1
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King G, Veros KM, MacLaren DAA, Leigh MPK, Spernyak JA, Clark SD. Human wildtype tau expression in cholinergic pedunculopontine tegmental neurons is sufficient to produce PSP-like behavioural deficits and neuropathology. Eur J Neurosci 2021; 54:7688-7709. [PMID: 34668254 DOI: 10.1111/ejn.15496] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 09/30/2021] [Accepted: 10/12/2021] [Indexed: 11/30/2022]
Abstract
Progressive Supranuclear Palsy (PSP) is the most common atypical parkinsonism and exhibits hallmark symptomology including motor function impairment and dysexecutive dementia. In contrast to Parkinson's disease, the underlying pathology displays aggregation of the protein tau, which is also seen in disorders such as Alzheimer's disease. Currently, there are no pharmacological treatments for PSP, and drug discovery efforts are hindered by the lack of an animal model specific to PSP. Based on previous results and clinical pathology, it was hypothesized that viral deposition of tau in cholinergic neurons within the hindbrain would produce a tauopathy along neural connections to produce PSP-like symptomology and pathology. By using a combination of ChAT-CRE rats and CRE-dependent AAV vectors, wildtype human tau (the PSP-relevant 1N4R isoform; hTau) was expressed in hindbrain cholinergic neurons. Compared to control subjects (GFP), rats with tau expression displayed deficits in a variety of behavioural paradigms: acoustic startle reflex, marble burying, horizontal ladder and hindlimb motor reflex. Postmortem, the hTau rats had significantly reduced number of cholinergic pedunculopontine tegmentum and dopaminergic substantia nigra neurons, as well as abnormal tau deposits. This preclinical model has multiple points of convergence with the clinical features of PSP, some of which distinguish between PSP and Parkinson's disease.
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Affiliation(s)
- Gabriella King
- Department of Pharmacology and Toxicology, University at Buffalo, Buffalo, New York, USA
| | - Kaliana M Veros
- Department of Pharmacology and Toxicology, University at Buffalo, Buffalo, New York, USA
| | | | | | - Joseph A Spernyak
- Department of Cell Stress Biology, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Stewart D Clark
- Department of Pharmacology and Toxicology, University at Buffalo, Buffalo, New York, USA
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2
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Klunk D, Woost TB, Fricke C, Classen J, Weise D. Differentiating neurodegenerative parkinsonian syndromes using vestibular evoked myogenic potentials and balance assessment. Clin Neurophysiol 2021; 132:2808-2819. [PMID: 34628341 DOI: 10.1016/j.clinph.2021.08.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 07/15/2021] [Accepted: 08/07/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Vestibular evoked myogenic potentials (VEMP) were investigated to differentiate between parkinsonian syndromes. We correlated balance and VEMP parameters to investigate the VEMP brainstem circuits as possible origin for postural instability. METHODS We assessed clinical status, ocular and cervical VEMP (oVEMP, cVEMP) and conducted a balance assessment (posturography, Activities-specific Balance Confidence Scale, Berg Balance Scale, modified Barthel Index) in 76 subjects: 30 with Parkinson's disease (PD), 16 with atypical parkinsonism (AP) and 30 healthy controls. VEMP were elicited by using a mini-shaker on the forehead. RESULTS Patients with PD had a prolonged oVEMP n10 in comparison to controls and prolonged p15 compared to controls and AP. Patients with AP showed reduced oVEMP amplitudes compared to PD and controls. CVEMP did not differ between groups. Postural impairment was higher in AP compared to controls and PD, particularly in the rating scales. No correlations between VEMP and posturography were found. A support vector machine classifier was able to automatically classify controls and patient subgroups with moderate to good accuracy based on oVEMP latencies and balance questionnaires. CONCLUSIONS Both oVEMP and posturography, but not cVEMP, may be differentially affected in PD and AP. We did not find evidence that impairment of the cVEMP or oVEMP pathways is directly related to postural impairment. SIGNIFICANCE OVEMP and balance assessment could be implemented in the differential diagnostic work-up of parkinsonian syndromes.
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Affiliation(s)
- Dietrich Klunk
- Department of Neurology, University of Leipzig, Liebigstraße 20, 04103 Leipzig, Germany; Department of Neurology, Altenburger Land Hospital, Am Waldessaum 10, 04600 Altenburg, Germany
| | - Timo B Woost
- Department of Neurology, University of Leipzig, Liebigstraße 20, 04103 Leipzig, Germany; Department of Psychiatry and Psychotherapy, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany
| | - Christopher Fricke
- Department of Neurology, University of Leipzig, Liebigstraße 20, 04103 Leipzig, Germany
| | - Joseph Classen
- Department of Neurology, University of Leipzig, Liebigstraße 20, 04103 Leipzig, Germany
| | - David Weise
- Department of Neurology, University of Leipzig, Liebigstraße 20, 04103 Leipzig, Germany; Department of Neurology, Asklepios Fachklinikum Stadtroda, Bahnhofstraße 1A, 07646 Stadtroda, Germany.
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3
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Gunduz A, Aktuglu-Zeybek AC, Tezer D, Enver EO, Zubarioglu T, Kiykim E, E Kiziltan M. Postural tremor in L-2-hydroxyglutaric aciduria is associated with cerebellar atrophy. Neurol Sci 2021; 43:2051-2058. [PMID: 34427791 DOI: 10.1007/s10072-021-05555-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 07/31/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVE In this study, we performed analysis of brainstem reflexes and movement disorders using surface polymyogram in L-2-hydroxyglutaric aciduria (L2HGA). We also reviewed all cases in the literature with detailed clinical and radiological description to analyze the anatomical correlates of involuntary movements. PATIENTS AND METHOD We performed surface electromyography of appropriate muscles, long-loop reflexes, and somatosensory evoked potentials and analyzed the neuroimaging findings in patients with L2HGA and recorded blink reflex (BR), auditory startle response (ASR), and startle response after somatosensory stimuli (SSS) in patients and healthy subjects. We also performed a systematic literature search to identify the association of neuroimaging findings and movements disorders in previous patients with L2HGA. RESULTS Thirteen patients were enrolled in the study. Among them, ten had low-amplitude postural tremor with a frequency between 4 and 7 Hz. The tremor was predominant on distal parts of the upper extremities. Postural tremor was accompanied by negative myoclonus in one-third. The BR, ASR, and SSS, all, were hypoactive. There was a close association of postural tremor with cerebellar atrophy in patients who participated in this study and by the analysis of the previously reported patients. CONCLUSIONS Low-amplitude postural tremor is common in L2HGA. It is related with cerebellar atrophy. Although the neuroimaging shows no overt lesions at the brainstem, there is a functional inhibition at this level.
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Affiliation(s)
- Aysegul Gunduz
- Department of Neurology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey.
| | - Ayse Cigdem Aktuglu-Zeybek
- Department of Pediatrics Division of Nutrition and Metabolism, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Damla Tezer
- Department of Neurology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Ece Oge Enver
- Department of Pediatrics Division of Nutrition and Metabolism, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Tanyel Zubarioglu
- Department of Pediatrics Division of Nutrition and Metabolism, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Ertugrul Kiykim
- Department of Pediatrics Division of Nutrition and Metabolism, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Meral E Kiziltan
- Department of Neurology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
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4
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Marsili L, Giannini G, Cortelli P, Colosimo C. Early recognition and diagnosis of multiple system atrophy: best practice and emerging concepts. Expert Rev Neurother 2021; 21:993-1004. [PMID: 34253122 DOI: 10.1080/14737175.2021.1953984] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Introduction: Multiple system atrophy (MSA) is a progressive degenerative disorder of the central and autonomic nervous systems characterized by parkinsonism, cerebellar ataxia, dysautonomia, and pyramidal signs. The confirmatory diagnosis is pathological, but clinical-diagnostic criteria have been developed to help clinicians. To date, the early diagnosis of MSA is challenging due to the lack of reliable diagnostic biomarkers.Areas covered: The authors reappraised the main clinical, neurophysiological, imaging, genetic, and laboratory evidence to help in the early diagnosis of MSA in the clinical and in the research settings. They also addressed the practical clinical issues in the differential diagnosis between MSA and other parkinsonian and cerebellar syndromes. Finally, the authors summarized the unmet needs in the early diagnosis of MSA and proposed the next steps for future research efforts in this field.Expert opinion: In the last decade, many advances have been achieved to help the correct MSA diagnosis since early stages. In the next future, the early diagnosis and correct classification of MSA, together with a better knowledge of the causative mechanisms of the disease, will hopefully allow the identification of suitable candidates to enroll in clinical trials and select the most appropriate disease-modifying strategies to slow down disease progression.
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Affiliation(s)
- Luca Marsili
- Gardner Family Center for Parkinson's Disease and Movement Disorders, Department of Neurology, University of Cincinnati, Cincinnati, OH, USA
| | - Giulia Giannini
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica NeuroMet, Ospedale Bellaria, Bologna, Italy.,Dipartimento di Scienze Biomediche e Neuromotorie, Università Bologna, Bologna, Italy
| | - Pietro Cortelli
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica NeuroMet, Ospedale Bellaria, Bologna, Italy.,Dipartimento di Scienze Biomediche e Neuromotorie, Università Bologna, Bologna, Italy
| | - Carlo Colosimo
- Department of Neurology, Santa Maria University Hospital, Terni, Italy
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5
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Li S, Cheng C, Lu L, Ma X, Zhang X, Li A, Chen J, Qian X, Gao X. Hearing Loss in Neurological Disorders. Front Cell Dev Biol 2021; 9:716300. [PMID: 34458270 PMCID: PMC8385440 DOI: 10.3389/fcell.2021.716300] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 07/23/2021] [Indexed: 12/11/2022] Open
Abstract
Sensorineural hearing loss (SNHL) affects approximately 466 million people worldwide, which is projected to reach 900 million by 2050. Its histological characteristics are lesions in cochlear hair cells, supporting cells, and auditory nerve endings. Neurological disorders cover a wide range of diseases affecting the nervous system, including Alzheimer's disease (AD), Parkinson's disease (PD), Huntington's disease (HD), autism spectrum disorder (ASD), etc. Many studies have revealed that neurological disorders manifest with hearing loss, in addition to typical nervous symptoms. The prevalence, manifestations, and neuropathological mechanisms underlying vary among different diseases. In this review, we discuss the relevant literature, from clinical trials to research mice models, to provide an overview of auditory dysfunctions in the most common neurological disorders, particularly those associated with hearing loss, and to explain their underlying pathological and molecular mechanisms.
