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Chiu SY, Chen R, Wang WE, Armstrong MJ, Boeve BF, Savica R, Ramanan V, Fields JA, Graff-Radford N, Ferman TJ, Kantarci K, Vaillancourt DE. Longitudinal Free-Water Changes in Dementia with Lewy Bodies. Mov Disord 2024; 39:836-846. [PMID: 38477399 PMCID: PMC11102324 DOI: 10.1002/mds.29763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 01/06/2024] [Accepted: 02/16/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Diffusion-weighted magnetic resonance imaging (dMRI) examines tissue microstructure integrity in vivo. Prior dementia with Lewy bodies (DLB) diffusion tensor imaging studies yielded mixed results. OBJECTIVE We employed free-water (FW) imaging to assess DLB progression and correlate with clinical decline in DLB. METHODS Baseline and follow-up MRIs were obtained at 12 and/or 24 months for 27 individuals with DLB or mild cognitive impairment with Lewy bodies (MCI-LB). FW was analyzed using the Mayo Clinic Adult Lifespan Template. Primary outcomes were FW differences between baseline and 12 or 24 months. To compare FW change longitudinally, we included 20 cognitively unimpaired individuals from the Alzheimer's Disease Neuroimaging Initiative. RESULTS We followed 23 participants to 12 months and 16 participants to 24 months. Both groups had worsening in Montreal Cognitive Assessment (MoCA) and Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) scores. We found significant FW increases at both time points compared to baseline in the insula, amygdala, posterior cingulum, parahippocampal, entorhinal, supramarginal, fusiform, retrosplenial, and Rolandic operculum regions. At 24 months, we found more widespread microstructural changes in regions implicated in visuospatial processing, motor, and cholinergic functions. Between-group analyses (DLB vs. controls) confirmed significant FW changes over 24 months in most of these regions. FW changes were associated with longitudinal worsening of MDS-UPDRS and MoCA scores. CONCLUSIONS FW increased in gray and white matter regions in DLB, likely due to neurodegenerative pathology associated with disease progression. FW change was associated with clinical decline. The findings support dMRI as a promising tool to track disease progression in DLB. © 2024 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Shannon Y. Chiu
- Department of Neurology, University of Florida, Gainesville, FL
- Department of Neurology, Mayo Clinic, Scottsdale, AZ
| | - Robin Chen
- Laboratory for Rehabilitation Neuroscience, University of Florida, Gainesville, FL
| | - Wei-en Wang
- Laboratory for Rehabilitation Neuroscience, University of Florida, Gainesville, FL
| | | | | | | | | | - Julie A. Fields
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | | | - Tanis J. Ferman
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL
| | - Kejal Kantarci
- Department of Neuroradiology, Mayo Clinic, Rochester, MN
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Gregorio I, Russo L, Torretta E, Barbacini P, Contarini G, Pacinelli G, Bizzotto D, Moriggi M, Braghetta P, Papaleo F, Gelfi C, Moro E, Cescon M. GBA1 inactivation in oligodendrocytes affects myelination and induces neurodegenerative hallmarks and lipid dyshomeostasis in mice. Mol Neurodegener 2024; 19:22. [PMID: 38454456 PMCID: PMC10921719 DOI: 10.1186/s13024-024-00713-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 02/20/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND Mutations in the β-glucocerebrosidase (GBA1) gene do cause the lysosomal storage Gaucher disease (GD) and are among the most frequent genetic risk factors for Parkinson's disease (PD). So far, studies on both neuronopathic GD and PD primarily focused on neuronal manifestations, besides the evaluation of microglial and astrocyte implication. White matter alterations were described in the central nervous system of paediatric type 1 GD patients and were suggested to sustain or even play a role in the PD process, although the contribution of oligodendrocytes has been so far scarcely investigated. METHODS We exploited a system to study the induction of central myelination in vitro, consisting of Oli-neu cells treated with dibutyryl-cAMP, in order to evaluate the expression levels and function of β-glucocerebrosidase during oligodendrocyte differentiation. Conduritol-B-epoxide, a β-glucocerebrosidase irreversible inhibitor was used to dissect the impact of β-glucocerebrosidase inactivation in the process of myelination, lysosomal degradation and α-synuclein accumulation in vitro. Moreover, to study the role of β-glucocerebrosidase in the white matter in vivo, we developed a novel mouse transgenic line in which β-glucocerebrosidase function is abolished in myelinating glia, by crossing the Cnp1-cre mouse line with a line bearing loxP sequences flanking Gba1 exons 9-11, encoding for β-glucocerebrosidase catalytic domain. Immunofluorescence, western blot and lipidomic analyses were performed in brain samples from wild-type and knockout animals in order to assess the impact of genetic inactivation of β-glucocerebrosidase on myelination and on the onset of early neurodegenerative hallmarks, together with differentiation analysis in primary oligodendrocyte cultures. RESULTS Here we show that β-glucocerebrosidase inactivation in oligodendrocytes induces lysosomal dysfunction and inhibits myelination in vitro. Moreover, oligodendrocyte-specific β-glucocerebrosidase loss-of-function was sufficient to induce in vivo demyelination and early neurodegenerative hallmarks, including axonal degeneration, α-synuclein accumulation and astrogliosis, together with brain lipid dyshomeostasis and functional impairment. CONCLUSIONS Our study sheds light on the contribution of oligodendrocytes in GBA1-related diseases and supports the need for better characterizing oligodendrocytes as actors playing a role in neurodegenerative diseases, also pointing at them as potential novel targets to set a brake to disease progression.
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Affiliation(s)
- Ilaria Gregorio
- Department of Molecular Medicine, University of Padova, Via Ugo Bassi 58/B, 35131, Padua, Italy
| | - Loris Russo
- Department of Molecular Medicine, University of Padova, Via Ugo Bassi 58/B, 35131, Padua, Italy
| | - Enrica Torretta
- Laboratory of Proteomics and Lipidomics, IRCCS Orthopedic Institute Galeazzi, Milan, 20161, Italy
| | - Pietro Barbacini
- Department of Biomedical Sciences for Health, University of Milan, 20133, Milan, Italy
| | - Gabriella Contarini
- Genetics of Cognition Laboratory, Neuroscience Area, Istituto Italiano Di Tecnologia, 16163, Genova, Italy
- Department of Biomedical and Technological Sciences, University of Catania, 95125, Catania, Italy
| | - Giada Pacinelli
- Genetics of Cognition Laboratory, Neuroscience Area, Istituto Italiano Di Tecnologia, 16163, Genova, Italy
- Padova Neuroscience Center (PNC), University of Padova, 35131, Padua, Italy
| | - Dario Bizzotto
- Department of Molecular Medicine, University of Padova, Via Ugo Bassi 58/B, 35131, Padua, Italy
| | - Manuela Moriggi
- Department of Biomedical Sciences for Health, University of Milan, 20133, Milan, Italy
| | - Paola Braghetta
- Department of Molecular Medicine, University of Padova, Via Ugo Bassi 58/B, 35131, Padua, Italy
| | - Francesco Papaleo
- Genetics of Cognition Laboratory, Neuroscience Area, Istituto Italiano Di Tecnologia, 16163, Genova, Italy
| | - Cecilia Gelfi
- Laboratory of Proteomics and Lipidomics, IRCCS Orthopedic Institute Galeazzi, Milan, 20161, Italy
- Department of Biomedical Sciences for Health, University of Milan, 20133, Milan, Italy
| | - Enrico Moro
- Department of Molecular Medicine, University of Padova, Via Ugo Bassi 58/B, 35131, Padua, Italy
| | - Matilde Cescon
- Department of Molecular Medicine, University of Padova, Via Ugo Bassi 58/B, 35131, Padua, Italy.
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Jellinger KA. Pathobiology of Cognitive Impairment in Parkinson Disease: Challenges and Outlooks. Int J Mol Sci 2023; 25:498. [PMID: 38203667 PMCID: PMC10778722 DOI: 10.3390/ijms25010498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 12/11/2023] [Accepted: 12/27/2023] [Indexed: 01/12/2024] Open
Abstract
Cognitive impairment (CI) is a characteristic non-motor feature of Parkinson disease (PD) that poses a severe burden on the patients and caregivers, yet relatively little is known about its pathobiology. Cognitive deficits are evident throughout the course of PD, with around 25% of subtle cognitive decline and mild CI (MCI) at the time of diagnosis and up to 83% of patients developing dementia after 20 years. The heterogeneity of cognitive phenotypes suggests that a common neuropathological process, characterized by progressive degeneration of the dopaminergic striatonigral system and of many other neuronal systems, results not only in structural deficits but also extensive changes of functional neuronal network activities and neurotransmitter dysfunctions. Modern neuroimaging studies revealed multilocular cortical and subcortical atrophies and alterations in intrinsic neuronal connectivities. The decreased functional connectivity (FC) of the default mode network (DMN) in the bilateral prefrontal cortex is affected already before the development of clinical CI and in the absence of structural changes. Longitudinal cognitive decline is associated with frontostriatal and limbic affections, white matter microlesions and changes between multiple functional neuronal networks, including thalamo-insular, frontoparietal and attention networks, the cholinergic forebrain and the noradrenergic system. Superimposed Alzheimer-related (and other concomitant) pathologies due to interactions between α-synuclein, tau-protein and β-amyloid contribute to dementia pathogenesis in both PD and dementia with Lewy bodies (DLB). To further elucidate the interaction of the pathomechanisms responsible for CI in PD, well-designed longitudinal clinico-pathological studies are warranted that are supported by fluid and sophisticated imaging biomarkers as a basis for better early diagnosis and future disease-modifying therapies.
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Affiliation(s)
- Kurt A Jellinger
- Institute of Clinical Neurobiology, Alberichgasse 5/13, A-1150 Vienna, Austria
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4
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Jahanshahi A, Ghareaghaji N, Hassanpour S, Vafadar A, Mousavi S, Khezerloo D. Cortical gray matter and cerebral white matter atrophy and asymmetry in Parkinson's disease patients with normal cognitive precede. Int J Neurosci 2023:1-6. [PMID: 38085250 DOI: 10.1080/00207454.2023.2294260] [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: 10/31/2023] [Accepted: 12/08/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Parkinson's disease is the second most common neurodegenerative disorder with complex and distributed motor and non-motor symptoms. In this study, cortical gray matter (GM) and cerebral white matter (WM) overall atrophy, and asymmetry of atrophy are investigated in PD with normal cognitive function. METHOD Forty-eight male Parkinson's disease(PD) patients with normal cognitive precede (PD-NC), and thirty matched healthy control (HC) subjects were selected from the Parkinson's Progression Markers Initiative (PPMI) database. Brain structures volumes were extracted using Freesurfer software based on subject 3 tesla MRI images. The normalized volume of cortical GM and cerebral WM were compared in two study groups, and then the asymmetry index (AI) of GM and WM atrophy was also assessed in two groups. Statistical analysis was constructed using a t-test with p < 0.05 of significance. RESULTS No significant difference was observed in the volume of cortical GM and cerebral WM in the two study groups. The cortical GM asymmetry index in the PD-NC group was significantly (p = 0.01) higher than the HC group, however, no difference was observed for the cerebral WM asymmetry index. CONCLUSION Atrophy in cortical GM and WM was not observed between the PD-NC and the HC group, however, the asymmetry index in GM was significant between the two group. It seems that the brain's bilateral balance has ruptured in PD. Cortical GM asymmetry in PD-NC can be considered a potent biomarker and should be investigated more in the future. In future studies, construction of a longitudinal study on this issue could be useful.
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Affiliation(s)
- Amirreza Jahanshahi
- Department of Radiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nahideh Ghareaghaji
- Department of Radiology, Faculty of Allied Medical Sciences, Tabriz University of Medical Science, Tabriz, Iran
| | - Samaneh Hassanpour
- Department of Medical Physics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Ali Vafadar
- Department of Medical Physics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Saeid Mousavi
- Department of Statistics and Epidemiology, Faculty of Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Davood Khezerloo
- Department of Radiology, Faculty of Allied Medical Sciences, Tabriz University of Medical Science, Tabriz, Iran
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Liao TW, Wang JJ, Tsai CC, Wang PN, Chen YL, Wu YM, Wu YR. A fixel-based analysis of white matter reductions early detects Parkinson disease with mild cognitive impairment. Biomed J 2023:100678. [PMID: 37949112 DOI: 10.1016/j.bj.2023.100678] [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: 06/07/2023] [Revised: 10/27/2023] [Accepted: 10/30/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND White matter (WM) tract alterations are early signs of cognitive impairment in Parkinson disease (PD) patients. Fixel-based analysis (FBA) has advantages over traditional diffusion tensor imaging in managing complex and crossing fibers. We used FBA to measure fiber-specific changes in patients with PD mild cognitive impairment (PD-MCI) and PD normal cognition (PD-NC). METHODS Seventy-one patients with PD without dementia were included: 39 PD-MCI and 32 PD-NC. All underwent diffusion-weighted imaging, clinical examinations, and tests to evaluate their cognitive function globally and in five cognitive domains. FBA was used to investigate fiber-tract alterations and compare PD-MCI with PD-NC subjects. Correlations with each cognitive test were analyzed. RESULTS Patients with PD-MCI were significantly older (P = 0.044), had a higher male-to-female ratio (P = 0.006) and total Unified Parkinson's Disease Rating Scale score (P = 0.001). All fixel-based metrics were significantly reduced within the body of the corpus callosum and superior corona radiata in PD-MCI patients (family-wise error-corrected P value < 0.05) compared with PD-NC patients. The cingulum, superior longitudinal fasciculi, and thalamocortical circuit exhibited predominantly fiber-bundle cross-section (FC) changes. In regression analysis, reduced FC values in cerebellar circuits were associated with poor motor function in PD-MCI patients and poor picture-naming ability in PD-NC patients. CONCLUSIONS PD-MCI patients have significant WM alterations compared with PD-NC patients. FBA revealed these changes in various bundle tracts, helping us to better understand specific WM changes that are functionally implicated in PD cognitive decline. FBA is potentially useful in detecting early cognitive decline in PD.
