The Effects of Cardiorespiratory and Motor Skill Fitness on Intrinsic Functional Connectivity of Neural Networks in Individuals with Parkinson's Disease

Background:

Studies in aging older adults have shown the positive association between cognition and exercise related fitness, particularly cardiorespiratory fitness. These reports have also demonstrated the association of high cardiorespiratory fitness, as well as other types of fitness, on the reversal of age-related decline in neural network connectivity, highlighting the potential role of fitness on age- and disease-related brain changes. While the clinical benefits of exercise are well-documented in Parkinson’s disease (PD), the extent to which cardiorespiratory fitness (assessed by estimated VO_2max testing) or motor skill fitness (assessed by the Physical Performance Test (PPT)) affects neural network connectivity in PD remains to be investigated. The purpose of this study was to explore the hypothesis that higher fitness level is associated with an increase in the intrinsic network connectivity of cognitive networks commonly affected in PD.

Methods:

In this cross-sectional resting state fMRI, we used a multivariate statistical approach based on high-dimensional independent component analysis (ICA) to investigate the association between two independent fitness metrics (estimated VO_2max and PPT) and resting state network connectivity.

Results:

We found that increased estimated VO_2max was associated with increased within network connectivity in cognitive networks known to be impaired in PD, including those sub-serving memory and executive function. There was a similar trend for high levels of PPT to be associated with increased within network connectivity in distinct resting state networks. The between functional network connectivity analysis revealed that cardiorespiratory fitness was associated with increased functional connectivity between somatosensory motor network and several cognitive networks sub-serving memory, attention, and executive function.

Conclusion:

This study provides important empirical data supporting the potential association between two forms of fitness and multiple resting state networks impacting PD cognition. Linking fitness to circuit specific modulation of resting state network connectivity will help establish a neural basis for the positive effects of fitness and specific exercise modalities and provide a foundation to identify underlying mechanisms to promote repair.

Thalamic volume mediates associations between cardiorespiratory fitness (VO2max) and cognition in Parkinson's disease

INTRODUCTION

Cognitive deficits occur in Parkinson's disease (PD). Cardiorespiratory fitness (CRF) is associated with better cognitive performance in aging especially in executive function (EF) and memory. The association between CRF and cognitive performance is understudied in people with PD. Brain structures underlying associations also remains unknown. This cross-sectional study examined the associations between CRF and cognitive performance in PD. We also examined associations between CRF and brain structures impacted in PD. Mediation analysis were conducted to examine whether brain structures impacted in PD mediate putative associations between CRF and cognitive performance.

METHODS

Individuals with PD (N = 33) underwent magnetic resonance imaging (MRI), CRF evaluation (estimated VO₂max), and neuropsychological assessment. Composite cognitive scores of episodic memory, EF, attention, language, and visuospatial functioning were generated. Structural equation models were constructed to examine whether MRI volume estimates (thalamus and pallidum) mediated associations between CRF and cognitive performance (adjusting for age, education, PD disease duration, sex, MDS-UPDRS motor score, and total intracranial volume).

RESULTS

Higher CRF was associated with better episodic memory (Standardized β = 0.391; p = 0.008), EF (Standardized β = 0.324; p = 0.025), and visuospatial performance (Standardized β = 0.570; p = 0.005). Higher CRF was associated with larger thalamic (Standardized β = 0.722; p = 0.004) and pallidum (Standardized β = 0.635; p = 0.004) volumes. Thalamic volume mediated the association between higher CRF and better EF (Indirect effect = 0.309) and episodic memory (Indirect effect = 0.209) performance (p < 0.05). The pallidum did not significantly mediate associations between CRF and cognitive outcomes.

CONCLUSION

The thalamus plays an important role in the association between CRF and both EF and episodic memory in PD.

Mild cognitive impairment, psychiatric symptoms, and executive functioning in patients with Parkinson's disease

OBJECTIVE

Mild cognitive impairment (MCI) and psychiatric symptoms (anxiety, depression, and apathy) are common in Parkinson's disease (PD). While studies have supported the association between psychiatric symptoms and cognitive performance in PD, it is unclear if the magnitude of link between psychiatric symptoms and cognitive health is stronger by MCI status. The purpose of this study was to examine the association between cognitive performance and psychiatric symptoms in PD and whether MCI status moderates this association.

