Albert F.G. Leentjens
- School for Mental Health and Neurosciences (MHeNS), Maastricht University, Maastricht, The Netherlands
- Department of Psychiatry, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Kathy Dujardin
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France
- Department of Neurology and Movement Disorders, Lille University Medical Centre, Lille, France
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Wolters AF, Michielse S, Kuijf ML, Defebvre L, Lopes R, Dujardin K, Leentjens AFG. Brain network characteristics and cognitive performance in motor subtypes of Parkinson's disease: A resting state fMRI study. Parkinsonism Relat Disord 2022; 105:32-38. [PMID: 36332290 DOI: 10.1016/j.parkreldis.2022.10.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 10/15/2022] [Accepted: 10/23/2022] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Parkinson's disease (PD) is a heterogeneous disorder with great variability in motor and non-motor manifestations. It is hypothesized that different motor subtypes are characterized by different neuropsychiatric and cognitive symptoms, but the underlying correlates in cerebral connectivity remain unknown. Our aim is to compare brain network connectivity between the postural instability and gait disorder (PIGD) and tremor-dominant (TD) subtypes, using both a within- and between-network analysis. METHODS This cross-sectional resting-state fMRI study includes 81 PD patients, 54 belonging to the PIGD and 27 to the TD subgroup. Group-level spatial maps were created using independent component analysis. Differences in functional connectivity were investigated using dual regression analysis and inter-network connectivity analysis. An additional voxel-based morphometry analysis was performed to examine if results were influenced by grey matter atrophy. RESULTS The PIGD subgroup scored worse than the TD subgroup on all cognitive domains. Resting-state fMRI network analyses suggested that the connection between the visual and sensorimotor network is a potential differentiator between PIGD and TD subgroups. However, after correcting for dopaminergic medication use these results were not significant anymore. There was no between-group difference in grey matter volume. CONCLUSION Despite clear motor and cognitive differences between the PIGD and TD subtypes, no significant differences were found in network connectivity. Methodological challenges, substantial symptom heterogeneity and many involved variables make analyses and hypothesis building around PD subtypes highly complex. More sensitive visualisation methods combined with machine learning approaches may be required in the search for characteristic underpinnings of PD subtypes.
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Affiliation(s)
- Amée F Wolters
- Department of Neurology, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Neurosurgery, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands.
| | - Stijn Michielse
- Department of Neurosurgery, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Mark L Kuijf
- Department of Neurology, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Neurosurgery, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Luc Defebvre
- Univ. Lille, Inserm, Lille Neuroscience & Cognition, F-59000, Lille, France; CHU Lille, Neurology and Movement Disorders, F-59000, Lille, France
| | - Renaud Lopes
- Univ. Lille, Inserm, Lille Neuroscience & Cognition, F-59000, Lille, France; Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, US 41 - UMS 2014 - PLBS, F-59000, Lille, France
| | - Kathy Dujardin
- Univ. Lille, Inserm, Lille Neuroscience & Cognition, F-59000, Lille, France; CHU Lille, Neurology and Movement Disorders, F-59000, Lille, France
| | - Albert F G Leentjens
- Department of Neurosurgery, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, Maastricht, the Netherlands
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Manceau C, Constant E, Brugallé E, Wawrziczny E, Sokolowski C, Flinois B, Baille G, Defebvre L, Dujardin K, Antoine P. Couples facing the “honeymoon period” of Parkinson's disease: A qualitative study of dyadic functioning. Br J Health Psychol 2022; 28:366-382. [PMID: 36301684 DOI: 10.1111/bjhp.12629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 10/09/2022] [Accepted: 10/12/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The public health issue of the Parkinson's disease (PD) has led to a great deal of research that has highlighted the individual challenges faced by the person with the Parkinson's disease (PwPD) and the caregiving spouse. Few studies, however, have sought to understand the functioning of couples facing PD, by differentiating each stage, each of which has its own issues. In particular, the "honeymoon period", characterized by a symptomatic respite allowed by the effectiveness of treatments for motor symptoms, has been poorly documented, especially at the dyadic level. DESIGN AND METHOD This qualitative study, based on Interpretative Phenomenological Analysis, aimed to understand the experience of couples and their functioning at this stage. Fifteen couples participated in separate semi-structured interviews for each partner. The analyses highlighted four dyadic dynamics, which call into question the relevance of the term "honeymoon" to describe the experience of couples. RESULTS While some couples appear to adjust by means of flexible functioning and a positive reinterpretation of this experience, other dyads oscillate between rigid hyperprotection in the face of perceived distress or a vicious circle of control/avoidance and, in some cases, gradually slipping towards the erosion of the relationship. DISCUSSION These results show that the relational difficulties suffered by partners at this stage should be taken into account as soon as possible after the diagnosis. Strengthening the communication and the togetherness between partners, as well as working on dyadic emotional regulation, are particularly relevant options for these couples.
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Affiliation(s)
- Charlotte Manceau
- Univ. Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives Villeneuve d'Ascq France
| | - Emilie Constant
- Univ. Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives Villeneuve d'Ascq France
| | - Elodie Brugallé
- Neurology and Movement Disorders Department CHU‐Lille Lille France
| | - Emilie Wawrziczny
- Univ. Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives Villeneuve d'Ascq France
| | - Céline Sokolowski
- Univ. Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives Villeneuve d'Ascq France
| | | | - Guillaume Baille
- Neurology and Movement Disorders Department Univ. Lille, Inserm, Lille Neurosciences and Cognition, CHU‐Lille Lille France
| | - Luc Defebvre
- Neurology and Movement Disorders Department Univ. Lille, Inserm, Lille Neurosciences and Cognition, CHU‐Lille Lille France
| | - Kathy Dujardin
- Neurology and Movement Disorders Department Univ. Lille, Inserm, Lille Neurosciences and Cognition, CHU‐Lille Lille France
| | - Pascal Antoine
- Univ. Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives Villeneuve d'Ascq France
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Dujardin K, de Peuter R, Dirven L, Gijtenbeek A, Manten-Horst E, Baas-Thijssen M. P08.03.A Conversation tool for brain tumor patients - tailor-made support and guidance for the patient and their proxies. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
An evaluation by the Dutch Neuro-Oncology Society (LWNO) showed that screening for psychosocial problems and the need for psychosocial care in glioma patients and their proxies is currently not optimal. Although tools to screen for psychosocial issues such as the Distress Thermometer exist, in daily practice they appear to be insufficient to discuss all disease-specific problems patients with brain tumors may encounter. We describe the development of a conversation tool to support the consultation between the patient with a brain tumor, their proxies and the health care professionals (HCPs).
Material and Methods
The development of the conversation tool for brain tumors was based on the tool used by the AYA Care Network in the Netherlands. Topics of importance for the entire care process were identified in a brainstorming session with 15 people (comprising HCPs, patients and proxies). Subsequently, the content of the conversation tool was determined by members of the LWNO and members of the LWNO-working group of nurses specialized in neuro-oncology (LWNO-v). Each topic in the conversation tool is supported by a visual, which was developed by a graphic design company in close collaboration with patients, proxies and HCPs.
Results
The conversation tool contains a total of 35 different topics covering six domains: physical health, daily life activities, psychological health, social relationships, loss of health and life, practical issues, all illustrated by a visual. The conversation tool can be given to the patient in booklet form before an appointment with the HCP, so they can prepare the conversation upfront. In addition, cards per domain will be available in the consultation room to be used during the appointment.
Conclusion:
By using the conversation tool, optimal individual guidance and support of patients with brain tumors is facilitated, as this patient population has unique issues that are often not covered by exiting tools. Using the conversation tool also promotes a nationally uniform way of working. Currently, an interactive tool for HCPs is being developed in which an overview of available interventions and best practices for the topics in the conversation tool are described, to ensure the needs of patients can be adequately addressed. The process of development of this tool can serve as an example for other cancer types.
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Affiliation(s)
| | - R de Peuter
- Comprehensive Cancer Organisation , Utrecht , Netherlands
| | | | | | - E Manten-Horst
- Nationaal AYA 'Jong&Kanker' Zorgnetwerk , Utrecht , Netherlands
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Dissanayaka NN, Forbes EJ, Perepezko K, Leentjens AFG, Dobkin RD, Dujardin K, Pontone GM. Phenomenology of Atypical Anxiety Disorders in Parkinson's Disease: A Systematic Review. Am J Geriatr Psychiatry 2022; 30:1026-1050. [PMID: 35305884 DOI: 10.1016/j.jagp.2022.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 02/03/2022] [Accepted: 02/10/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Anxiety is a prominent concern in Parkinson's disease (PD) that negatively impacts quality of life, increases functional disability, and complicates clinical management. Atypical presentations of anxiety are under-recognized and inadequately treated in patients with PD, compromising global PD care. METHODS This systematic review focuses on the prevalence, symptomology and clinical correlates of atypical presentations of PD-related anxiety following PRISMA guidelines. RESULTS Of the 60 studies meeting inclusion criteria, 14 focused on 'Anxiety Not Otherwise Specified (NOS)' or equivalent, 31 reported on fluctuating anxiety symptoms, and 22 reported on 'Fear of Falling (FOF)'. Anxiety NOS accounted for a weighted mean prevalence of 14.9%, fluctuating anxiety for 34.19%, and FOF for 51.5%. These latter two exceeded the average reported overall prevalence rate of 31% for anxiety disorders in PD. We identified a diverse array of anxiety symptoms related to motor and non-motor symptoms of PD, to complications of PD medication (such as "on" and "off" fluctuations, or both), and, to a lesser extent, to cognitive symptoms. CONCLUSION Atypical anxiety is common, clinically relevant, and heterogeneous in nature. A better understanding of the phenomenology, clinical course, and pathophysiology of varied forms of atypical anxiety in PD is needed to improve recognition, advance therapeutic development and ultimately optimize quality of life in PD.
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Affiliation(s)
- Nadeeka N Dissanayaka
- UQ Centre for Clinical Research, Faculty of Medicine (NND, EJF), The University of Queensland, Brisbane, Australia; School of Psychology (NND, EJF), University of Queensland, Brisbane, Australia; Department of Neurology (NND), Royal Brisbane & Women's Hospital, Brisbane, Australia.
| | - Elana J Forbes
- UQ Centre for Clinical Research, Faculty of Medicine (NND, EJF), The University of Queensland, Brisbane, Australia; School of Psychology (NND, EJF), University of Queensland, Brisbane, Australia
| | - Kate Perepezko
- Department of Mental Health (KP), Johns Hopkins University Blomberg School of Public Health, Baltimore, USA
| | - Albert F G Leentjens
- Department of Psychiatry (AFGL), Maastricht University Medical Center, Maastricht, the Netherlands
| | - Roseanne D Dobkin
- Department of Psychiatry (RDD), Rutgers University, Robert Wood Johnson Medical School, Piscataway, New Jersey, USA
| | - Kathy Dujardin
- Department of Neurology and Movement Disorders (KD), University Lille, Lille, France
| | - Gregory M Pontone
- Department of Psychiatry and Behavioral Sciences (GMP), Johns Hopkins University School of Medicine, Baltimore, USA; Department of Neurology (GMP), Johns Hopkins University School of Medicine, Baltimore, USA
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Carey G, Lopes R, Moonen Anja J, Kuchcinski G, Defebvre L, Dujardin K, Leentjens A. La thérapie comportementale et cognitive pour l’anxiété dans la maladie de Parkinson induit des modifications cérébrales fonctionnelles. Rev Neurol (Paris) 2022. [DOI: 10.1016/j.neurol.2022.02.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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14
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Bayot M, Gérard M, Derambure P, Dujardin K, Defebvre L, Betrouni N, Delval A. Functional networks underlying freezing of gait: a resting-state electroencephalographic study. Neurophysiol Clin 2022; 52:212-222. [PMID: 35351387 DOI: 10.1016/j.neucli.2022.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 03/09/2022] [Accepted: 03/09/2022] [Indexed: 10/18/2022] Open
Abstract
INTRODUCTION The pathophysiology of freezing of gait in people with Parkinson's disease (PD) remains unclear, despite its association with motor, cognitive, limbic and sensory-perceptual impairments. Resting-state electroencephalography (EEG) may provide functional information for a better understanding of freezing of gait by studying spectral power and connectivity between brain regions in different frequency bands. METHODS High-resolution EEG was recorded in 36 patients with PD (18 freezers, 18 non-freezers), and 18 healthy controls during a 5-min resting-state protocol with eyes open, followed by a basic spectral analysis in the sensor space and a more advanced analysis of functional connectivity at the source level. RESULTS Freezers showed a diffusely higher theta-band relative spectral power than controls. This increased power was correlated with a deficit in executive control. Concerning resting-state functional connectivity, connectivity strength within a left fronto-parietal network appeared to be higher in freezers than in controls in the theta band, and to be correlated with freezing severity and a history of falls. CONCLUSION We have shown that spectral power and connectivity analyses of resting-state EEG provide useful and complementary information to better understand freezing of gait in PD. The higher connectivity strength seen within the left ventral attention network in freezers is in keeping with an excessive guidance of behavior by external cues, due to executive dysfunction, and spectral analysis also found changes in freezers that was closely correlated with executive control deficits. This exaggerated influence of the external environment might result in behavioral consequences that contribute to freezing of gait episodes. These findings should be further investigated with a longitudinal study.
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Affiliation(s)
- Madli Bayot
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Department of Clinical Neurophysiology, F-59000 Lille, France
| | - Morgane Gérard
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Department of Clinical Neurophysiology, F-59000 Lille, France
| | - Philippe Derambure
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Department of Clinical Neurophysiology, F-59000 Lille, France
| | - Kathy Dujardin
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Department of Neurology and Movement Disorders, F-59000 Lille, France
| | - Luc Defebvre
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Department of Neurology and Movement Disorders, F-59000 Lille, France
| | - Nacim Betrouni
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Department of Clinical Neurophysiology, F-59000 Lille, France
| | - Arnaud Delval
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Department of Clinical Neurophysiology, F-59000 Lille, France.
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Vignando M, Ffytche D, Lewis SJG, Lee PH, Chung SJ, Weil RS, Hu MT, Mackay CE, Griffanti L, Pins D, Dujardin K, Jardri R, Taylor JP, Firbank M, McAlonan G, Mak HKF, Ho SL, Mehta MA. Author Correction: Mapping brain structural differences and neuroreceptor correlates in Parkinson's disease visual hallucinations. Nat Commun 2022; 13:971. [PMID: 35169136 PMCID: PMC8847348 DOI: 10.1038/s41467-022-28491-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Affiliation(s)
- Miriam Vignando
- Department of Neuroimaging, King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, SE5 8AF, UK.
| | - Dominic Ffytche
- Department of Old Age Psychiatry, King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, SE5 8AF, UK
| | - Simon J G Lewis
- ForeFront Parkinson's Disease Research Clinic, Brain and Mind Centre, School of Medical Sciences, University of Sydney, Camperdown, NSW, Australia
| | - Phil Hyu Lee
- Yonsei University College of Medicine, Seoul, South Korea
| | | | - Rimona S Weil
- Dementia Research Centre, University College London, 8-11 Queen Square, London, WC1M 3BG, UK
- Wellcome Centre for Neuroimaging, University College London, London, UK
| | - Michele T Hu
- Oxford Parkinson's Disease Centre, Oxford, UK
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Clare E Mackay
- Oxford Parkinson's Disease Centre, Oxford, UK
- Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Human Brain Activity, Department of Psychiatry, University of Oxford, Oxford, UK
| | - Ludovica Griffanti
- Oxford Parkinson's Disease Centre, Oxford, UK
- Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Human Brain Activity, Department of Psychiatry, University of Oxford, Oxford, UK
| | - Delphine Pins
- Univ. Lille, Inserm, CHU Lille, U1172 - Centre Lille Neuroscience & Cognition, 59000, Lille, France
| | - Kathy Dujardin
- Univ. Lille, Inserm, CHU Lille, U1172 - Centre Lille Neuroscience & Cognition, 59000, Lille, France
| | - Renaud Jardri
- Univ. Lille, Inserm, CHU Lille, U1172 - Centre Lille Neuroscience & Cognition, 59000, Lille, France
| | - John-Paul Taylor
- Newcastle University, Translational and Clinical Research Institute, Biomedical Research Building, Campus for Ageing and Vitality, Newcastle Upon Tyne, NE4 5PL, UK
| | - Michael Firbank
- Newcastle University, Translational and Clinical Research Institute, Biomedical Research Building, Campus for Ageing and Vitality, Newcastle Upon Tyne, NE4 5PL, UK
| | - Grainne McAlonan
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, SE5 8AF, UK
| | - Henry K F Mak
- Division of Neurology, Department of Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong
| | - Shu Leong Ho
- Division of Neurology, Department of Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong
| | - Mitul A Mehta
- Department of Neuroimaging, King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, SE5 8AF, UK
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Devignes Q, Lopes R, Dujardin K. Neuroimaging outcomes associated with mild cognitive impairment subtypes in Parkinson's disease: A systematic review. Parkinsonism Relat Disord 2022; 95:122-137. [DOI: 10.1016/j.parkreldis.2022.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 01/26/2022] [Accepted: 02/11/2022] [Indexed: 02/07/2023]
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Gérard M, Bayot M, Derambure P, Dujardin K, Defebvre L, Betrouni N, Delval A. EEG-based functional connectivity and executive control in patients with Parkinson’s disease and freezing of gait. Clin Neurophysiol 2022; 137:207-215. [DOI: 10.1016/j.clinph.2022.01.128] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 12/08/2021] [Accepted: 01/11/2022] [Indexed: 01/13/2023]
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18
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Vignando M, Ffytche D, Lewis SJG, Lee PH, Chung SJ, Weil RS, Hu MT, Mackay CE, Griffanti L, Pins D, Dujardin K, Jardri R, Taylor JP, Firbank M, McAlonan G, Mak HKF, Ho SL, Mehta MA. Mapping brain structural differences and neuroreceptor correlates in Parkinson's disease visual hallucinations. Nat Commun 2022; 13:519. [PMID: 35082285 PMCID: PMC8791961 DOI: 10.1038/s41467-022-28087-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 12/14/2021] [Indexed: 12/16/2022] Open
Abstract
Parkinson's psychosis (PDP) describes a spectrum of symptoms that may arise in Parkinson's disease (PD) including visual hallucinations (VH). Imaging studies investigating the neural correlates of PDP have been inconsistent in their findings, due to differences in study design and limitations of scale. Here we use empirical Bayes harmonisation to pool together structural imaging data from multiple research groups into a large-scale mega-analysis, allowing us to identify cortical regions and networks involved in VH and their relation to receptor binding. Differences of morphometrics analysed show a wider cortical involvement underlying VH than previously recognised, including primary visual cortex and surrounding regions, and the hippocampus, independent of its role in cognitive decline. Structural covariance analyses point to the involvement of the attentional control networks in PD-VH, while associations with receptor density maps suggest neurotransmitter loss may be linked to the cortical changes.