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Affiliation(s)
- Ting-Wei Liao
- Department of Neurology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
| | - Jiun-Jie Wang
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan; Healthy Aging Research Center, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Medical Imaging Research Center, Institute for Radiological Research, Chang Gung University/Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chih-Chien Tsai
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan; Healthy Aging Research Center, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Pei-Ning Wang
- Division of General Neurology, Department of Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yao-Liang Chen
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Yi-Ming Wu
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan
| | - Yih-Ru Wu
- Department of Neurology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan; Department of Neurology, Chang Gung University, College of Medicine, Taoyuan, Taiwan.
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Nieto-Escamez F, Obrero-Gaitán E, Cortés-Pérez I. Visual Dysfunction in Parkinson's Disease. Brain Sci 2023; 13:1173. [PMID: 37626529 PMCID: PMC10452537 DOI: 10.3390/brainsci13081173] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 07/11/2023] [Accepted: 08/03/2023] [Indexed: 08/27/2023] Open
Abstract
Non-motor symptoms in Parkinson's disease (PD) include ocular, visuoperceptive, and visuospatial impairments, which can occur as a result of the underlying neurodegenerative process. Ocular impairments can affect various aspects of vision and eye movement. Thus, patients can show dry eyes, blepharospasm, reduced blink rate, saccadic eye movement abnormalities, smooth pursuit deficits, and impaired voluntary and reflexive eye movements. Furthermore, visuoperceptive impairments affect the ability to perceive and recognize visual stimuli accurately, including impaired contrast sensitivity and reduced visual acuity, color discrimination, and object recognition. Visuospatial impairments are also remarkable, including difficulties perceiving and interpreting spatial relationships between objects and difficulties judging distances or navigating through the environment. Moreover, PD patients can present visuospatial attention problems, with difficulties attending to visual stimuli in a spatially organized manner. Moreover, PD patients also show perceptual disturbances affecting their ability to interpret and determine meaning from visual stimuli. And, for instance, visual hallucinations are common in PD patients. Nevertheless, the neurobiological bases of visual-related disorders in PD are complex and not fully understood. This review intends to provide a comprehensive description of visual disturbances in PD, from sensory to perceptual alterations, addressing their neuroanatomical, functional, and neurochemical correlates. Structural changes, particularly in posterior cortical regions, are described, as well as functional alterations, both in cortical and subcortical regions, which are shown in relation to specific neuropsychological results. Similarly, although the involvement of different neurotransmitter systems is controversial, data about neurochemical alterations related to visual impairments are presented, especially dopaminergic, cholinergic, and serotoninergic systems.
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Affiliation(s)
- Francisco Nieto-Escamez
- Department of Psychology, University of Almeria, 04120 Almeria, Spain
- Center for Neuropsychological Assessment and Rehabilitation (CERNEP), 04120 Almeria, Spain
| | - Esteban Obrero-Gaitán
- Department of Health Sciences, University of Jaen, Paraje Las Lagunillas s/n, 23071 Jaen, Spain;
| | - Irene Cortés-Pérez
- Department of Health Sciences, University of Jaen, Paraje Las Lagunillas s/n, 23071 Jaen, Spain;
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Mao S, Teng X, Li Z, Zu J, Zhang T, Xu C, Cui G. Association of serum neurofilament light chain and glial fibrillary acidic protein levels with cognitive decline in Parkinson's disease. Brain Res 2023; 1805:148271. [PMID: 36754139 DOI: 10.1016/j.brainres.2023.148271] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 02/01/2023] [Accepted: 02/04/2023] [Indexed: 02/10/2023]
Abstract
OBJECTIVES To investigate whether serum neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) levels are associated with motor and cognitive function in Parkinson's disease (PD). METHODS This cross-sectional study recruited 140 participants, including 103 PD patients and 37 healthy controls (HC). Serum NfL and GFAP levels were measured using the ultrasensitive single-molecule array (Simoa) technique. Motor and cognitive function were evaluated using the Movement Disorder Society Unified Parkinson's Disease Rating Scale Part III (MDS-UPDRS III) and Beijing version of the Montreal Cognitive Assessment (MoCA). Spearman's correlation analyses were used to determine the correlation between serum NfL and GFAP levels and clinical features in PD patients. Binary logistic regression analysis was used to assess the association between serum biomarkers and cognitive impairment in PD patients. RESULTS We observed significantly higher serum NfL and GFAP levels in PD patients than in HC (p < 0.001). Serum NfL and GFAP levels were negatively correlated with MoCA scores (NfL: r = - 0.472, p < 0.001; r = 0.395, p < 0.001) and multiple cognitive domains and showed no correlation with motor symptom severity after adjusting for age and sex. Binary logistic regression analysis showed that the serum NfL and GFAP levels were independent contributors to PD with dementia (p < 0.05). CONCLUSIONS Both serum NfL and GFAP levels correlated with cognitive impairment, but not motor symptoms, in PD patients. Serum NfL and GFAP levels can serve as biomarkers for PD patients at risk of cognitive decline.
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Affiliation(s)
- Shuai Mao
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, 99 West Huaihai Road, Xuzhou, Jiangsu Province 221000, China; Department of Neurology, The First Clinical College, Xuzhou Medical University, 209 Tongshan Road, Xuzhou, Jiangsu Province 221000, China
| | - Xing Teng
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, 99 West Huaihai Road, Xuzhou, Jiangsu Province 221000, China; Department of Neurology, The First Clinical College, Xuzhou Medical University, 209 Tongshan Road, Xuzhou, Jiangsu Province 221000, China
| | - Zhen Li
- Department of Neurology, The First Clinical College, Xuzhou Medical University, 209 Tongshan Road, Xuzhou, Jiangsu Province 221000, China
| | - Jie Zu
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, 99 West Huaihai Road, Xuzhou, Jiangsu Province 221000, China
| | - Tao Zhang
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, 99 West Huaihai Road, Xuzhou, Jiangsu Province 221000, China
| | - Chuanying Xu
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, 99 West Huaihai Road, Xuzhou, Jiangsu Province 221000, China; Department of Neurology, The First Clinical College, Xuzhou Medical University, 209 Tongshan Road, Xuzhou, Jiangsu Province 221000, China.
| | - Guiyun Cui
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, 99 West Huaihai Road, Xuzhou, Jiangsu Province 221000, China; Department of Neurology, The First Clinical College, Xuzhou Medical University, 209 Tongshan Road, Xuzhou, Jiangsu Province 221000, China.
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8
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Zhang C, Yuan Y, Sang T, Yu L, Yu Y, Liu X, Zhou W, Zeng Q, Wang J, Peng G, Feng Y. Local white matter abnormalities in Parkinson's disease with mild cognitive impairment: Assessed with neurite orientation dispersion and density imaging. J Neurosci Res 2023; 101:1154-1169. [PMID: 36854050 DOI: 10.1002/jnr.25179] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 12/06/2022] [Accepted: 01/31/2023] [Indexed: 03/02/2023]
Abstract
Mild cognitive impairment is a nonmotor complication in Parkinson's disease (PD) that have a high risk of developing dementia. White matter is associated with cognitive function in PD and the alterations may occur before the symptoms of the disease. Previous diffusion tensor imaging (DTI) studies lacked specificity to characterize the concrete contributions of distinct white matter tissue properties. This may lead to inconsistent conclusions about the alteration of white matter microstructure. Here, we used neurite orientation dispersion and density imaging (NODDI) and white matter fiber clustering method to uncover local white matter microstructures in PD with mild cognitive impairment (PD-MCI). This study included 23 PD-MCI and 20 PD with normal cognition (PD-NC) and 21 healthy controls (HC). To probe specific and fine-grained differences, metrics of NODDI and DTI in white matter fiber clusters were evaluated using along-tract analysis. Our results showed that PD-MCI patients had significantly lower neurite density index (NDI) and orientation dispersion index (ODI) in white matter fiber clusters in the prefrontal region. Correlation analysis and receiver operating characteristic (ROC) analysis revealed that the diagnostic performance of NODDI-derived metrics in cingulum bundle (2 clusters) and thalamo-frontal (2 clusters) were superior to DTI metrics. Our study provides a more specific insight to uncover local white matter abnormalities in PD-MCI, which benefit understanding the underlying mechanism of cognitive decline in PD and predicting the disease in advance.
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Affiliation(s)
- Chengzhe Zhang
- Institute of Information Processing and Automation, College of Information Engineering, Zhejiang University of Technology, Hangzhou, China
| | - Yuan Yuan
- Department of Neurology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Tian Sang
- Institute of Information Processing and Automation, College of Information Engineering, Zhejiang University of Technology, Hangzhou, China
| | - Lihua Yu
- Department of Neurology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yan Yu
- Institute of Information Processing and Automation, College of Information Engineering, Zhejiang University of Technology, Hangzhou, China
| | - Xiaoming Liu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenyang Zhou
- Institute of Information Processing and Automation, College of Information Engineering, Zhejiang University of Technology, Hangzhou, China
| | - Qingrun Zeng
- Institute of Information Processing and Automation, College of Information Engineering, Zhejiang University of Technology, Hangzhou, China
| | - Jingqiang Wang
- Institute of Information Processing and Automation, College of Information Engineering, Zhejiang University of Technology, Hangzhou, China
| | - Guoping Peng
- Department of Neurology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yuanjing Feng
- Institute of Information Processing and Automation, College of Information Engineering, Zhejiang University of Technology, Hangzhou, China
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9
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Stewart SA, Pimer L, Fisk JD, Rusak B, Leslie RA, Eskes G, Schoffer K, McKelvey JR, Rolheiser T, Khan MN, Robertson H, Good KP. Olfactory Function and Diffusion Tensor Imaging as Markers of Mild Cognitive Impairment in Early Stages of Parkinson's Disease. Clin EEG Neurosci 2023; 54:91-97. [PMID: 34841903 PMCID: PMC9693894 DOI: 10.1177/15500594211058263] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Parkinson's disease (PD) is a neurodegenerative disorder that is typified by motor signs and symptoms but can also lead to significant cognitive impairment and dementia Parkinson's Disease Dementia (PDD). While dementia is considered a nonmotor feature of PD that typically occurs later, individuals with PD may experience mild cognitive impairment (PD-MCI) earlier in the disease course. Olfactory deficit (OD) is considered another nonmotor symptom of PD and often presents even before the motor signs and diagnosis of PD. We examined potential links among cognitive impairment, olfactory functioning, and white matter integrity of olfactory brain regions in persons with early-stage PD. Cognitive tests were used to establish groups with PD-MCI and with normal cognition (PD-NC). Olfactory functioning was examined using the University of Pennsylvania Smell Identification Test (UPSIT) while the white matter integrity of the anterior olfactory structures (AOS) was examined using magnetic resonance imaging (MRI) diffusion tensor imaging (DTI) analysis. Those with PD-MCI demonstrated poorer olfactory functioning and abnormalities based on all DTI parameters in the AOS, relative to PD-NC individuals. OD and microstructural changes in the AOS of individuals with PD may serve as additional biological markers of PD-MCI.
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Affiliation(s)
| | - Laura Pimer
- 3688Dalhousie University, Halifax, NS, Canada
| | - John D Fisk
- 432234Nova Scotia Health, Halifax, NS, Canada
| | | | | | - Gail Eskes
- 3688Dalhousie University, Halifax, NS, Canada
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Habich A, Wahlund LO, Westman E, Dierks T, Ferreira D. (Dis-)Connected Dots in Dementia with Lewy Bodies-A Systematic Review of Connectivity Studies. Mov Disord 2023; 38:4-15. [PMID: 36253921 PMCID: PMC10092805 DOI: 10.1002/mds.29248] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 08/04/2022] [Accepted: 09/12/2022] [Indexed: 01/21/2023] Open
Abstract
Studies on dementia with Lewy bodies (DLB) have mainly focused on the degeneration of distinct cortical and subcortical regions related to the deposition of Lewy bodies. In view of the proposed trans-synaptic spread of the α-synuclein pathology, investigating the disease only in this segregated fashion would be detrimental to our understanding of its progression. In this systematic review, we summarize findings on structural and functional brain connectivity in DLB, as connectivity measures may offer better insights on how the brain is affected by the spread of the pathology. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched Web of Science, PubMed, and SCOPUS for relevant articles published up to November 1, 2021. Of 1215 identified records, we selected and systematically reviewed 53 articles that compared connectivity features between patients with DLB and healthy controls. Structural and functional magnetic resonance imaging, positron emission tomography, single-positron emission computer tomography, and electroencephalography assessments of patients revealed widespread abnormalities within and across brain networks in DLB. Frontoparietal, default mode, and visual networks and their connections to other brain regions featured the most consistent disruptions, which were also associated with core clinical features and cognitive impairments. Furthermore, graph theoretical measures revealed disease-related decreases in local and global network efficiency. This systematic review shows that structural and functional connectivity characteristics in DLB may be particularly valuable at early stages, before overt brain atrophy can be observed. This knowledge may help improve the diagnosis and prognosis in DLB as well as pinpoint targets for future disease-modifying treatments. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Annegret Habich
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Lars-Olof Wahlund
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Eric Westman
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Department of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Thomas Dierks
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Daniel Ferreira
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
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11
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Droby A, Nosatzki S, Edry Y, Thaler A, Giladi N, Mirelman A, Maidan I. The interplay between structural and functional connectivity in early stage Parkinson's disease patients. J Neurol Sci 2022; 442:120452. [PMID: 36265263 DOI: 10.1016/j.jns.2022.120452] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 08/21/2022] [Accepted: 10/04/2022] [Indexed: 10/31/2022]
Abstract
The mechanisms underlying cognitive disturbances in Parkinson's disease (PD) are poorly understood but likely to depend on the ongoing degenerative processes affecting structural and functional connectivity (FC). This pilot study examined patterns of FC alterations during a cognitive task using EEG and structural characteristics of white matter (WM) pathways connecting these activated regions in early-stage PD. Eleven PD patients and nine healthy controls (HCs) underwent EEG recording during an auditory oddball task and MRI scans. Source localization was performed and Gaussian mixture model was fitted to identify brain regions with high power during task performance. These areas served as seed regions for connectivity analysis. FC among these regions was assessed by measures of magnitude squared coherence (MSC), and phase-locking value (PLV), while structural connectivity was evaluated using fiber tracking based on diffusion tensor imaging (DTI). The paracentral lobule (PL), superior parietal lobule (SPL), superior and middle frontal gyrus (SMFG), parahippocampal gyrus, superior and middle temporal gyri (STG, MTG) demonstrated increased activation during task performance. Compared to HCs, PD showed lower FC between SMFG and PL and between SMFG and SPL in MSC (p = 0.012 and p = 0.036 respectively). No significant differences between the groups were observed in PLV and the measured DTI metrics along WM tracts. These findings demonstrate that in early PD, cognitive performance changes might be attributed to FC alterations, suggesting that FC is affected early on in the degenerative process, whereas structural damage is more prominent in advanced stages as a result of the disease burden accumulation.