METHODS/DESIGN

Participants (N = 187) completed a comprehensive neuropsychological assessment that included measures of attention, language, executive function (EF), visuospatial ability, episodic memory, and psychiatric symptoms. Participants were classified as PD-MCI (N = 73) or PD-normal cognition (NC; N = 114). Linear regression analyses were conducted to examine the association between psychiatric symptoms and cognitive performance and the moderating effect of PD-MCI status.

RESULTS

There were no differences in mean psychiatric symptoms between PD-MCI and PD-NC. Psychiatric symptoms were predominantly associated with worse EF. The magnitude of the association between anxiety and worse EF was larger in participants with PD-MCI compared with PD-NC. A multivariable regression analysis examining the independent contributions of each symptom demonstrated the most robust association between EF and anxiety.

CONCLUSIONS

Symptoms of anxiety, depression, and apathy are associated with worse executive functioning in individuals with PD. PD-MCI may be important in moderating the association between cognitive performance, specifically anxiety, and EF. Factors that promote cognitive resilience may serve as key therapeutic modalities in managing neuropsychiatric symptoms in PD.

Worse cognitive performance predicts increased anxiety and depressive symptoms in patients with Parkinson's disease: A bidirectional analysis

OBJECTIVE

Symptoms of anxiety, depression commonly co-occur with cognitive decline in patients with Parkinson's disease (PD). The directionality of this association is unclear, however, in that poor cognitive performance may lead to increased symptoms of anxiety and depression or higher anxiety and depressive symptoms may lead to cognitive decline. The purpose of this study was to elucidate the directionality of the association between symptoms of anxiety and depression with cognitive performance in newly diagnosed patients with PD.

METHOD

Longitudinal data from 362 nondemented participants from the Parkinson's Progression Markers Initiative (PPMI) were examined. Participants completed as many as five assessments of anxiety symptoms, depressive symptoms, and cognitive performance over a 4-year period. Bivariate dual change score models were fit to examine the dynamic association between level and change of anxiety and depressive symptoms with level and change in cognitive performance.

RESULTS

Across all cognitive domains, worse performance was associated with subsequently higher state anxiety, trait anxiety, and depressive symptoms. The reverse direction was not significant as higher state anxiety, trait anxiety, and depressive symptoms were not associated with subsequent declines in cognitive performance.

CONCLUSIONS

Poorer cognitive performance, across all cognitive domains, was a risk factor for increased symptoms of anxiety and depression a year later. No support was present for the alternative hypothesis that anxiety and depression are associated with subsequent cognitive decline. Clinical implications include the importance of psychoeducation, as well as assessing and monitoring anxiety and depression in patients with PD with poor cognitive performance. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Increased flavour diversity of Chardonnay wines by spontaneous fermentation and co-fermentation with Hanseniaspora vineae

Discovery, characterisation and use of novel yeast strains for winemaking is increasingly regarded as a way for improving quality and to provide variation, including subtle characteristic differences in fine wines. The objective of this work was to evaluate the use of a native apiculate strain, selected from grapes, Hanseniaspora vineae (H. vineae) 02/5A. Fermentations were done in triplicate, working with 225 L oak barrels, using a Chardonnay grape must. Three yeast fermentation strategies were compared: conventional inoculation with a commercial Saccharomyces cerevisiae strain, ALG 804, sequential inoculation with H. vineae and then strain ALG 804 and spontaneous fermentation. Yeast strain identification was performed during fermentation, in which the apiculate strain was found to be active, until 9% of alcohol in volume, for the co-fermentation and the spontaneous fermentation was completed by three native S. cerevisiae strains. Basic winemaking parameters and some key chemical analysis, such as concentration of glycerol, biogenic amines, organic acids, and aroma compounds were analysed. Sensory analysis was done using a trained panel and further evaluated with professional winemakers. Sequential inoculation with H. vineae followed by S. cerevisiae resulted in relatively dry wines, with increased aroma and flavour diversity compared with wines resulting from inoculation with S. cerevisiae alone. Wines produced from sequential inoculations were considered, by a winemaker's panel, to have an increased palate length and body. Characteristics of wines derived from sequential inoculation could be explained due to significant increases in glycerol and acetyl and ethyl ester flavour compounds and relative decreases in alcohols and fatty acids. Aroma sensory analysis of wine character and flavour, attributed to winemaking using H. vineae, indicated a significant increase in fruit intensity described as banana, pear, apple, citric fruits and guava. GC analysis of the relative accumulation of 23 compounds to significantly different concentrations for the three fermentation strategies is discussed in relation to aroma compound composition.