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Affiliation(s)
- Miriam Vignando
- Department of Neuroimaging, King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, SE5 8AF, UK.
| | - Dominic Ffytche
- Department of Old Age Psychiatry, King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, SE5 8AF, UK
| | - Simon J G Lewis
- ForeFront Parkinson's Disease Research Clinic, Brain and Mind Centre, School of Medical Sciences, University of Sydney, Camperdown, NSW, Australia
| | - Phil Hyu Lee
- Yonsei University College of Medicine, Seoul, South Korea
| | | | - Rimona S Weil
- Dementia Research Centre, University College London, 8-11 Queen Square, London, WC1M 3BG, UK
- Wellcome Centre for Neuroimaging, University College London, London, UK
| | - Michele T Hu
- Oxford Parkinson's Disease Centre, Oxford, UK
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Clare E Mackay
- Oxford Parkinson's Disease Centre, Oxford, UK
- Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Human Brain Activity, Department of Psychiatry, University of Oxford, Oxford, UK
| | - Ludovica Griffanti
- Oxford Parkinson's Disease Centre, Oxford, UK
- Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Human Brain Activity, Department of Psychiatry, University of Oxford, Oxford, UK
| | - Delphine Pins
- Univ. Lille, Inserm, CHU Lille, U1172 - Centre Lille Neuroscience & Cognition, 59000, Lille, France
| | - Kathy Dujardin
- Univ. Lille, Inserm, CHU Lille, U1172 - Centre Lille Neuroscience & Cognition, 59000, Lille, France
| | - Renaud Jardri
- Univ. Lille, Inserm, CHU Lille, U1172 - Centre Lille Neuroscience & Cognition, 59000, Lille, France
| | - John-Paul Taylor
- Newcastle University, Translational and Clinical Research Institute, Biomedical Research Building, Campus for Ageing and Vitality, Newcastle Upon Tyne, NE4 5PL, UK
| | - Michael Firbank
- Newcastle University, Translational and Clinical Research Institute, Biomedical Research Building, Campus for Ageing and Vitality, Newcastle Upon Tyne, NE4 5PL, UK
| | - Grainne McAlonan
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, SE5 8AF, UK
| | - Henry K F Mak
- Division of Neurology, Dept of Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong
| | - Shu Leong Ho
- Division of Neurology, Dept of Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong
| | - Mitul A Mehta
- Department of Neuroimaging, King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, SE5 8AF, UK
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19
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Constant E, Brugallé E, Wawrziczny E, Sokolowski C, Manceau C, Flinois B, Baille G, Luc D, Dujardin K, Antoine P. Relationship Dynamics of Couples Facing Advanced-Stage Parkinson’s Disease: A Dyadic Interpretative Phenomenological Analysis. Front Psychol 2022; 12:770334. [PMID: 35140654 PMCID: PMC8818672 DOI: 10.3389/fpsyg.2021.770334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 12/15/2021] [Indexed: 11/13/2022] Open
Abstract
Background/ObjectiveSeveral studies have examined the impact of Parkinson’s disease (PD) on the quality of couples’ relationships. To date, few studies have explored how couples experience their relationship dynamic by taking into account the disease stage. The objectives of this study were to understand the experience of each partner and to study the mechanisms that underlie their couple organization in the advanced stage of PD.MethodsSemistructured individual interviews conducted with fifteen patients and their partners were the subject of a dyadic interpretative phenomenological analysis.ResultsThree themes were identified from the analysis: the first, “A Closeness That Separates,” allows the identification of different patterns of interactions that lead to emotional distancing between the partners; the second, “The Adversity Is Not Unbearable, But Going It Alone Would Be,” emphasizes the importance of how the assisting partner provides support; and the third, “Be Prepared for Anything and Facing an Uncertain Future,” reveals the extent and modes of the dyadic regulation of the emotions linked to what the future may hold.ConclusionPsychological support is important to help couples express both their feelings and their respective needs in the evolving context of PD.
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Affiliation(s)
- Emilie Constant
- Université de Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives, Lille, France
- *Correspondence: Emilie Constant,
| | - Elodie Brugallé
- Université de Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives, Lille, France
| | - Emilie Wawrziczny
- Université de Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives, Lille, France
| | - Céline Sokolowski
- Université de Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives, Lille, France
| | - Charlotte Manceau
- Université de Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives, Lille, France
| | - Bérengère Flinois
- Centre Hospitalier Regional et Universitaire de Lille, Lille, France
| | - Guillaume Baille
- Centre Hospitalier Regional et Universitaire de Lille, Lille, France
| | - Defebvre Luc
- Centre Hospitalier Regional et Universitaire de Lille, Lille, France
| | - Kathy Dujardin
- Centre Hospitalier Regional et Universitaire de Lille, Lille, France
| | - Pascal Antoine
- Université de Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives, Lille, France
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20
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Betrouni N, Alazard E, Bayot M, Carey G, Derambure P, Defebvre L, Leentjens AF, Delval A, Dujardin K. Anxiety in Parkinson's disease: A resting-state high density EEG study. Neurophysiol Clin 2022; 52:202-211. [PMID: 35042630 DOI: 10.1016/j.neucli.2022.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 01/06/2022] [Accepted: 01/06/2022] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE To identify markers of Parkinson's disease (PD) related anxiety, using high density electroencephalography (hd-EEG). METHODS 108 patients participated in the study. They were divided into two groups: with and without clinically relevant anxiety, according to their score on the Parkinson Anxiety Scale. Resting-state hd-EEG was recorded. Spectral and functional connectivity characteristics were compared between the two groups. RESULTS Thirty-three patients (31%) had significant anxiety symptoms. In the spectral analysis, relative power in the alpha1 frequency band in the right prefrontal cortex was lower in patients with anxiety than without. Functional connectivity analysis showed a stronger connectivity between the left insula and several regions of the right prefrontal cortex in patients with anxiety than in those without. CONCLUSION This study shows the pivotal role of the insula and frontal cortex in the pathophysiology of anxiety in PD and extends the results of previous studies using magnetic resonance imaging or positron emission tomography imaging.
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Affiliation(s)
- Nacim Betrouni
- Univ. Lille, INSERM, CHU Lille, U1172, Degenerative & Vascular Cognitive Disorders, F-59000 Lille, France.
| | - Edouard Alazard
- Univ. Lille, INSERM, CHU Lille, U1172, Degenerative & Vascular Cognitive Disorders, F-59000 Lille, France
| | - Madli Bayot
- Univ. Lille, INSERM, CHU Lille, U1172, Degenerative & Vascular Cognitive Disorders, F-59000 Lille, France; CHU Lille, Clinical Neurophysiology Department, F-59000 Lille, France
| | - Guillaume Carey
- Univ. Lille, INSERM, CHU Lille, U1172, Degenerative & Vascular Cognitive Disorders, F-59000 Lille, France; CHU Lille, Neurology and Movement Disorders Department, F-59000 Lille, France
| | - Philippe Derambure
- Univ. Lille, INSERM, CHU Lille, U1172, Degenerative & Vascular Cognitive Disorders, F-59000 Lille, France; CHU Lille, Clinical Neurophysiology Department, F-59000 Lille, France
| | - Luc Defebvre
- Univ. Lille, INSERM, CHU Lille, U1172, Degenerative & Vascular Cognitive Disorders, F-59000 Lille, France; CHU Lille, Neurology and Movement Disorders Department, F-59000 Lille, France
| | | | - Arnaud Delval
- Univ. Lille, INSERM, CHU Lille, U1172, Degenerative & Vascular Cognitive Disorders, F-59000 Lille, France; CHU Lille, Clinical Neurophysiology Department, F-59000 Lille, France
| | - Kathy Dujardin
- Univ. Lille, INSERM, CHU Lille, U1172, Degenerative & Vascular Cognitive Disorders, F-59000 Lille, France; CHU Lille, Neurology and Movement Disorders Department, F-59000 Lille, France
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21
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Devignes Q, Daoudi S, Viard R, Lopes R, Betrouni N, Kuchcinski G, Rolland AS, Moreau C, Defebvre L, Bardinet E, Bonnet M, Brefel-Courbon C, Delmaire C, El Mountassir F, Fluchère F, Fradet A, Giordana C, Hainque E, Houvenaghel JF, Jarraya B, Klinger H, Maltête D, Marques A, Meyer M, Rascol O, Rouaud T, Tir M, Wirth T, Corvol JC, Devos D, Dujardin K. Heterogeneity of PD-MCI in Candidates to Subthalamic Deep Brain Stimulation: Associated Cortical and Subcortical Modifications. J Parkinsons Dis 2022; 12:1507-1526. [PMID: 35599498 DOI: 10.3233/jpd-223232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Parkinson's disease mild cognitive impairment (PD-MCI) is frequent and heterogenous. There is no consensus about its influence on subthalamic deep brain stimulation (STN-DBS) outcomes. OBJECTIVE To determine the prevalence of PD-MCI and its subtypes in candidates to STN-DBS. Secondarily, we sought to identify MRI structural markers associated with cognitive impairment in these subgroups. METHODS Baseline data from the French multicentric PREDISTIM cohort were used. Candidates to STN-DBS were classified according to their cognitive performance in normal cognition (PD-NC) or PD-MCI. The latter included frontostriatal (PD-FS) and posterior cortical (PD-PC) subtypes. Between-group comparisons were performed on demographical and clinical variables as well as on T1-weighted MRI sequences at the cortical and subcortical levels. RESULTS 320 patients were included: 167 (52%) PD-NC and 153 (48%) PD-MCI patients. The latter group included 123 (80%) PD-FS and 30 (20%) PD-PC patients. There was no between-group difference regarding demographic and clinical variables. PD-PC patients had significantly lower global efficiency than PD-FS patients and significantly worse performance on visuospatial functions, episodic memory, and language. Compared to PD-NC, PD-MCI patients had cortical thinning and radiomic-based changes in the left caudate nucleus and hippocampus. There were no significant differences between the PD-MCI subtypes. CONCLUSION Among the candidates to STN-DBS, a significant proportion has PD-MCI which is associated with cortical and subcortical alterations. Some PD-MCI patients have posterior cortical deficits, a subtype known to be at higher risk of dementia.