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Affiliation(s)
- Amgad Droby
- Laboratory of Early Markers of Neurodegeneration (LEMON), Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Department of Neurology, Sackler School of Medicine, Tel Aviv University, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.
| | - Shai Nosatzki
- Laboratory of Early Markers of Neurodegeneration (LEMON), Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Israel
| | - Yariv Edry
- Laboratory of Early Markers of Neurodegeneration (LEMON), Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Israel
| | - Avner Thaler
- Laboratory of Early Markers of Neurodegeneration (LEMON), Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Department of Neurology, Sackler School of Medicine, Tel Aviv University, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Nir Giladi
- Laboratory of Early Markers of Neurodegeneration (LEMON), Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Department of Neurology, Sackler School of Medicine, Tel Aviv University, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Anat Mirelman
- Laboratory of Early Markers of Neurodegeneration (LEMON), Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Department of Neurology, Sackler School of Medicine, Tel Aviv University, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Inbal Maidan
- Laboratory of Early Markers of Neurodegeneration (LEMON), Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Department of Neurology, Sackler School of Medicine, Tel Aviv University, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
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12
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Bai X, Guo T, Chen J, Guan X, Zhou C, Wu J, Liu X, Wu H, Wen J, Gu L, Gao T, Xuan M, Huang P, Zhang B, Xu X, Zhang M. Microstructural but not macrostructural cortical degeneration occurs in Parkinson’s disease with mild cognitive impairment. NPJ Parkinsons Dis 2022; 8:151. [DOI: 10.1038/s41531-022-00416-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 10/14/2022] [Indexed: 11/11/2022] Open
Abstract
AbstractThis study aimed to investigate the cortical microstructural/macrostructural degenerative patterns in Parkinson’s disease (PD) patients with mild cognitive impairment (MCI). Overall, 38 PD patients with normal cognition (PD-NC), 38 PD-MCI, and 32 healthy controls (HC) were included. PD-MCI was diagnosed according to the MDS Task Force level II criteria. Cortical microstructural alterations were evaluated with Neurite Orientation Dispersion and Density Imaging. Cortical thickness analyses were derived from T1-weighted imaging using the FreeSurfer software. For cortical microstructural analyses, compared with HC, PD-NC showed lower orientation dispersion index (ODI) in bilateral cingulate and paracingulate gyri, supplementary motor area, right paracentral lobule, and precuneus (PFWE < 0.05); while PD-MCI showed lower ODI in widespread regions covering bilateral frontal, parietal, occipital, and right temporal areas and lower neurite density index in left frontal area, left cingulate, and paracingulate gyri (PFWE < 0.05). Furthermore, compared with PD-NC, PD-MCI showed reduced ODI in right frontal area and bilateral caudate nuclei (voxel P < 0.01 and cluster >100 voxels) and the ODI values were associated with the Montreal Cognitive Assessment scores (r = 0.440, P < 0.001) and the memory performance (r = 0.333, P = 0.004) in the PD patients. However, for cortical thickness analyses, there was no difference in the between-group comparisons. In conclusion, cortical microstructural alterations may precede macrostructural changes in PD-MCI. This study provides insightful evidence for the degenerative patterns in PD-MCI and contributes to our understanding of the latent biological basis of cortical neurite changes for early cognitive impairment in PD.
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REDUCED POWER AND PHASE-LOCKING VALUES WERE ACCOMPANIED BY THALAMUS, PUTAMEN AND HIPPOCAMPUS ATROPHY IN PARKINSON'S DISEASE WITH MILD COGNITIVE IMPAIRMENT: AN EVENT-RELATED OSCILLATION STUDY. Neurobiol Aging 2022; 121:88-106. [DOI: 10.1016/j.neurobiolaging.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 09/30/2022] [Accepted: 10/05/2022] [Indexed: 11/07/2022]
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14
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Longitudinal corpus callosum microstructural decline in early-stage Parkinson’s disease in association with akinetic-rigid symptom severity. NPJ Parkinsons Dis 2022; 8:108. [PMID: 36038586 PMCID: PMC9424284 DOI: 10.1038/s41531-022-00372-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 08/02/2022] [Indexed: 12/26/2022] Open
Abstract
Previous diffusion tensor imaging (DTI) studies of Parkinson’s disease (PD) show reduced microstructural integrity of the corpus callosum (CC) relative to controls, although the characteristics of such callosal degradation remain poorly understood. Here, we utilized a longitudinal approach to identify microstructural decline in the entire volume of the CC and its functional subdivisions over 2 years and related the callosal changes to motor symptoms in early-stage PD. The study sample included 61 PD subjects (N = 61, aged 45–82, 38 M & 23 F, H&Y ≤ 2) from the Parkinson’s Progressive Markers Initiative database (PPMI). Whole-brain voxel-wise results revealed significant fractional anisotropy (FA) and mean diffusivity (MD) changes in the CC, especially in the genu and splenium. Using individually drawn CC regions of interest (ROI), our analysis further revealed that almost all subdivisions of the CC show significant decline in FA to certain extents over the two-year timeframe. Additionally, FA seemed lower in the right hemisphere of the CC at both time-points, and callosal FA decline was associated with FA and MD decline in widespread cortical and subcortical areas. Notably, multiple regression analysis revealed that across-subject akinetic-rigid severity was negatively associated with callosal FA at baseline and 24 months follow-up, and the effect was strongest in the anterior portion of the CC. These results suggest that callosal microstructure alterations in the anterior CC may serve as a viable biomarker for akinetic-rigid symptomology and disease progression, even in early PD.
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15
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Haghshomar M, Shobeiri P, Seyedi SA, Abbasi-Feijani F, Poopak A, Sotoudeh H, Kamali A, Aarabi MH. Cerebellar Microstructural Abnormalities in Parkinson's Disease: a Systematic Review of Diffusion Tensor Imaging Studies. CEREBELLUM (LONDON, ENGLAND) 2022; 21:545-571. [PMID: 35001330 DOI: 10.1007/s12311-021-01355-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/01/2021] [Indexed: 06/14/2023]
Abstract
Diffusion tensor imaging (DTI) is now having a strong momentum in research to evaluate the neural fibers of the CNS. This technique can study white matter (WM) microstructure in neurodegenerative disorders, including Parkinson's disease (PD). Previous neuroimaging studies have suggested cerebellar involvement in the pathogenesis of PD, and these cerebellum alterations can correlate with PD symptoms and stages. Using the PRISMA 2020 framework, PubMed and EMBASE were searched to retrieve relevant articles. Our search revealed 472 articles. After screening titles and abstracts, and full-text review, and implementing the inclusion criteria, 68 papers were selected for synthesis. Reviewing the selected studies revealed that the patterns of reduction in cerebellum WM integrity, assessed by fractional anisotropy, mean diffusivity, radial diffusivity, and axial diffusivity measures can differ symptoms and stages of PD. Cerebellar diffusion tensor imaging (DTI) changes in PD patients with "postural instability and gait difficulty" are significantly different from "tremor dominant" PD patients. Freezing of the gate is strongly related to cerebellar involvement depicted by DTI. The "reduced cognition," "visual disturbances," "sleep disorders," "depression," and "olfactory dysfunction" are not related to cerebellum microstructural changes on DTI, while "impulsive-compulsive behavior" can be linked to cerebellar WM alteration. Finally, higher PD stages and longer disease duration are associated with cerebellum white matter alteration depicted by DTI. Depiction of cerebellar white matter involvement in PD is feasible by DTI. There is an association with disease duration and severity and several clinical presentations with DTI findings. This clinical-imaging association may eventually improve disease management.
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Affiliation(s)
- Maryam Haghshomar
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- NeuroImaging Network (NIN), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Parnian Shobeiri
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
- NeuroImaging Network (NIN), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, No. 10, Al-e-Ahmad and Chamran Highway intersection, Tehran, 1411713137, Iran.
| | | | | | - Amirhossein Poopak
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Houman Sotoudeh
- Department of Radiology and Neurology, University of Alabama at Birmingham (UAB), Birmingham, AL, USA
| | - Arash Kamali
- Department of Diagnostic and Interventional Radiology, University of Texas McGovern Medical School, Houston, TX, USA
| | - Mohammad Hadi Aarabi
- Department of Neuroscience (DNS), Padova Neuroscience Center-PNC, University of Padova, Padua, Italy
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16
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Morphological basis of Parkinson disease-associated cognitive impairment: an update. J Neural Transm (Vienna) 2022; 129:977-999. [PMID: 35726096 DOI: 10.1007/s00702-022-02522-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 05/25/2022] [Indexed: 12/15/2022]
Abstract
Cognitive impairment is one of the most salient non-motor symptoms of Parkinson disease (PD) that poses a significant burden on the patients and carers as well as being a risk factor for early mortality. People with PD show a wide spectrum of cognitive dysfunctions ranging from subjective cognitive decline and mild cognitive impairment (MCI) to frank dementia. The mean frequency of PD with MCI (PD-MCI) is 25.8% and the pooled dementia frequency is 26.3% increasing up to 83% 20 years after diagnosis. A better understanding of the underlying pathological processes will aid in directing disease-specific treatment. Modern neuroimaging studies revealed considerable changes in gray and white matter in PD patients with cognitive impairment, cortical atrophy, hypometabolism, dopamine/cholinergic or other neurotransmitter dysfunction and increased amyloid burden, but multiple mechanism are likely involved. Combined analysis of imaging and fluid markers is the most promising method for identifying PD-MCI and Parkinson disease dementia (PDD). Morphological substrates are a combination of Lewy- and Alzheimer-associated and other concomitant pathologies with aggregation of α-synuclein, amyloid, tau and other pathological proteins in cortical and subcortical regions causing destruction of essential neuronal networks. Significant pathological heterogeneity within PD-MCI reflects deficits in various cognitive domains. This review highlights the essential neuroimaging data and neuropathological changes in PD with cognitive impairment, the amount and topographical distribution of pathological protein aggregates and their pathophysiological relevance. Large-scale clinicopathological correlative studies are warranted to further elucidate the exact neuropathological correlates of cognitive impairment in PD and related synucleinopathies as a basis for early diagnosis and future disease-modifying therapies.
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17
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DeLuca V, Voits T. Bilingual experience affects white matter integrity across the lifespan. Neuropsychologia 2022; 169:108191. [DOI: 10.1016/j.neuropsychologia.2022.108191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 02/18/2022] [Accepted: 02/24/2022] [Indexed: 01/28/2023]
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18
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Kan H, Uchida Y, Ueki Y, Arai N, Tsubokura S, Kunitomo H, Kasai H, Aoyama K, Matsukawa N, Shibamoto Y. R2* relaxometry analysis for mapping of white matter alteration in Parkinson's disease with mild cognitive impairment. Neuroimage Clin 2022; 33:102938. [PMID: 34998126 PMCID: PMC8741619 DOI: 10.1016/j.nicl.2022.102938] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 12/22/2021] [Accepted: 01/03/2022] [Indexed: 12/01/2022]
Abstract
R2* relaxometry analysis combined with QSM revealed detail of WM alteration in PD-MCI. R2* relaxometry analysis can detect slight demyelination in PD-MCI. R2* value shows potential for early evaluation of cognitive decline in PD.