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Affiliation(s)
- Siyu Li
- Department of Otolaryngology Head and Neck Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Jiangsu Provincial Key Medical Discipline (Laboratory), Nanjing, China
- Research Institute of Otolaryngology, Nanjing, China
| | - Cheng Cheng
- Department of Otolaryngology Head and Neck Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Jiangsu Provincial Key Medical Discipline (Laboratory), Nanjing, China
- Research Institute of Otolaryngology, Nanjing, China
| | - Ling Lu
- Department of Otolaryngology Head and Neck Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Jiangsu Provincial Key Medical Discipline (Laboratory), Nanjing, China
- Research Institute of Otolaryngology, Nanjing, China
| | - Xiaofeng Ma
- Department of Otolaryngology Head and Neck Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Jiangsu Provincial Key Medical Discipline (Laboratory), Nanjing, China
| | - Xiaoli Zhang
- Department of Otolaryngology Head and Neck Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Jiangsu Provincial Key Medical Discipline (Laboratory), Nanjing, China
- Research Institute of Otolaryngology, Nanjing, China
| | - Ao Li
- Department of Otolaryngology Head and Neck Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Jiangsu Provincial Key Medical Discipline (Laboratory), Nanjing, China
- Research Institute of Otolaryngology, Nanjing, China
| | - Jie Chen
- Department of Otolaryngology Head and Neck Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Jiangsu Provincial Key Medical Discipline (Laboratory), Nanjing, China
- Research Institute of Otolaryngology, Nanjing, China
| | - Xiaoyun Qian
- Department of Otolaryngology Head and Neck Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Jiangsu Provincial Key Medical Discipline (Laboratory), Nanjing, China
- Research Institute of Otolaryngology, Nanjing, China
| | - Xia Gao
- Department of Otolaryngology Head and Neck Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Jiangsu Provincial Key Medical Discipline (Laboratory), Nanjing, China
- Research Institute of Otolaryngology, Nanjing, China
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6
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Stankovic I, Fanciulli A, Kostic VS, Krismer F, Meissner WG, Palma JA, Panicker JN, Seppi K, Wenning GK. Laboratory-Supported Multiple System Atrophy beyond Autonomic Function Testing and Imaging: A Systematic Review by the MoDiMSA Study Group. Mov Disord Clin Pract 2021; 8:322-340. [PMID: 33816659 DOI: 10.1002/mdc3.13158] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 12/24/2020] [Accepted: 01/11/2021] [Indexed: 12/15/2022] Open
Abstract
Background Neuroimaging has been used to support a diagnosis of possible multiple system atrophy (MSA). Only blood pressure changes upon standing are included in the second consensus criteria but other autonomic function tests (AFT) are also useful to diagnose widespread and progressive autonomic failure typical of MSA. Additional diagnostic tools are of interest to improve accuracy of MSA diagnosis. Objectives To assess the utility of diagnostic tools beyond brain imaging and AFT in enhancing a laboratory-supported diagnosis of MSA to support the upcoming revision of the consensus criteria. Methods The International Parkinson and Movement Disorders Society MSA Study Group (MoDiMSA) performed a systematic review of original papers on biomarkers, sleep studies, genetic, neuroendocrine, neurophysiological, neuropsychological and other tests including olfactory testing and acute levodopa challenge test published before August 2019. Results Evaluation of history of levodopa responsiveness and olfaction is useful in patients in whom MSA-parkinsonian subtype is suspected. Neuropsychological testing is useful to exclude dementia at time of diagnosis. Applicability of sphincter EMG is limited. When MSA-cerebellar subtype is suspected, a screening for the common causes of adult-onset progressive ataxia is useful, including spinocerebellar ataxias in selected patients. Diagnosing stridor and REM sleep behavior disorder is useful in both MSA subtypes. However, none of these tools are validated in large longitudinal cohorts of postmortem confirmed MSA cases. Conclusions Despite limited evidence, additional laboratory work-up of patients with possible MSA beyond imaging and AFT should be considered to optimize the clinical diagnostic accuracy.
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Affiliation(s)
- Iva Stankovic
- Neurology Clinic, Clinical Center of Serbia, School of Medicine University of Belgrade Belgrade Serbia
| | | | - Vladimir S Kostic
- Neurology Clinic, Clinical Center of Serbia, School of Medicine University of Belgrade Belgrade Serbia
| | - Florian Krismer
- Department of Neurology Medical University of Innsbruck Innsbruck Austria
| | - Wassilios G Meissner
- Department of Neurology for Neurodegenerative Diseases, French Reference Center for MSA University Hospital Bordeaux Bordeaux France.,Institute of Neurodegenerative Diseases, University Bordeaux, CNRS, UMR 5293 Bordeaux France.,Department of Medicine University of Otago Christchurch New Zealand.,New Zealand Brain Research Institute Christchurch New Zealand
| | - Jose Alberto Palma
- Department of Neurology, Dysautonomia Center, Langone Medical Center New York University School of Medicine New York New York USA
| | - Jalesh N Panicker
- UCL Institute of Neurology London United Kingdom.,Department of Uro-Neurology The National Hospital for Neurology and Neurosurgery London United Kingdom
| | - Klaus Seppi
- Department of Neurology Medical University of Innsbruck Innsbruck Austria
| | - Gregor K Wenning
- Department of Neurology Medical University of Innsbruck Innsbruck Austria
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7
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Paparella G, Di Stefano G, Fasolino A, Di Pietro G, Colella D, Truini A, Cruccu G, Berardelli A, Bologna M. Painful stimulation increases spontaneous blink rate in healthy subjects. Sci Rep 2020; 10:20014. [PMID: 33203984 PMCID: PMC7672065 DOI: 10.1038/s41598-020-76804-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 10/05/2020] [Indexed: 12/22/2022] Open
Abstract
Spontaneous blink rate is considered a biomarker of central dopaminergic activity. Recent evidence suggests that the central dopaminergic system plays a role in nociception. In the present study, we aimed to investigate whether pain modulates spontaneous blink rate in healthy subjects. We enrolled 15 participants. Spontaneous blink rate was quantified with an optoelectronic system before and after: (1) a painful laser stimulation, and (2) an acoustic startling stimulation. In control experiments, we investigated whether laser stimulation effects depended on stimulation intensity and whether laser stimulation induced any changes in the blink reflex recovery cycle. Finally, we investigated any relationship between spontaneous blink rate modification and pain modulation effect during the cold pressor test. Laser, but not acoustic, stimulation increased spontaneous blink rate. This effect was independent of stimulation intensity and negatively correlated with pain perception. No changes in trigeminal-facial reflex circuit excitability were elicited by laser stimulation. The cold pressor test also induced an increased spontaneous blink rate. Our study provides evidence on the role of dopamine in nociception and suggests that dopaminergic activity may be involved in pain modulation. These findings lay the groundwork for further investigations in patients with pathological conditions characterized by dopaminergic deficit and pain.
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Affiliation(s)
| | - Giulia Di Stefano
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università, 30, 00185, Rome, Italy
| | - Alessandra Fasolino
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università, 30, 00185, Rome, Italy
| | - Giuseppe Di Pietro
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università, 30, 00185, Rome, Italy
| | - Donato Colella
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università, 30, 00185, Rome, Italy
| | - Andrea Truini
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università, 30, 00185, Rome, Italy
| | - Giorgio Cruccu
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università, 30, 00185, Rome, Italy
| | - Alfredo Berardelli
- IRCCS Neuromed, Pozzilli, IS, Italy. .,Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università, 30, 00185, Rome, Italy.
| | - Matteo Bologna
- IRCCS Neuromed, Pozzilli, IS, Italy.,Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università, 30, 00185, Rome, Italy
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8
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Prepulse Inhibition of the Auditory Startle Reflex Assessment as a Hallmark of Brainstem Sensorimotor Gating Mechanisms. Brain Sci 2020; 10:brainsci10090639. [PMID: 32947873 PMCID: PMC7563436 DOI: 10.3390/brainsci10090639] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 09/09/2020] [Accepted: 09/14/2020] [Indexed: 12/20/2022] Open
Abstract
When a low-salience stimulus of any type of sensory modality-auditory, visual, tactile-immediately precedes an unexpected startle-like stimulus, such as the acoustic startle reflex, the startle motor reaction becomes less pronounced or is even abolished. This phenomenon is known as prepulse inhibition (PPI), and it provides a quantitative measure of central processing by filtering out irrelevant stimuli. As PPI implies plasticity of a reflex and is related to automatic or attentional processes, depending on the interstimulus intervals, this behavioral paradigm might be considered a potential marker of short- and long-term plasticity. Assessment of PPI is directly related to the examination of neural sensorimotor gating mechanisms, which are plastic-adaptive operations for preventing overstimulation and helping the brain to focus on a specific stimulus among other distracters. Despite their obvious importance in normal brain activity, little is known about the intimate physiology, circuitry, and neurochemistry of sensorimotor gating mechanisms. In this work, we extensively review the current literature focusing on studies that used state-of-the-art techniques to interrogate the neuroanatomy, connectomics, neurotransmitter-receptor functions, and sex-derived differences in the PPI process, and how we can harness it as biological marker in neurological and psychiatric pathology.