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Affiliation(s)
- Quentin Devignes
- Univ. Lille, Inserm, Lille Neurosciences and Cognition, CHU-Lille, Neurology and Movement Disorders department, NS-Park/F-CRIN, Lille, France
| | - Sami Daoudi
- Univ. Lille, Inserm, Lille Neurosciences and Cognition, CHU-Lille, Neurology and Movement Disorders department, NS-Park/F-CRIN, Lille, France
| | - Romain Viard
- Univ. Lille, CNRS, Inserm, US 41 - UMS 2014 - PLBS, CHU Lille, Lille Pasteur Institute, Lille, France
| | - Renaud Lopes
- Univ. Lille, CNRS, Inserm, US 41 - UMS 2014 - PLBS, CHU Lille, Lille Pasteur Institute, Lille, France
| | - Nacim Betrouni
- Univ. Lille, Inserm, Lille Neurosciences and Cognition, CHU-Lille, Neurology and Movement Disorders department, NS-Park/F-CRIN, Lille, France
| | - Gregory Kuchcinski
- Univ. Lille, CNRS, Inserm, US 41 - UMS 2014 - PLBS, CHU Lille, Lille Pasteur Institute, Lille, France
| | - Anne-Sophie Rolland
- Univ. Lille, Inserm, Lille Neurosciences and Cognition, CHU-Lille, Department of Medical Pharmacology, NS-Park/F-CRIN, Lille, France
| | - Caroline Moreau
- Univ. Lille, Inserm, Lille Neurosciences and Cognition, CHU-Lille, Neurology and Movement Disorders department, NS-Park/F-CRIN, Lille, France
| | - Luc Defebvre
- Univ. Lille, Inserm, Lille Neurosciences and Cognition, CHU-Lille, Neurology and Movement Disorders department, NS-Park/F-CRIN, Lille, France
| | - Eric Bardinet
- Institut du Cerveau (ICM), Centre de Neuro-Imagerie de Recherche (CENIR), UMR S 1127, CNRS UMR 7225, Sorbonne Université, Paris, France
| | - Marie Bonnet
- Centre Expert Parkinson, NS-Park/F-CRIN, Centre Mémoire de Ressources et de Recherche, IMNc, Hôpital Pellegrin, CHU de Bordeaux, France
| | - Christine Brefel-Courbon
- Service de Neurologie B8, Centre Expert Parkinson, NS-Park/F-CRIN, Hôpital Pierre Paul Riquet, CHU Purpan, Toulouse, France
| | - Christine Delmaire
- Department of Radiology, NS-Park/F-CRIN, Hôpital Fondation A de Rothschild, Paris, France
| | - Fouzia El Mountassir
- Université Paris-Saclay, CEA, CNRS, Baobab, Neurospin, Gif-sur-Yvette, France and Institut du Cerveau (ICM), UMR S 1127, CNRS UMR 7225, Sorbonne Université, Paris, France
| | - Frédérique Fluchère
- Department of Neurology, NS-Park/F-CRIN, Assistance Publique - Hôpitaux de Marseille (APHM), Timone University Hospital and Institut de Neurosciences de la Timone, Marseille, France
| | - Anne Fradet
- Neurology Department, NS-Park/F-CRIN, University Hospital of Poitiers and INSERM, University of Poitiers, Centre d'Investigation Clinique CIC 1402, Poitiers, France
| | - Caroline Giordana
- Department of Neurology, NS-Park/F-CRIN, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Elodie Hainque
- Sorbonne Université, Paris Brain Institute - ICM, NS-Park/F-CRIN, Assistance publique Hôpitaux de Paris, Inserm, CRNS, Hôpital Pitié-Salpêtrière, Department of Neurology, Paris, France
| | | | - Béchir Jarraya
- Neuroscience Pole, NS-Park/F-CRIN, Hôpital Foch, Suresnes, University of Versailles Paris-Saclay, INSERM-CEA NeuroSpin, Saclay, France
| | - Hélène Klinger
- Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, NS-Park/F-CRIN, Lyon, France
| | - David Maltête
- Department of Neurology, NS-Park/F-CRIN, Rouen University Hospital and University of Rouen, France; INSERM U1239, Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, Mont-Saint-Aignan, France
| | - Ana Marques
- Université Clermont Auvergne, CNRS, Clermont Auvergne INP, Institut Pascal, Clermont-Ferrand University Hospital, Neurology department, NS-Park/F-CRIN, Clermont-Ferrand, France
| | - Mylène Meyer
- Neurology department, NS-Park/F-CRIN, Central Hospital, CHRU-Nancy, Nancy, France
| | - Olivier Rascol
- Department of Clinical Pharmacology and Neuroscience, NS-Park/F-CRIN, Toulouse University Hospital, Toulouse, France
| | - Tiphaine Rouaud
- Department of Neurology, Centre Expert Parkinson, NS-Park/F-CRIN, CHU Nantes, Nantes, France
| | - Melissa Tir
- Department of Neurology, NS-PARK/FCRIN, Amiens University Hospital, Amiens, France
| | - Thomas Wirth
- Service de Neurologie, NS-Park/F-CRIN, Hôpitaux Universitaires de Strasbourg et Fédération de Médecine Translationnelle de Médecine de Strasbourg, Strasbourg, France
- Institut de Génétique et de Biologie Moléculaire et Cellulaire, INSERM-U964/CNRS-UMR7104/Université de Strasbourg, Illkirch, France
| | - Jean-Christophe Corvol
- Sorbonne Université, Paris Brain Institute - ICM, NS-Park/F-CRIN, Assistance publique Hôpitaux de Paris, Inserm, CRNS, Hôpital Pitié-Salpêtrière, Department of Neurology, Paris, France
| | - David Devos
- Univ. Lille, Inserm, Lille Neurosciences and Cognition, CHU-Lille, Neurology and Movement Disorders department, NS-Park/F-CRIN, Lille, France
- Univ. Lille, Inserm, Lille Neurosciences and Cognition, CHU-Lille, Department of Medical Pharmacology, NS-Park/F-CRIN, Lille, France
| | - Kathy Dujardin
- Univ. Lille, Inserm, Lille Neurosciences and Cognition, CHU-Lille, Neurology and Movement Disorders department, NS-Park/F-CRIN, Lille, France
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22
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Devignes Q, Bordier C, Viard R, Defebvre L, Kuchcinski G, Leentjens AFG, Lopes R, Dujardin K. Resting-State Functional Connectivity in Frontostriatal and Posterior Cortical Subtypes in Parkinson's Disease-Mild Cognitive Impairment. Mov Disord 2021; 37:502-512. [PMID: 34918782 DOI: 10.1002/mds.28888] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 11/10/2021] [Accepted: 11/29/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The "dual syndrome hypothesis" distinguished two subtypes in mild cognitive impairment (MCI) in Parkinson's disease: frontostriatal, characterized by attentional and executive deficits; and posterior cortical, characterized by visuospatial, memory, and language deficits. OBJECTIVE The aim was to identify resting-state functional modifications associated with these subtypes. METHODS Ninety-five nondemented patients categorized as having normal cognition (n = 31), frontostriatal (n = 14), posterior cortical (n = 20), or mixed (n = 30) cognitive subtype had a 3 T resting-state functional magnetic resonance imaging scan. Twenty-four age-matched healthy controls (HCs) were also included. A group-level independent component analysis was performed to identify resting-state networks, and the selected components were subdivided into 564 cortical regions in addition to 26 basal ganglia regions. Global intra- and inter-network connectivity along with global and local efficiencies was compared between groups. The network-based statistics approach was used to identify connections significantly different between groups. RESULTS Patients with posterior cortical deficits had increased intra-network functional connectivity (FC) within the basal ganglia network compared with patients with frontostriatal deficits. Patients with frontostriatal deficits had reduced inter-network FC between several networks, including the visual, default-mode, sensorimotor, salience, dorsal attentional, basal ganglia, and frontoparietal networks, compared with HCs, patients with normal cognition, and patients with a posterior cortical subtype. Similar results were also found between patients with a mixed subtype and HCs. CONCLUSION MCI subtypes are associated with specific changes in resting-state FC. Longitudinal studies are needed to determine the predictive potential of these markers regarding the risk of developing dementia. © 2021 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Quentin Devignes
- Univ. Lille, Inserm 1172, Lille Neurosciences and Cognition, CHU Lille, Lille, France
| | - Cécile Bordier
- Univ. Lille, Inserm 1172, Lille Neurosciences and Cognition, CHU Lille, Lille, France.,Univ. Lille, CNRS, Inserm, US 41-UMS 2014-PLBS, CHU Lille, Lille Pasteur Institute, Lille, France.,Department of Neuroradiology, CHU Lille, Lille, France
| | - Romain Viard
- Univ. Lille, Inserm 1172, Lille Neurosciences and Cognition, CHU Lille, Lille, France.,Univ. Lille, CNRS, Inserm, US 41-UMS 2014-PLBS, CHU Lille, Lille Pasteur Institute, Lille, France.,Department of Neuroradiology, CHU Lille, Lille, France
| | - Luc Defebvre
- Univ. Lille, Inserm 1172, Lille Neurosciences and Cognition, CHU Lille, Lille, France.,Neurology and Movement Disorders Department, CHU Lille, Lille, France
| | - Grégory Kuchcinski
- Univ. Lille, Inserm 1172, Lille Neurosciences and Cognition, CHU Lille, Lille, France.,Univ. Lille, CNRS, Inserm, US 41-UMS 2014-PLBS, CHU Lille, Lille Pasteur Institute, Lille, France.,Department of Neuroradiology, CHU Lille, Lille, France
| | - Albert F G Leentjens
- Department of Psychiatry, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Renaud Lopes
- Univ. Lille, Inserm 1172, Lille Neurosciences and Cognition, CHU Lille, Lille, France.,Univ. Lille, CNRS, Inserm, US 41-UMS 2014-PLBS, CHU Lille, Lille Pasteur Institute, Lille, France.,Department of Neuroradiology, CHU Lille, Lille, France
| | - Kathy Dujardin
- Univ. Lille, Inserm 1172, Lille Neurosciences and Cognition, CHU Lille, Lille, France.,Neurology and Movement Disorders Department, CHU Lille, Lille, France
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23
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Jia XZ, Zhao N, Dong HM, Sun JW, Barton M, Burciu R, Carrière N, Cerasa A, Chen BY, Chen J, Coombes S, Defebvre L, Delmaire C, Dujardin K, Esposito F, Fan GG, Di Nardo F, Feng YX, Fling BW, Garg S, Gilat M, Gorges M, Ho SL, Horak FB, Hu X, Hu XF, Huang B, Huang PY, Jia ZJ, Jones C, Kassubek J, Krajcovicova L, Kurani A, Li J, Li Q, Liu AP, Liu B, Liu H, Liu WG, Lopes R, Lou YT, Luo W, Madhyastha T, Mao NN, McAlonan G, McKeown MJ, Pang S, Quattrone A, Rektorova I, Sarica A, Shang HF, Shine JM, Shukla P, Slavicek T, Song XP, Tedeschi G, Tessitore A, Vaillancourt D, Wang J, Wang J, Jane Wang Z, Wei LQ, Wu X, Xu XJ, Yan L, Yang J, Yang WQ, Yao NL, Zhang DL, Zhang JQ, Zhang MM, Zhang YL, Zhou CH, Yan CG, Zuo XN, Hallett M, Wu T, Zang YF. Small P values may not yield robust findings: an example using REST-meta-PD. Sci Bull (Beijing) 2021; 66:2148-2152. [PMID: 36654102 DOI: 10.1016/j.scib.2021.06.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Xi-Ze Jia
- Center for Cognition and Brain Disorders, the Affiliated Hospital, Hangzhou Normal University, Hangzhou 310015, China; Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou 311121, China
| | - Na Zhao
- Center for Cognition and Brain Disorders, the Affiliated Hospital, Hangzhou Normal University, Hangzhou 310015, China; Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou 311121, China
| | - Hao-Ming Dong
- National Basic Science Data Center, Beijing 100190, China; State Key Laboratory of Cognitive Neuroscience and Learning & McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China
| | - Jia-Wei Sun
- School of Information and Electronics Technology, Jiamusi University, Jiamusi 154007, China
| | - Marek Barton
- Neuroscience Program, Central European Institute of Technology, CEITEC, Masaryk University, Brno 62500, Czech Republic
| | - Roxana Burciu
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville FL 32611, USA
| | - Nicolas Carrière
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille F-59000, France
| | - Antonio Cerasa
- The Institute for Biomedical Research and Innovation, National Research Council, Mangone CS 87050, Italy
| | - Bo-Yu Chen
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang 110001, China
| | - Jun Chen
- Department of Radiology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, China
| | - Stephen Coombes
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville FL 32611, USA
| | - Luc Defebvre
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille F-59000, France
| | - Christine Delmaire
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille F-59000, France
| | - Kathy Dujardin
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille F-59000, France
| | - Fabrizio Esposito
- Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Fisciano, SA 132-84084, Italy
| | - Guo-Guang Fan
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang 110001, China
| | - Federica Di Nardo
- Department of Advanced Medical and Surgery Sciences, University of Campania "Luigi Vanvitelli", Caserta 81100, Italy
| | - Yi-Xuan Feng
- Eye Center of the 2nd Affiliated Hospital, Medical College of Zhejiang University, Hangzhou 310020, China; Zhejiang Provincial Key Lab of Ophthalmology, Hangzhou 310020, China
| | - Brett W Fling
- Department of Health and Exercise Science, Colorado State University, Fort Collins CO 80523, USA
| | - Saurabh Garg
- Department of Health and Exercise Science, Colorado State University, Fort Collins CO 80523, USA; Department of Medicine (Neurology) University of British Columbia, Vancouver BC V6T 1B7, Canada
| | - Moran Gilat
- Brain and Mind Center, The University of Sydney, Sydney NSW 2006, Australia
| | - Martin Gorges
- Department of Neurology, Ulm University, Ulm 89081, Germany
| | - Shu-Leong Ho
- Division of Neurology, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong 999077, China
| | - Fay B Horak
- Department of Neurology, School of Medicine, Oregon Health & Science University, Oregon 97239-3098, USA; VA Portland Health Care System, Portland OR 97239, USA
| | - Xiao Hu
- Department of Radiology, The Affiliated Brain Hospital with Nanjing Medical University, Nanjing 210029, China
| | - Xiao-Fei Hu
- Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Biao Huang
- Department of Radiology, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Pei-Yu Huang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Ze-Juan Jia
- Graduate School of Hebei Medical University, Shijiazhuang 50017, China
| | - Christina Jones
- Pacific Parkinson's Research Centre, University of British Columbia, Vancouver BC V6E 2M6, Canada; Department of Medicine (Neurology) University of British Columbia, Vancouver BC V6T 1B7, Canada
| | - Jan Kassubek
- Department of Neurology, Ulm University, Ulm 89081, Germany
| | - Lenka Krajcovicova
- Neuroscience Program, Central European Institute of Technology, CEITEC, Masaryk University, Brno 62500, Czech Republic
| | - Ajay Kurani
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago IL 60611, USA
| | - Jing Li
- Department of Neurology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Qing Li
- College of Information Science and Technology, Beijing Normal University, Beijing 100875, China
| | - Ai-Ping Liu
- Department of Electrical and Computer Engineering, University of British Columbia, Vancouver BC V6T 1Z4, Canada
| | - Bo Liu
- Department of Radiology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, China
| | - Hu Liu
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang 110001, China
| | - Wei-Guo Liu
- Department of Neurology, The Affiliated Brain Hospital With Nanjing Medical University, Nanjing 210029, China
| | - Renaud Lopes
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille F-59000, France
| | - Yu-Ting Lou
- Department of Paediatrics, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Wei Luo
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Tara Madhyastha
- Department of Radiology, University of Washington, Seattle WA 98195-7117, USA
| | - Ni-Ni Mao
- College of Information Science and Technology, Beijing Normal University, Beijing 100875, China
| | - Grainne McAlonan
- South London and Maudsley NHS Foundation Trust, London BR3 3BX, UK; State Key Laboratory for Cognitive Sciences, The University of Hong Kong, Hong Kong 999077, China; Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, King's College London, London WC2R 2LS, UK
| | - Martin J McKeown
- Pacific Parkinson's Research Centre, University of British Columbia, Vancouver BC V6E 2M6, Canada; Department of Medicine (Neurology) University of British Columbia, Vancouver BC V6T 1B7, Canada
| | - Shirley Pang
- Division of Neurology, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong 999077, China
| | - Andrea Quattrone
- Institute of Neurology, University Magna Graecia of Catanzaro, Catanzaro CZ 88100, Italy
| | - Irena Rektorova
- Neuroscience Program, Central European Institute of Technology, CEITEC, Masaryk University, Brno 62500, Czech Republic
| | - Alessia Sarica
- Neuroscience Center, Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro CZ 88100, Italy
| | - Hui-Fang Shang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu 610065, China
| | - James M Shine
- Brain and Mind Center, The University of Sydney, Sydney NSW 2006, Australia
| | | | - Tomas Slavicek
- Neuroscience Program, Central European Institute of Technology, CEITEC, Masaryk University, Brno 62500, Czech Republic
| | - Xiao-Peng Song
- Department of Neurology, The Affiliated Brain Hospital With Nanjing Medical University, Nanjing 210029, China
| | - Gioacchino Tedeschi
- Department of Advanced Medical and Surgery Sciences, University of Campania "Luigi Vanvitelli", Caserta 81100, Italy
| | - Alessandro Tessitore
- Department of Advanced Medical and Surgery Sciences, University of Campania "Luigi Vanvitelli", Caserta 81100, Italy
| | - David Vaillancourt
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville FL 32611, USA
| | - Jian Wang
- Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Jue Wang
- School of Sports Medicine and Health, Chengdu Sport University, Chengdu 610041, China
| | - Z Jane Wang
- Department of Electrical and Computer Engineering, University of British Columbia, Vancouver BC V6T 1Z4, Canada
| | - Lu-Qing Wei
- Department of Neurology, The Affiliated Brain Hospital With Nanjing Medical University, Nanjing 210029, China
| | - Xia Wu
- College of Information Science and Technology, Beijing Normal University, Beijing 100875, China
| | - Xiao-Jun Xu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Lei Yan
- Department of Neurology, The Affiliated Brain Hospital With Nanjing Medical University, Nanjing 210029, China
| | - Jing Yang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu 610065, China
| | - Wan-Qun Yang
- Department of Radiology, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Nai-Lin Yao
- Department of Psychiatry, Queen Mary Hospital, The University of Hong Kong, Hong Kong 999077, China
| | - De-Long Zhang
- Department of Radiology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, China
| | - Jiu-Quan Zhang
- Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Min-Ming Zhang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Yan-Ling Zhang
- Department of Neurology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Cai-Hong Zhou
- Department of Radiology, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Chao-Gan Yan
- National Basic Science Data Center, Beijing 100190, China
| | - Xi-Nian Zuo
- National Basic Science Data Center, Beijing 100190, China; State Key Laboratory of Cognitive Neuroscience and Learning & McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China.
| | - Mark Hallett
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda MD 20892, USA
| | - Tao Wu
- Department of Neurobiology, Neurology and Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing Institute of Geriatrics, Beijing 100053, China; Clinical Center for Parkinson's Disease, Capital Medical University, Beijing 100069, China; Beijing Key Laboratory for Parkinson's Disease, Parkinson Disease Center of Beijing Institute for Brain Disorders, Beijing 100050, China; National Clinical Research Center for Geriatric Disorders, Beijing 100730, China
| | - Yu-Feng Zang
- Center for Cognition and Brain Disorders, the Affiliated Hospital, Hangzhou Normal University, Hangzhou 310015, China; Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou 311121, China.
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24
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Devignes Q, Viard R, Betrouni N, Carey G, Kuchcinski G, Defebvre L, Leentjens AFG, Lopes R, Dujardin K. Posterior Cortical Cognitive Deficits Are Associated With Structural Brain Alterations in Mild Cognitive Impairment in Parkinson's Disease. Front Aging Neurosci 2021; 13:668559. [PMID: 34054507 PMCID: PMC8155279 DOI: 10.3389/fnagi.2021.668559] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 03/22/2021] [Indexed: 12/16/2022] Open
Abstract
Context: Cognitive impairments are common in patients with Parkinson's disease (PD) and are heterogeneous in their presentation. The "dual syndrome hypothesis" suggests the existence of two distinct subtypes of mild cognitive impairment (MCI) in PD: a frontostriatal subtype with predominant attentional and/or executive deficits and a posterior cortical subtype with predominant visuospatial, memory, and/or language deficits. The latter subtype has been associated with a higher risk of developing dementia. Objective: The objective of this study was to identify structural modifications in cortical and subcortical regions associated with each PD-MCI subtype. Methods: One-hundred and fourteen non-demented PD patients underwent a comprehensive neuropsychological assessment as well as a 3T magnetic resonance imaging scan. Patients were categorized as having no cognitive impairment (n = 41) or as having a frontostriatal (n = 16), posterior cortical (n = 25), or a mixed (n = 32) MCI subtype. Cortical regions were analyzed using a surface-based Cortical thickness (CTh) method. In addition, the volumes, shapes, and textures of the caudate nuclei, hippocampi, and thalami were studied. Tractometric analyses were performed on associative and commissural white matter (WM) tracts. Results: There were no between-group differences in volumetric measurements and cortical thickness. Shape analyses revealed more abundant and more extensive deformations fields in the caudate nuclei, hippocampi, and thalami in patients with posterior cortical deficits compared to patients with no cognitive impairment. Decreased fractional anisotropy (FA) and increased mean diffusivity (MD) were also observed in the superior longitudinal fascicle, the inferior fronto-occipital fascicle, the striato-parietal tract, and the anterior and posterior commissural tracts. Texture analyses showed a significant difference in the right hippocampus of patients with a mixed MCI subtype. Conclusion: PD-MCI patients with posterior cortical deficits have more abundant and more extensive structural alterations independently of age, disease duration, and severity, which may explain why they have an increased risk of dementia.