Background R2* relaxometry analysis combined with quantitative susceptibility mapping (QSM), which has high sensitivity to iron deposition, can distinguish microstructural changes of the white matter (WM) and iron deposition, thereby providing a sensitive and biologically specific measure of the WM owing to the changes in myelin and its surrounding environment. This study aimed to explore the microstructural WM alterations associated with cognitive impairment in patients with Parkinson’s disease (PD) using R2* relaxometry analysis combined with QSM. Materials and methods We enrolled 24 patients with PD and mild cognitive impairment (PD-MCI), 22 patients with PD and normal cognition (PD-CN), and 19 age- and sex-matched healthy controls (HC). All participants underwent Montreal Cognitive Assessment (MoCA) and brain magnetic resonance imaging, including structural three-dimensional T1-weighted images and multiple spoiled gradient echo sequence (mGRE). The R2* and susceptibility maps were estimated from the multiple magnitude images of mGRE. The susceptibility maps were used for verifying iron deposition in the WM. The voxel-based R2* of the entire WM and its correlation with cognitive performance were analyzed. Results In the voxel-based group comparisons, the R2* in the PD-MCI group was lower in some WM regions, including the corpus callosum, than R2* in the PD-CN and HC groups. The mean susceptibility values in almost all brain regions were negative and close-to-zero values, indicating no detectable paramagnetic iron deposition in the WM of all subjects. There was a significant positive correlation between R2* and MoCA in some regions of the WM, mainly the corpus callosum and left hemisphere. Conclusion R2* relaxometry analysis for WM microstructural changes provided further biologic insights on demyelination and changes in the surrounding environment, supported by the QSM results demonstrating no iron existence. This analysis highlighted the potential for the early evaluation of cognitive decline in patients with PD.
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Affiliation(s)
- Hirohito Kan
- Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Japan; Department of Radiology, Nagoya City University, Graduate School of Medical Sciences, Japan.
| | - Yuto Uchida
- Department of Neurology, Nagoya City University, Graduate School of Medical Sciences, Japan; Department of Neurology, Toyokawa City Hospital, Japan.
| | - Yoshino Ueki
- Department of Rehabilitation Medicine, Nagoya City University, Graduate School of Medical Sciences, Japan.
| | - Nobuyuki Arai
- Department of Radiology, Suzuka University of Medical Science, Japan.
| | | | - Hiroshi Kunitomo
- Department of Radiology, Nagoya City University Hospital, Japan.
| | - Harumasa Kasai
- Department of Radiology, Nagoya City University Hospital, Japan
| | - Kiminori Aoyama
- Department of Rehabilitation Medicine, Nagoya City University, Graduate School of Medical Sciences, Japan
| | - Noriyuki Matsukawa
- Department of Neurology, Nagoya City University, Graduate School of Medical Sciences, Japan.
| | - Yuta Shibamoto
- Department of Radiology, Nagoya City University, Graduate School of Medical Sciences, Japan.
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19
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Chung SJ, Kim YJ, Jung JH, Lee HS, Ye BS, Sohn YH, Jeong Y, Lee PH. Association Between White Matter Connectivity and Early Dementia in Patients With Parkinson Disease. Neurology 2022; 98:e1846-e1856. [PMID: 35190467 DOI: 10.1212/wnl.0000000000200152] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 01/18/2022] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Several clinical and neuroimaging biomarkers have been proposed to identify individuals with Parkinson's disease (PD) who are at risk for ongoing cognitive decline. This study aimed to explore whether white matter (WM) connectivity disruption is associated with dementia conversion in patients with newly diagnosed PD with mild cognitive impairment (PD-MCI). METHODS Seventy-five patients with drug-naïve PD-MCI who underwent serial cognitive assessments during the follow-up period (>5 years) were enrolled for the neuroimaging analyses. The patients were classified into either the PD with dementia (PDD) high-risk group (PDD-H, n = 38) or low-risk group (PDD-L, n = 37), depending on whether they converted to dementia within 5 years of PD diagnosis. We conducted degree-based statistic analyses based on a graph-theoretical concept to identify the subnetworks whose WM connectivity was disrupted in the PDD-H group compared with the PDD-L group. RESULTS The PDD-H group showed poorer cognitive performance on frontal/executive, visual memory/visuospatial, and attention/working memory/language function than the PDD-L group at baseline assessment. The PDD-H group exhibited more severely disrupted WM connectivity in both frontal and posterior cortical regions with eight hub nodes in the degree-based statistic analysis. The strength of structural connectivity within the identified subnetworks was correlated with the composite scores of frontal/executive function domain (γ = 0.393) and the risk score of PDD conversion within 5 years (γ = -0.480). CONCLUSIONS This study demonstrated that disrupted WM connectivity in frontal and posterior cortical regions, which correlated with frontal/executive dysfunction, is associated with early dementia conversion in PD-MCI.
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Affiliation(s)
- Seok Jong Chung
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea.,Department of Neurology, Yongin Severance Hospital, Yonsei University Health System, Yongin, South Korea
| | - Yae Ji Kim
- Program of Brain and Cognitive Engineering, Korea Advanced Institute of Science and Technology, Daejeon, South Korea.,KI for Health Science and Technology, Korea Advanced Institute of Science and Technology, Daejeon, South Korea
| | - Jin Ho Jung
- Department of Neurology, Inje University Busan Paik Hospital, Busan, South Korea.,Dementia and Neurodegenerative Disease Research Center, Inje University, Busan, South Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, South Korea
| | - Byoung Seok Ye
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Young H Sohn
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Yong Jeong
- Program of Brain and Cognitive Engineering, Korea Advanced Institute of Science and Technology, Daejeon, South Korea.,KI for Health Science and Technology, Korea Advanced Institute of Science and Technology, Daejeon, South Korea.,Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology, Daejeon, South Korea
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea; .,Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, South Korea
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20
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Hou Y, Shang H. Magnetic Resonance Imaging Markers for Cognitive Impairment in Parkinson’s Disease: Current View. Front Aging Neurosci 2022; 14:788846. [PMID: 35145396 PMCID: PMC8821910 DOI: 10.3389/fnagi.2022.788846] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 01/03/2022] [Indexed: 12/24/2022] Open
Abstract
Cognitive impairment (CI) ranging from mild cognitive impairment (MCI) to dementia is a common and disturbing complication in patients with Parkinson’s disease (PD). Numerous studies have focused on neuropathological mechanisms underlying CI in PD, along with the identification of specific biomarkers for CI. Magnetic resonance imaging (MRI), a promising method, has been adopted to examine the changes in the brain and identify the candidate biomarkers associated with CI. In this review, we have summarized the potential biomarkers for CI in PD which have been identified through multi-modal MRI studies. Structural MRI technology is widely used in biomarker research. Specific patterns of gray matter atrophy are promising predictors of the evolution of CI in patients with PD. Moreover, other MRI techniques, such as MRI related to small-vessel disease, neuromelanin-sensitive MRI, quantitative susceptibility mapping, MR diffusion imaging, MRI related to cerebrovascular abnormality, resting-state functional MRI, and proton magnetic resonance spectroscopy, can provide imaging features with a good degree of prediction for CI. In the future, novel combined biomarkers should be developed using the recognized analysis tools and predictive algorithms in both cross-sectional and longitudinal studies.
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21
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Coundouris SP, Henry JD, Lehn AC. Moving beyond emotions in Parkinson's disease. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2022; 61:647-665. [PMID: 35048398 DOI: 10.1111/bjc.12354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 12/09/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Emotion recognition is a fundamental neurocognitive capacity that is a critical predictor of interpersonal function and, in turn, mental health. Although people with Parkinson's disease (PD) often exhibit difficulties recognizing emotions, almost all studies to date have focused on basic emotions (happiness, sadness, anger, surprise, fear, and disgust), with little consideration of how more cognitively complex self-conscious emotions such as contempt, embarrassment, and pride might also be affected. Further, the few studies that have considered self-conscious emotions have relied on high intensity, static stimuli. The aim of the present study was to therefore provide the first examination of how self-conscious emotion recognition is affected by PD using a dynamic, dual-intensity measure that more closely captures how emotion recognition judgements are made in daily life. METHOD People with PD (n = 42) and neurotypical controls (n = 42) completed a validated measure of self-conscious facial emotion recognition. For comparative purposes, in addition to a broader clinical test battery, both groups also completed a traditional static emotion recognition measure and a measure of self-conscious emotional experience. RESULTS Relative to controls, the PD group did not differ in their capacity to recognize basic emotions but were impaired in their recognition of self-conscious emotions. These difficulties were associated with elevated negative affect and poorer subjective well-being. CONCLUSIONS Difficulties recognizing self-conscious emotions may be more problematic for people with PD than difficulties recognizing basic ones, with implications for interventions focused on helping people with this disorder develop and maintain strong social networks. PRACTITIONER POINTS This is the first direct investigation into how the recognition of self-conscious emotion is affected in Parkinson's disease using dynamic, dual-intensity stimuli, thus providing an important extension to prior literature that has focused solely on basic emotion recognition and/or relied on static, high-intensity stimuli. Results revealed preserved basic facial emotional recognition coexisting with impairment in all three self-conscious emotions assessed, therefore suggesting that the latter stimuli type may function as a more sensitive indicator of Parkinson's disease-related social cognitive impairment. Problems with self-conscious emotion recognition in people with Parkinson's disease were associated with poorer broader subjective well-being and increased negative affect. This aligns with the broader literature linking interpersonal difficulties with poorer clinical outcomes in this cohort.
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Affiliation(s)
- Sarah P Coundouris
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Julie D Henry
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Alexander C Lehn
- Department of Neurology, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.,The University of Queensland Princess Alexandra Hospital Clinical School, Woolloongabba, Queensland, Australia
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22
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Nyatega CO, Qiang L, Adamu MJ, Kawuwa HB. Gray matter, white matter and cerebrospinal fluid abnormalities in Parkinson's disease: A voxel-based morphometry study. Front Psychiatry 2022; 13:1027907. [PMID: 36325532 PMCID: PMC9618656 DOI: 10.3389/fpsyt.2022.1027907] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 09/26/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Parkinson's disease (PD) is a chronic neurodegenerative disorder characterized by bradykinesia, tremor, and rigidity among other symptoms. With a 70% cumulative prevalence of dementia in PD, cognitive impairment and neuropsychiatric symptoms are frequent. MATERIALS AND METHODS In this study, we looked at anatomical brain differences between groups of patients and controls. A total of 138 people with PD were compared to 64 age-matched healthy people using voxel-based morphometry (VBM). VBM is a fully automated technique that allows for the identification of regional differences in gray matter (GM), white matter (WM), and cerebrospinal fluid (CSF) allowing for an objective comparison of brains of different groups of people. We used statistical parametric mapping for image processing and statistical analysis. RESULTS In comparison to controls, PD patients had lower GM volumes in the left middle cingulate, left lingual gyrus, right calcarine and left fusiform gyrus, also PD patients indicated lower WM volumes in the right middle cingulate, left lingual gyrus, right calcarine, and left inferior occipital gyrus. Moreover, PD patients group demonstrated higher CSF in the left caudate compared to the controls. CONCLUSION Physical fragility and cognitive impairments in PD may be detected more easily if anatomical abnormalities to the cingulate gyrus, occipital lobe and the level of CSF in the caudate are identified. Thus, our findings shed light on the role of the brain in PD and may aid in a better understanding of the events that occur in PD patients.
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Affiliation(s)
- Charles Okanda Nyatega
- School of Electrical and Information Engineering, Tianjin University, Tianjin, China.,Department of Electronics and Telecommunication Engineering, Mbeya University of Science and Technology, Mbeya, Tanzania
| | - Li Qiang
- School of Microelectronics, Tianjin University, Tianjin, China
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Functional neuroanatomy of cognition in Parkinson's disease. PROGRESS IN BRAIN RESEARCH 2022; 269:289-307. [DOI: 10.1016/bs.pbr.2022.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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24
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Bian B, Couvy-Duchesne B, Wray NR, McRae AF. OUP accepted manuscript. Brain Commun 2022; 4:fcac078. [PMID: 35441133 PMCID: PMC9014537 DOI: 10.1093/braincomms/fcac078] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 12/08/2021] [Accepted: 03/28/2022] [Indexed: 11/13/2022] Open
Abstract
Genetic variants in the human leukocyte antigen and killer cell immunoglobulin-like receptor regions have been associated with many brain-related diseases, but how they shape brain structure and function remains unclear. To identify the genetic variants in HLA and KIR genes associated with human brain phenotypes, we performed a genetic association study of ∼30 000 European unrelated individuals using brain MRI phenotypes generated by the UK Biobank (UKB). We identified 15 HLA alleles in HLA class I and class II genes significantly associated with at least one brain MRI-based phenotypes (P < 5 × 10−8). These associations converged on several main haplotypes within the HLA. In particular, the human leukocyte antigen alleles within an ancestral haplotype 8.1 were associated with multiple MRI measures, including grey matter volume, cortical thickness (TH) and diffusion MRI (dMRI) metrics. These alleles have been strongly associated with schizophrenia. Additionally, associations were identified between HLA-DRB1*04∼DQA1*03:01∼DQB1*03:02 and isotropic volume fraction of diffusion MRI in multiple white matter tracts. This haplotype has been reported to be associated with Parkinson’s disease. These findings suggest shared genetic associations between brain MRI biomarkers and brain-related diseases. Additionally, we identified 169 associations between the complement component 4 (C4) gene and imaging phenotypes. We found that C4 gene copy number was associated with cortical TH and dMRI metrics. No KIR gene copy numbers were associated with image-derived phenotypes at genome-wide threshold. To address the multiple testing burden in the phenome-wide association study, we performed a multi-trait association analysis using trait-based association test that uses extended Simes procedure and identified MRI image-specific associations. This study contributes to insight into how critical immune genes affect brain-related traits as well as the development of neurological and neuropsychiatric disorders.