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9
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De Groote E, De Keyser K, Santens P, Talsma D, Bockstael A, Botteldooren D, De Letter M. Future Perspectives on the Relevance of Auditory Markers in Prodromal Parkinson's Disease. Front Neurol 2020; 11:689. [PMID: 32765404 PMCID: PMC7378374 DOI: 10.3389/fneur.2020.00689] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Accepted: 06/09/2020] [Indexed: 11/13/2022] Open
Abstract
Research on auditory processing in Parkinson's disease (PD) has recently made substantial progress. At present, evidence has been found for altered auditory processing in the clinical stage of PD. The auditory alterations in PD have been demonstrated with low-cost and non-invasive assessments that are already used in routine clinical practice. Since auditory alterations have been reported early in disease progression, it would be highly relevant to investigate whether auditory markers could be provided in the prodromal stage of PD. In addition, auditory alterations in early stage PD might be modulated by dopaminergic medication. Therefore, the aim of this review is (1) to summarize the literature on auditory processing in PD with a specific focus on the early disease stages, (2) to give future perspectives on which audiological and electrophysiological measurements could be useful in the prodromal stage of PD and (3) to assess the effect of dopaminergic medication on potential auditory markers in the prodromal stage of PD.
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Affiliation(s)
- Evelien De Groote
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Kim De Keyser
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Patrick Santens
- Department of Neurology, Ghent University Hospital, Ghent, Belgium
| | - Durk Talsma
- Department of Experimental Psychology, Ghent University, Ghent, Belgium
| | - Annelies Bockstael
- Department of Information Technology, INTEC, Acoustics Research Group, Ghent University, Ghent, Belgium
| | - Dick Botteldooren
- Department of Information Technology, INTEC, Acoustics Research Group, Ghent University, Ghent, Belgium
| | - Miet De Letter
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
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10
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Merchant SHI, Vial-Undurraga F, Leodori G, van Gerpen JA, Hallett M. Myoclonus: An Electrophysiological Diagnosis. Mov Disord Clin Pract 2020; 7:489-499. [PMID: 32626792 DOI: 10.1002/mdc3.12986] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 04/03/2020] [Accepted: 05/03/2020] [Indexed: 12/28/2022] Open
Abstract
Background Many different movement disorders have similar "jerk-like" phenomenology and can be misconstrued as myoclonus. Different types of myoclonus also share similar phenomenological characteristics that can be difficult to distinguish solely based on clinical exam. However, they have distinctive physiologic characteristics that can help refine categorization of jerk-like movements. Objectives In this review, we briefly summarize the clinical, physiologic, and pathophysiologic characteristics of different types of myoclonus. The methodology and technical considerations for the electrophysiologic assessment of jerk-like movements are reviewed. A simplistic pragmatic approach for the classification of myoclonus and other jerk-like movements based on objective electrophysiologic characteristics is proposed. Conclusions Clinical neurophysiology is an underutilized tool in the diagnosis and treatment of movement disorders. Various jerk-like movements have distinguishing physiologic characteristics, differentiated in the milliseconds range, which is beyond human capacity. We argue that the categorization of movement disorders as myoclonus can be refined based on objective physiology that can have important prognostic and therapeutic implications.
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Affiliation(s)
| | | | | | - Jay A van Gerpen
- Department of Neurology University of Alabama Huntsville Alabama USA
| | - Mark Hallett
- National Institute of Neurological Disorders and Stroke National Institutes of Health Bethesda Maryland USA
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11
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Laine CM, Valero-Cuevas FJ. Parkinson's Disease Exhibits Amplified Intermuscular Coherence During Dynamic Voluntary Action. Front Neurol 2020; 11:204. [PMID: 32308641 PMCID: PMC7145888 DOI: 10.3389/fneur.2020.00204] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 03/09/2020] [Indexed: 12/29/2022] Open
Abstract
Parkinson's disease (PD) is typically diagnosed and evaluated on the basis of overt motor dysfunction, however, subtle changes in the frequency spectrum of neural drive to muscles have been reported as well. During dynamic actions, coactive muscles of healthy adults often share a common source of 6-15 Hz (alpha-band) neural drive, creating synchronous alpha-band activity in their EMG signals. Individuals with PD commonly exhibit kinetic action tremor at similar frequencies, but the potential relationship between the intermuscular alpha-band neural drive seen in healthy adults and the action tremor associated with PD is not well-understood. A close relationship is most tenable during voluntary dynamic tasks where alpha-band neural drive is strongest in healthy adults, and where neural circuits affected by PD are most engaged. In this study, we characterized the frequency spectrum of EMG synchronization (intermuscular coherence) in 16 participants with PD and 15 age-matched controls during two dynamic motor tasks: (1) rotation of a dial between the thumb and index finger, and (2) dynamic scaling of isometric precision pinch force. These tasks produce different profiles of coherence between the first dorsal interosseous and abductor pollicis brevis muscles. We sought to determine if alpha-band intermuscular coherence would be amplified in participants with PD relative to controls, if such differences would be task-specific, and if they would correlate with symptom severity. We found that relative to controls, the PD group displayed amplified, but similarly task-dependent, coherence in the alpha-band. The magnitude of coherence during the rotation task correlated with overall symptom severity as per the UPDRS rating scale. Finally, we explored the potential for our coherence measures, with no additional information, to discriminate individuals with PD from controls. The area under the Receiver Operating Characteristic curve (AUC) indicated a clear separation between groups (AUC = 0.96), even though participants with PD were on their typical medication and displayed only mild-moderate symptoms. We conclude that a task-dependent, intermuscular neural drive within the alpha-band is amplified in PD. Its quantification via intermuscular coherence analysis may provide a useful tool for detecting the presence of PD, or assessing its progression.
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Affiliation(s)
- Christopher M Laine
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, United States
| | - Francisco J Valero-Cuevas
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, United States.,Department of Biomedical Engineering, University of Southern California, Los Angeles, CA, United States
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12
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Jafari Z, Kolb BE, Mohajerani MH. Auditory Dysfunction in Parkinson's Disease. Mov Disord 2020; 35:537-550. [PMID: 32052894 DOI: 10.1002/mds.28000] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 01/21/2020] [Accepted: 01/27/2020] [Indexed: 12/11/2022] Open
Abstract
PD is a progressive and complex neurological disorder with heterogeneous symptomatology. PD is characterized by classical motor features of parkinsonism and nonmotor symptoms and involves extensive regions of the nervous system, various neurotransmitters, and protein aggregates. Extensive evidence supports auditory dysfunction as an additional nonmotor feature of PD. Studies indicate a broad range of auditory impairments in PD, from the peripheral hearing system to the auditory brainstem and cortical areas. For instance, research demonstrates a higher occurrence of hearing loss in early-onset PD and evidence of abnormal auditory evoked potentials, event-related potentials, and habituation to novel stimuli. Electrophysiological data, such as auditory P3a, also is suggested as a sensitive measure of illness duration and severity. Improvement in auditory responses following dopaminergic therapies also indicates the presence of similar neurotransmitters (i.e., glutamate and dopamine) in the auditory system and basal ganglia. Nonetheless, hearing impairments in PD have received little attention in clinical practice so far. This review summarizes evidence of peripheral and central auditory impairments in PD and provides conclusions and directions for future empirical and clinical research. © 2020 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Zahra Jafari
- Department of Neuroscience, Canadian Centre for Behavioural Neuroscience, University of Lethbridge, Lethbridge, AB, Canada.,Department of Basic Sciences in Rehabilitation, School of Rehabilitation Sciences, Iran University of Medical Science (IUMS), Tehran, Iran
| | - Bryan E Kolb
- Department of Neuroscience, Canadian Centre for Behavioural Neuroscience, University of Lethbridge, Lethbridge, AB, Canada
| | - Majid H Mohajerani
- Department of Neuroscience, Canadian Centre for Behavioural Neuroscience, University of Lethbridge, Lethbridge, AB, Canada
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13
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Mavroudis I, Petridis F, Kazis D. Cerebrospinal Fluid, Imaging, and Physiological Biomarkers in Dementia With Lewy Bodies. Am J Alzheimers Dis Other Demen 2019; 34:421-432. [PMID: 31422676 PMCID: PMC10653361 DOI: 10.1177/1533317519869700] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Dementia with Lewy bodies is a progressive neurodegenerative disorder, clinically characterized by gradual cognitive impairment and fluctuating cognition, behavioral changes and recurrent visual hallucinations, and autonomic function and movement symptoms in the type of parkinsonism. It is the second most common type of dementia in the Western world after Alzheimer disease. Over the last 20 years, many neurophysiological, neuroimaging, and cerebrospinal fluid (CSF) biomarkers have been described toward a better discrimination between dementia with Lewy bodies, Alzheimer disease, and other neurodegenerative conditions.In the present review, we aim to describe the neurophysiological, imaging, and CSF biomarkers in dementia with Lewy bodies and to question whether they could be reliable tools for the clinical practice.
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Affiliation(s)
- Ioannis Mavroudis
- Department of Neurology, Leeds Teaching Hospitals, Leeds, United Kingdom
| | - Foivos Petridis
- Third Department of Neurology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios Kazis
- Third Department of Neurology, Aristotle University of Thessaloniki, Thessaloniki, Greece
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14
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Song S, Wang Q, Jiang L, Oyarzabal E, Riddick NV, Wilson B, Moy SS, Shih YYI, Hong JS. Noradrenergic dysfunction accelerates LPS-elicited inflammation-related ascending sequential neurodegeneration and deficits in non-motor/motor functions. Brain Behav Immun 2019; 81:374-387. [PMID: 31247288 PMCID: PMC6754798 DOI: 10.1016/j.bbi.2019.06.034] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 06/20/2019] [Accepted: 06/22/2019] [Indexed: 02/06/2023] Open
Abstract
The loss of central norepinephrine (NE) released by neurons of the locus coeruleus (LC) occurs with aging, and is thought to be an important factor in producing the many of the nonmotor symptoms and exacerbating the degenerative process in animal models of Parkinson's disease (PD). We hypothesize that selectively depleting noradrenergic LC neurons prior to the induction of chronic neuroinflammation may not only accelerate the rate of progressive neurodegeneration throughout the brain, but may exacerbate nonmotor and motor behavioral phenotypes that recapitulate symptoms of PD. For this reason, we used a "two-hit" mouse model whereby brain NE were initially depleted by DSP-4 one week prior to exposing mice to LPS. We found that pretreatment with DSP-4 potentiated LPS-induced sequential neurodegeneration in SNpc, hippocampus, and motor cortex, but not in VTA and caudate/putamen. Mechanistic study revealed that DSP-4 enhanced LPS-induced microglial activation and subsequently elevated neuronal oxidative stress in affected brain regions in a time-dependent pattern. To further characterize the effects of DSP-4 on non-motor and motor symptoms in the LPS model, physiological and behavioral tests were performed at different time points following injection. Consistent with the enhanced neurodegeneration, DSP-4 accelerated the progressive deficits of non-motor symptoms including hyposmia, constipation, anxiety, sociability, exaggerated startle response and impaired learning. Furthermore, notable decreases of motor functions, including decreased rotarod activity, grip strength, and gait disturbance, were observed in treated mice. In summary, our studies provided not only an accelerated "two-hit" PD model that recapitulates the features of sequential neuron loss and the progression of motor/non-motor symptoms of PD, but also revealed the critical role of early LC noradrenergic neuron damage in the pathogenesis of PD-like symptoms.