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Affiliation(s)
- Quentin Devignes
- Lille Neuroscience and Cognition, Lille University, Inserm, Lille University Medical Centre, Lille, France
| | - Romain Viard
- US 41—UMS 2014—PLBS, Lille University, CNRS, Inserm, Lille University Medical Centre, Pasteur Institute, Lille, France
- Department of Neuroradiology, Lille University Medical Centre, Lille, France
| | - Nacim Betrouni
- Lille Neuroscience and Cognition, Lille University, Inserm, Lille University Medical Centre, Lille, France
| | - Guillaume Carey
- Lille Neuroscience and Cognition, Lille University, Inserm, Lille University Medical Centre, Lille, France
- Neurology and Movement Disorders Department, Lille University Medical Centre, Lille, France
| | - Gregory Kuchcinski
- Lille Neuroscience and Cognition, Lille University, Inserm, Lille University Medical Centre, Lille, France
- US 41—UMS 2014—PLBS, Lille University, CNRS, Inserm, Lille University Medical Centre, Pasteur Institute, Lille, France
- Department of Neuroradiology, Lille University Medical Centre, Lille, France
| | - Luc Defebvre
- Lille Neuroscience and Cognition, Lille University, Inserm, Lille University Medical Centre, Lille, France
- Neurology and Movement Disorders Department, Lille University Medical Centre, Lille, France
| | | | - Renaud Lopes
- Lille Neuroscience and Cognition, Lille University, Inserm, Lille University Medical Centre, Lille, France
- US 41—UMS 2014—PLBS, Lille University, CNRS, Inserm, Lille University Medical Centre, Pasteur Institute, Lille, France
- Department of Neuroradiology, Lille University Medical Centre, Lille, France
| | - Kathy Dujardin
- Lille Neuroscience and Cognition, Lille University, Inserm, Lille University Medical Centre, Lille, France
- Neurology and Movement Disorders Department, Lille University Medical Centre, Lille, France
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25
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Moonen AJH, Mulders AEP, Defebvre L, Duits A, Flinois B, Köhler S, Kuijf ML, Leterme AC, Servant D, de Vugt M, Dujardin K, Leentjens AFG. Cognitive Behavioral Therapy for Anxiety in Parkinson's Disease: A Randomized Controlled Trial. Mov Disord 2021; 36:2539-2548. [PMID: 33617699 PMCID: PMC9290129 DOI: 10.1002/mds.28533] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 01/13/2021] [Accepted: 01/22/2021] [Indexed: 12/14/2022] Open
Abstract
Background Anxiety disorders are among the most prevalent and disabling neuropsychiatric syndromes in patients with Parkinsonʼs disease (PD), but no randomized controlled treatment trials of anxiety have been published to date. Objective The aim of this study was to assess the effectiveness of cognitive behavioral therapy (CBT) in the treatment of anxiety in patients with PD. Methods Forty‐eight patients with PD with anxiety were randomized 1:1 between CBT and clinical monitoring only (CMO). The CBT program was developed to specifically address anxiety symptoms in PD and consisted of 10 weekly sessions. Assessments were conducted by blinded assessors at baseline, at the end of the intervention, after 3 months, and after 6 months (CBT group only). Main outcome measures were the Hamilton Anxiety Rating Scale (HARS) and the Parkinson Anxiety Scale (PAS). Results Both the CBT and CMO groups showed clinically relevant improvement. Although there was no between‐group difference in outcome on the Hamilton Anxiety Rating Scale (6.7‐point reduction in the CBT group versus 3.9‐point reduction in the CMO group; P = 0.15), there was both a statistically significant and a clinically relevant between‐group difference on the total PAS in favor of CBT (9.9‐point reduction in the CBT group versus 5.2‐point reduction in the CMO group; P = 0.012), which was due to improvement on the PAS subscales for episodic (situational) anxiety and avoidance behavior. This greater improvement was maintained at 3‐ and 6‐month follow‐ups. Conclusion CBT is an effective treatment for anxiety in patients with PD and reduces situational and social anxiety, as well as avoidance behavior. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society
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Affiliation(s)
- Anja J H Moonen
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, the Netherlands.,Research School of Mental Health and Neuroscience (Mhens), Maastricht University, Maastricht, the Netherlands
| | - Anne E P Mulders
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, the Netherlands.,Research School of Mental Health and Neuroscience (Mhens), Maastricht University, Maastricht, the Netherlands
| | - Luc Defebvre
- Neurology and Movement Disorders Department, Centre Hospitalier Universitaire, Lille, France
| | - Annelien Duits
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, the Netherlands.,Research School of Mental Health and Neuroscience (Mhens), Maastricht University, Maastricht, the Netherlands
| | - Bérengère Flinois
- Neurology and Movement Disorders Department, Centre Hospitalier Universitaire, Lille, France
| | - Sebastian Köhler
- Research School of Mental Health and Neuroscience (Mhens), Maastricht University, Maastricht, the Netherlands
| | - Mark L Kuijf
- Research School of Mental Health and Neuroscience (Mhens), Maastricht University, Maastricht, the Netherlands.,Department of Neurology, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Anne-Claire Leterme
- Neurology and Movement Disorders Department, Centre Hospitalier Universitaire, Lille, France
| | - Dominique Servant
- Neurology and Movement Disorders Department, Centre Hospitalier Universitaire, Lille, France
| | - Marjolein de Vugt
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, the Netherlands.,Research School of Mental Health and Neuroscience (Mhens), Maastricht University, Maastricht, the Netherlands
| | - Kathy Dujardin
- Neurology and Movement Disorders Department, Centre Hospitalier Universitaire, Lille, France.,Degenerative & Vascular Cognitive Disorders, University of Lille, Lille, France
| | - Albert F G Leentjens
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, the Netherlands.,Research School of Mental Health and Neuroscience (Mhens), Maastricht University, Maastricht, the Netherlands
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26
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Carey G, Görmezoğlu M, de Jong JJ, Hofman PA, Backes WH, Dujardin K, Leentjens AF. Neuroimaging of Anxiety in Parkinson's Disease: A Systematic Review. Mov Disord 2021; 36:327-339. [PMID: 33289195 PMCID: PMC7984351 DOI: 10.1002/mds.28404] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 10/02/2020] [Accepted: 10/26/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The aim of this systematic review was (1) to identify the brain regions involved in anxiety in Parkinson's disease (PD) based on neuroimaging studies and (2) to interpret the findings against the background of dysfunction of the fear circuit and limbic cortico-striato-thalamocortical circuit. METHODS Studies assessing anxiety symptoms in PD patients and studies using magnetic resonance imaging, positron emission tomography, or single-photon emission computed tomography were included. RESULTS The severity of anxiety was associated with changes in the fear circuit and the cortico-striato-thalamocortical limbic circuit. In the fear circuit, a reduced gray-matter volume of the amygdala and the anterior cingulate cortex (ACC); an increased functional connectivity (FC) between the amygdala and orbitofrontal cortex (OFC) and hippocampus and between the striatum and the medial prefrontal cortex (PFC), temporal cortex, and insula; and a reduced FC between the lateral PFC and the OFC, hippocampus, and amygdala were reported. In the cortico-striato-thalamocortical limbic circuit, a reduced FC between the striatum and ACC; a reduced dopaminergic and noradrenergic activity in striatum, thalamus, and locus coeruleus; and a reduced serotoninergic activity in the thalamus were reported. CONCLUSION To conclude, anxiety is associated with structural and functional changes in both the hypothesized fear and the limbic cortico-striato-thalamocortical circuits. These circuits overlap and may well constitute parts of a more extensive pathway, of which different parts play different roles in anxiety. The neuropathology of PD may affect these circuits in different ways, explaining the high prevalence of anxiety in PD and also the associated cognitive, motor, and psychiatric symptoms. © 2020 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Guillaume Carey
- School for Mental Health and Neurosciences (MHeNS)Maastricht UniversityMaastrichtthe Netherlands
- Université de Lille, Inserm, CHU Lille, Lille Neurosciences and CognitionLilleFrance
| | - Meltem Görmezoğlu
- Department of PsychiatryMaastricht University Medical CenterMaastrichtthe Netherlands
- Department of Psychiatry, Ondokuz Mayis University HospitalOndokuz Mayıs UniversitySamsunTurkey
| | - Joost J.A. de Jong
- School for Mental Health and Neurosciences (MHeNS)Maastricht UniversityMaastrichtthe Netherlands
- Department of Radiology and Nuclear MedicineMaastricht University Medical CenterMaastrichtthe Netherlands
| | - Paul A.M. Hofman
- School for Mental Health and Neurosciences (MHeNS)Maastricht UniversityMaastrichtthe Netherlands
- Department of Radiology and Nuclear MedicineMaastricht University Medical CenterMaastrichtthe Netherlands
| | - Walter H. Backes
- School for Mental Health and Neurosciences (MHeNS)Maastricht UniversityMaastrichtthe Netherlands
- Department of Radiology and Nuclear MedicineMaastricht University Medical CenterMaastrichtthe Netherlands
| | - Kathy Dujardin
- Université de Lille, Inserm, CHU Lille, Lille Neurosciences and CognitionLilleFrance
| | - Albert F.G. Leentjens
- School for Mental Health and Neurosciences (MHeNS)Maastricht UniversityMaastrichtthe Netherlands
- Department of PsychiatryMaastricht University Medical CenterMaastrichtthe Netherlands
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27
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Dujardin K, Duhem S, Guerouaou N, Djelad S, Drumez E, Duhamel A, Bombois S, Nasreddine Z, Bordet R, Deplanque D. Validation in French of the Montreal Cognitive Assessment 5-Minute, a brief cognitive screening test for phone administration. Rev Neurol (Paris) 2021; 177:972-979. [PMID: 33478740 DOI: 10.1016/j.neurol.2020.09.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 08/24/2020] [Accepted: 09/10/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND The prevalence of cognitive impairment and dementia is high and steadily increasing. Early detection of cognitive decline is crucial since some interventions can reduce the risk of progression to dementia. However, there is a lack of manageable scales for assessing cognitive functions outside specialized consultations. Recently, the MoCA-5min, a short version of the Montreal Cognitive assessment (MoCA), phone-administered, was validated for screening for vascular cognitive impairment. The aim of the present study was to validate the MoCA-5min in French in diverse clinical populations. METHODS The Cantonese version of the MoCA-5min was adapted for French language. Healthy volunteers and patients with possible or established cognitive impairment (Alzheimer's disease or related disorders, Parkinson's disease, Huntington's disease, type-2 diabetes) participated in the study. The original MoCA and the MoCA-5min were administered, by phone, with a 30-day interval. Alternate forms were used to reduce learning effects. RESULTS The scores of the original MoCA and MoCA-5min correlated significantly (Spearman rho=0.751, P<0.0001, 95% confidence interval 0.657 to 0.819). Internal consistency was good (Cronbach alpha=0.795). The area under the ROC curve was 0.870 and the optimal cut-off value for separating patients with and without cognitive impairment with the MoCA-5min was≤27 with 87.32% sensitivity and 76.09% specificity. Interrater and test-retest reliability were adequate. CONCLUSION This study demonstrates that the French version of the MoCA-5min is a valid and reliable scale for detecting cognitive impairment in different clinical populations. It is administrable by phone and thus suitable for remote assessment as well as for large-scale screening and epidemiological studies.
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Affiliation(s)
- K Dujardin
- Inserm, Lille Neurosciences and Cognition, CHU de Lille, University Lille, 59000 Lille, France; Neurology and Movement Disorders, Lille University Medical Center, Lille, France.
| | - S Duhem
- Clinical Investigation Center, Lille University Medical Center, Lille, France
| | - N Guerouaou
- Clinical Investigation Center, Lille University Medical Center, Lille, France
| | - S Djelad
- Neurology and Movement Disorders, Lille University Medical Center, Lille, France
| | - E Drumez
- EA 2694 - METRICS : évaluation des technologies de santé et des pratiques médicales, CHU de Lille, University Lille, Lille, France
| | - A Duhamel
- EA 2694 - METRICS : évaluation des technologies de santé et des pratiques médicales, CHU de Lille, University Lille, Lille, France
| | - S Bombois
- Inserm, Lille Neurosciences and Cognition, CHU de Lille, University Lille, 59000 Lille, France
| | | | - R Bordet
- Inserm, Lille Neurosciences and Cognition, CHU de Lille, University Lille, 59000 Lille, France
| | - D Deplanque
- Inserm, Lille Neurosciences and Cognition, CHU de Lille, University Lille, 59000 Lille, France
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28
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Delval A, Betrouni N, Tard C, Devos D, Dujardin K, Defebvre L, Labidi J, Moreau C. Do kinematic gait parameters help to discriminate between fallers and non-fallers with Parkinson's disease? Clin Neurophysiol 2021; 132:536-541. [PMID: 33450575 DOI: 10.1016/j.clinph.2020.11.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 10/22/2020] [Accepted: 11/09/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Although a number of clinical factors have been linked to falls in Parkinson's disease (PD), the diagnostic value of gait parameters remains subject to debate. The objective of this retrospective study was to determine to what extent the combination of gait parameters with clinical characteristics can distinguish between fallers and non-fallers. METHODS Using a video motion system, we recorded gait in 174 patients with PD. The patients' clinical characteristics (including motor status, cognitive status, disease duration, dopaminergic treatment and any history of falls or freezing of gait) were noted. The considered kinematic gait parameters included indices of gait bradykinesia and hypokinesia, asymmetry, variability, and foot clearance. After a parameters selection using an ANCOVA analysis, support vector machine algorithm was used to build classification models for distinguishing between fallers and non-fallers. Two models were built, the first included clinical data only while the second incorporated the selected gait parameters. RESULTS The "clinical-only" model had an accuracy of 94% for distinguishing between fallers and non-fallers. The model incorporating additional gait parameters including stride time and foot clearance performed even better, with an accuracy of up to 97%. CONCLUSION Although fallers differed significantly from non-fallers with regard to disease duration, motor impairment or dopaminergic treatment, the addition of gait parameters such as foot clearance or stride time to clinical variables increased the model's discriminant power. SIGNIFICANCE This predictive model now needs to be validated in prospective cohorts.
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Affiliation(s)
- Arnaud Delval
- Univ. Lille, Inserm, U1172 - Lille Neuroscience and Cognition, F-59000 Lille, France; Clinical Neurophysiology Department, Lille University Medical Center, F-59000 Lille, France; Lille Center of Excellence for Neurodegenerative Diseases, LiCEND, France.
| | - Nacim Betrouni
- Univ. Lille, Inserm, U1172 - Lille Neuroscience and Cognition, F-59000 Lille, France; Lille Center of Excellence for Neurodegenerative Diseases, LiCEND, France
| | - Céline Tard
- Univ. Lille, Inserm, U1172 - Lille Neuroscience and Cognition, F-59000 Lille, France; Neurology and Movement Disorders Department, Lille University Medical Center, F-59000 Lille, France; Lille Center of Excellence for Neurodegenerative Diseases, LiCEND, France
| | - David Devos
- Univ. Lille, Inserm, U1172 - Lille Neuroscience and Cognition, F-59000 Lille, France; Neurology and Movement Disorders Department, Lille University Medical Center, F-59000 Lille, France; Lille Center of Excellence for Neurodegenerative Diseases, LiCEND, France
| | - Kathy Dujardin
- Univ. Lille, Inserm, U1172 - Lille Neuroscience and Cognition, F-59000 Lille, France; Neurology and Movement Disorders Department, Lille University Medical Center, F-59000 Lille, France; Lille Center of Excellence for Neurodegenerative Diseases, LiCEND, France
| | - Luc Defebvre
- Univ. Lille, Inserm, U1172 - Lille Neuroscience and Cognition, F-59000 Lille, France; Neurology and Movement Disorders Department, Lille University Medical Center, F-59000 Lille, France; Lille Center of Excellence for Neurodegenerative Diseases, LiCEND, France
| | - Jordan Labidi
- Univ. Lille, Inserm, U1172 - Lille Neuroscience and Cognition, F-59000 Lille, France
| | - Caroline Moreau
- Univ. Lille, Inserm, U1172 - Lille Neuroscience and Cognition, F-59000 Lille, France; Neurology and Movement Disorders Department, Lille University Medical Center, F-59000 Lille, France; Lille Center of Excellence for Neurodegenerative Diseases, LiCEND, France
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29
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Mestre TA, Fereshtehnejad SM, Berg D, Bohnen NI, Dujardin K, Erro R, Espay AJ, Halliday G, van Hilten JJ, Hu MT, Jeon B, Klein C, Leentjens AF, Marinus J, Mollenhauer B, Postuma R, Rajalingam R, Rodríguez-Violante M, Simuni T, Surmeier DJ, Weintraub D, McDermott MP, Lawton M, Marras C. Parkinson's Disease Subtypes: Critical Appraisal and Recommendations. J Parkinsons Dis 2021; 11:395-404. [PMID: 33682731 PMCID: PMC8150501 DOI: 10.3233/jpd-202472] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND In Parkinson's disease (PD), there is heterogeneity in the clinical presentation and underlying biology. Research on PD subtypes aims to understand this heterogeneity with potential contribution for the knowledge of disease pathophysiology, natural history and therapeutic development. There have been many studies of PD subtypes but their impact remains unclear with limited application in research or clinical practice. OBJECTIVE To critically evaluate PD subtyping systems. METHODS We conducted a systematic review of PD subtypes, assessing the characteristics of the studies reporting a subtyping system for the first time. We completed a critical appraisal of their methodologic quality and clinical applicability using standardized checklists. RESULTS We included 38 studies. The majority were cross-sectional (n = 26, 68.4%), used a data-driven approach (n = 25, 65.8%), and non-clinical biomarkers were rarely used (n = 5, 13.1%). Motor characteristics were the domain most commonly reported to differentiate PD subtypes. Most of the studies did not achieve the top rating across items of a Methodologic Quality checklist. In a Clinical Applicability Checklist, the clinical importance of differences between subtypes, potential treatment implications and applicability to the general population were rated poorly, and subtype stability over time and prognostic value were largely unknown. CONCLUSION Subtyping studies undertaken to date have significant methodologic shortcomings and most have questionable clinical applicability and unknown biological relevance. The clinical and biological signature of PD may be unique to the individual, rendering PD resistant to meaningful cluster solutions. New approaches that acknowledge the individual-level heterogeneity and that are more aligned with personalized medicine are needed.