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Affiliation(s)
- Beilei Bian
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Baptiste Couvy-Duchesne
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD 4072, Australia
- Paris Brain Institute, CNRS, INRIA, Paris, France
| | - Naomi R. Wray
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD 4072, Australia
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
| | - Allan F. McRae
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD 4072, Australia
- Correspondence to: Allan F. McRae The University of Queensland Brisbane, QLD 4072, Australia E-mail:
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Hattori T, Reynolds R, Wiggs E, Horovitz SG, Lungu C, Chen G, Yasuda E, Hallett M. Neural correlates of working memory and compensation at different stages of cognitive impairment in Parkinson’s disease. NEUROIMAGE: CLINICAL 2022; 35:103100. [PMID: 35780660 PMCID: PMC9421432 DOI: 10.1016/j.nicl.2022.103100] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 05/09/2022] [Accepted: 06/23/2022] [Indexed: 11/22/2022] Open
Abstract
PD patients have two types of compensatory mechanisms for working memory (WM). First, hyperactivation for different WM load tasks depending on cognitive status. PD-CogNL has hyperactivation for moderate and heavy working memory load tasks. PD-MCI and PDD have hyperactivation for control and light working memory load tasks. Second, bilateral recruitment of WM-related areas improves WM performance.
Working memory (WM) impairment is one of the most frequent cognitive deficits in Parkinson's disease (PD). However, it is not known how neural activity is altered and compensatory responses eventually fail during progression. We aimed to elucidate neural correlates of WM and compensatory mechanisms in PD. Eighteen cognitively normal PD patients (PD-CogNL), 16 with PD with mild cognitive impairment (PD-MCI), 11 with PD with dementia (PDD), and 17 healthy controls (HCs) were evaluated. Subjects performed an n-back task. Functional MRI data were analyzed by event-related analysis for correct responses. Brain activations were evaluated by comparing them to fixation cross or 0-back task, and correlated with n-back task performance. When compared to fixation cross, PD-CogNL patients had more activation in WM areas than HCs for both the 2- and 3-back tasks. PD-MCI and PDD patients had more activation in WM areas than HCs for the 0- and 1-back task. 2-back task performance was correlated with brain activations (vs. 0-back task) in the bilateral dorsolateral prefrontal cortex and frontal eye field (FEF) and left rostral prefrontal cortex, caudate nucleus, inferior/superior parietal lobule (IPL/SPL), and anterior insular cortex as well as anterior cingulate cortex. 3-back task performance was correlated with brain activations (vs. 0-back task) in the left FEF, right caudate nucleus, and bilateral IPL/SPL. Additional activations on top of the 0-back task, rather than fixation cross, are the neural correlates of WM. Our results suggest PD patients have two types of compensatory mechanisms: (1) Hyperactivation for different WM load tasks depending on their cognitive status. PD-CogNL have hyperactivation for moderate and heavy working memory load tasks while maintaining normal working memory performance. In contrast, PD-MCI and PDD have hyperactivation for control task and light working memory load task, leaving less neural resources to further activate for more demanding tasks and resulting in impaired working memory performance. (2) Bilateral recruitment of WM-related areas, in particular the DLPFC, FEF, IPL/SPL and caudate nucleus, to improve WM performance.
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Martín-Bastida A, Delgado-Alvarado M, Navalpotro-Gómez I, Rodríguez-Oroz MC. Imaging Cognitive Impairment and Impulse Control Disorders in Parkinson's Disease. Front Neurol 2021; 12:733570. [PMID: 34803882 PMCID: PMC8602579 DOI: 10.3389/fneur.2021.733570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 09/28/2021] [Indexed: 12/04/2022] Open
Abstract
Dementia and mild forms of cognitive impairment as well as neuropsychiatric symptoms (i. e., impulse control disorders) are frequent and disabling non-motor symptoms of Parkinson's disease (PD). The identification of changes in neuroimaging studies for the early diagnosis and monitoring of the cognitive and neuropsychiatric symptoms associated with Parkinson's disease, as well as their pathophysiological understanding, are critical for the development of an optimal therapeutic approach. In the current literature review, we present an update on the latest structural and functional neuroimaging findings, including high magnetic field resonance and radionuclide imaging, assessing cognitive dysfunction and impulse control disorders in PD.
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Affiliation(s)
- Antonio Martín-Bastida
- Department of Neurology, Clínica Universidad de Navarra, Pamplona, Spain.,CIMA, Center of Applied Medical Research, Universidad de Navarra, Neurosciences Program, Pamplona, Spain
| | | | - Irene Navalpotro-Gómez
- Cognitive Impairment and Movement Disorders Unit, Neurology Department, Hospital del Mar, Barcelona, Spain.,Clinical and Biological Research in Neurodegenerative Diseases, Integrative Pharmacology and Systems Neurosciences Research Group, Neurosciences Research Program, Hospital del Mar Research Institute (IMIM), Barcelona, Spain.,Barcelonabeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain
| | - María Cruz Rodríguez-Oroz
- Department of Neurology, Clínica Universidad de Navarra, Pamplona, Spain.,CIMA, Center of Applied Medical Research, Universidad de Navarra, Neurosciences Program, Pamplona, Spain.,IdiSNA, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
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27
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Huang LC, Chen LG, Wu PA, Pang CY, Lin SZ, Tsai ST, Chen SY. Effect of deep brain stimulation on brain network and white matter integrity in Parkinson's disease. CNS Neurosci Ther 2021; 28:92-104. [PMID: 34643338 PMCID: PMC8673709 DOI: 10.1111/cns.13741] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 09/22/2021] [Accepted: 09/23/2021] [Indexed: 11/27/2022] Open
Abstract
Aims The effects of subthalamic nucleus (STN)‐deep brain stimulation (DBS) on brain topological metrics, functional connectivity (FC), and white matter integrity were studied in levodopa‐treated Parkinson’s disease (PD) patients before and after DBS. Methods Clinical assessment, resting‐state functional MRI (rs‐fMRI), and diffusion tensor imaging (DTI) were performed pre‐ and post‐DBS in 15 PD patients, using a within‐subject design. The rs‐fMRI identified brain network topological metric and FC changes using graph‐theory‐ and seed‐based methods. White matter integrity was determined by DTI and tract‐based spatial statistics. Results Unified Parkinson's Disease Rating Scale III (UPDRS‐ III) scores were significantly improved by 35.3% (p < 0.01) after DBS in PD patients, compared with pre‐DBS patients without medication. Post‐DBS PD patients showed a significant decrease in the graph‐theory‐based degree and cost in the middle temporal gyrus and temporo‐occipital part‐Right. Changes in FC were seen in four brain regions, and a decrease in white matter integrity was seen in the left anterior corona radiata. The topological metrics changes were correlated with Beck Depression Inventory II (BDI‐II) and the FC changes with UPDRS‐III scores. Conclusion STN‐DBS modulated graph‐theoretical metrics, FC, and white matter integrity. Brain connectivity changes observed with multi‐modal imaging were also associated with postoperative clinical improvement. These findings suggest that the effects of STN‐DBS are caused by brain network alterations.
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Affiliation(s)
- Li-Chuan Huang
- Department of Medical Imaging, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.,Department of Medical Imaging and Radiological Sciences, Tzu Chi University of Science and Technology, Hualien, Taiwan
| | - Li-Guo Chen
- Department of Medical Imaging, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Ping-An Wu
- Department of Medical Imaging, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Cheng-Yoong Pang
- Department of Medical Research, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.,Cardiovascular and Metabolomics Research Center, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Shinn-Zong Lin
- Department of Neurosurgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Sheng-Tzung Tsai
- Department of Neurosurgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Shin-Yuan Chen
- Department of Neurosurgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
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28
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立花 久. [Diagnosis and treatment of old-onset Parkinson's disease]. Nihon Ronen Igakkai Zasshi 2021; 58:341-352. [PMID: 34483156 DOI: 10.3143/geriatrics.58.341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Cascone AD, Langella S, Sklerov M, Dayan E. Frontoparietal network resilience is associated with protection against cognitive decline in Parkinson's disease. Commun Biol 2021; 4:1021. [PMID: 34471211 PMCID: PMC8410800 DOI: 10.1038/s42003-021-02478-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 07/22/2021] [Indexed: 02/07/2023] Open
Abstract
Though Parkinson's disease is primarily defined as a movement disorder, it is also characterized by a range of non-motor symptoms, including cognitive decline. The onset and progression of cognitive decline in individuals with Parkinson's disease is variable, and the neurobiological mechanisms that contribute to, or protect against, cognitive decline in Parkinson's disease are poorly understood. Using resting-state functional magnetic resonance imaging data collected from individuals with Parkinson's disease with and without cognitive decline, we examined the relationship between topological brain-network resilience and cognition in Parkinson's disease. By leveraging network attack analyses, we demonstrate that relative to individuals with Parkinson's disease experiencing cognitive decline, the frontoparietal network in cognitively stable individuals with Parkinson's disease is significantly more resilient to network perturbation. Our findings suggest that the topological robustness of the frontoparietal network is associated with the absence of cognitive decline in individuals with Parkinson's disease.
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Affiliation(s)
- Arianna D Cascone
- Neuroscience Curriculum, University of North at Chapel Hill, Chapel Hill, NC, United States
| | - Stephanie Langella
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Miriam Sklerov
- Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Eran Dayan
- Department of Radiology and Biomedical Research Imaging Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
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Milán-Tomás Á, Fernández-Matarrubia M, Rodríguez-Oroz MC. Lewy Body Dementias: A Coin with Two Sides? Behav Sci (Basel) 2021; 11:94. [PMID: 34206456 PMCID: PMC8301188 DOI: 10.3390/bs11070094] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/12/2021] [Accepted: 06/15/2021] [Indexed: 02/07/2023] Open
Abstract
Lewy body dementias (LBDs) consist of dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD), which are clinically similar syndromes that share neuropathological findings with widespread cortical Lewy body deposition, often with a variable degree of concomitant Alzheimer pathology. The objective of this article is to provide an overview of the neuropathological and clinical features, current diagnostic criteria, biomarkers, and management of LBD. Literature research was performed using the PubMed database, and the most pertinent articles were read and are discussed in this paper. The diagnostic criteria for DLB have recently been updated, with the addition of indicative and supportive biomarker information. The time interval of dementia onset relative to parkinsonism remains the major distinction between DLB and PDD, underpinning controversy about whether they are the same illness in a different spectrum of the disease or two separate neurodegenerative disorders. The treatment for LBD is only symptomatic, but the expected progression and prognosis differ between the two entities. Diagnosis in prodromal stages should be of the utmost importance, because implementing early treatment might change the course of the illness if disease-modifying therapies are developed in the future. Thus, the identification of novel biomarkers constitutes an area of active research, with a special focus on α-synuclein markers.
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Affiliation(s)
- Ángela Milán-Tomás
- Department of Neurology, Clínica Universidad de Navarra, 28027 Madrid, Spain;
| | - Marta Fernández-Matarrubia
- Department of Neurology, Clínica Universidad de Navarra, 31008 Pamplona, Spain;
- IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
| | - María Cruz Rodríguez-Oroz
- Department of Neurology, Clínica Universidad de Navarra, 28027 Madrid, Spain;
- Department of Neurology, Clínica Universidad de Navarra, 31008 Pamplona, Spain;
- IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
- CIMA, Center of Applied Medical Research, Universidad de Navarra, Neurosciences Program, 31008 Pamplona, Spain
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Inguanzo A, Segura B, Sala-Llonch R, Monte-Rubio G, Abos A, Campabadal A, Uribe C, Baggio HC, Marti MJ, Valldeoriola F, Compta Y, Bargallo N, Junque C. Impaired Structural Connectivity in Parkinson's Disease Patients with Mild Cognitive Impairment: A Study Based on Probabilistic Tractography. Brain Connect 2021; 11:380-392. [PMID: 33626962 PMCID: PMC8215419 DOI: 10.1089/brain.2020.0939] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Background: Probabilistic tractography, in combination with graph theory, has been used to reconstruct the structural whole-brain connectome. Threshold-free network-based statistics (TFNBS) is a useful technique to study structural connectivity in neurodegenerative disorders; however, there are no previous studies using TFNBS in Parkinson's disease (PD) with and without mild cognitive impairment (MCI). Materials and Methods: Sixty-two PD patients, 27 of whom classified as PD-MCI, and 51 healthy controls (HC) underwent diffusion-weighted 3T magnetic resonance imaging. Probabilistic tractography, using FMRIB Software Library (FSL), was used to compute the number of streamlines (NOS) between regions. NOS matrices were used to find group differences with TFNBS, and to calculate global and local measures of network integrity using graph theory. A binominal logistic regression was then used to assess the discrimination between PD with and without MCI using non-overlapping significant tracts. Tract-based spatial statistics were also performed with FSL to study changes in fractional anisotropy (FA) and mean diffusivity. Results: PD-MCI showed 37 white matter connections with reduced connectivity strength compared with HC, mainly involving temporal/occipital regions. These were able to differentiate PD-MCI from PD without MCI with an area under the curve of 83-85%. PD without MCI showed disrupted connectivity in 18 connections involving frontal/temporal regions. No significant differences were found in graph measures. Only PD-MCI showed reduced FA compared with HC. Discussion: TFNBS based on whole-brain probabilistic tractography can detect structural connectivity alterations in PD with and without MCI. Reduced structural connectivity in fronto-striatal and posterior cortico-cortical connections is associated with PD-MCI.