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Affiliation(s)
- Sheng Song
- Neuropharmacology Section, Neurobiology Laboratory, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina, USA,Biomedical Research Imaging Center, University of North Caroline at Chapel Hill, Chapel Hill, NC, USA
| | - Qingshan Wang
- Neuropharmacology Section, Neurobiology Laboratory, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina, USA,Department of Toxicology, School of Public Health, Dalian Medical University, Dalian, Liaoning, China
| | - Lulu Jiang
- Neuropharmacology Section, Neurobiology Laboratory, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina, USA,Institute of Toxicology, School of Public Health, Shandong University, Jinan, Shandong, China
| | - Esteban Oyarzabal
- Neuropharmacology Section, Neurobiology Laboratory, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina, USA,Biomedical Research Imaging Center, University of North Caroline at Chapel Hill, Chapel Hill, NC, USA
| | - Natallia V. Riddick
- Department of Psychiatry and Carolina Institute for Developmental Disabilities, University of North Carolina School of Medicine, Chapel Hill, NC 27599, USA
| | - Belinda Wilson
- Neuropharmacology Section, Neurobiology Laboratory, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina, USA
| | - Sheryl S. Moy
- Department of Psychiatry and Carolina Institute for Developmental Disabilities, University of North Carolina School of Medicine, Chapel Hill, NC 27599, USA
| | - Yen-Yu Ian Shih
- Biomedical Research Imaging Center, University of North Caroline at Chapel Hill, Chapel Hill, NC, USA
| | - Jau-Shyong Hong
- Neuropharmacology Section, Neurobiology Laboratory, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA.
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Weise D, Pargac C, Pelz JO, Rumpf JJ, Fricke C, Classen J. Assessing blink reflex circuits by three different afferent routes in Parkinson’s disease. Clin Neurophysiol 2019; 130:582-587. [DOI: 10.1016/j.clinph.2018.12.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 12/04/2018] [Accepted: 12/16/2018] [Indexed: 10/27/2022]
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MacLaren DAA, Ljungberg TL, Griffin ME, Clark SD. Pedunculopontine tegmentum cholinergic loss leads to a progressive decline in motor abilities and neuropathological changes resembling progressive supranuclear palsy. Eur J Neurosci 2018; 48:3477-3497. [PMID: 30339310 DOI: 10.1111/ejn.14212] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 08/28/2018] [Accepted: 09/27/2018] [Indexed: 11/28/2022]
Abstract
Progressive supranuclear palsy (PSP) is the most common atypical Parkinsonism. Although PSP shares some symptomology with Parkinson's disease (PD), PSP has a different underlying pathology characterized by tau aggregation. Furthermore, PSP sufferers respond poorly to PD medications and there are no effective alternative therapeutics. The development of both palliative and disease altering therapeutics has been hampered by the lack of an animal model that displays relevant PSP-like pathology and behavioral deficits. Previously, our lab found that in rats the selective removal of cholinergic pedunculopontine neurons (whose axonal projections overlap with areas of PSP pathology), mimics the extensive loss of cholinergic pedunculopontine neurons seen in PSP, and produces a unique PSP-like combination of deficits in: startle reflex, attention, and motor function. The present study extends those findings by allowing the lesion to incubate for over a year and compares behavioral and post-mortem pathology of pedunculopontine-cholinergic-lesioned and sham-lesioned rats. There was an early startle reflex deficit which did not improve over time. Progressive declines in motor function developed over the course of the year, including an increase in the number of "slips" while navigating various beams and poorly coordinated transitions from an elevated platform into homecages. Histological analysis discovered that the loss off cholinergic pedunculopontine neurons precipitated a significant loss of substantia nigra tyrosine hydroxylase-positive neurons and a significant enlargement of the lateral ventricles. The latter is a distinguishing feature between PSP and PD. This preclinical animal model of PSP has the potential to further our understanding of PSP and aid in the testing of potential therapeutic agents.
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Affiliation(s)
- Duncan A A MacLaren
- Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Trisha L Ljungberg
- Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Meghan E Griffin
- Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Stewart D Clark
- Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
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Kızıltan ME, Leba LK, Gündüz A, Pazarcı N, Özkara Ç, Yeni N. Does Valproic Acid/Na Valproate Suppress Auditory Startle Reflex in Patients With Epilepsy? Clin EEG Neurosci 2018; 49:407-413. [PMID: 29262725 DOI: 10.1177/1550059417747155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND OBJECTIVE Auditory startle response (ASR) was normal in juvenile myoclonic epilepsy whereas it was suppressed in progressive myoclonic epilepsy. However, both groups were using valproic acid/Na valproate (VPA) in different doses. Therefore, we aimed to analyze whether VPA has an impact on ASR in a cohort of epilepsy. For this purpose, we included patients with epilepsy and analyzed ASR in patients who were using VPA. PATIENTS AND METHOD We included 51 consecutive patients who had epilepsy and were using VPA between January 2014 and January 2016. Two control groups of 37 epilepsy patients using other antiepileptic drugs (AEDs) and of 25 healthy subjects were also constituted. All participants underwent investigations of ASR and startle response to somatosensory inputs (SSS) under similar conditions. RESULTS An analysis of patients using VPA, not using VPA and healthy subjects revealed significantly longer latency and lower probability of orbicularis oculi (O.oc) and sternocleidomastoid responses after auditory stimulation, decreased total ASR probability and longer latency of O.oc response after somatosensory stimulation in patient groups compared with healthy subjects. Multivariate analysis showed type of AED had a role in the generation of abnormalities. VPA, carbamazepine, and multiple AED use caused suppression of ASR. Total ASR probability was decreased or O.oc latency got longer with longer duration of VPA use whereas serum VPA level at the time of investigation did not correlate with total ASR probability. DISCUSSION Both ASR and SSS are suppressed by the effect of VPA, especially in patients using for a long period and in patients using other AEDs with VPA. Given the fact that VPA leads to long-standing synaptic changes of dopaminergic transmission, abnormalities of this network may be the more likely cause.
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Affiliation(s)
- Meral E Kızıltan
- 1 Cerrahpaşa School of Medicine, Istanbul University, Istanbul, Turkey
| | - Leyla Köse Leba
- 1 Cerrahpaşa School of Medicine, Istanbul University, Istanbul, Turkey
| | - Ayşegül Gündüz
- 1 Cerrahpaşa School of Medicine, Istanbul University, Istanbul, Turkey
| | - Nevin Pazarcı
- 1 Cerrahpaşa School of Medicine, Istanbul University, Istanbul, Turkey
| | - Çiğdem Özkara
- 1 Cerrahpaşa School of Medicine, Istanbul University, Istanbul, Turkey
| | - Naz Yeni
- 1 Cerrahpaşa School of Medicine, Istanbul University, Istanbul, Turkey
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18
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Neurophysiological studies on atypical parkinsonian syndromes. Parkinsonism Relat Disord 2017; 42:12-21. [DOI: 10.1016/j.parkreldis.2017.06.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 06/14/2017] [Accepted: 06/24/2017] [Indexed: 01/31/2023]
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19
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Brainstem reflexes are hyperactive in patients with drug-induced akathisia. Neurol Sci 2017; 38:1683-1689. [DOI: 10.1007/s10072-017-3038-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 06/17/2017] [Indexed: 10/19/2022]
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20
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McDiarmid TA, Bernardos AC, Rankin CH. Habituation is altered in neuropsychiatric disorders-A comprehensive review with recommendations for experimental design and analysis. Neurosci Biobehav Rev 2017; 80:286-305. [PMID: 28579490 DOI: 10.1016/j.neubiorev.2017.05.028] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 05/29/2017] [Indexed: 02/03/2023]
Abstract
Abnormalities in the simplest form of learning, habituation, have been reported in a variety of neuropsychiatric disorders as etiologically diverse as Autism Spectrum Disorder, Fragile X syndrome, Schizophrenia, Parkinson's Disease, Huntington's Disease, Attention Deficit Hyperactivity Disorder, Tourette's Syndrome, and Migraine. Here we provide the first comprehensive review of what is known about alterations in this form of non-associative learning in each disorder. Across several disorders, abnormal habituation is predictive of symptom severity, highlighting the clinical significance of habituation and its importance to normal cognitive function. Abnormal habituation is discussed within the greater framework of learning theory and how it may relate to disease phenotype either as a cause, symptom, or therapy. Important considerations for the design and interpretation of habituation experiments are outlined with the hope that these will aid both clinicians and basic researchers investigating how this simple form of learning is altered in disease.
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Affiliation(s)
- Troy A McDiarmid
- Graduate Program in Neuroscience, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia, V6T 1Z3, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Rm F221, 2211 Wesbrook Mall, Vancouver, British Columbia, V6T 2B5, Canada
| | - Aram C Bernardos
- Graduate Program in Neuroscience, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia, V6T 1Z3, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Rm F221, 2211 Wesbrook Mall, Vancouver, British Columbia, V6T 2B5, Canada
| | - Catharine H Rankin
- Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver, British Columbia, V6T 1Z4, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Rm F221, 2211 Wesbrook Mall, Vancouver, British Columbia, V6T 2B5, Canada.