Fabrication and characterization of a diluted magnetic semiconducting TM co-doped Al:ZnO (TM=Co, Ni) thin films by sol-gel spin coating method

Effect of transition metal oxides (TM=Co and Ni) co-doping on the crystallinity, surface morphology, grain growth and magnetic properties of nanostructure Al:ZnO thin films has been studied for diluted magnetic semiconductor applications. Al:ZnO thin films were fabricated by sol-gel spin coating on p-type Si (100) substrates. Fabrication of hexagonal wurtzite TM co-doped Al:ZnO thin films having thickness 2μm was successfully achieved. The Raman spectra of the TM co-doped Al:ZnO thin films showed a broad vibrational mode in the range 520-540cm(-1) due to crystal defects created co-doping elements in the ZnO host lattice. Scanning electron microscopy (SEM) revealed that the films are composed of uniform size, polycrystalline dense ZnO particles with defect free, smooth surfaces. The surface roughness was further verified with atomic force microscopy (AFM). The energy dispersive X-ray spectroscopic analysis (EDX) confirmed the stoichiometric compositions of the TM co-doped Al:ZnO films. The magnetic measurements exhibited that the Co, Al:ZnO and Ni, Al:ZnO thin films were ferromagnetic at room temperature.

Preoperative oral supplement with immunonutrients in cancer patients

BACKGROUND

Early postoperative enteral nutrition with immune-enhancing supplements has helped to restore immune function and reduce infectious complications in patients with cancer undergoing major gastrointestinal operations. The aim of this study was to evaluate the effectiveness of similar supplements (containing arginine and arginine plus omega-3 fatty acids) given preoperatively for 1 week before cancer surgery.

METHODS

In this randomized, double-blinded study, patients scheduled to undergo elective resection of upper gastrointestinal tumors were given one of three different oral liquid supplemental diets (control, arginine, arginine plus omega-3 fatty acids) to be taken each day for 7 days before surgery. Blood samples were obtained upon enrollment, on the morning of surgery, and on postoperative day 1 for analysis of immunologic function.

RESULTS

Mean serum ornithine (a metabolite of arginine) levels were significantly higher compared with controls, but no significant increase in mean serum arginine levels was noted on the morning of surgery for those patients who received arginine as part of the supplement. In conjunction with these findings, there were no differences among groups in mean lymphocyte mitogenesis, mean peripheral blood mononuclear cell production of cytokines, or clinical outcomes.

CONCLUSIONS

Use of oral liquid supplements in this fashion did not improve lymphocyte proliferation or monocyte functions in patients with cancer undergoing major surgery.

Early postoperative enteral feeding following major upper gastrointestinal surgery

For a variety of reasons, enteral feeding is frequently delayed following major abdominal surgery. The purpose of this study was to evaluate prospectively the feasibility and tolerance of early jejunal feeding following major upper gastrointestinal surgery. Beginning on postoperative day 1, patients (n = 167) received a full-strength enteral formula at the rate of 25 ml/hr through a jejunal feeding tube. Diets were advanced to the calculated target rate (25 kcal/kg/day) by postoperative day 4. Complications of tube feeding, calories received, and patient symptoms were recorded daily. There were no major complications or deaths resulting from placement of a jejunal tube or from early enteral feeding. Patients had abdominal symptoms such as cramping, distention, nausea, and diarrhea on 9%, 18%, 4%, and 24% of all feeding days, respectively. The majority of these symptoms, with the exception of diarrhea, were graded as mild. Patients undergoing surgery for pancreatic malignancy had significantly more diarrhea than patients undergoing esophagectomy or gastrectomy. Despite these differences in symptoms, patients received an average of 78% of their targeted caloric goal by postoperative day 4 and maintained this level throughout the study. Early enteral feeding for patients undergoing esophageal, gastric, or pancreatic resections is both safe and feasible despite the occurrence of predominantly mild gastrointestinal symptoms.