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Affiliation(s)
- Anna Inguanzo
- Institute of Neurosciences, University of Barcelona, Barcelona, Catalonia, Spain
- Medical Psychology Unit, Department of Medicine, University of Barcelona, Barcelona, Catalonia, Spain
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
| | - Barbara Segura
- Institute of Neurosciences, University of Barcelona, Barcelona, Catalonia, Spain
- Medical Psychology Unit, Department of Medicine, University of Barcelona, Barcelona, Catalonia, Spain
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED: CB06/05/0018-ISCIII), Barcelona, Catalonia, Spain
| | - Roser Sala-Llonch
- Institute of Neurosciences, University of Barcelona, Barcelona, Catalonia, Spain
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
- Department of Biomedicine, University of Barcelona, Barcelona, Catalonia, Spain
- Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Barcelona, Catalonia, Spain
| | - Gemma Monte-Rubio
- Institute of Neurosciences, University of Barcelona, Barcelona, Catalonia, Spain
- Medical Psychology Unit, Department of Medicine, University of Barcelona, Barcelona, Catalonia, Spain
| | - Alexandra Abos
- Institute of Neurosciences, University of Barcelona, Barcelona, Catalonia, Spain
- Medical Psychology Unit, Department of Medicine, University of Barcelona, Barcelona, Catalonia, Spain
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
| | - Anna Campabadal
- Institute of Neurosciences, University of Barcelona, Barcelona, Catalonia, Spain
- Medical Psychology Unit, Department of Medicine, University of Barcelona, Barcelona, Catalonia, Spain
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
| | - Carme Uribe
- Institute of Neurosciences, University of Barcelona, Barcelona, Catalonia, Spain
- Medical Psychology Unit, Department of Medicine, University of Barcelona, Barcelona, Catalonia, Spain
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
- Research Imaging Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), University of Toronto, Toronto, Canada
| | - Hugo Cesar Baggio
- Institute of Neurosciences, University of Barcelona, Barcelona, Catalonia, Spain
- Medical Psychology Unit, Department of Medicine, University of Barcelona, Barcelona, Catalonia, Spain
| | - Maria Jose Marti
- Institute of Neurosciences, University of Barcelona, Barcelona, Catalonia, Spain
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED: CB06/05/0018-ISCIII), Barcelona, Catalonia, Spain
- Movement Disorders Unit, Neurology Service, Institut de Neurociències, University of Barcelona, Hospital Clínic de Barcelona, Barcelona, Catalonia, Spain
| | - Francesc Valldeoriola
- Institute of Neurosciences, University of Barcelona, Barcelona, Catalonia, Spain
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED: CB06/05/0018-ISCIII), Barcelona, Catalonia, Spain
- Movement Disorders Unit, Neurology Service, Institut de Neurociències, University of Barcelona, Hospital Clínic de Barcelona, Barcelona, Catalonia, Spain
| | - Yaroslau Compta
- Institute of Neurosciences, University of Barcelona, Barcelona, Catalonia, Spain
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED: CB06/05/0018-ISCIII), Barcelona, Catalonia, Spain
- Movement Disorders Unit, Neurology Service, Institut de Neurociències, University of Barcelona, Hospital Clínic de Barcelona, Barcelona, Catalonia, Spain
| | - Nuria Bargallo
- Centre de Diagnostic per la Imatge, Hospital Clínic de Barcelona, Barcelona, Catalonia, Spain
- Magnetic Resonance Core Facility, Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
| | - Carme Junque
- Institute of Neurosciences, University of Barcelona, Barcelona, Catalonia, Spain
- Medical Psychology Unit, Department of Medicine, University of Barcelona, Barcelona, Catalonia, Spain
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED: CB06/05/0018-ISCIII), Barcelona, Catalonia, Spain
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Devignes Q, Viard R, Betrouni N, Carey G, Kuchcinski G, Defebvre L, Leentjens AFG, Lopes R, Dujardin K. Posterior Cortical Cognitive Deficits Are Associated With Structural Brain Alterations in Mild Cognitive Impairment in Parkinson's Disease. Front Aging Neurosci 2021; 13:668559. [PMID: 34054507 PMCID: PMC8155279 DOI: 10.3389/fnagi.2021.668559] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 03/22/2021] [Indexed: 12/16/2022] Open
Abstract
Context: Cognitive impairments are common in patients with Parkinson's disease (PD) and are heterogeneous in their presentation. The "dual syndrome hypothesis" suggests the existence of two distinct subtypes of mild cognitive impairment (MCI) in PD: a frontostriatal subtype with predominant attentional and/or executive deficits and a posterior cortical subtype with predominant visuospatial, memory, and/or language deficits. The latter subtype has been associated with a higher risk of developing dementia. Objective: The objective of this study was to identify structural modifications in cortical and subcortical regions associated with each PD-MCI subtype. Methods: One-hundred and fourteen non-demented PD patients underwent a comprehensive neuropsychological assessment as well as a 3T magnetic resonance imaging scan. Patients were categorized as having no cognitive impairment (n = 41) or as having a frontostriatal (n = 16), posterior cortical (n = 25), or a mixed (n = 32) MCI subtype. Cortical regions were analyzed using a surface-based Cortical thickness (CTh) method. In addition, the volumes, shapes, and textures of the caudate nuclei, hippocampi, and thalami were studied. Tractometric analyses were performed on associative and commissural white matter (WM) tracts. Results: There were no between-group differences in volumetric measurements and cortical thickness. Shape analyses revealed more abundant and more extensive deformations fields in the caudate nuclei, hippocampi, and thalami in patients with posterior cortical deficits compared to patients with no cognitive impairment. Decreased fractional anisotropy (FA) and increased mean diffusivity (MD) were also observed in the superior longitudinal fascicle, the inferior fronto-occipital fascicle, the striato-parietal tract, and the anterior and posterior commissural tracts. Texture analyses showed a significant difference in the right hippocampus of patients with a mixed MCI subtype. Conclusion: PD-MCI patients with posterior cortical deficits have more abundant and more extensive structural alterations independently of age, disease duration, and severity, which may explain why they have an increased risk of dementia.
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Affiliation(s)
- Quentin Devignes
- Lille Neuroscience and Cognition, Lille University, Inserm, Lille University Medical Centre, Lille, France
| | - Romain Viard
- US 41—UMS 2014—PLBS, Lille University, CNRS, Inserm, Lille University Medical Centre, Pasteur Institute, Lille, France
- Department of Neuroradiology, Lille University Medical Centre, Lille, France
| | - Nacim Betrouni
- Lille Neuroscience and Cognition, Lille University, Inserm, Lille University Medical Centre, Lille, France
| | - Guillaume Carey
- Lille Neuroscience and Cognition, Lille University, Inserm, Lille University Medical Centre, Lille, France
- Neurology and Movement Disorders Department, Lille University Medical Centre, Lille, France
| | - Gregory Kuchcinski
- Lille Neuroscience and Cognition, Lille University, Inserm, Lille University Medical Centre, Lille, France
- US 41—UMS 2014—PLBS, Lille University, CNRS, Inserm, Lille University Medical Centre, Pasteur Institute, Lille, France
- Department of Neuroradiology, Lille University Medical Centre, Lille, France
| | - Luc Defebvre
- Lille Neuroscience and Cognition, Lille University, Inserm, Lille University Medical Centre, Lille, France
- Neurology and Movement Disorders Department, Lille University Medical Centre, Lille, France
| | | | - Renaud Lopes
- Lille Neuroscience and Cognition, Lille University, Inserm, Lille University Medical Centre, Lille, France
- US 41—UMS 2014—PLBS, Lille University, CNRS, Inserm, Lille University Medical Centre, Pasteur Institute, Lille, France
- Department of Neuroradiology, Lille University Medical Centre, Lille, France
| | - Kathy Dujardin
- Lille Neuroscience and Cognition, Lille University, Inserm, Lille University Medical Centre, Lille, France
- Neurology and Movement Disorders Department, Lille University Medical Centre, Lille, France
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33
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Chung SJ, Jeon S, Yoo HS, Lee YH, Yun M, Lee SK, Lee PH, Sohn YH, Evans AC, Ye BS. Neural Correlates of Cognitive Performance in Alzheimer's Disease- and Lewy Bodies-Related Cognitive Impairment. J Alzheimers Dis 2021; 73:873-885. [PMID: 31868668 DOI: 10.3233/jad-190814] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Clinicopathological studies have demonstrated that the neuropsychological profiles and outcomes are different between two dementia subtypes, namely Alzheimer's disease (AD) and Lewy bodies-related disease. OBJECTIVE We investigated the neural correlates of cognitive dysfunction in patients with AD-related cognitive impairment (ADCI) and those with Lewy bodies-related cognitive impairment (LBCI). METHODS We enrolled 216 ADCI patients, 183 LBCI patients, and 30 controls. Cortical thickness and diffusion tensor imaging analyses were performed to correlate gray matter and white matter (WM) abnormalities to cognitive composite scores for memory, visuospatial, and attention/executive domains in the ADCI spectrum (ADCI patients and controls) and the LBCI spectrum (LBCI patients and controls) separately. RESULTS Memory dysfunction correlated with cortical thinning and increased mean diffusivity in the AD-prone regions, particularly the medial temporal region, in ADCI. Meanwhile, it only correlated with increased mean diffusivity in the WM adjacent to the anteromedial temporal, insula, and basal frontal cortices in LBCI. Visuospatial dysfunction correlated with cortical thinning in posterior brain regions in ADCI, while it correlated with decreased fractional anisotropy in the corpus callosum and widespread WM regions in LBCI. Attention/executive dysfunction correlated with cortical thinning and WM abnormalities in widespread brain regions in both disease spectra; however, ADCI had more prominent correlation with cortical thickness and LBCI did with fractional anisotropy values. CONCLUSIONS Our study demonstrated that ADCI and LBCI have different neural correlates with respect to cognitive dysfunction. Cortical thinning had greater effects on cognitive dysfunction in the ADCI, while WM disruption did in the LBCI.
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Affiliation(s)
- Seok Jong Chung
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Seun Jeon
- McGill Center for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Han Soo Yoo
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Yang Hyun Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Mijin Yun
- Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Seung-Koo Lee
- Department of Radiology, Yonsei University College of Medicine, Seoul, South Korea
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Young Ho Sohn
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Alan C Evans
- McGill Center for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Byoung Seok Ye
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
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34
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Meta-Analysis of Cognition in Parkinson's Disease Mild Cognitive Impairment and Dementia Progression. Neuropsychol Rev 2021; 32:149-160. [PMID: 33860906 DOI: 10.1007/s11065-021-09502-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 03/24/2021] [Indexed: 12/19/2022]
Abstract
Mild cognitive changes, including executive dysfunction, are seen in Parkinson's Disease (PD). Approximately 30% of individuals with PD develop Parkinson's disease dementia (PDD). Mild cognitive impairment (MCI) has been identified as a transitional state between normal cognition and dementia. Although PD-MCI and its cognitive correlates have been increasingly studied as a risk indicator for development of PDD, investigations into the PD-MCI construct have yielded heterogeneous findings. Thus, a typical PD-MCI cognitive profile remains undefined. The present meta-analysis examined published cross-sectional studies of PD-MCI and cognitively normal PD (PD-CN) groups to provide aggregated effect sizes of group test performance by cognitive domain. Subsequently, longitudinal studies examining PD-MCI to PDD progression were meta-analyzed. Ninety-two cross-sectional articles of PD-MCI vs. PD-CN were included; 5 longitudinal studies of PD-MCI conversion to PDD were included. Random effects meta-analytic models were constructed resulting in effect sizes (Hedges' g) for cognitive domains. Overall performance across all measures produced a large effect size (g = 0.83, 95% CI [0.79, 0.86], t2 = 0.18) in cross-sectional analyses, with cognitive screeners producing the largest effect (g = 1.09, 95% CI [1.00, 1.17], t2 = 0.19). Longitudinally, overall measures produced a moderate effect (g = 0.47, 95% CI [0.40, 0.53], t2 = 0.01), with measures of executive functioning exhibiting the largest effect (g = 0.70, 95% CI [0.51, 0.89], t2 = 0.01). Longitudinal effects were made more robust by low heterogeneity. This report provides the first comprehensive meta-analysis of PD-MCI cognitive outcomes and predictors in PD-MCI conversion to PDD. Limitations include heterogeneity of cross-sectional effect sizes and the potential impact of small-study effects. Areas for continued research include visuospatial skills and visual memory in PD-MCI and longitudinal examination of executive dysfunction in PD-MCI.
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35
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Oxtoby NP, Leyland LA, Aksman LM, Thomas GEC, Bunting EL, Wijeratne PA, Young AL, Zarkali A, Tan MMX, Bremner FD, Keane PA, Morris HR, Schrag AE, Alexander DC, Weil RS. Sequence of clinical and neurodegeneration events in Parkinson's disease progression. Brain 2021; 144:975-988. [PMID: 33543247 PMCID: PMC8041043 DOI: 10.1093/brain/awaa461] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 10/05/2020] [Accepted: 10/24/2020] [Indexed: 02/07/2023] Open
Abstract
Dementia is one of the most debilitating aspects of Parkinson's disease. There are no validated biomarkers that can track Parkinson's disease progression, nor accurately identify patients who will develop dementia and when. Understanding the sequence of observable changes in Parkinson's disease in people at elevated risk for developing dementia could provide an integrated biomarker for identifying and managing individuals who will develop Parkinson's dementia. We aimed to estimate the sequence of clinical and neurodegeneration events, and variability in this sequence, using data-driven statistical modelling in two separate Parkinson's cohorts, focusing on patients at elevated risk for dementia due to their age at symptom onset. We updated a novel version of an event-based model that has only recently been extended to cope naturally with clinical data, enabling its application in Parkinson's disease for the first time. The observational cohorts included healthy control subjects and patients with Parkinson's disease, of whom those diagnosed at age 65 or older were classified as having high risk of dementia. The model estimates that Parkinson's progression in patients at elevated risk for dementia starts with classic prodromal features of Parkinson's disease (olfaction, sleep), followed by early deficits in visual cognition and increased brain iron content, followed later by a less certain ordering of neurodegeneration in the substantia nigra and cortex, neuropsychological cognitive deficits, retinal thinning in dopamine layers, and further deficits in visual cognition. Importantly, we also characterize variation in the sequence. We found consistent, cross-validated results within cohorts, and agreement between cohorts on the subset of features available in both cohorts. Our sequencing results add powerful support to the increasing body of evidence suggesting that visual processing specifically is affected early in patients with Parkinson's disease at elevated risk of dementia. This opens a route to earlier and more precise detection, as well as a more detailed understanding of the pathological mechanisms underpinning Parkinson's dementia.