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Affiliation(s)
- Tiago A. Mestre
- Parkinson’s disease and Movement Disorders Center, Division of Neurology, Department of Medicine, The Ottawa Hospital Research Institute, The University of Ottawa Brain and Research Institute, Ottawa, ON, Canada
- Division of Neurology, Department of Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | | | - Daniela Berg
- Department of Neurology, Christian-Albrechts-University, Kiel, Germany
| | - Nicolaas I. Bohnen
- Departments of Radiology & Neurology, University of Michigan, University of Michigan Udall Center, Ann Arbor VAMC, Ann Arbor, MI, USA
| | - Kathy Dujardin
- Movement Disorders Department, Center of Excellence for Neurodegenerative Diseases LiCEND, Lille, France
| | - Roberto Erro
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Neuroscience Section, University of Salerno, Baronissi (SA), Italy
| | - Alberto J. Espay
- James J. and Joan A. Gardner Family Center for Parkinson’s Disease and Movement Disorders, Department of Neurology, University of Cincinnati, Cincinnati, OH, USA
| | - Glenda Halliday
- Brain and Mind Centre and Central Clinical School, Faculty of Medicine and Health, University of Sydney, Australia
| | | | - Michele T. Hu
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Neurology Department, Oxford, United Kingdom
| | - Beomseok Jeon
- Department of Neurology, Seoul National University Hospital, Seoul, Korea
| | - Christine Klein
- Institute of Neurogenetics, University of Luebeck, Luebeck, Germany
| | - Albert F.G. Leentjens
- Department of Psychiatry, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Johan Marinus
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Brit Mollenhauer
- Paracelsus-Elena-Klinik, Kassel and University Medical Center Goettingen, Department of Neurology, Kassel, Germany
| | - Ronald Postuma
- Department of Neurology, McGill University, Montreal, Quebec, Canada
| | - Rajasumi Rajalingam
- Edmond J. Safra Program in Parkinson’s Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University Health Network, Toronto, Canada
| | | | - Tanya Simuni
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - D. James Surmeier
- Department of Physiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Daniel Weintraub
- Departments of Psychiatry and Neurology, Perelman School of Medicine at the University of Pennsylvania; Parkinson’s Disease Research, Education and Clinical Center (PADRECC), Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA
| | - Michael P. McDermott
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA
| | - Michael Lawton
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Connie Marras
- Edmond J. Safra Program in Parkinson’s Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University Health Network, Toronto, Canada
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30
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Lefebvre S, Very E, Jardri R, Horn M, Yrondi A, Delmaire C, Rascle C, Dujardin K, Thomas P, Pins D. The neural correlates of the visual consciousness in schizophrenia: an fMRI study. Eur Arch Psychiatry Clin Neurosci 2021; 271:661-675. [PMID: 32813032 PMCID: PMC8119280 DOI: 10.1007/s00406-020-01167-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 07/08/2020] [Indexed: 12/12/2022]
Abstract
In the current literature, two distinct and opposite models are suggested to explain the consciousness disorders in schizophrenia. The first one suggests that consciousness disorders rely on a low-level processing deficit, when the second model suggests that consciousness disorders rely on disruption in the ability to consciously access information, with preserved unconscious processing. The current study aims to understand the mechanisms associated with visual consciousness disorder in order to pave the road that will settle the debate regarding these hypotheses. During a functional magnetic resonance imaging session, 19 healthy participants (HC) and 15 patients with schizophrenia (SCZ) performed a visual detection task to compare the neural substrates associated with the conscious access to the visual inputs. The visual detection threshold was significantly higher in SCZ than in HC [t(32) = 3.37, p = 0.002]. Whole-brain ANOVA demonstrated that around the visual detection threshold patients with SCZ failed to activate a large network of brain areas compared to HC. (1) During conscious vision, HC engaged more the left cuneus and the right occipital cortex than patients with SCZ, (2) during unconscious vision, HC engaged a large network that patients with SCZ failed to activate, and finally, (3) during the access to consciousness process, patients with SCZ failed to activate the anterior cingulate cortex. These results suggest that the consciousness disorders in schizophrenia rely on specific dysfunctions depending on the consciousness stage. The disorders of the conscious vision are associated with dysfunction of occipital areas while the ones associated with unconscious vision rely on a large widespread network. Finally, the conscious access to the visual inputs is impaired by a dysfunction of the anterior cingulate cortex. The current study suggests that none of the two suggested models can explain consciousness disorders in schizophrenia. We suggest that there is an alternative model supporting that the conscious access to visual inputs is due to a disengagement of the supragenual anterior cingulate during the unconscious processing of the visual inputs associated with a sensory deficit.
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Affiliation(s)
- S. Lefebvre
- University of Lille, Inserm U1172, Centre Lille Neuroscience and Cognition, CHU Lille, 59000 Lille, France ,Plateforme CURE, CHU Lille, Hôpital Fontan, 59000 Lille, France ,Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - E. Very
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, INSERM UMR 1214, CHU PURPAN – Pavillon BAUDOT, Place du Dr Joseph Baylac, 31024 Toulouse, France
| | - R. Jardri
- University of Lille, Inserm U1172, Centre Lille Neuroscience and Cognition, CHU Lille, 59000 Lille, France ,Plateforme CURE, CHU Lille, Hôpital Fontan, 59000 Lille, France
| | - M. Horn
- University of Lille, Inserm U1172, Centre Lille Neuroscience and Cognition, CHU Lille, 59000 Lille, France ,Plateforme CURE, CHU Lille, Hôpital Fontan, 59000 Lille, France
| | - A. Yrondi
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, INSERM UMR 1214, CHU PURPAN – Pavillon BAUDOT, Place du Dr Joseph Baylac, 31024 Toulouse, France
| | - C. Delmaire
- University of Lille, Inserm U1172, Centre Lille Neuroscience and Cognition, CHU Lille, 59000 Lille, France ,Neuroimaging Department, Lille University Medical Center, 59000 Lille, France
| | - C. Rascle
- Plateforme CURE, CHU Lille, Hôpital Fontan, 59000 Lille, France
| | - K. Dujardin
- University of Lille, Inserm U1172, Centre Lille Neuroscience and Cognition, CHU Lille, 59000 Lille, France ,Department of Neurology and Movement Disorders, Lille University Medical Center, 59000 Lille, France
| | - P. Thomas
- University of Lille, Inserm U1172, Centre Lille Neuroscience and Cognition, CHU Lille, 59000 Lille, France ,Plateforme CURE, CHU Lille, Hôpital Fontan, 59000 Lille, France
| | - D. Pins
- University of Lille, Inserm U1172, Centre Lille Neuroscience and Cognition, CHU Lille, 59000 Lille, France ,Plateforme CURE, CHU Lille, Hôpital Fontan, 59000 Lille, France
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31
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Monje MHG, Fuller RLM, Cubo E, Mestre TA, Tan AH, Stout JC, Ali S, Chahine L, Dujardin K, Fitzer-Attas CJ, Youn J, Bloem BR, Horak FB, Merola A, Reilmann R, Paul SS, Dorsey ER, Maetzler W, Espay AJ, Martinez-Martin P, Stebbins GT, Sánchez-Ferro Á. Toward e-Scales: Digital Administration of the International Parkinson and Movement Disorder Society Rating Scales. Mov Disord Clin Pract 2020; 8:208-214. [PMID: 33553489 DOI: 10.1002/mdc3.13135] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 09/30/2020] [Accepted: 11/14/2020] [Indexed: 12/17/2022] Open
Affiliation(s)
- Mariana H G Monje
- HM CINAC, Hospital Universitario HM Puerta del Sur Madrid Spain.,Department of Anatomy, Histology and Neuroscience, School of Medicine Universidad Autónoma de Madrid Madrid Spain
| | | | - Esther Cubo
- Neurology Department Hospital Universitario Burgos Burgos Spain
| | - Tiago A Mestre
- Parkinson's Disease and Movement Disorders Center, Division of Neurology, Department of Medicine The Ottawa Hospital Research Institute, University of Ottawa Ottawa Ontario Canada
| | - Ai Huey Tan
- Division of Neurology and the Mah Pooi Soo & Tan Chin Nam Centre for Parkinson's & Related Disorders, Faculty of Medicine University of Malaya Kuala Lumpur Malaysia
| | - Julie C Stout
- Turner Institute for Brain and Mental Health, School of Psychological Sciences Monash University Clayton Victoria Australia
| | - Shazia Ali
- International Movement Disorders Society Milwaukee Illinois USA
| | - Lana Chahine
- Neurology Department, School of Medicine University of Pittsburgh Pittsburgh Pennsylvania USA
| | - Kathy Dujardin
- Movement Disorders Department Lille University Medical Center Lille France
| | | | - Jinyoung Youn
- Neurology Department Samsung Medical Center School of Medicine Seoul South Korea
| | - Bastiaan R Bloem
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology Centre of Expertise for Parkinson & Movement Disorders Nijmegen The Netherlands
| | - Fay B Horak
- Department of Neurology Oregon Health and Science University Portland Oregon USA
| | - Aristide Merola
- Department of Neurology Ohio State Wexner Medical Center Columbus Ohio USA
| | - Ralf Reilmann
- George-Huntingon-Institute & Department of Clinical Radiology University of Muenster Münster Germany.,Department of Neurodegeneration, Hertie Institute for Clinical Brain Research University of Tuebingen Tübingen Germany
| | - Serene S Paul
- Discipline of Physiotherapy, Sydney School of Health Sciences, Faculty of Medicine and Health University of Sydney Sydney New South Wales Australia
| | - Earl Ray Dorsey
- Center for Health + Technology and Department of Neurology University of Rochester Medical Center Rochester New York USA
| | - Walter Maetzler
- Department of Neurology University Hospital Schleswig-Holstein, Kiel University Kiel Germany
| | - Alberto J Espay
- Gardner Family Center for Parkinson's Disease and Movement Disorders and Neurology Department University of Cincinnati Cincinnati Ohio USA
| | - Pablo Martinez-Martin
- Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED) Carlos III Institute of Health Madrid Spain
| | - Glenn T Stebbins
- Department of Neurological Sciences Rush University Medical Center Chicago Illinois USA
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32
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Maltête D, Wallon D, Bourilhon J, Lefaucheur R, Danaila T, Thobois S, Defebvre L, Dujardin K, Houeto JL, Godefroy O, Krystkowiak P, Martinaud O, Gillibert A, Chastan M, Vera P, Hannequin D, Welter ML, Derrey S. Nucleus Basalis of Meynert Stimulation for Lewy Body Dementia: A Phase I Randomized Clinical Trial. Neurology 2020; 96:e684-e697. [PMID: 33199437 DOI: 10.1212/wnl.0000000000011227] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 09/30/2020] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVES Nucleus basalis of Meynert deep brain stimulation (NBM-DBS) has been proposed for patients with dementia. Here, we aim to assess the safety and effects of NBM-DBS in patients with Lewy body dementia (LBD), in a randomized, double-blind, crossover clinical trial. METHODS Six patients with mild to moderate LBD (mean [SD] age, 62.2 [7.8] years) were included, operated on for bilateral NBM-DBS, and assigned to receive either active or sham NBM-DBS followed by the opposite condition for 3 months. The primary outcome was the difference in the total free recalls of the Free and Cued Selective Reminding Test (FCSRT) between active and sham NBM-DBS. Secondary outcomes were assessments of the safety and effects of NBM-DBS on cognition, motor disability, sleep, and PET imaging. RESULTS There was no significant difference in the FCSRT score with active vs sham NBM-DBS. The surgical procedures were well tolerated in all patients, but we observed significant decreases in Stroop and Benton scores after electrode implantation. We observed no significant difference in other scales between active and sham NBM-DBS. With active NBM-DBS relative to baseline, phonemic fluency and motor disability significantly decreased. Lastly, the superior lingual gyrus metabolic activity significantly increased with active NBM-DBS. CONCLUSIONS NBM-DBS does not appear to be totally safe for patients with LBD with no evidence of cognitive benefit. CLINICALTRIALSGOV IDENTIFIER NCT01340001. CLASSIFICATION OF EVIDENCE This study provides Class II evidence that, for patients with LBD operated on for bilateral NBM-DBS, active NBM-DBS stimulation compared to sham stimulation did not significantly change selective recall scores.
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Affiliation(s)
- David Maltête
- From the Departments of Neurology (D.M., D.W., R.L., D.H.), Neurophysiology (J.B., M.-L.W.), and Neurosurgery (S.D.), Rouen University Hospital and University of Rouen; INSERM U1239 (D.M.), Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, Mont-Saint-Aignan; Department of Neurology C (T.D., S.T.), Hopital Neurologique Pierre Wertheimer, University of Lyon, Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Sud Charles Mérieux; Department of Neurology (L.D., K.D.), Lille University Hospital, INSERM 1171; Department of Neurology (J.-L.H.), CIC-INSERM 1402, CHU de Poitiers; Université de Poitiers (J.-L.H.); Department of Neurology (O.G., P.K.), Amiens University Hospital; Department of Neurology (O.M.), Caen University Hospital; Department of Biostatistics (A.G.), Rouen University Hospital; Department of Nuclear Medicine (M.C., P.V.), Henri Becquerel Cancer Center and Rouen University Hospital; and QuantIF-LITIS [EA (Equipe d'Accueil) 4108-FR CNRS 3638] (M.C., P.V.), Faculty of Medicine, University of Rouen, France.