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21
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Sleep bruxism is related to decreased inhibitory control of trigeminal motoneurons, but not with reticulobulbar system. Neurol Sci 2016; 38:75-81. [DOI: 10.1007/s10072-016-2711-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 09/06/2016] [Indexed: 12/23/2022]
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22
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Leon-Sarmiento FE, Peckham E, Leon-Ariza DS, Bara-Jimenez W, Hallett M. Auditory and Lower Limb Tactile Prepulse Inhibition in Primary Restless Legs Syndrome: Clues to Its Pathophysiology. J Clin Neurophysiol 2016; 32:369-74. [PMID: 26241246 DOI: 10.1097/wnp.0000000000000196] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The resting sensory discomfort transiently relieved upon movement of the affected area in restless legs syndrome suggests that sensorimotor integration mechanisms, specifically gating, may be altered in the disease. The authors sought to determine the effects of prepulse auditory and tactile stimulation applied to lower limbs on the blink reflex of patients with restless legs syndrome and healthy subjects. Seventeen patients with restless legs syndrome and 17 age- and sex-matched healthy controls were investigated. Auditory stimuli and tactile lower limb stimulation were applied as prepulses. The R2 response of the blink reflex induced by electrical stimulation applied to the right supraorbital nerve was selected as the test stimulus. Time intervals between prepulses and response-eliciting stimuli were 40, 70, 90, 110, and 200 milliseconds. There were no differences in either the auditory or tactile prepulse conditions between patients and controls and no differences between these measures within subject groups. We concluded that the tactile lower limb and the auditory prepulse effects on the brainstem interneurons mediating the blink reflex share common neural pathways. Because forebrain interneurons mediate these prepulse effects, they are likely not involved in the disordered sensorimotor interaction of restless legs syndrome.
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Affiliation(s)
- Fidias E Leon-Sarmiento
- *Human Motor Control Section, NINDS, National Institutes of Health, Bethesda, Maryland, U.S.A.; †Smell and Taste Center, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, U.S.A.; ‡Mediciencias Research Group, Unicolciencias/Universidad Nacional, Bogota, Colombia; and §Faculty of Health, Universidad de Santander (UDES), Bucaramanga, Colombia
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23
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Jennum P, Christensen JA, Zoetmulder M. Neurophysiological basis of rapid eye movement sleep behavior disorder: informing future drug development. Nat Sci Sleep 2016; 8:107-20. [PMID: 27186147 PMCID: PMC4847600 DOI: 10.2147/nss.s99240] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia characterized by a history of recurrent nocturnal dream enactment behavior and loss of skeletal muscle atonia and increased phasic muscle activity during REM sleep: REM sleep without atonia. RBD and associated comorbidities have recently been identified as one of the most specific and potentially sensitive risk factors for later development of any of the alpha-synucleinopathies: Parkinson's disease, dementia with Lewy bodies, and other atypical parkinsonian syndromes. Several other sleep-related abnormalities have recently been identified in patients with RBD/Parkinson's disease who experience abnormalities in sleep electroencephalographic frequencies, sleep-wake transitions, wake and sleep stability, occurrence and morphology of sleep spindles, and electrooculography measures. These findings suggest a gradual involvement of the brainstem and other structures, which is in line with the gradual involvement known in these disorders. We propose that these findings may help identify biomarkers of individuals at high risk of subsequent conversion to parkinsonism.
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Affiliation(s)
- Poul Jennum
- Department of Clinical Neurophysiology, Faculty of Health Sciences, Danish Center for Sleep Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Julie Ae Christensen
- Department of Clinical Neurophysiology, Faculty of Health Sciences, Danish Center for Sleep Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Marielle Zoetmulder
- Department of Clinical Neurophysiology, Faculty of Health Sciences, Danish Center for Sleep Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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Cromarty RA, Elder GJ, Graziadio S, Baker M, Bonanni L, Onofrj M, O'Brien JT, Taylor JP. Neurophysiological biomarkers for Lewy body dementias. Clin Neurophysiol 2015; 127:349-359. [PMID: 26183755 PMCID: PMC4727506 DOI: 10.1016/j.clinph.2015.06.020] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Revised: 06/05/2015] [Accepted: 06/23/2015] [Indexed: 11/07/2022]
Abstract
Biomarkers are needed to improve Lewy body dementia (LBD) diagnosis and measure treatment response. There is substantial heterogeneity in neurophysiology biomarker methodologies limiting comparison. However, there is tentative evidence to suggest neurophysiological approaches may show promise as potential biomarkers of LBD.
Objective Lewy body dementias (LBD) include both dementia with Lewy bodies (DLB) and Parkinson’s disease with dementia (PDD), and the differentiation of LBD from other neurodegenerative dementias can be difficult. Currently, there are few biomarkers which might assist early diagnosis, map onto LBD symptom severity, and provide metrics of treatment response. Traditionally, biomarkers in LBD have focussed on neuroimaging modalities; however, as biomarkers need to be simple, inexpensive and non-invasive, neurophysiological approaches might also be useful as LBD biomarkers. Methods In this review, we searched PubMED and PsycINFO databases in a semi-systematic manner in order to identify potential neurophysiological biomarkers in the LBDs. Results We identified 1491 studies; of these, 37 studies specifically examined neurophysiological biomarkers in LBD patients. We found that there was substantial heterogeneity with respect to methodologies and patient cohorts. Conclusion Generally, many of the findings have yet to be replicated, although preliminary findings reinforce the potential utility of approaches such as quantitative electroencephalography and motor cortical stimulation paradigms. Significance Various neurophysiological techniques have the potential to be useful biomarkers in the LBDs. We recommend that future studies focus on maximising the diagnostic specificity and sensitivity of the most promising neurophysiological biomarkers.
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Affiliation(s)
- Ruth A Cromarty
- Institute of Neuroscience, Campus for Aging and Vitality, Newcastle University, Newcastle upon Tyne NE4 5PL, UK.
| | - Greg J Elder
- Institute of Neuroscience, Campus for Aging and Vitality, Newcastle University, Newcastle upon Tyne NE4 5PL, UK
| | - Sara Graziadio
- Institute of Neuroscience, Framlington Place, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
| | - Mark Baker
- Institute of Neuroscience, Framlington Place, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
| | - Laura Bonanni
- Clinica Neurologica, Dipartimento di Neuroscienze e Imaging, Università "G.D'Annunzio" Chieti-Pescara, Italy
| | - Marco Onofrj
- Clinica Neurologica, Dipartimento di Neuroscienze e Imaging, Università "G.D'Annunzio" Chieti-Pescara, Italy
| | - John T O'Brien
- Department of Psychiatry, University of Cambridge, Cambridge Biomedical Campus, Cambridge CB2 0SP, UK
| | - John-Paul Taylor
- Institute of Neuroscience, Campus for Aging and Vitality, Newcastle University, Newcastle upon Tyne NE4 5PL, UK
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25
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Yavuz D, Gündüz A, Ertan S, Apaydın H, Şifoğlu A, Kiziltan G, Kiziltan ME. Specific brainstem and cortico-spinal reflex abnormalities in coexisting essential tremor and Parkinson's disease (ET-PD). Neurophysiol Clin 2015; 45:143-9. [PMID: 25892331 DOI: 10.1016/j.neucli.2015.01.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 10/15/2014] [Accepted: 01/04/2015] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE We aimed to analyze functional changes at brainstem and spinal levels in essential tremor (ET), Parkinson's disease (PD) and coexisting essential tremor and Parkinson's disease (ET-PD). PATIENTS AND METHOD Age- and gender-matched patients with tremor (15 ET, 7 ET with resting tremor, 25 ET-PD and 10 PD) and 12 healthy subjects were enrolled in the study. Diagnosis was established according to standardized clinical criteria. Electrophysiological studies included blink reflex (BR), auditory startle reaction (ASR) and long latency reflex (LLR). RESULTS Blink reflex was normal and similar in all groups. Probability of ASR was significantly lower in ET-PD group whereas it was similar to healthy subjects in ET and PD (P<0.001). LLR was recorded during voluntary activity in all three groups. LLR II was more common in ET, PD and ET-PD groups. LLR III was far more common in the PD group (n=3, 13.6% in ET; n=4, 16.0% in ET-PD and n=7, 46.7% in PD; p=0.037). CONCLUSIONS Despite the integrity of BR pathways, ASR and LLR show distinctive abnormalities in ET-PD. In our opinion, our electrophysiological findings support the hypothesis that ET-PD is a distinct entity.
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Affiliation(s)
- D Yavuz
- Istanbul University, Cerrahpasa School of Medicine, Department of Neurology, 34098 K.M.Pasa, Istanbul, Turkey
| | - A Gündüz
- Istanbul University, Cerrahpasa School of Medicine, Department of Neurology, 34098 K.M.Pasa, Istanbul, Turkey.
| | - S Ertan
- Istanbul University, Cerrahpasa School of Medicine, Department of Neurology, 34098 K.M.Pasa, Istanbul, Turkey
| | - H Apaydın
- Istanbul University, Cerrahpasa School of Medicine, Department of Neurology, 34098 K.M.Pasa, Istanbul, Turkey
| | - A Şifoğlu
- Istanbul University, Cerrahpasa School of Medicine, Department of Neurology, 34098 K.M.Pasa, Istanbul, Turkey
| | - G Kiziltan
- Istanbul University, Cerrahpasa School of Medicine, Department of Neurology, 34098 K.M.Pasa, Istanbul, Turkey
| | - M E Kiziltan
- Istanbul University, Cerrahpasa School of Medicine, Department of Neurology, 34098 K.M.Pasa, Istanbul, Turkey
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26
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Auditory startle response is normal in juvenile myoclonic epilepsy. Neurol Sci 2015; 36:1247-9. [PMID: 25805707 DOI: 10.1007/s10072-015-2181-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 03/17/2015] [Indexed: 10/23/2022]
Abstract
Juvenile myoclonic epilepsy (JME) is hypothesized to originate from the dysfunction of thalamo-cortical circuit. We aimed to analyze any changes in auditory startle response in JME patients to determine the role of brainstem in JME. The responses of 18 JME patients to auditory simulation were recorded over the unilateral orbicularis oculi, masseter, sternocleidomastoid, and extremity muscles. Results were compared with those of 18 age and gender matched healthy volunteers. Total auditory startle response frequencies were similar between the two groups (31.1 ± 11.1 % vs. 33.7 ± 8.7 %, p = 0.400). Other parameters over each muscle were also similar. There were no impacts of antiepileptic drug use or disease duration. We may conclude that our findings may provide sufficient evidence for the lack of functional changes of the auditory startle response circuit even in longstanding cases of JME.