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Affiliation(s)
- Neil P Oxtoby
- Centre for Medical Image Computing, Department of Computer Science and Department of Medical Physics and Biomedical Engineering, UCL, London, UK
| | | | - Leon M Aksman
- Centre for Medical Image Computing, Department of Computer Science and Department of Medical Physics and Biomedical Engineering, UCL, London, UK
| | - George E C Thomas
- Dementia Research Centre, UCL Institute of Neurology, UCL, London, UK
| | - Emma L Bunting
- Dementia Research Centre, UCL Institute of Neurology, UCL, London, UK
| | - Peter A Wijeratne
- Centre for Medical Image Computing, Department of Computer Science and Department of Medical Physics and Biomedical Engineering, UCL, London, UK
| | - Alexandra L Young
- Centre for Medical Image Computing, Department of Computer Science and Department of Medical Physics and Biomedical Engineering, UCL, London, UK
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Angelika Zarkali
- Dementia Research Centre, UCL Institute of Neurology, UCL, London, UK
| | - Manuela M X Tan
- Department of Clinical and Movement Neuroscience, UCL Queen Square Institute of Neurology, UCL, London, UK
- Movement Disorders Consortium, UCL, London, UK
| | - Fion D Bremner
- Neuro-ophthalmology, National Hospital for Neurology and Neurosurgery, University College London Hospitals, London, UK
| | - Pearse A Keane
- Institute of Ophthalmology, UCL, London, UK
- Moorfields Eye Hospital, London, UK
| | - Huw R Morris
- Department of Clinical and Movement Neuroscience, UCL Queen Square Institute of Neurology, UCL, London, UK
- Movement Disorders Consortium, UCL, London, UK
| | - Anette E Schrag
- Department of Clinical and Movement Neuroscience, UCL Queen Square Institute of Neurology, UCL, London, UK
- Movement Disorders Consortium, UCL, London, UK
| | - Daniel C Alexander
- Centre for Medical Image Computing, Department of Computer Science and Department of Medical Physics and Biomedical Engineering, UCL, London, UK
| | - Rimona S Weil
- Dementia Research Centre, UCL Institute of Neurology, UCL, London, UK
- Movement Disorders Consortium, UCL, London, UK
- The Wellcome Centre for Human Neuroimaging, UCL Institute of Neurology, UCL, London, UK
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36
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Orad RI, Shiner T. Differentiating dementia with Lewy bodies from Alzheimer's disease and Parkinson's disease dementia: an update on imaging modalities. J Neurol 2021; 269:639-653. [PMID: 33511432 DOI: 10.1007/s00415-021-10402-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 01/07/2021] [Accepted: 01/08/2021] [Indexed: 12/16/2022]
Abstract
Dementia with Lewy bodies is the second most common cause of neurodegenerative dementia after Alzheimer's disease. Dementia with Lewy bodies can provide a diagnostic challenge due to the frequent overlap of clinical signs with other neurodegenerative conditions, namely Parkinson's disease dementia, and Alzheimer's disease. Part of this clinical overlap is due to the neuropathological overlap. Dementia with Lewy bodies is characterized by the accumulation of aggregated α-synuclein protein in Lewy bodies, similar to Parkinson's disease and Parkinson's disease dementia. However, it is also frequently accompanied by aggregation of amyloid-beta and tau, the pathological hallmarks of Alzheimer's disease. Neuroimaging is central to the diagnostic process. This review is an overview of both established and evolving imaging methods that can improve diagnostic accuracy and improve management of this disorder.
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Affiliation(s)
- Rotem Iris Orad
- Cognitive Neurology Unit, Neurological Institute, Tel Aviv Sourasky Medical Center, 6, Weismann St, Tel Aviv, Israel. .,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Tamara Shiner
- Cognitive Neurology Unit, Neurological Institute, Tel Aviv Sourasky Medical Center, 6, Weismann St, Tel Aviv, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.,Movement Disorders Unit, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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37
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Wei X, Luo C, Li Q, Hu N, Xiao Y, Liu N, Lui S, Gong Q. White Matter Abnormalities in Patients With Parkinson's Disease: A Meta-Analysis of Diffusion Tensor Imaging Using Tract-Based Spatial Statistics. Front Aging Neurosci 2021; 12:610962. [PMID: 33584244 PMCID: PMC7876070 DOI: 10.3389/fnagi.2020.610962] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 12/28/2020] [Indexed: 02/05/2023] Open
Abstract
Background: Tract-based spatial statistics (TBSS) studies based on diffusion tensor imaging (DTI) have revealed extensive abnormalities in white matter (WM) fibers of Parkinson's disease (PD); however, the results were inconsistent. Therefore, a meta-analytical approach was used in this study to find the most prominent and replicable WM abnormalities of PD. Methods: Online databases were systematically searched for all TBSS studies comparing fractional anisotropy (FA) between patients with PD and controls. Subsequently, we performed the meta-analysis using a coordinate-based meta-analytic software called seed-based d mapping. Meanwhile, meta-regression was performed to explore the potential correlation between the alteration of FA and the clinical characteristics of PD. Results: Out of a total of 1,701 studies that were identified, 23 studies were included. Thirty datasets, including 915 patients (543 men) with PD and 836 healthy controls (449 men), were included in the current study. FA reduction was identified in the body of the corpus callosum (CC; 245 voxels; z = -1.739; p < 0.001) and the left inferior fronto-occipital fasciculus (IFOF) 118 voxels; z = -1.182; p < 0.001). Both CC and IFOF maintained significance in the sensitivity analysis. No increase in FA was identified, but the percentage of male patients with PD was positively associated with the value of FA in the body of the CC. Conclusions: Although some limitations exist, DTI is regarded as a valid way to identify the pathophysiology of PD. It could be more beneficial to integrate DTI parameters with other MRI techniques to explore brain degeneration in PD.
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Affiliation(s)
- Xia Wei
- Department of Radiology, Functional and Molecular Imaging Key Laboratory of Sichuan Province, Huaxi MR Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China.,Psychoradiology Research Unit of the Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, China.,Department of Radiology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Chunyan Luo
- Department of Radiology, Functional and Molecular Imaging Key Laboratory of Sichuan Province, Huaxi MR Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China.,Psychoradiology Research Unit of the Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, China.,Department of Radiology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Qian Li
- Department of Radiology, Functional and Molecular Imaging Key Laboratory of Sichuan Province, Huaxi MR Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China.,Psychoradiology Research Unit of the Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, China.,Department of Radiology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Na Hu
- Department of Radiology, Functional and Molecular Imaging Key Laboratory of Sichuan Province, Huaxi MR Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China.,Psychoradiology Research Unit of the Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, China.,Department of Radiology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Yuan Xiao
- Department of Radiology, Functional and Molecular Imaging Key Laboratory of Sichuan Province, Huaxi MR Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China.,Psychoradiology Research Unit of the Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, China.,Department of Radiology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Nian Liu
- Department of Radiology, Functional and Molecular Imaging Key Laboratory of Sichuan Province, Huaxi MR Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China.,Psychoradiology Research Unit of the Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, China.,Department of Radiology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Su Lui
- Department of Radiology, Functional and Molecular Imaging Key Laboratory of Sichuan Province, Huaxi MR Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China.,Psychoradiology Research Unit of the Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, China.,Department of Radiology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Qiyong Gong
- Department of Radiology, Functional and Molecular Imaging Key Laboratory of Sichuan Province, Huaxi MR Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, China.,Psychoradiology Research Unit of the Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, China.,Department of Radiology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
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38
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Wilson H, de Natale ER, Politis M. Nucleus basalis of Meynert degeneration predicts cognitive impairment in Parkinson's disease. HANDBOOK OF CLINICAL NEUROLOGY 2021; 179:189-205. [DOI: 10.1016/b978-0-12-819975-6.00010-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
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39
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Inguanzo A, Sala-Llonch R, Segura B, Erostarbe H, Abos A, Campabadal A, Uribe C, Baggio H, Compta Y, Marti M, Valldeoriola F, Bargallo N, Junque C. Hierarchical cluster analysis of multimodal imaging data identifies brain atrophy and cognitive patterns in Parkinson’s disease. Parkinsonism Relat Disord 2021; 82:16-23. [DOI: 10.1016/j.parkreldis.2020.11.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 09/15/2020] [Accepted: 11/10/2020] [Indexed: 11/24/2022]
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40
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Chen X, Liu M, Wu Z, Cheng H. Topological Abnormalities of Functional Brain Network in Early-Stage Parkinson's Disease Patients With Mild Cognitive Impairment. Front Neurosci 2020; 14:616872. [PMID: 33424546 PMCID: PMC7793724 DOI: 10.3389/fnins.2020.616872] [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: 10/13/2020] [Accepted: 11/18/2020] [Indexed: 11/17/2022] Open
Abstract
Recent studies have demonstrated structural and functional alterations in Parkinson's disease (PD) with mild cognitive impairment (MCI). However, the topological patterns of functional brain networks in newly diagnosed PD patients with MCI are unclear so far. In this study, we used functional magnetic resonance imaging (fMRI) and graph theory approaches to explore the functional brain network in 45 PD patients with MCI (PD-MCI), 22 PD patients without MCI (PD-nMCI), and 18 healthy controls (HC). We found that the PD-MCI, PD-nMCI, and HC groups exhibited a small-world architecture in the functional brain network. However, early-stage PD-MCI patients had decreased clustering coefficient, increased characteristic path length, and changed nodal centrality in the default mode network (DMN), control network (CN), somatomotor network (SMN), and visual network (VN), which might contribute to factors for MCI symptoms in PD patients. Our results demonstrated that PD-MCI patients were associated with disrupted topological organization in the functional network, thus providing a topological network insight into the role of information exchange in the underlying development of MCI symptoms in PD patients.
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Affiliation(s)
- Xiangbin Chen
- Department of TCM Internal Medicine, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, China
| | - Mengting Liu
- School of Music, Jimei University, Xiamen, China
| | - Zhibing Wu
- Department of TCM Internal Medicine, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, China
| | - Hao Cheng
- Department of Ultrasonography, Shaanxi Cancer Hospital Affiliated to Xi’an Jiaotong University, Xi’an, China
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41
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Chandio BQ, Risacher SL, Pestilli F, Bullock D, Yeh FC, Koudoro S, Rokem A, Harezlak J, Garyfallidis E. Bundle analytics, a computational framework for investigating the shapes and profiles of brain pathways across populations. Sci Rep 2020; 10:17149. [PMID: 33051471 PMCID: PMC7555507 DOI: 10.1038/s41598-020-74054-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 09/22/2020] [Indexed: 11/08/2022] Open
Abstract
Tractography has created new horizons for researchers to study brain connectivity in vivo. However, tractography is an advanced and challenging method that has not been used so far for medical data analysis at a large scale in comparison to other traditional brain imaging methods. This work allows tractography to be used for large scale and high-quality medical analytics. BUndle ANalytics (BUAN) is a fast, robust, and flexible computational framework for real-world tractometric studies. BUAN combines tractography and anatomical information to analyze the challenging datasets and identifies significant group differences in specific locations of the white matter bundles. Additionally, BUAN takes the shape of the bundles into consideration for the analysis. BUAN compares the shapes of the bundles using a metric called bundle adjacency which calculates shape similarity between two given bundles. BUAN builds networks of bundle shape similarities that can be paramount for automating quality control. BUAN is freely available in DIPY. Results are presented using publicly available Parkinson's Progression Markers Initiative data.