| | - David Wallon
- From the Departments of Neurology (D.M., D.W., R.L., D.H.), Neurophysiology (J.B., M.-L.W.), and Neurosurgery (S.D.), Rouen University Hospital and University of Rouen; INSERM U1239 (D.M.), Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, Mont-Saint-Aignan; Department of Neurology C (T.D., S.T.), Hopital Neurologique Pierre Wertheimer, University of Lyon, Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Sud Charles Mérieux; Department of Neurology (L.D., K.D.), Lille University Hospital, INSERM 1171; Department of Neurology (J.-L.H.), CIC-INSERM 1402, CHU de Poitiers; Université de Poitiers (J.-L.H.); Department of Neurology (O.G., P.K.), Amiens University Hospital; Department of Neurology (O.M.), Caen University Hospital; Department of Biostatistics (A.G.), Rouen University Hospital; Department of Nuclear Medicine (M.C., P.V.), Henri Becquerel Cancer Center and Rouen University Hospital; and QuantIF-LITIS [EA (Equipe d'Accueil) 4108-FR CNRS 3638] (M.C., P.V.), Faculty of Medicine, University of Rouen, France
| | - Julie Bourilhon
- From the Departments of Neurology (D.M., D.W., R.L., D.H.), Neurophysiology (J.B., M.-L.W.), and Neurosurgery (S.D.), Rouen University Hospital and University of Rouen; INSERM U1239 (D.M.), Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, Mont-Saint-Aignan; Department of Neurology C (T.D., S.T.), Hopital Neurologique Pierre Wertheimer, University of Lyon, Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Sud Charles Mérieux; Department of Neurology (L.D., K.D.), Lille University Hospital, INSERM 1171; Department of Neurology (J.-L.H.), CIC-INSERM 1402, CHU de Poitiers; Université de Poitiers (J.-L.H.); Department of Neurology (O.G., P.K.), Amiens University Hospital; Department of Neurology (O.M.), Caen University Hospital; Department of Biostatistics (A.G.), Rouen University Hospital; Department of Nuclear Medicine (M.C., P.V.), Henri Becquerel Cancer Center and Rouen University Hospital; and QuantIF-LITIS [EA (Equipe d'Accueil) 4108-FR CNRS 3638] (M.C., P.V.), Faculty of Medicine, University of Rouen, France
| | - Romain Lefaucheur
- From the Departments of Neurology (D.M., D.W., R.L., D.H.), Neurophysiology (J.B., M.-L.W.), and Neurosurgery (S.D.), Rouen University Hospital and University of Rouen; INSERM U1239 (D.M.), Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, Mont-Saint-Aignan; Department of Neurology C (T.D., S.T.), Hopital Neurologique Pierre Wertheimer, University of Lyon, Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Sud Charles Mérieux; Department of Neurology (L.D., K.D.), Lille University Hospital, INSERM 1171; Department of Neurology (J.-L.H.), CIC-INSERM 1402, CHU de Poitiers; Université de Poitiers (J.-L.H.); Department of Neurology (O.G., P.K.), Amiens University Hospital; Department of Neurology (O.M.), Caen University Hospital; Department of Biostatistics (A.G.), Rouen University Hospital; Department of Nuclear Medicine (M.C., P.V.), Henri Becquerel Cancer Center and Rouen University Hospital; and QuantIF-LITIS [EA (Equipe d'Accueil) 4108-FR CNRS 3638] (M.C., P.V.), Faculty of Medicine, University of Rouen, France
| | - Teodor Danaila
- From the Departments of Neurology (D.M., D.W., R.L., D.H.), Neurophysiology (J.B., M.-L.W.), and Neurosurgery (S.D.), Rouen University Hospital and University of Rouen; INSERM U1239 (D.M.), Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, Mont-Saint-Aignan; Department of Neurology C (T.D., S.T.), Hopital Neurologique Pierre Wertheimer, University of Lyon, Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Sud Charles Mérieux; Department of Neurology (L.D., K.D.), Lille University Hospital, INSERM 1171; Department of Neurology (J.-L.H.), CIC-INSERM 1402, CHU de Poitiers; Université de Poitiers (J.-L.H.); Department of Neurology (O.G., P.K.), Amiens University Hospital; Department of Neurology (O.M.), Caen University Hospital; Department of Biostatistics (A.G.), Rouen University Hospital; Department of Nuclear Medicine (M.C., P.V.), Henri Becquerel Cancer Center and Rouen University Hospital; and QuantIF-LITIS [EA (Equipe d'Accueil) 4108-FR CNRS 3638] (M.C., P.V.), Faculty of Medicine, University of Rouen, France
| | - Stéphane Thobois
- From the Departments of Neurology (D.M., D.W., R.L., D.H.), Neurophysiology (J.B., M.-L.W.), and Neurosurgery (S.D.), Rouen University Hospital and University of Rouen; INSERM U1239 (D.M.), Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, Mont-Saint-Aignan; Department of Neurology C (T.D., S.T.), Hopital Neurologique Pierre Wertheimer, University of Lyon, Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Sud Charles Mérieux; Department of Neurology (L.D., K.D.), Lille University Hospital, INSERM 1171; Department of Neurology (J.-L.H.), CIC-INSERM 1402, CHU de Poitiers; Université de Poitiers (J.-L.H.); Department of Neurology (O.G., P.K.), Amiens University Hospital; Department of Neurology (O.M.), Caen University Hospital; Department of Biostatistics (A.G.), Rouen University Hospital; Department of Nuclear Medicine (M.C., P.V.), Henri Becquerel Cancer Center and Rouen University Hospital; and QuantIF-LITIS [EA (Equipe d'Accueil) 4108-FR CNRS 3638] (M.C., P.V.), Faculty of Medicine, University of Rouen, France
| | - Luc Defebvre
- From the Departments of Neurology (D.M., D.W., R.L., D.H.), Neurophysiology (J.B., M.-L.W.), and Neurosurgery (S.D.), Rouen University Hospital and University of Rouen; INSERM U1239 (D.M.), Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, Mont-Saint-Aignan; Department of Neurology C (T.D., S.T.), Hopital Neurologique Pierre Wertheimer, University of Lyon, Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Sud Charles Mérieux; Department of Neurology (L.D., K.D.), Lille University Hospital, INSERM 1171; Department of Neurology (J.-L.H.), CIC-INSERM 1402, CHU de Poitiers; Université de Poitiers (J.-L.H.); Department of Neurology (O.G., P.K.), Amiens University Hospital; Department of Neurology (O.M.), Caen University Hospital; Department of Biostatistics (A.G.), Rouen University Hospital; Department of Nuclear Medicine (M.C., P.V.), Henri Becquerel Cancer Center and Rouen University Hospital; and QuantIF-LITIS [EA (Equipe d'Accueil) 4108-FR CNRS 3638] (M.C., P.V.), Faculty of Medicine, University of Rouen, France
| | - Kathy Dujardin
- From the Departments of Neurology (D.M., D.W., R.L., D.H.), Neurophysiology (J.B., M.-L.W.), and Neurosurgery (S.D.), Rouen University Hospital and University of Rouen; INSERM U1239 (D.M.), Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, Mont-Saint-Aignan; Department of Neurology C (T.D., S.T.), Hopital Neurologique Pierre Wertheimer, University of Lyon, Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Sud Charles Mérieux; Department of Neurology (L.D., K.D.), Lille University Hospital, INSERM 1171; Department of Neurology (J.-L.H.), CIC-INSERM 1402, CHU de Poitiers; Université de Poitiers (J.-L.H.); Department of Neurology (O.G., P.K.), Amiens University Hospital; Department of Neurology (O.M.), Caen University Hospital; Department of Biostatistics (A.G.), Rouen University Hospital; Department of Nuclear Medicine (M.C., P.V.), Henri Becquerel Cancer Center and Rouen University Hospital; and QuantIF-LITIS [EA (Equipe d'Accueil) 4108-FR CNRS 3638] (M.C., P.V.), Faculty of Medicine, University of Rouen, France
| | - Jean-Luc Houeto
- From the Departments of Neurology (D.M., D.W., R.L., D.H.), Neurophysiology (J.B., M.-L.W.), and Neurosurgery (S.D.), Rouen University Hospital and University of Rouen; INSERM U1239 (D.M.), Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, Mont-Saint-Aignan; Department of Neurology C (T.D., S.T.), Hopital Neurologique Pierre Wertheimer, University of Lyon, Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Sud Charles Mérieux; Department of Neurology (L.D., K.D.), Lille University Hospital, INSERM 1171; Department of Neurology (J.-L.H.), CIC-INSERM 1402, CHU de Poitiers; Université de Poitiers (J.-L.H.); Department of Neurology (O.G., P.K.), Amiens University Hospital; Department of Neurology (O.M.), Caen University Hospital; Department of Biostatistics (A.G.), Rouen University Hospital; Department of Nuclear Medicine (M.C., P.V.), Henri Becquerel Cancer Center and Rouen University Hospital; and QuantIF-LITIS [EA (Equipe d'Accueil) 4108-FR CNRS 3638] (M.C., P.V.), Faculty of Medicine, University of Rouen, France
| | - Olivier Godefroy
- From the Departments of Neurology (D.M., D.W., R.L., D.H.), Neurophysiology (J.B., M.-L.W.), and Neurosurgery (S.D.), Rouen University Hospital and University of Rouen; INSERM U1239 (D.M.), Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, Mont-Saint-Aignan; Department of Neurology C (T.D., S.T.), Hopital Neurologique Pierre Wertheimer, University of Lyon, Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Sud Charles Mérieux; Department of Neurology (L.D., K.D.), Lille University Hospital, INSERM 1171; Department of Neurology (J.-L.H.), CIC-INSERM 1402, CHU de Poitiers; Université de Poitiers (J.-L.H.); Department of Neurology (O.G., P.K.), Amiens University Hospital; Department of Neurology (O.M.), Caen University Hospital; Department of Biostatistics (A.G.), Rouen University Hospital; Department of Nuclear Medicine (M.C., P.V.), Henri Becquerel Cancer Center and Rouen University Hospital; and QuantIF-LITIS [EA (Equipe d'Accueil) 4108-FR CNRS 3638] (M.C., P.V.), Faculty of Medicine, University of Rouen, France
| | - Pierre Krystkowiak
- From the Departments of Neurology (D.M., D.W., R.L., D.H.), Neurophysiology (J.B., M.-L.W.), and Neurosurgery (S.D.), Rouen University Hospital and University of Rouen; INSERM U1239 (D.M.), Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, Mont-Saint-Aignan; Department of Neurology C (T.D., S.T.), Hopital Neurologique Pierre Wertheimer, University of Lyon, Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Sud Charles Mérieux; Department of Neurology (L.D., K.D.), Lille University Hospital, INSERM 1171; Department of Neurology (J.-L.H.), CIC-INSERM 1402, CHU de Poitiers; Université de Poitiers (J.-L.H.); Department of Neurology (O.G., P.K.), Amiens University Hospital; Department of Neurology (O.M.), Caen University Hospital; Department of Biostatistics (A.G.), Rouen University Hospital; Department of Nuclear Medicine (M.C., P.V.), Henri Becquerel Cancer Center and Rouen University Hospital; and QuantIF-LITIS [EA (Equipe d'Accueil) 4108-FR CNRS 3638] (M.C., P.V.), Faculty of Medicine, University of Rouen, France
| | - Olivier Martinaud
- From the Departments of Neurology (D.M., D.W., R.L., D.H.), Neurophysiology (J.B., M.-L.W.), and Neurosurgery (S.D.), Rouen University Hospital and University of Rouen; INSERM U1239 (D.M.), Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, Mont-Saint-Aignan; Department of Neurology C (T.D., S.T.), Hopital Neurologique Pierre Wertheimer, University of Lyon, Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Sud Charles Mérieux; Department of Neurology (L.D., K.D.), Lille University Hospital, INSERM 1171; Department of Neurology (J.-L.H.), CIC-INSERM 1402, CHU de Poitiers; Université de Poitiers (J.-L.H.); Department of Neurology (O.G., P.K.), Amiens University Hospital; Department of Neurology (O.M.), Caen University Hospital; Department of Biostatistics (A.G.), Rouen University Hospital; Department of Nuclear Medicine (M.C., P.V.), Henri Becquerel Cancer Center and Rouen University Hospital; and QuantIF-LITIS [EA (Equipe d'Accueil) 4108-FR CNRS 3638] (M.C., P.V.), Faculty of Medicine, University of Rouen, France
| | - André Gillibert
- From the Departments of Neurology (D.M., D.W., R.L., D.H.), Neurophysiology (J.B., M.-L.W.), and Neurosurgery (S.D.), Rouen University Hospital and University of Rouen; INSERM U1239 (D.M.), Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, Mont-Saint-Aignan; Department of Neurology C (T.D., S.T.), Hopital Neurologique Pierre Wertheimer, University of Lyon, Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Sud Charles Mérieux; Department of Neurology (L.D., K.D.), Lille University Hospital, INSERM 1171; Department of Neurology (J.-L.H.), CIC-INSERM 1402, CHU de Poitiers; Université de Poitiers (J.-L.H.); Department of Neurology (O.G., P.K.), Amiens University Hospital; Department of Neurology (O.M.), Caen University Hospital; Department of Biostatistics (A.G.), Rouen University Hospital; Department of Nuclear Medicine (M.C., P.V.), Henri Becquerel Cancer Center and Rouen University Hospital; and QuantIF-LITIS [EA (Equipe d'Accueil) 4108-FR CNRS 3638] (M.C., P.V.), Faculty of Medicine, University of Rouen, France
| | - Mathieu Chastan
- From the Departments of Neurology (D.M., D.W., R.L., D.H.), Neurophysiology (J.B., M.-L.W.), and Neurosurgery (S.D.), Rouen University Hospital and University of Rouen; INSERM U1239 (D.M.), Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, Mont-Saint-Aignan; Department of Neurology C (T.D., S.T.), Hopital Neurologique Pierre Wertheimer, University of Lyon, Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Sud Charles Mérieux; Department of Neurology (L.D., K.D.), Lille University Hospital, INSERM 1171; Department of Neurology (J.-L.H.), CIC-INSERM 1402, CHU de Poitiers; Université de Poitiers (J.-L.H.); Department of Neurology (O.G., P.K.), Amiens University Hospital; Department of Neurology (O.M.), Caen University Hospital; Department of Biostatistics (A.G.), Rouen University Hospital; Department of Nuclear Medicine (M.C., P.V.), Henri Becquerel Cancer Center and Rouen University Hospital; and QuantIF-LITIS [EA (Equipe d'Accueil) 4108-FR CNRS 3638] (M.C., P.V.), Faculty of Medicine, University of Rouen, France
| | - Pierre Vera
- From the Departments of Neurology (D.M., D.W., R.L., D.H.), Neurophysiology (J.B., M.-L.W.), and Neurosurgery (S.D.), Rouen University Hospital and University of Rouen; INSERM U1239 (D.M.), Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, Mont-Saint-Aignan; Department of Neurology C (T.D., S.T.), Hopital Neurologique Pierre Wertheimer, University of Lyon, Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Sud Charles Mérieux; Department of Neurology (L.D., K.D.), Lille University Hospital, INSERM 1171; Department of Neurology (J.-L.H.), CIC-INSERM 1402, CHU de Poitiers; Université de Poitiers (J.-L.H.); Department of Neurology (O.G., P.K.), Amiens University Hospital; Department of Neurology (O.M.), Caen University Hospital; Department of Biostatistics (A.G.), Rouen University Hospital; Department of Nuclear Medicine (M.C., P.V.), Henri Becquerel Cancer Center and Rouen University Hospital; and QuantIF-LITIS [EA (Equipe d'Accueil) 4108-FR CNRS 3638] (M.C., P.V.), Faculty of Medicine, University of Rouen, France
| | - Didier Hannequin
- From the Departments of Neurology (D.M., D.W., R.L., D.H.), Neurophysiology (J.B., M.-L.W.), and Neurosurgery (S.D.), Rouen University Hospital and University of Rouen; INSERM U1239 (D.M.), Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, Mont-Saint-Aignan; Department of Neurology C (T.D., S.T.), Hopital Neurologique Pierre Wertheimer, University of Lyon, Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Sud Charles Mérieux; Department of Neurology (L.D., K.D.), Lille University Hospital, INSERM 1171; Department of Neurology (J.-L.H.), CIC-INSERM 1402, CHU de Poitiers; Université de Poitiers (J.-L.H.); Department of Neurology (O.G., P.K.), Amiens University Hospital; Department of Neurology (O.M.), Caen University Hospital; Department of Biostatistics (A.G.), Rouen University Hospital; Department of Nuclear Medicine (M.C., P.V.), Henri Becquerel Cancer Center and Rouen University Hospital; and QuantIF-LITIS [EA (Equipe d'Accueil) 4108-FR CNRS 3638] (M.C., P.V.), Faculty of Medicine, University of Rouen, France
| | - Marie-Laure Welter
- From the Departments of Neurology (D.M., D.W., R.L., D.H.), Neurophysiology (J.B., M.-L.W.), and Neurosurgery (S.D.), Rouen University Hospital and University of Rouen; INSERM U1239 (D.M.), Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, Mont-Saint-Aignan; Department of Neurology C (T.D., S.T.), Hopital Neurologique Pierre Wertheimer, University of Lyon, Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Sud Charles Mérieux; Department of Neurology (L.D., K.D.), Lille University Hospital, INSERM 1171; Department of Neurology (J.-L.H.), CIC-INSERM 1402, CHU de Poitiers; Université de Poitiers (J.-L.H.); Department of Neurology (O.G., P.K.), Amiens University Hospital; Department of Neurology (O.M.), Caen University Hospital; Department of Biostatistics (A.G.), Rouen University Hospital; Department of Nuclear Medicine (M.C., P.V.), Henri Becquerel Cancer Center and Rouen University Hospital; and QuantIF-LITIS [EA (Equipe d'Accueil) 4108-FR CNRS 3638] (M.C., P.V.), Faculty of Medicine, University of Rouen, France
| | - Stéphane Derrey
- From the Departments of Neurology (D.M., D.W., R.L., D.H.), Neurophysiology (J.B., M.-L.W.), and Neurosurgery (S.D.), Rouen University Hospital and University of Rouen; INSERM U1239 (D.M.), Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, Mont-Saint-Aignan; Department of Neurology C (T.D., S.T.), Hopital Neurologique Pierre Wertheimer, University of Lyon, Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Sud Charles Mérieux; Department of Neurology (L.D., K.D.), Lille University Hospital, INSERM 1171; Department of Neurology (J.-L.H.), CIC-INSERM 1402, CHU de Poitiers; Université de Poitiers (J.-L.H.); Department of Neurology (O.G., P.K.), Amiens University Hospital; Department of Neurology (O.M.), Caen University Hospital; Department of Biostatistics (A.G.), Rouen University Hospital; Department of Nuclear Medicine (M.C., P.V.), Henri Becquerel Cancer Center and Rouen University Hospital; and QuantIF-LITIS [EA (Equipe d'Accueil) 4108-FR CNRS 3638] (M.C., P.V.), Faculty of Medicine, University of Rouen, France
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Bayot M, Dujardin K, Dissaux L, Tard C, Defebvre L, Bonnet CT, Allart E, Allali G, Delval A. Can dual-task paradigms predict Falls better than single task? - A systematic literature review. Neurophysiol Clin 2020; 50:401-440. [PMID: 33176988 DOI: 10.1016/j.neucli.2020.10.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 10/06/2020] [Accepted: 10/06/2020] [Indexed: 11/18/2022] Open
Abstract
With about one third of adults aged 65 years and older being reported worldwide to fall each year, and an even higher prevalence with advancing age, aged-related falls and the associated disabilities and mortality are a major public health concern. In this context, identification of fall risk in healthy older adults is a key component of fall prevention. Since dual-task outcomes rely on the interaction between cognition and motor control, some studies have demonstrated the role of dual-task walking performance or costs in predicting future fallers. However, based on previous reviews on the topic, (1) discriminative and (2) predictive powers of dual tasks involving gait and a concurrent task are still a matter of debate, as is (3) their superiority over single tasks in terms of fall-risk prediction. Moreover, less attention has been paid to dual tasks involving postural control and transfers (such as gait initiation and turns) as motor tasks. In the present paper, we therefore systematically reviewed recent literature over the last 7 years in order to answer the three above mentioned questions regarding the future of lab-based dual tasks (involving posture, gait initiation, gait and turning) as easily applicable tests for identifying healthy older adult fallers. Despite great heterogeneity among included studies, we emphasized, among other things, the promising added value of dual tasks including turns and other transfers, such as in the Timed Up and Go test, for prediction of falls. Further investigation of these is thus warranted.