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27
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MacLaren DAA, Markovic T, Clark SD. Assessment of sensorimotor gating following selective lesions of cholinergic pedunculopontine neurons. Eur J Neurosci 2014; 40:3526-37. [PMID: 25208852 DOI: 10.1111/ejn.12716] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Revised: 07/23/2014] [Accepted: 08/08/2014] [Indexed: 12/21/2022]
Abstract
Sensorimotor gating is the state-dependent transfer of sensory information into a motor system. When this occurs at an early stage of the processing stream it enables stimuli to be filtered out or partially ignored, thereby reducing the demands placed on advanced systems. Prepulse inhibition (PPI) of the acoustic startle reflex (ASR) is the standard measure of sensorimotor gating. A brainstem-midbrain circuitry is widely viewed as mediating both PPI and ASR. In this circuitry, the pedunculopontine tegmental nucleus (PPTg) integrates sensory input and cortico-basal ganglia output and, via presumed cholinergic signaling, inhibits ASR-generating neurons within the reticular formation. Non-selective damage to all neuronal types within PPTg reduces PPI. We assessed whether this effect originates in the loss of cholinergic signaling by examining ASR and PPI in rats bearing non-selective (excitotoxic) or selective cholinergic (Dtx-UII) lesions of PPTg. Excitotoxic lesions had no effect on ASR but reduced PPI at all prepulse levels tested. In contrast, selective depletion of cholinergic neurons reduced ASR to the extent that PPI was not measurable with standard (10-20 s) inter-trial intervals. Subsequent testing revealed appreciable ASRs could be generated when the inter-trial interval was increased (180 s). Under these conditions, PPI was assessed and no deficits were found after lesions of cholinergic PPTg neurons. These results show that cholinergic output from PPTg is essential for rapidly regenerating the ASR, but has no influence on PPI. Results are discussed in terms of sensorimotor integration circuitry and psychiatric disorders that feature disrupted ASR and PPI.
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Affiliation(s)
- Duncan A A MacLaren
- Department of Pharmacology and Toxicology, School of Medicine and Biomedical Sciences, University at Buffalo, SUNY, Buffalo, NY, USA
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Kızıltan ME, Gunduz A, Kızıltan G, Tekeoğlu A, Sohtaoğlu M. Brainstem and spinal reflex studies in patients with primary progressive freezing of gait. J Neurol Sci 2014; 343:51-5. [PMID: 24867166 DOI: 10.1016/j.jns.2014.05.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 04/12/2014] [Accepted: 05/07/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Meral E Kızıltan
- Department of Neurology, Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey
| | - Aysegul Gunduz
- Department of Neurology, Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey.
| | - Gunes Kızıltan
- Department of Neurology, Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey
| | - Anıl Tekeoğlu
- Department of Neurology, Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey
| | - Melis Sohtaoğlu
- Department of Neurology, Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey
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Colosimo C, Bak TH, Bologna M, Berardelli A. Fifty years of progressive supranuclear palsy. J Neurol Neurosurg Psychiatry 2014; 85:938-44. [PMID: 24013274 DOI: 10.1136/jnnp-2013-305740] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Carlo Colosimo
- Department of Neurology and Psychiatry, "Sapienza" University, Rome, Italy
| | - Thomas H Bak
- School of Philosophy, Psychology and Language Sciences (PPLS) & Centre for Clinical Brain Sciences (CCBS), University of Edinburgh, Edinburgh, UK
| | | | - Alfredo Berardelli
- Department of Neurology and Psychiatry, "Sapienza" University, Rome, Italy Neuromed Institute IRCCS, Pozzilli (IS), Italy
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Zoetmulder M, Biernat HB, Nikolic M, Korbo L, Jennum PJ. Sensorimotor gating deficits in multiple system atrophy: Comparison with Parkinson's disease and idiopathic REM sleep behavior disorder. Parkinsonism Relat Disord 2014; 20:297-302. [DOI: 10.1016/j.parkreldis.2013.11.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Revised: 10/22/2013] [Accepted: 11/30/2013] [Indexed: 01/20/2023]
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Campbell AD, Squair JW, Chua R, Inglis JT, Carpenter MG. First trial and StartReact effects induced by balance perturbations to upright stance. J Neurophysiol 2013; 110:2236-45. [PMID: 23945786 DOI: 10.1152/jn.00766.2012] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Postural responses (PR) to a balance perturbation differ between the first and subsequent perturbations. One explanation for this first trial effect is that perturbations act as startling stimuli that initiate a generalized startle response (GSR) as well as the PR. Startling stimuli, such as startling acoustic stimuli (SAS), are known to elicit GSRs, as well as a StartReact effect, in which prepared movements are initiated earlier by a startling stimulus. In this study, a StartReact effect paradigm was used to determine if balance perturbations can also act as startle stimuli. Subjects completed two blocks of simple reaction time trials involving wrist extension to a visual imperative stimulus (IS). Each block included 15 CONTROL trials that involved a warning cue and subsequent IS, followed by 10 repeated TEST trials, where either a SAS (TESTSAS) or a toes-up support-surface rotation (TESTPERT) was presented coincident with the IS. StartReact effects were observed during the first trial in both TESTSAS and TESTPERT conditions as evidenced by significantly earlier wrist movement and muscle onsets compared with CONTROL. Likewise, StartReact effects were observed in all repeated TESTSAS and TESTPERT trials. In contrast, GSRs in sternocleidomastoid and PRs were large in the first trial, but significantly attenuated over repeated presentation of the TESTPERT trials. Results suggest that balance perturbations can act as startling stimuli. Thus first trial effects are likely PRs which are superimposed with a GSR that is initially large, but habituates over time with repeated exposure to the startling influence of the balance perturbation.
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Affiliation(s)
- A D Campbell
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada; and
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Behavioral characterization of A53T mice reveals early and late stage deficits related to Parkinson's disease. PLoS One 2013; 8:e70274. [PMID: 23936403 PMCID: PMC3731353 DOI: 10.1371/journal.pone.0070274] [Citation(s) in RCA: 131] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Accepted: 06/17/2013] [Indexed: 11/19/2022] Open
Abstract
Parkinson's disease (PD) pathology is characterized by the formation of intra-neuronal inclusions called Lewy bodies, which are comprised of alpha-synuclein (α-syn). Duplication, triplication or genetic mutations in α-syn (A53T, A30P and E46K) are linked to autosomal dominant PD; thus implicating its role in the pathogenesis of PD. In both PD patients and mouse models, there is increasing evidence that neuronal dysfunction occurs before the accumulation of protein aggregates (i.e., α-syn) and neurodegeneration. Characterization of the timing and nature of symptomatic dysfunction is important for understanding the impact of α-syn on disease progression. Furthermore, this knowledge is essential for identifying pathways and molecular targets for therapeutic intervention. To this end, we examined various functional and morphological endpoints in the transgenic mouse model expressing the human A53T α-syn variant directed by the mouse prion promoter at specific ages relating to disease progression (2, 6 and 12 months of age). Our findings indicate A53T mice develop fine, sensorimotor, and synaptic deficits before the onset of age-related gross motor and cognitive dysfunction. Results from open field and rotarod tests show A53T mice develop age-dependent changes in locomotor activity and reduced anxiety-like behavior. Additionally, digigait analysis shows these mice develop an abnormal gait by 12 months of age. A53T mice also exhibit spatial memory deficits at 6 and 12 months, as demonstrated by Y-maze performance. In contrast to gross motor and cognitive changes, A53T mice display significant impairments in fine- and sensorimotor tasks such as grooming, nest building and acoustic startle as early as 1-2 months of age. These mice also show significant abnormalities in basal synaptic transmission, paired-pulse facilitation and long-term depression (LTD). Combined, these data indicate the A53T model exhibits early- and late-onset behavioral and synaptic impairments similar to PD patients and may provide useful endpoints for assessing novel therapeutic interventions for PD.