[Qualitative and quantitiative differences in the plasma lipoproteins of obese, hyperlipidemic or normolipidemic men and women]

The aim of this study was to evaluate the alterations of the lipoprotein composition and their relation with the insulin-resistance and/or hyperinsulinemia in non diabetic obese patients. Twenty-two no obese(13 women and 9 men) and 30 obese patients (BMI > 30) were studied, who were divided into two groups according to the total lipid levels. The first group was formed by 18 obese patients (10 women and 8 men) with normal serum cholesterol (Chol) concentration < 200 mg/dL and triglycerides (TG) < 150mg/dL (NO), while the second group were formed by 12 obese patients (3 women and 9 men) with elevated Chol level > 200mg/dL and/or TG > 150 mg/dL (HO). A clinical and anthropometric examination was performed to each patient, as well as a glucose tolerance test, including serum glucose and insulin determinations. Likewise, the plasma lipoproteins (VLDL, LDL, HDL2 and HDL3) were isolated by ultracentrifugation and their cholesterol and triglycerides content were determined by enzymatic methods. In this report, we demonstrate the existence of compensatory basal hyperinsulinemia in men and women on both obese patients populations as well as alterations in the lipoprotein composition, mostly a TG overload even on NO. On the other hand, the presence of lipids and lipoproteins modification were obvious in those patients with abdominal obesity, on whom the hyperinsulinemia was more evident, which could be related with the high risk of cardiovascular disease in this kind of patients.

Alterations in the sleep-waking cycle induced by cooling of the locus coeruleus area

Bilateral or unilateral, localized and reversible cooling (+10 degrees C) of the anterior part of the locus coeruleus area (LCp) in the cat induced, in rapid succession, slow wave sleep (SWS) and a transitory phase of SWS + PGO. These states of sleep were followed in 40-50% of the animals by paradoxical sleep (PS). These effects (on SWS, SWS + PGO and PS) occurred following repetitive periods of short duration cooling and were maintained during long duration cooling (70 min). Unilateral cooling of the ventral part of the locus coeruleus area (LC alpha) and peri-LC alpha induced wakefulness, regardless of the states of sleep in which the cooling was performed. After a cryolesion (-24 degrees C) of the nucleus raphe dorsalis, cooling of the LCp did not induce a hypnogenic effect. Electrical stimulation of the locus coeruleus area, however, always induced wakefulness.

Single unit recordings in the nuclei raphe dorsalis and magnus during the sleep-waking cycle of semi-chronic prepared cats

Single unit recordings were performed in the nuclei raphe dorsalis (RD) and raphe magnus (RM) of semi-chronic prepared cats during spontaneous or cryogenically induced sleep. Of the RD neurons 75% showed a discharge pattern which decreased during slow wave sleep and paradoxical sleep (PS); such a decrease in spiking was related to the occurrence of ponto-geniculo-occipital (PGO) waves. to the contrary, 78% of the RM neurons demonstrated a discharge pattern which significantly increased during PS, and especially when PGO waves were present.

[Effect of cooling and electrical stimulation of nuclei of raphe system on states of alertness in cat]

In cats prepared in a 'semi-chronic' manner (spinal cord transected, brachial plexus sectioned bilaterally) all states of alertness are present; their quantitative evolution is characterized by an immediate postoperative period with continuous wakefulness and a secondary period of recovery of the states of sleep, which are then maintained. In such a preparation, localized moderate cooling (+10 degrees C) of the nucleus raphe dorsalis induces slow wave sleep and paradoxical sleep; the same type of cooling of the nucleus raphe magnus induces wakefulness; however, the electrical stimulation of these two nuclei always induces wakefulness. Cooling of the nuclei raphe centralis or pontis suppresses only the 'ponto-geniculo-occipital' (PGO) waves. Colling of the nuclei raphe obscurus and pallidus induces wakedfulness, but stage I of slow wave sleep may occur. Treatment with p-chlorophenylalanine (PCPA) before making the semi-chronic preparation produces the classical syndrome characterized by cortical activation and continuous discharge of PGO waves; in this case cooling of the nucleus raphe dorsalis no longer induces slow wave sleep but only paradoxical sleep; after injection of DL-5-HTP, slow wave sleep is obtained again through cooling; this effect diminishes progressively.