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Affiliation(s)
- Madli Bayot
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Department of Clinical Neurophysiology, F-59000 Lille, France
| | - Kathy Dujardin
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Department of Neurology and Movement Disorders, F-59000 Lille, France
| | - Lucile Dissaux
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Department of Clinical Neurophysiology, F-59000 Lille, France
| | - Céline Tard
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Department of Neurology and Movement Disorders, F-59000 Lille, France
| | - Luc Defebvre
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Department of Neurology and Movement Disorders, F-59000 Lille, France
| | - Cédrick T Bonnet
- Univ. Lille, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, CNRS UMR 9193, F-59000 Lille, France
| | - Etienne Allart
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Neurorehabilitation Unit, F-59000 Lille, France
| | - Gilles Allali
- Department of Neurology, Geneva University Hospitals and University of Geneva, Geneva 1211, Switzerland, Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY, US
| | - Arnaud Delval
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Department of Clinical Neurophysiology, F-59000 Lille, France.
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Vermaete I, Dujardin K, Stammen F. Looking back on 15 years of ultrasound-guided alcohol septal ablation for hypertrophic obstructive cardiomyopathy. Acta Cardiol 2020; 75:483-491. [PMID: 31204591 DOI: 10.1080/00015385.2019.1626550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Septal reduction remains an important target of current therapeutic modalities in hypertrophic obstructive cardiomyopathy (HOCM). Surgical septal myectomy has long been considered the gold standard in pharmacotherapy-refractory severely symptomatic patients with marked left ventricular outflow tract (LVOT) obstruction. In recent years, percutaneous alcohol septal ablation (ASA) has matured into the preferred strategy for patients with favourable anatomy and no other coexisting surgically amenable disease.Methods: We discuss 26 HOCM patients with persistent dyspnoea, angina or syncope despite optimal medical treatment. Baseline septal wall thickness was 20 ± 3 mm, with peak resting/provoked LVOT gradients of 53 ± 35/112 ± 40 mmHg. Guided by echocardiography, alcohol injection could be restricted to the first septal coronary artery in 85% of patients, provoking basal septal infarction with average troponin rise of 3.0 ng/ml.Results: Eighty-six per cent of patients experienced sustained clinical improvement, associated with a reduction of septal wall thickness to 15 ± 3 mm and resting LVOT gradient to 21 ± 15 mmHg. One of the two non-responders underwent additional septal myectomy 11 years after ASA. Notable adverse events during the follow-up of 7.2 ± 4.7 years included: persistent conduction disturbances (65%) necessitating early postprocedural permanent pacemaker implantation (15%); atrial fibrillation (32%); ventricular tachycardia (4%) and aortic stenosis (14%). Six patients died, of which only 1 cardiac death.Conclusions: Our case series underscores the efficacy of ASA at relieving LVOT obstruction and improving symptoms in properly selected HOCM patients, with acceptably low procedural and long term mortality and morbidity.
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Affiliation(s)
- I. Vermaete
- Department of Cardiology, UZ Leuven, Leuven, Belgium
| | - K. Dujardin
- Department of Cardiology, AZ Delta, Roeselare, Belgium
| | - F. Stammen
- Department of Cardiology, AZ Delta, Roeselare, Belgium
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Carey G, Lopes R, Viard R, Betrouni N, Kuchcinski G, Devignes Q, Defebvre L, Leentjens AFG, Dujardin K. Anxiety in Parkinson's disease is associated with changes in the brain fear circuit. Parkinsonism Relat Disord 2020; 80:89-97. [PMID: 32979785 DOI: 10.1016/j.parkreldis.2020.09.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 08/23/2020] [Accepted: 09/14/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Anxiety is frequent in Parkinson's disease (PD) and has a negative impact on disease symptoms and quality of life. The underlying mechanisms remain largely unknown. The aim of this study was to identify anatomical and functional changes associated to PD-related anxiety by comparing the volume, shape and texture of the amygdala, the cortical thickness as well as the functional connectivity (FC) of the fear circuit in patients with and without clinically relevant anxiety. METHODS Non-demented PD patients were recruited, and anxiety was quantified using the Parkinson Anxiety Scale. Structural MRI was used to compare cortical thickness and amygdala structure and resting-state functional MRI to compare FC patterns of the amygdala and resting-state functional networks in both groups. RESULTS We included 118 patients: 34 with (A+) and 84 without (A-) clinically relevant anxiety. Clusters of cortical thinning were identified in the bilateral fronto-cingulate and left parietal cortices of the A+ group. The texture and the shape of the left amygdala was different in the A+ group but the overall volume did not differ between groups. FC between the amygdala and the whole brain regions did not differ between groups. The internetwork resting-state FC was higher between the "fear circuit" and salience network in the A+ group. CONCLUSION Anxiety in PD induces structural modifications of the left amygdala, atrophy of the bilateral fronto-cingulate and the left parietal cortices, and a higher internetwork resting-state FC between the fear circuit and the salience network.
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Affiliation(s)
- Guillaume Carey
- Univ. Lille, Inserm, CHU Lille, Lille Neurosciences and Cognition, Lille, France.
| | - Renaud Lopes
- Univ. Lille, Inserm, CHU Lille, Lille Neurosciences and Cognition, Lille, France; Department of Neuroradiology, Lille University Medical Centre, Lille, France
| | - Romain Viard
- Univ. Lille, Inserm, CHU Lille, Lille Neurosciences and Cognition, Lille, France; Department of Neuroradiology, Lille University Medical Centre, Lille, France
| | - Nacim Betrouni
- Univ. Lille, Inserm, CHU Lille, Lille Neurosciences and Cognition, Lille, France
| | - Gregory Kuchcinski
- Univ. Lille, Inserm, CHU Lille, Lille Neurosciences and Cognition, Lille, France; Department of Neuroradiology, Lille University Medical Centre, Lille, France
| | - Quentin Devignes
- Univ. Lille, Inserm, CHU Lille, Lille Neurosciences and Cognition, Lille, France
| | - Luc Defebvre
- Univ. Lille, Inserm, CHU Lille, Lille Neurosciences and Cognition, Lille, France; Neurology and Movement Disorders Department, Lille University Medical Centre, Lille, France
| | - Albert F G Leentjens
- Department of Psychiatry, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Kathy Dujardin
- Univ. Lille, Inserm, CHU Lille, Lille Neurosciences and Cognition, Lille, France; Neurology and Movement Disorders Department, Lille University Medical Centre, Lille, France
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Carey G, Lopes R, Viard R, Betrouni N, Defebvre L, Leentjens A, Dujardin K. L’anxiété dans la maladie de Parkinson est associée à des modifications dans le circuit cérébral de la peur. Rev Neurol (Paris) 2020. [DOI: 10.1016/j.neurol.2020.01.258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Baille G, Perez T, Devos D, Machuron F, Dujardin K, Chenivesse C, Defebvre L, Moreau C. Dyspnea Is a Specific Symptom in Parkinson's Disease. J Parkinsons Dis 2020; 9:785-791. [PMID: 31476170 DOI: 10.3233/jpd-191713] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Dyspnea is a multidimensional sensation that is reported in Parkinson's disease (PD). The multidimensional dyspnea profile (MDP) questionnaire can help to distinguish the perceptive dimension and the emotion response. OBJECTIVE The aim was to assess the clinical features associated with dyspnea using the MDP questionnaire in order to determine which aspects of the symptom was linked with anxiety, depression or motor severity of the disease. METHODS Non-demented patients were asked whether they experienced shortness of breath in the last month. In case of positive answer, dyspnea was assessed by the MDP. MDS-UPDRS, global cognitive performance, non-motor symptoms and quality of life were assessed. RESULTS 60/163 patients were dyspneic since 4.6±2.4 years. The most frequent best sensory quality (SQ) described were: hyperpnoea (35%), physical breathing effort (25%) and air hunger (20%). Hyperpnoea and air hunger had the highest SQ intensity. Anxiety had the highest intensity in the emotional domain. CONCLUSION Dyspnea is a frequent symptom in PD, with specific presentations and two main aspects: one related with anxiety and another with ventilation control impairment.
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Affiliation(s)
- Guillaume Baille
- Department of Neurology, Expert Center for Parkinson's Disease, INSERM UMRS_1171, Lille University Medical Center, LICEND COEN center, Lille, France
| | - Thierry Perez
- CHU Lille, Lung Function Department, Univ Lille, INSERM 1019, CNRS UMR 8204, Institut Pasteur de Lille, Center for Infection and Immunity of Lille, Lille, France
| | - David Devos
- CHU Lille, Department of Allergy and Respiratory Medicine, Competence Center for rare lung diseases, Univ. Lille, CNRS, INSERM, Institut Pasteur de Lille, U1019 - UMR 8204 - CIIL - Center for Infection and Immunity of Lille, Lille, France
| | - François Machuron
- Univ. Lille, CHU Lille, EA 2694 - Santé Publique: Épidémiologie et Qualité des Soins, Department of Biostatistics, Lille, France
| | - Kathy Dujardin
- Department of Neurology, Expert Center for Parkinson's Disease, INSERM UMRS_1171, Lille University Medical Center, LICEND COEN center, Lille, France
| | - Cécile Chenivesse
- CHU Lille, Lung Function Department, Univ Lille, INSERM 1019, CNRS UMR 8204, Institut Pasteur de Lille, Center for Infection and Immunity of Lille, Lille, France
| | - Luc Defebvre
- Department of Neurology, Expert Center for Parkinson's Disease, INSERM UMRS_1171, Lille University Medical Center, LICEND COEN center, Lille, France
| | - Caroline Moreau
- Department of Neurology, Expert Center for Parkinson's Disease, INSERM UMRS_1171, Lille University Medical Center, LICEND COEN center, Lille, France
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Grolez G, Viard R, Lopes R, Kuchcinski G, Defebvre L, Devos D, Dujardin K, Moreau C. Functional correlates of cognitive slowing in Parkinson's disease. Parkinsonism Relat Disord 2020; 76:3-9. [PMID: 32531530 DOI: 10.1016/j.parkreldis.2020.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 03/31/2020] [Accepted: 05/04/2020] [Indexed: 12/01/2022]
Abstract
Although attentional impairments (particularly cognitive slowing) are frequent in Parkinson's disease (PD), the mechanisms underlying these phenomena have not been fully characterized. The MRI-compatible version of the Symbol Digit Modalities Test (SDMT) has been applied to healthy individuals but not previously to patients with PD. We sought to assess functional changes in brain activation patterns associated with cognitive slowing in PD. Eighteen patients with PD and 11 matched healthy controls (HCs) were enrolled. High-resolution three-dimensional T1-weighted images and blood-oxygen-level-dependent images were acquired during the SDMT. SDMT-related brain networks for the HC and PD groups were extracted from one-sample T-test maps. In each hemisphere, correlated regions were identified by selecting 120 voxels around the peak of each significant cluster (puncorrected<0.001). Regions of interest were then analyzed. When performing the SDMT, both groups displayed activation in the frontal, parietal and occipital regions known to be involved in attention. In the PD group, activation was lower in several parts of the cerebellum, left and right occipital cortices, and right supramarginal gyrus. In eight of these regions, fMRI activation was positively correlated with performance in the SDMT task. Our results suggest that the right supramarginal gyrus (an important interface for information integration), the cerebellum, and the left and right occipital cortices are involved in cognitive slowing in PD. A lower level of brain activation was associated with greater cognitive impairment.
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Affiliation(s)
- Guillaume Grolez
- Lille Neuroscience and Cognition, UMR 1172, Team1 Degenerative and vascular cognitive disorders, Lille, France; Lille University Medical Center, Department of Neurology, Lille, France.
| | - Romain Viard
- Lille Neuroscience and Cognition, UMR 1172, Team1 Degenerative and vascular cognitive disorders, Lille, France; Lille University Medical Center, Department of Neuroradiology, Lille, France.
| | - Renaud Lopes
- Lille Neuroscience and Cognition, UMR 1172, Team1 Degenerative and vascular cognitive disorders, Lille, France; Lille University Medical Center, Department of Neuroradiology, Lille, France.
| | - Grégory Kuchcinski
- Lille Neuroscience and Cognition, UMR 1172, Team1 Degenerative and vascular cognitive disorders, Lille, France; Lille University Medical Center, Department of Neuroradiology, Lille, France.
| | - Luc Defebvre
- Lille Neuroscience and Cognition, UMR 1172, Team1 Degenerative and vascular cognitive disorders, Lille, France; Lille University Medical Center, Department of Neurology, Lille, France.
| | - David Devos
- Lille Neuroscience and Cognition, UMR 1172, Team1 Degenerative and vascular cognitive disorders, Lille, France; Lille University Medical Center, Department of Neurology, Lille, France; Lille University Medical Center, Department of Pharmacology, Lille, France.
| | - Kathy Dujardin
- Lille Neuroscience and Cognition, UMR 1172, Team1 Degenerative and vascular cognitive disorders, Lille, France; Lille University Medical Center, Department of Neurology, Lille, France.
| | - Caroline Moreau
- Lille Neuroscience and Cognition, UMR 1172, Team1 Degenerative and vascular cognitive disorders, Lille, France; Lille University Medical Center, Department of Neurology, Lille, France.
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Dujardin K, Anne W, Pollet P, Acou WJ, Galvao P. 243Reviewing electronic health records with the use of natural language processing to determine the prognostic impact of AF and anticoagulation therapy in patients undergoing PCI. Europace 2020. [DOI: 10.1093/europace/euaa162.218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Between 10-15% of patients undergoing percutaneous coronary intervention (PCI) have a history of atrial fibrillation (AF), and require both oral anticoagulant (OAC) as well as antiplatelet therapy following PCI. However this combination puts the patient at a high risk of serious or fatal bleeding complications. Using big data from electronic health records (EHR) provides the unique opportunity to observe to what extent AF and anticoagulant therapy affect the outcome of patients undergoing PCI in routine clinical practice.
Purpose
We analysed whether a history of AF and the use of OAC upon discharge was independently associated with short-term, mid-term and long-term mortality in large single institution cohort of patients undergoing PCI.
Methods
This retrospective EHR study was approved by the institutional review board and data privacy officer. The study population comprised all patients undergoing either planned or urgent PCI between 2012 and 2018. SNOMED time coded past and current medical diagnosis, procedures and drug therapy were extracted from the medical correspondence using natural language processing, procedural characteristics were obtained from the PCI database, and hospital admission data, billing cost, length of stay and vital status were added from the hospital administrative software. Vital status was obtained in all patients. The independent predictors of mortality were analysed using a stepwise multivariate logistic linear regression analysis, with automated forward selection of variables. For each variable the odds ratio with confidence intervals were derived from the regression model. The validity of the model was tested with the Hosmer and Lemeshow test.