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Nardone R, Golaszewski S, Höller Y, Christova M, Trinka E, Brigo F. Neurophysiological insights into the pathophysiology of REM sleep behavior disorders: A review. Neurosci Res 2013; 76:106-12. [DOI: 10.1016/j.neures.2013.03.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2012] [Revised: 03/08/2013] [Accepted: 03/20/2013] [Indexed: 11/24/2022]
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Berardelli A, Wenning GK, Antonini A, Berg D, Bloem BR, Bonifati V, Brooks D, Burn DJ, Colosimo C, Fanciulli A, Ferreira J, Gasser T, Grandas F, Kanovsky P, Kostic V, Kulisevsky J, Oertel W, Poewe W, Reese JP, Relja M, Ruzicka E, Schrag A, Seppi K, Taba P, Vidailhet M. EFNS/MDS-ES/ENS [corrected] recommendations for the diagnosis of Parkinson's disease. Eur J Neurol 2013; 20:16-34. [PMID: 23279440 DOI: 10.1111/ene.12022] [Citation(s) in RCA: 330] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2012] [Accepted: 09/18/2012] [Indexed: 01/24/2023]
Abstract
BACKGROUND A Task Force was convened by the EFNS/MDS-ES Scientist Panel on Parkinson's disease (PD) and other movement disorders to systemically review relevant publications on the diagnosis of PD. METHODS Following the EFNS instruction for the preparation of neurological diagnostic guidelines, recommendation levels have been generated for diagnostic criteria and investigations. RESULTS For the clinical diagnosis, we recommend the use of the Queen Square Brain Bank criteria (Level B). Genetic testing for specific mutations is recommended on an individual basis (Level B), taking into account specific features (i.e. family history and age of onset). We recommend olfactory testing to differentiate PD from other parkinsonian disorders including recessive forms (Level A). Screening for pre-motor PD with olfactory testing requires additional tests due to limited specificity. Drug challenge tests are not recommended for the diagnosis in de novo parkinsonian patients. There is an insufficient evidence to support their role in the differential diagnosis between PD and other parkinsonian syndromes. We recommend an assessment of cognition and a screening for REM sleep behaviour disorder, psychotic manifestations and severe depression in the initial evaluation of suspected PD cases (Level A). Transcranial sonography is recommended for the differentiation of PD from atypical and secondary parkinsonian disorders (Level A), for the early diagnosis of PD and in the detection of subjects at risk for PD (Level A), although the technique is so far not universally used and requires some expertise. Because specificity of TCS for the development of PD is limited, TCS should be used in conjunction with other screening tests. Conventional magnetic resonance imaging and diffusion-weighted imaging at 1.5 T are recommended as neuroimaging tools that can support a diagnosis of multiple system atrophy (MSA) or progressive supranuclear palsy versus PD on the basis of regional atrophy and signal change as well as diffusivity patterns (Level A). DaTscan SPECT is registered in Europe and the United States for the differential diagnosis between degenerative parkinsonisms and essential tremor (Level A). More specifically, DaTscan is indicated in the presence of significant diagnostic uncertainty such as parkinsonism associated with neuroleptic exposure and atypical tremor manifestations such as isolated unilateral postural tremor. Studies of [(123) I]MIBG/SPECT cardiac uptake may be used to identify patients with PD versus controls and MSA patients (Level A). All other SPECT imaging studies do not fulfil registration standards and cannot be recommended for routine clinical use. At the moment, no conclusion can be drawn as to diagnostic efficacy of autonomic function tests, neurophysiological tests and positron emission tomography imaging in PD. CONCLUSIONS The diagnosis of PD is still largely based on the correct identification of its clinical features. Selected investigations (genetic, olfactory, and neuroimaging studies) have an ancillary role in confirming the diagnosis, and some of them could be possibly used in the near future to identify subjects in a pre-symptomatic phase of the disease.
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Affiliation(s)
- A Berardelli
- Dipartimento di Neurologia e Psichiatria and IRCCS NEUROMED Institute, Sapienza, Università di Roma, Rome, Italy.
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Mandillo S, Golini E, Marazziti D, Di Pietro C, Matteoni R, Tocchini-Valentini GP. Mice lacking the Parkinson's related GPR37/PAEL receptor show non-motor behavioral phenotypes: age and gender effect. GENES BRAIN AND BEHAVIOR 2013; 12:465-77. [DOI: 10.1111/gbb.12041] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Revised: 02/15/2013] [Accepted: 04/05/2013] [Indexed: 12/14/2022]
Affiliation(s)
- S. Mandillo
- CNR-National Research Council, IBCN-Institute of Cell Biology and Neurobiology; EMMA-Infrafrontier-IMPC; Monterotondo Scalo; Rome; Italy
| | - E. Golini
- CNR-National Research Council, IBCN-Institute of Cell Biology and Neurobiology; EMMA-Infrafrontier-IMPC; Monterotondo Scalo; Rome; Italy
| | - D. Marazziti
- CNR-National Research Council, IBCN-Institute of Cell Biology and Neurobiology; EMMA-Infrafrontier-IMPC; Monterotondo Scalo; Rome; Italy
| | - C. Di Pietro
- CNR-National Research Council, IBCN-Institute of Cell Biology and Neurobiology; EMMA-Infrafrontier-IMPC; Monterotondo Scalo; Rome; Italy
| | - R. Matteoni
- CNR-National Research Council, IBCN-Institute of Cell Biology and Neurobiology; EMMA-Infrafrontier-IMPC; Monterotondo Scalo; Rome; Italy
| | - G. P. Tocchini-Valentini
- CNR-National Research Council, IBCN-Institute of Cell Biology and Neurobiology; EMMA-Infrafrontier-IMPC; Monterotondo Scalo; Rome; Italy
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Nonnekes J, Scotti A, Oude Nijhuis LB, Smulders K, Queralt A, Geurts ACH, Bloem BR, Weerdesteyn V. Are postural responses to backward and forward perturbations processed by different neural circuits? Neuroscience 2013; 245:109-20. [PMID: 23624061 DOI: 10.1016/j.neuroscience.2013.04.036] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Revised: 04/15/2013] [Accepted: 04/16/2013] [Indexed: 11/17/2022]
Abstract
Startle pathways may contribute to rapid accomplishment of postural stability. Here we investigate the possible influence of a startling auditory stimulus (SAS) on postural responses. We formulated four specific questions: (1) can a concurrent SAS shorten the onset of automatic postural responses?; and if so (2) is this effect different for forward versus backward perturbations?; (3) does this effect depend on prior knowledge of the perturbation direction?; and (4) is this effect different for low- and high-magnitude perturbations? Balance was perturbed in 11 healthy participants by a movable platform that suddenly translated forward or backward. Each participant received 160 perturbations, 25% of which were combined with a SAS. We varied the direction and magnitude of the perturbations, as well as the prior knowledge of perturbation direction. Perturbation trials were interspersed with SAS-only trials. The SAS accelerated and strengthened postural responses with clear functional benefits (better balance control), but this was only true for responses that protected against falling backwards (i.e. in tibialis anterior and rectus femoris). These muscles also demonstrated the most common SAS-triggered responses without perturbation. Increasing the perturbation magnitude accelerated postural responses, but again with a larger acceleration for backward perturbations. We conclude that postural responses to backward and forward perturbations may be processed by different neural circuits, with influence of startle pathways on postural responses to backward perturbations. These findings give directions for future studies investigating whether deficits in startle pathways may explain the prominent backward instability seen in patients with Parkinson's disease and progressive supranuclear palsy.
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Affiliation(s)
- J Nonnekes
- Radboud University Medical Centre, Nijmegen Centre for Evidence Based Practice, Department of Rehabilitation, Nijmegen, The Netherlands.
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Acoustic startle response in patients with orthostatic tremor. Neurosci Lett 2012; 525:100-4. [PMID: 22884645 DOI: 10.1016/j.neulet.2012.07.060] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2012] [Revised: 07/25/2012] [Accepted: 07/27/2012] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND AIM Orthostatic tremor is a high frequency tremor predominantly on calf muscles during standing. Brainstem is the most probable generator in the pathogenesis since it comprises bilaterally projecting centers regulating stance or tone. We aimed to investigate the functional role of brainstem through the evaluation of acoustic startle response in primary orthostatic tremor patients. PATIENTS AND METHOD We included 7 (2 males) consecutive patients and 13 (5 males) healthy volunteers. Diagnosis was confirmed by polymyographic surface electromyography. All subjects underwent acoustic startle response and blink reflex investigations. RESULTS Presence rate (71.4% vs. 100%, p=0.042) and response rate (27.5% vs. 40.5%, p=0.047) of total acoustic startle response were lower in patient group. Similarly, probability over orbicularis oculi was lower among patients (p=0.003). However, blink reflex was observed in all patients and healthy volunteers and latencies of startle and blink reflexes were similar between groups. CONCLUSIONS In our patient group, normal response rate and latencies of R1 and R2 show structural integrity of at least blink reflex circuit at brainstem. On the other hand, suppressed response rates probably reflect decreased excitability of auditory startle reflex pathway.
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Differential effect of dopa and subthalamic stimulation on vestibular activity in Parkinson's disease. Mov Disord 2012; 27:1268-75. [DOI: 10.1002/mds.25061] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2011] [Revised: 02/17/2012] [Accepted: 04/25/2012] [Indexed: 11/07/2022] Open
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Brooks S, Higgs G, Jones L, Dunnett SB. Longitudinal analysis of the behavioural phenotype in HdhQ92 Huntington's disease knock-in mice. Brain Res Bull 2012; 88:148-55. [DOI: 10.1016/j.brainresbull.2010.05.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2010] [Revised: 04/27/2010] [Accepted: 05/02/2010] [Indexed: 01/01/2023]
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40
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Brooks S, Higgs G, Janghra N, Jones L, Dunnett SB. Longitudinal analysis of the behavioural phenotype in YAC128 (C57BL/6J) Huntington's disease transgenic mice. Brain Res Bull 2012; 88:113-20. [DOI: 10.1016/j.brainresbull.2010.05.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2010] [Revised: 04/27/2010] [Accepted: 05/02/2010] [Indexed: 10/19/2022]
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Nanhoe-Mahabier W, Allum JHJ, Overeem S, Borm GF, Oude Nijhuis LB, Bloem BR. First trial reactions and habituation rates over successive balance perturbations in Parkinson's disease. Neuroscience 2012; 217:123-9. [PMID: 22542872 DOI: 10.1016/j.neuroscience.2012.03.064] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Accepted: 03/18/2012] [Indexed: 11/26/2022]
Abstract
BACKGROUND Balance control in Parkinson's disease is often studied using dynamic posturography, typically with serial identical balance perturbations. Because subjects can learn from the first trial, the magnitude of balance reactions rapidly habituates during subsequent trials. Changes in this habituation rate might yield a clinically useful marker. We studied balance reactions in Parkinson's disease using posturography, specifically focusing on the responses to the first, fully unpractised balance disturbance, and on the subsequent habituation rates. METHODS Eight Parkinson patients and eight age- and gender-matched controls received eight consecutive toe-up rotations of a support-surface. Balance reactions were measured with a motion analysis system and converted to centre of mass displacements (primary outcome). RESULTS Mean centre of mass displacement during the first trial was 51% greater in patients than controls (P=0.019), due to excessive trunk flexion and greater ankle plantar-flexion. However, habituated trials were comparable in both groups. Patients also habituated slower: controls were fully habituated at trial 2, whereas habituation in patients required up to five trials (P=0.004). The number of near-falls during the first trial was significantly correlated with centre of mass displacement during the first trial and with habituation rate. CONCLUSIONS Higher first trial reactions and a slow habituation rate discriminated Parkinson's patients from controls, but habituated trials did not. Further work should demonstrate whether this also applies to clinical balance tests, such as the pull test, and whether repeated delivery of such tests offers better diagnostic value for evaluating fall risks in parkinsonian patients.