Results
During a 6 year period 5223 patients were identified who underwent a total of 6854 PCI’s, of which 74% were men with a median age of 71 years. At the time of PCI, 256 patients had AF and were not treated with OAC, 549 patients had AF and were treated with OAC, 284 patients developed AF during follow up and 5765 were in sinus rhythm. Patients with a history of AF or ensuing AF were older, more often had multivessel coronary disease, a history of CABG and MI, renal failure, diabetes mellitus and a lower ejection fraction. AF was found to be a strong independent predictor of mortality at 30 days (OR: 2,8), 120 days (OR: 2), 1 year (OR: 1,9) and 5 years (OR: 1,7) following PCI. By contrast OAC was associated with lower odds ratios of mortality at 30 days (OR: 0,4), 120 days (OR: 0,4), 1 year (OR: 0,7) and 5 years (OR: 0,7). Also the occurence of AF post PCI was linked with an increased mortality
Conclusions
In this large data set of patients undergoing PCI in routine clinical practice, a history of AF was independently associated with increased short-term, mid-term and long-term mortality. On the other hand, OAC was associated with improved short-term, mid-term and long-term mortality survival following PCI.
Abstract Figure.
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Affiliation(s)
| | - W Anne
- AZ Delta, Roeselare, Belgium
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Blaise AS, Baille G, Carrière N, Devos D, Dujardin K, Grolez G, Kreisler A, Kyheng M, Moreau C, Mutez E, Seguy D, Defebvre L. Safety and effectiveness of levodopa-carbidopa intestinal gel for advanced Parkinson's disease: A large single-center study. Rev Neurol (Paris) 2020; 176:268-276. [DOI: 10.1016/j.neurol.2019.07.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 07/21/2019] [Accepted: 07/23/2019] [Indexed: 01/15/2023]
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Baille G, Chenivesse C, Perez T, Dujardin K, Defebvre L, Moreau C. Dyspnea: A Missing Item of the MDS-UPDRS Part I? Mov Disord 2020; 35:1079. [PMID: 32212349 DOI: 10.1002/mds.28036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 03/05/2020] [Indexed: 11/11/2022] Open
Affiliation(s)
- Guillaume Baille
- Movement Disorders Department, Parkinson's Disease Center, Lille University Medical Center, Lille, France
| | - Cecile Chenivesse
- CHU Lille, Department of Allergy and Respiratory Medicine, Competence Center for rare lung diseases, University Lille, CNRS, INSERM, Institut Pasteur de Lille, U1019-UMR 8204-CIIL-Center for Infection and Immunity of Lille, Lille, France
| | - Thierry Perez
- CHU Lille, Lung Function Department, University Lille, INSERM 1019, CNRS UMR 8204, Institut Pasteur de Lille, Center for Infection and Immunity of Lille, Lille, France
| | - Kathy Dujardin
- Movement Disorders Department, Parkinson's Disease Center, Lille University Medical Center, Lille, France
| | - Luc Defebvre
- Movement Disorders Department, Parkinson's Disease Center, Lille University Medical Center, Lille, France
| | - Caroline Moreau
- Movement Disorders Department, Parkinson's Disease Center, Lille University Medical Center, Lille, France
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Delval A, Bayot M, Defebvre L, Dujardin K. Cortical Oscillations during Gait: Wouldn't Walking be so Automatic? Brain Sci 2020; 10:E90. [PMID: 32050471 PMCID: PMC7071606 DOI: 10.3390/brainsci10020090] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 02/03/2020] [Accepted: 02/07/2020] [Indexed: 01/12/2023] Open
Abstract
Gait is often considered as an automatic movement but cortical control seems necessary to adapt gait pattern with environmental constraints. In order to study cortical activity during real locomotion, electroencephalography (EEG) appears to be particularly appropriate. It is now possible to record changes in cortical neural synchronization/desynchronization during gait. Studying gait initiation is also of particular interest because it implies motor and cognitive cortical control to adequately perform a step. Time-frequency analysis enables to study induced changes in EEG activity in different frequency bands. Such analysis reflects cortical activity implied in stabilized gait control but also in more challenging tasks (obstacle crossing, changes in speed, dual tasks…). These spectral patterns are directly influenced by the walking context but, when analyzing gait with a more demanding attentional task, cortical areas other than the sensorimotor cortex (prefrontal, posterior parietal cortex, etc.) seem specifically implied. While the muscular activity of legs and cortical activity are coupled, the precise role of the motor cortex to control the level of muscular contraction according to the gait task remains debated. The decoding of this brain activity is a necessary step to build valid brain-computer interfaces able to generate gait artificially.
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Affiliation(s)
- Arnaud Delval
- UMR-S1172, Lille Neuroscience & Cognition, Inserm, University Lille, 59000 Lille, France; (M.B.); (L.D.); (K.D.)
- Clinical Neurophysiology Department, CHU Lille, 59000 Lille, France
| | - Madli Bayot
- UMR-S1172, Lille Neuroscience & Cognition, Inserm, University Lille, 59000 Lille, France; (M.B.); (L.D.); (K.D.)
- Clinical Neurophysiology Department, CHU Lille, 59000 Lille, France
| | - Luc Defebvre
- UMR-S1172, Lille Neuroscience & Cognition, Inserm, University Lille, 59000 Lille, France; (M.B.); (L.D.); (K.D.)
- Movement Disorders Department, CHU Lille, 59000 Lille, France
| | - Kathy Dujardin
- UMR-S1172, Lille Neuroscience & Cognition, Inserm, University Lille, 59000 Lille, France; (M.B.); (L.D.); (K.D.)
- Movement Disorders Department, CHU Lille, 59000 Lille, France
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Dujardin K, Sgambato V. Neuropsychiatric Disorders in Parkinson's Disease: What Do We Know About the Role of Dopaminergic and Non-dopaminergic Systems? Front Neurosci 2020; 14:25. [PMID: 32063833 PMCID: PMC7000525 DOI: 10.3389/fnins.2020.00025] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 01/10/2020] [Indexed: 12/13/2022] Open
Abstract
Besides the hallmark motor symptoms (rest tremor, hypokinesia, rigidity, and postural instability), patients with Parkinson’s disease (PD) have non-motor symptoms, namely neuropsychiatric disorders. They are frequent and may influence the other symptoms of the disease. They have also a negative impact on the quality of life of patients and their caregivers. In this article, we will describe the clinical manifestations of the main PD-related behavioral disorders (depression, anxiety disorders, apathy, psychosis, and impulse control disorders). We will also provide an overview of the clinical and preclinical literature regarding the underlying mechanisms with a focus on the role of the dopaminergic and non-dopaminergic systems.
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Affiliation(s)
- Kathy Dujardin
- Inserm U1171 Degenerative and Vascular Cognitive Disorders, Lille University Medical Center, Lille, France
| | - Véronique Sgambato
- CNRS, Institut des Sciences Cognitives Marc Jeannerod, UMR 5229, Lyon University, Bron, France
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Pontone GM, Dissanayaka N, Apostolova L, Brown RG, Dobkin R, Dujardin K, Friedman JH, Leentjens AFG, Lenze EJ, Marsh L, Mari L, Monchi O, Richard IH, Schrag A, Strafella AP, Vernaleo B, Weintraub D, Mari Z. Report from a multidisciplinary meeting on anxiety as a non-motor manifestation of Parkinson's disease. NPJ Parkinsons Dis 2019; 5:30. [PMID: 31840044 PMCID: PMC6906437 DOI: 10.1038/s41531-019-0102-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 10/17/2019] [Indexed: 12/14/2022] Open
Abstract
Anxiety is a severe problem for at least one-third of people living with Parkinson's disease (PD). Anxiety appears to have a greater adverse impact on quality of life than motor impairment. Despite its high prevalence and impact on daily life, anxiety is often undiagnosed and untreated. To better address anxiety in PD, future research must improve knowledge about the mechanism of anxiety in PD and address the lack of empirical evidence from clinical trials. In response to these challenges, the Parkinson's Foundation sponsored an expert meeting on anxiety on June 13th and 14th 2018. This paper summarizes the findings from that meeting informed by a review of the existing literature and discussions among patients, caregivers, and an international, clinician-scientist, expert panel working group. The goal is to provide recommendations to improve our understanding and treatment of anxiety in PD.
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Affiliation(s)
- Gregory M. Pontone
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD USA
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - Nadeeka Dissanayaka
- The University of Queensland Centre for Clinical Research, Faculty of Medicine, Brisbane, Australia
- School of Psychology, The University of Queensland, Brisbane, Australia
- Department of Neurology, Royal Brisbane & Woman’s Hospital, Brisbane, Australia
| | - Liana Apostolova
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN USA
| | - Richard G. Brown
- Department of Psychology, Institute of Psychiatry Psychology and Neuroscience, King’s College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Roseanne Dobkin
- Department of Psychiatry, Rutgers University, Robert Wood Johnson Medical School, Piscataway, NJ USA
| | - Kathy Dujardin
- Department of Neurology and Movement Disorders, Lille University Medical Center, Lille, France
| | - Joseph H. Friedman
- Movement Disorders Program, Butler Hospital; Department of Neurology, Warren Alpert Medical School of Brown University, Providence, RI USA
| | - Albert F. G. Leentjens
- Department of Psychiatry, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Eric J. Lenze
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO USA
| | - Laura Marsh
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX USA
- Department of Psychiatry, Baylor College of Medicine, Houston, TX USA
| | - Lynda Mari
- Person Holistic Innovation, Las Vegas, NV USA
| | - Oury Monchi
- Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - Irene H. Richard
- Department of Neurology, University of Rochester Medical Center, Rochester, NY USA
| | - Anette Schrag
- Department of Clinical and Movement Neurosciences, University College London, London, UK
| | - Antonio P. Strafella
- E.J. Safra Parkinson Disease Program, Toronto Western Hospital & Krembil Research Institute, UHN; Research Imaging Centre, Campbell Family Mental Health Research Institute, CAMH; University of Toronto, Ontario, Canada
| | | | - Daniel Weintraub
- Departments of Psychiatry and Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA USA
- Parkinson’s Disease Research, Education and Clinical Center, Philadelphia Veterans Affairs Medical Center, Philadelphia, PA USA
| | - Zoltan Mari
- Cleveland Clinic Lou Ruvo Center for Brain Health, Movement Disorders Program, Las Vegas, NV USA
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Delval A, Betrouni N, Tard C, Devos D, Dujardin K, Defebvre L, Labidi J, Moreau C. Do kinematic parameters of gait discriminate fallers and non-fallers in Parkinson's disease? Neurophysiol Clin 2019. [DOI: 10.1016/j.neucli.2019.10.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Bayot M, Braquet A, Tard C, Defebvre L, Derambure P, Dujardin K, Delval A. Impact des capacités attentionnelles sur l’initiation du pas chez les patients souffrant de la maladie de Parkinson avec freezing de la marche : étude électroencéphalographique. Neurophysiol Clin 2019. [DOI: 10.1016/j.neucli.2019.10.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Betrouni N, Lopes R, Defebvre L, Leentjens AFG, Dujardin K. Texture features of magnetic resonance images: A marker of slight cognitive deficits in Parkinson's disease. Mov Disord 2019; 35:486-494. [PMID: 31758820 DOI: 10.1002/mds.27931] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 09/23/2019] [Accepted: 11/06/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Cognitive impairment is a frequent nonmotor symptom of Parkinson's disease. Depending on severity, patients are considered to have mild cognitive impairment or dementia. However, among the cognitively intact patients, some may have deficits in a less severe range. The early detection of such subtle symptoms may be important for the initiation of care strategies. OBJECTIVE To identify imaging markers of early cognitive symptoms, potentially before usual signs, such as atrophy, become manifest. METHODS A total of 102 patients with Parkinson's disease and 17 age-matched cognitively intact healthy controls underwent extensive neuropsychological assessment and T1-weighted magnetic resonance imaging. Parkinson's disease patients were separated into 3 groups according to their cognitive status: intact, with slight slowing, and with mild deficits in executive functions. Texture features as measured by first-order and second-order statistics were computed in the following 6 brain regions: the hippocampus, thalamus, amygdala, putamen, caudate nucleus, and pallidum. They were tested between the groups, and their correlation with cognition was examined. Volumetric measurements were made for comparison. RESULTS Texture analysis showed significant between-group differences for 2 features-skewness and entropy in the hippocampus, the thalamus, and the amygdala-and the volume analysis revealed no between-group difference. These features were significantly correlated with cognitive performance. CONCLUSION These results support the assumption that signal alterations associated with Parkinson's disease-related cognitive decline can be captured very early by texture analysis. As these changes appear to reflect clinical phenomena, texture analysis may be a promising marker for helping cognitive phenotyping in Parkinson's disease. © 2019 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Nacim Betrouni
- Université de Lille, Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Lille (CHU Lille), Degenerative & Vascular Cognitive Disorders, Lille, France
| | - Renaud Lopes
- Université de Lille, Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Lille (CHU Lille), Degenerative & Vascular Cognitive Disorders, Lille, France
| | - Luc Defebvre
- Université de Lille, Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Lille (CHU Lille), Degenerative & Vascular Cognitive Disorders, Lille, France.,Neurology and Movement Disorders Department, CHU Lille, Lille, France
| | - Albert F G Leentjens
- Department of Psychiatry, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Kathy Dujardin
- Université de Lille, Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Lille (CHU Lille), Degenerative & Vascular Cognitive Disorders, Lille, France.,Neurology and Movement Disorders Department, CHU Lille, Lille, France
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Wolters AF, Moonen AJH, Lopes R, Leentjens AFG, Duits AA, Defebvre L, Delmaire C, Hofman PA, van Bussel FC, Dujardin K. Grey matter abnormalities are associated only with severe cognitive decline in early stages of Parkinson's disease. Cortex 2019; 123:1-11. [PMID: 31733342 DOI: 10.1016/j.cortex.2019.09.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 06/11/2019] [Accepted: 09/26/2019] [Indexed: 11/25/2022]
Abstract
Cognitive impairment is common in Parkinson's disease (PD), yet with large heterogeneity in the range and course of deficits. In a cross-sectional study, 124 PD patients underwent extensive clinical and neuropsychological assessment as well as a 3T MRI scan of the brain. Our aim was to identify differences in grey matter volume and thickness, as well as cortical folding, across different cognitive profiles as defined through a data-driven exploratory cluster analysis of neuropsychological data. The identified cognitive groups ranged from cognitively intact patients to patients with severe deficits in all cognitive domains, whilst showing comparable levels of motor disability and disease duration. Each group was compared to the cognitively intact PD group using voxel- and vertex-based morphometry. Results revealed widespread age-related grey matter abnormalities associated with progressive worsening of cognitive functions in mild PD. When adjusted for age, significant differences were only seen between cognitively intact and severely affected PD patients and these were restricted to the right posterior cingulate and the right precuneus. Reduced cortical thickness was seen in the right inferior temporal gyrus and reduced folding in the right temporal region. As these differences were not associated with age, we assume that they are associated with underlying pathology of the cognitive decline. Given the limited involvement of grey matter differences, and the absence of differences in vascular changes across the groups, we hypothesize a more important role for white matter tract changes in cognitive decline in PD.
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Affiliation(s)
- Amée F Wolters
- Department of Neurology, Maastricht University Medical Center, Maastricht, the Netherlands; School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Anja J H Moonen
- School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Renaud Lopes
- Univ. Lille, U1171 - Degenerative & Vascular Cognitive Disorders, Lille, France; Inserm, U1171, Lille, France; CHU Lille, Neuroimaging Department, Lille, France
| | - Albert F G Leentjens
- School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, Maastricht, the Netherlands.
| | - Annelien A Duits
- School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Luc Defebvre
- Univ. Lille, U1171 - Degenerative & Vascular Cognitive Disorders, Lille, France; Inserm, U1171, Lille, France; CHU Lille, Neurology and Movement Disorders, Lille, France
| | - Christine Delmaire
- Univ. Lille, U1171 - Degenerative & Vascular Cognitive Disorders, Lille, France; Inserm, U1171, Lille, France; CHU Lille, Neuroimaging Department, Lille, France
| | - Paul A Hofman
- School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Radiology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Frank C van Bussel
- School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Radiology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Kathy Dujardin
- Univ. Lille, U1171 - Degenerative & Vascular Cognitive Disorders, Lille, France; Inserm, U1171, Lille, France; CHU Lille, Neurology and Movement Disorders, Lille, France
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Dujardin K, Roman D, Baille G, Pins D, Lefebvre S, Delmaire C, Defebvre L, Jardri R. What can we learn from fMRI capture of visual hallucinations in Parkinson’s disease? Brain Imaging Behav 2019; 14:329-335. [DOI: 10.1007/s11682-019-00185-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Bayot M, Braquet A, Tard C, Defebvre L, Dujardin K, Derambure P, Delval A. P30-S Impact of attentional abilities on step initiation in Parkinsonian patients with freezing of gait. Clin Neurophysiol 2019. [DOI: 10.1016/j.clinph.2019.04.568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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