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Affiliation(s)
- W Nanhoe-Mahabier
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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Abstract
Over the last 25 years, clinical neurophysiology has made many advances in the understanding, diagnosis, and even treatment of different movement disorders. Transcranial magnetic stimulation has been the biggest technical advance. Progress in pathophysiology includes improved knowledge about bradykinesia in Parkinson's disease, loss of inhibition and increased plasticity in dystonia, abnormal startle in hyperekplexia, and various features of psychogenic movement disorders that can aid diagnosis. Studies have been done looking at the use of noninvasive brain stimulation for therapy, but effects are generally small.
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Affiliation(s)
- Mark Hallett
- Human Motor Control Section, NINDS, NIH, Bethesda, Maryland 20892-1428, USA.
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Thevathasan W, Pogosyan A, Hyam JA, Jenkinson N, Bogdanovic M, Coyne TJ, Silburn PA, Aziz TZ, Brown P. A block to pre-prepared movement in gait freezing, relieved by pedunculopontine nucleus stimulation. ACTA ACUST UNITED AC 2011; 134:2085-95. [PMID: 21705424 PMCID: PMC3122373 DOI: 10.1093/brain/awr131] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Gait freezing and postural instability are disabling features of Parkinsonian disorders, treatable with pedunculopontine nucleus stimulation. Both features are considered deficits of proximal and axial musculature, innervated predominantly by reticulospinal pathways and tend to manifest when gait and posture require adjustment. Adjustments to gait and posture are amenable to pre-preparation and rapid triggered release. Experimentally, such accelerated release can be elicited by loud auditory stimuli—a phenomenon known as ‘StartReact’. We observed StartReact in healthy and Parkinsonian controls. However, StartReact was absent in Parkinsonian patients with severe gait freezing and postural instability. Pedunculopontine nucleus stimulation restored StartReact proximally and proximal reaction times to loud stimuli correlated with gait and postural disturbance. These findings suggest a relative block to triggered, pre-prepared movement in gait freezing and postural instability, relieved by pedunculopontine nucleus stimulation.
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Rogers MW, Kennedy R, Palmer S, Pawar M, Reising M, Martinez KM, Simuni T, Zhang Y, MacKinnon CD. Postural preparation prior to stepping in patients with Parkinson's disease. J Neurophysiol 2011; 106:915-24. [DOI: 10.1152/jn.00005.2010] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
People with Parkinson's disease (PD) frequently have difficulties with generating anticipatory postural adjustments (APAs) for forward propulsion and lateral weight transfer when initiating gait. This impairment has been attributed to deficits in motor planning and preparation. This study examined the preparation of APAs prior to an imperative cue to initiate forward stepping. A startling acoustic stimulus (SAS) was used to probe the state of preparation of the APA in eight PD (off medication) and seven matched control subjects. Subjects performed visually cued trials involving a pre-cue light instructing them to prepare to step, followed 3.5 s later by a go-cue light to rapidly initiate stepping. In random trials, a SAS (124 dB) was presented at −1,500, −1,000, −500, −250, −100, or 0 ms before the go-cue. Subjects also performed self-initiated steps. Ground reaction forces (GRFs), center of pressure (CoP) changes, and electromyographic (EMG) signals were recorded. The SAS triggered APAs in 94 ± 11% (PD) and 96 ± 8% (control) of trials at latencies 89 ± 4 ms (PD) and 97 ± 3 ms (control) earlier than Control trials. The temporal profile of APA preparation was similar between groups. However, peak EMG, GRF, and mediolateral CoP amplitudes were reduced in PD. SAS-evoked APAs at 0 ms matched Control trial APAs and were enhanced compared with self-initiated stepping. These results demonstrate that people with mild to moderate PD can plan and prepare the appropriate APA sequence prior to the expected cue to initiate gait; however, the prepared APAs are underscaled in magnitude.
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Affiliation(s)
- Mark W. Rogers
- Department of Physical Therapy and Rehabilitation Science, School of Medicine, University of Maryland, Baltimore, Maryland; and
| | - Robert Kennedy
- Department of Physical Therapy and Human Movement Sciences and
| | - Sonia Palmer
- Department of Physical Therapy and Human Movement Sciences and
| | - Monika Pawar
- Department of Physical Therapy and Human Movement Sciences and
| | - Maggie Reising
- Department of Physical Therapy and Human Movement Sciences and
| | | | - Tanya Simuni
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Yunhui Zhang
- Department of Physical Therapy and Human Movement Sciences and
| | - Colum D. MacKinnon
- Department of Physical Therapy and Human Movement Sciences and
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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Dynamic posturography in Parkinson's disease: diagnostic utility of the “first trial effect”. Neuroscience 2010; 168:387-94. [DOI: 10.1016/j.neuroscience.2010.03.068] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2009] [Revised: 03/28/2010] [Accepted: 03/31/2010] [Indexed: 11/21/2022]
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Narayana S, Fox PT, Zhang W, Franklin C, Robin DA, Vogel D, Ramig LO. Neural correlates of efficacy of voice therapy in Parkinson's disease identified by performance-correlation analysis. Hum Brain Mapp 2010; 31:222-36. [PMID: 19639554 DOI: 10.1002/hbm.20859] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
LSVT LOUD (Lee Silverman Voice Treatment) is efficacious in the treatment of speech disorders in idiopathic Parkinson's disease (IPD), particularly hypophonia. Functional imaging in patients with IPD has shown abnormalities in several speech regions and changes in these areas immediately following treatment. This study serves to extend the analysis by correlating changes of regional neural activity with the main behavioral change following treatment, namely, increased vocal intensity. Ten IPD participants with hypophonia were studied before and after LSVT LOUD. Cerebral blood flow during rest and reading conditions were measured by H(2)(15)O-positron emission tomography. Z-score images were generated by contrasting reading with rest conditions for pre- and post-LSVT LOUD sessions. Neuronal activity during reading in the pre- versus post-LSVT LOUD contrast was correlated with corresponding change in vocal intensity to generate correlation images. Behaviorally, vocal intensity for speech tasks increased significantly after LSVT LOUD. The contrast and correlation analyses indicate a treatment-dependent shift to the right hemisphere with modification in the speech motor regions as well as in prefrontal and temporal areas. We interpret the modification of activity in these regions to be a top-down effect of LSVT LOUD. The absence of an effect of LSVT LOUD on the basal ganglion supports this argument. Our findings indicate that the therapeutic effect of LSVT LOUD in IPD hypophonia results from a shift in cortical activity to the right hemisphere. These findings demonstrate that the short-term changes in the speech motor and multimodal integration areas can occur in a top-down manner.
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Affiliation(s)
- Shalini Narayana
- Department of Radiology, Research Imaging Center, University of Texas Health Science Center at San Antonio, Texas 78229, USA.
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47
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Bakker MJ, Boer F, van der Meer JN, Koelman JH, Boerée T, Bour L, Tijssen MA. Quantification of the auditory startle reflex in children. Clin Neurophysiol 2009; 120:424-30. [DOI: 10.1016/j.clinph.2008.11.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2008] [Revised: 09/23/2008] [Accepted: 11/03/2008] [Indexed: 10/21/2022]
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48
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Bologna M, Agostino R, Gregori B, Belvisi D, Ottaviani D, Colosimo C, Fabbrini G, Berardelli A. Voluntary, spontaneous and reflex blinking in patients with clinically probable progressive supranuclear palsy. Brain 2008; 132:502-10. [PMID: 19043083 DOI: 10.1093/brain/awn317] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Patients with progressive supranuclear palsy (PSP) often have blinking abnormalities. In this study we examined the kinematic features of voluntary, spontaneous and reflex blinking in 11 patients with PSP and healthy control subjects. Patients were asked to blink voluntarily as fast as possible; spontaneous blinking was recorded during two 60 s rest periods; reflex blinking was evoked by electrical stimulation of the supraorbital nerve. Eyelid movements were recorded with the SMART analyzer motion system. During voluntary blinking the closing and opening phases lasted longer in patients than in healthy subjects. Furthermore, the peak velocity of the closing phase of voluntary blinking was lower in patients than healthy subjects. During spontaneous blinking the blink rate was markedly lower in patients than in control subjects. Patient's recordings also showed kinematic abnormalities of spontaneous (reduced peak velocity of both closing and opening phases) and reflex (reduced peak velocity and increased duration of the opening phase) blinking. Recordings during reflex blinking disclosed an enhanced excitability of the interneuronal pool mediating the closing and opening blink phases. Finally, the pause, a neurophysiological marker of the switching processes between the closing and opening phases, was prolonged in all the three types of blinking. The abnormal kinematic variables correlated with patients' clinical and kinematic features. Abnormal voluntary, spontaneous and reflex blinking in patients with PSP reflects the widespread cortical, subcortical and brainstem degeneration related to this disease.
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Affiliation(s)
- Matteo Bologna
- Department of Neurological Sciences, Sapienza, University of Rome, Rome, Italy
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49
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The auditory startle response in parkinsonism may reveal the extent but not type of pathology. J Neurol 2008; 255:628-32. [DOI: 10.1007/s00415-008-0758-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2007] [Revised: 09/04/2007] [Accepted: 09/27/2007] [Indexed: 10/22/2022]
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50
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Laterality of auditory startle responses in humans. Clin Neurophysiol 2008; 119:309-14. [DOI: 10.1016/j.clinph.2007.11.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2007] [Revised: 10/30/2007] [Accepted: 11/11/2007] [Indexed: 11/23/2022]
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