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Affiliation(s)
- Bramsh Qamar Chandio
- Department of Intelligent Systems Engineering, Luddy School of Informatics, Computing and Engineering, Indiana University Bloomington, Bloomington, IN, USA.
| | | | - Franco Pestilli
- Department of Psychology, The University of Texas, Austin, TX, USA
| | - Daniel Bullock
- Department of Psychological and Brain Sciences, Indiana University Bloomington, Bloomington, IN, USA
| | - Fang-Cheng Yeh
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, USA
| | - Serge Koudoro
- Department of Intelligent Systems Engineering, Luddy School of Informatics, Computing and Engineering, Indiana University Bloomington, Bloomington, IN, USA
| | - Ariel Rokem
- Department of Psychology and eScience Institute, University of Washington, Washington, DC, USA
| | - Jaroslaw Harezlak
- School of Public Health, Indiana University Bloomington, Bloomington, IN, USA
| | - Eleftherios Garyfallidis
- Department of Intelligent Systems Engineering, Luddy School of Informatics, Computing and Engineering, Indiana University Bloomington, Bloomington, IN, USA
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42
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Zhang Y, Burock MA. Diffusion Tensor Imaging in Parkinson's Disease and Parkinsonian Syndrome: A Systematic Review. Front Neurol 2020; 11:531993. [PMID: 33101169 PMCID: PMC7546271 DOI: 10.3389/fneur.2020.531993] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 08/18/2020] [Indexed: 12/21/2022] Open
Abstract
Diffusion tensor imaging (DTI) allows measuring fractional anisotropy and similar microstructural indices of the brain white matter. Lower than normal fractional anisotropy as well as higher than normal diffusivity is associated with loss of microstructural integrity and neurodegeneration. Previous DTI studies in Parkinson's disease (PD) have demonstrated abnormal fractional anisotropy in multiple white matter regions, particularly in the dopaminergic nuclei and dopaminergic pathways. However, DTI is not considered a diagnostic marker for the earliest Parkinson's disease since anisotropic alterations present a temporally divergent pattern during the earliest Parkinson's course. This article reviews a majority of clinically employed DTI studies in PD, and it aims to prove the utilities of DTI as a marker of diagnosing PD, correlating clinical symptomatology, tracking disease progression, and treatment effects. To address the challenge of DTI being a diagnostic marker for early PD, this article also provides a comparison of the results from a longitudinal, early stage, multicenter clinical cohort of Parkinson's research with previous publications. This review provides evidences of DTI as a promising marker for monitoring PD progression and classifying atypical PD types, and it also interprets the possible pathophysiologic processes under the complex pattern of fractional anisotropic changes in the first few years of PD. Recent technical advantages, limitations, and further research strategies of clinical DTI in PD are additionally discussed.
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Affiliation(s)
- Yu Zhang
- Department of Psychiatry, War Related Illness and Injury Study Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, United States
| | - Marc A Burock
- Department of Psychiatry, Mainline Health, Bryn Mawr Hospital, Bryn Mawr, PA, United States
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43
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Jia X, Pan Z, Chen H, Wang Z, Li K, Wang X, Wang Z, Ma H, Feng T, Yang Q. Differential functional dysconnectivity of caudate nucleus subdivisions in Parkinson's disease. Aging (Albany NY) 2020; 12:16183-16194. [PMID: 32687066 PMCID: PMC7485745 DOI: 10.18632/aging.103628] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 06/18/2020] [Indexed: 04/21/2023]
Abstract
Caudate dopaminergic dysfunction is implied in the pathophysiology of patients with Parkinson's disease (PD). Still, connectivity specificities of the caudate nucleus (CN) subdivisions and the effect of dopamine are poorly understood. We collected MRI and neuropsychological data from 34 PD patients and 26 age- and sex-matched healthy elderly individuals (HEs) in this study. Resting-state functional connectivity analysis revealed that compared to the other CN subdivisions, the CN head was more strongly connected to the default mode network (DMN), the CN body to the frontoparietal network (FPN), and the CN tail to the visual network in HEs. PD patients off medication showed reduced connectivity within all these subdivision networks. In PD patients on medication, functional connectivity in the CN head network was significantly improved in the medial prefrontal cortex and in the body network it was improved in the dorsolateral prefrontal cortex. These improvements contributed to ameliorated motivation and cognitive function in PD patients. Our results highlighted the specific alterations and dopamine modulation in these CN subdivision networks in PD, which may provide insight into the pathophysiology and therapeutics of this disease.
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Affiliation(s)
- Xiuqin Jia
- Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
- Equal contribution
| | - Zhenyu Pan
- Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
- Equal contribution
| | - Huimin Chen
- Department of Movement Disorders, Center for Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Parkinson's Disease Center, Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China
- Equal contribution
| | - Zhijiang Wang
- Peking University Sixth Hospital (Institute of Mental Health), Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), Beijing, China
- National Clinical Research Centerfor Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Kun Li
- Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Xuemei Wang
- Department of Movement Disorders, Center for Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Parkinson's Disease Center, Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China
| | - Zhan Wang
- Department of Movement Disorders, Center for Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Parkinson's Disease Center, Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China
| | - Huizi Ma
- Department of Movement Disorders, Center for Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Parkinson's Disease Center, Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China
| | - Tao Feng
- Department of Movement Disorders, Center for Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
- Parkinson's Disease Center, Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China
| | - Qi Yang
- Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
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44
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Beyond Alzheimer's disease: Can bilingualism be a more generalized protective factor in neurodegeneration? Neuropsychologia 2020; 147:107593. [PMID: 32882240 DOI: 10.1016/j.neuropsychologia.2020.107593] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 07/10/2020] [Accepted: 08/26/2020] [Indexed: 01/18/2023]
Abstract
Bilingualism has been argued to have an impact on cognition and brain structure. Effects have been reported across the lifespan: from healthy children to ageing adults, including clinical (ageing) populations. It has been argued that active bilingualism may significantly contribute to the delaying of the expression of Alzheimer's disease symptoms. If bilingualism plays an ameliorative role against the expression of neurodegeneration in dementia, it is possible that it could have similar effects for other neurodegenerative disorders, including Multiple Sclerosis, Parkinson's and Huntington's Diseases. To date, however, direct relevant evidence remains limited, not least because the necessary scientific motivations for investigating this with greater depth have not yet been fully articulated. Herein, we provide a roadmap that reviews the relevant literatures, highlighting potential links across neurodegenerative disorders and bilingualism more generally.
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Li Y, Guo T, Guan X, Gao T, Sheng W, Zhou C, Wu J, Xuan M, Gu Q, Zhang M, Yang Y, Huang P. Fixel-based analysis reveals fiber-specific alterations during the progression of Parkinson's disease. Neuroimage Clin 2020; 27:102355. [PMID: 32736325 PMCID: PMC7394754 DOI: 10.1016/j.nicl.2020.102355] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 06/12/2020] [Accepted: 07/16/2020] [Indexed: 12/13/2022]
Abstract
Disruption of brain circuits is one of the core mechanisms of Parkinson's disease (PD). Understanding structural connection alterations in PD is important for effective treatment. However, due to methodological limitations, most studies were unable to account for confounding factors such as crossing fibers and were unable to identify damages to specific fiber tracts. In the present study, we aimed to demonstrate tract-specific white matter structural changes in PD patients and their relationship with clinical symptoms. Ninety-eight PD patients, divided into early (ES) and middle stage (MS) groups, and 76 healthy controls (HCs) underwent brain magnetic resonance imaging scans and clinical assessments. Fixel-based analysis was used to investigate fiber tract alterations in PD patients. Compared to HCs, the PD patients showed decreased fiber density (FD) in the corpus callosum (CC), increased FD in the cortical spinal tract (CST), and increased fiber-bundle cross-section (FC, log-transformed: log-FC) in the superior cerebellar peduncle (SCP). Analysis of variance (ANOVA) revealed significant differences in FD in the CST and log-FC in the SCP among the three groups. Post-hoc analysis revealed that the mean FD values of the CST were higher in ES and MS patient groups compared to HCs, and the mean log-FC values of the SCP were higher in ES and MS patient groups compared to HCs. Additionally, the FD values of the CC in PD patients were negatively correlated with the Unified Parkinson's Disease Rating Scale part-III (UPDRS-III) scores (r = -0.257, p = 0.032), Hamilton Depression Rating Scale 17 Items (HAMD-17) scores (r = -0.230, p = 0.033), and Hamilton Anxiety Scale (HAMA) scores (r = -0.248, p = 0.032). Moreover, log-FC values of the SCP (r = 0.274, p = 0.028) and FD values of the CST (r = 0.384, p < 0.001) were positively correlated with the UPDRS-III scores. We concluded that PD patients had both decreased and increased white matter integrity within specific fiber bundles. Additionally, these white matter alterations were different across disease stages, suggesting the occurrence of complex pathological and compensatory changes during the development of PD.
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Affiliation(s)
- Yanxuan Li
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, 325000 Wenzhou, China
| | - Tao Guo
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310000 Hangzhou, China
| | - Xiaojun Guan
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310000 Hangzhou, China
| | - Ting Gao
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310000 Hangzhou, China
| | - Wenshuang Sheng
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, 325000 Wenzhou, China
| | - Cheng Zhou
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310000 Hangzhou, China
| | - Jingjing Wu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310000 Hangzhou, China
| | - Min Xuan
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310000 Hangzhou, China
| | - Quanquan Gu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310000 Hangzhou, China
| | - Minming Zhang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310000 Hangzhou, China
| | - Yunjun Yang
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, 325000 Wenzhou, China.
| | - Peiyu Huang
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, 325000 Wenzhou, China; Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310000 Hangzhou, China.
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Aftanas LI, Brack IV, Kulikova KI, Filimonova EA, Dzemidovich SS, Piradov MA, Suponeva NA, Poidasheva AG. [Clinical and neurophysiological effects of dual-target high-frequency rTMS over the primary motor and prefrontal cortex in Parkinson's disease]. Zh Nevrol Psikhiatr Im S S Korsakova 2020; 120:29-36. [PMID: 32621465 DOI: 10.17116/jnevro202012005129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To evaluate therapeutic effects of navigational dual-target high-frequency rTMS over the primary motor (M1, bilateral) and the left dorsolateral prefrontal cortex (DLPFC) on clinical dynamics of Parkinson's disease (PD) symptoms in a parallel placebo-controlled study. MATERIAL AND METHODS The study included 46 patients randomized into equal therapeutic and placebo rTMS groups. Navigational therapeutic and placebo10 Hz rTMS was applied over the M1 and DLPFC areas (20 daily sessions, for 3 weeks). Assessment of the dynamics of clinical symptoms was performed using the MDS UPDRS scale (Parts I-IV) before the first session, immediately after 20 sessions, and 4-6 weeks after the rTMS course. Non-motor and mental symptoms were assessed using the Hamilton Depression Rating Scale (HDRS-17), Beck depression inventory (BDI-II), Depression, Anxiety and Stress (DASS-21) scales and the Mini Mental State Examination (MMSE). RESULTS Significant therapeutic effects of rTMS compared to placebo were established: a greater decrease in overall score on the MDS-UPDRS scale (parts I-IV), a decrease in the severity of non-motor (part I) and motor symptoms (part III, with a large therapeutic effect for the symptoms of rigidity, bradykinesia and postural instability), as well as the severity of motor complications of dopamine replacement therapy (part IV). The effects of rTMS on motor symptoms persisted 4 weeks after the end of the stimulation course. It is also important to note significant positive dynamics in both rTMS and placebo groups in the form of comparable reduction in the severity of everyday motor symptoms (MDS-UPDRS part II), improvement of the total scores on MMSE, HDRS, BDI-II, DASS-21. CONCLUSIONS The dual-target high-frequency rTMS over the primary motor cortex (bilateral) and the left dorsolateral prefrontal cortex has positive therapeutic effects on the motor and affective symptoms of Parkinson's disease, which are significantly stronger than that of the placebo stimulation.
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Affiliation(s)
- L I Aftanas
- Research Institute of Physiology and Fundamental Medicine, Novosibirsk, Russia.,Novosibirsk State University, Department of Neurosciences, Novosibirsk, Russia
| | - I V Brack
- Research Institute of Physiology and Fundamental Medicine, Novosibirsk, Russia
| | - K I Kulikova
- Research Institute of Physiology and Fundamental Medicine, Novosibirsk, Russia
| | - E A Filimonova
- Research Institute of Physiology and Fundamental Medicine, Novosibirsk, Russia
| | - S S Dzemidovich
- Research Institute of Physiology and Fundamental Medicine, Novosibirsk, Russia
| | - M A Piradov
- Research Center of Neurology, Moscow, Russia
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The cerebral blood flow deficits in Parkinson's disease with mild cognitive impairment using arterial spin labeling MRI. J Neural Transm (Vienna) 2020; 127:1285-1294. [PMID: 32632889 DOI: 10.1007/s00702-020-02227-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 06/30/2020] [Indexed: 12/19/2022]
Abstract
Parkinson's disease (PD) with mild cognitive impairment (PD-MCI) is currently diagnosed based on an arbitrarily predefined standard deviation of neuropsychological test scores, and more objective biomarkers for PD-MCI diagnosis are needed. The purpose of this study was to define possible brain perfusion-based biomarkers of not only mild cognitive impairment, but also risky gene carriers in PD using arterial spin labeling magnetic resonance imaging (ASL-MRI). Fifteen healthy controls (HC), 26 cognitively normal PD (PD-CN), and 27 PD-MCI subjects participated in this study. ASL-MRI data were acquired by signal targeting with alternating radio-frequency labeling with Look-Locker sequence at 3 T. Single nucleotide polymorphism genotyping for rs9468 [microtubule-associated protein tau (MAPT) H1/H1 versus H1/H2 haplotype] was performed using a Stratagene Mx3005p real-time polymerase chain-reaction system (Agilent Technologies, USA). There were 15 subjects with MAPT H1/H1 and 11 subjects with MAPT H1/H2 within PD-MCI, and 33 subjects with MAPT H1/H1 and 19 subjects with MAPT H1/H2 within all PD. Voxel-wise differences of cerebral blood flow (CBF) values between HC, PD-CN and PD-MCI were assessed by one-way analysis of variance followed by pairwise post hoc comparisons. Further, the subgroup of PD patients carrying the risky MAPT H1/H1 haplotype was compared with noncarriers (MAPT H1/H2 haplotype) in terms of CBF by a two-sample t test. A pattern that could be summarized as "posterior hypoperfusion" (PH) differentiated the PD-MCI group from the HC group with an accuracy of 92.6% (sensitivity = 93%, specificity = 93%). Additionally, the PD patients with MAPT H1/H1 haplotype had decreased perfusion than the ones with H1/H2 haplotype at the posterior areas of the visual network (VN), default mode network (DMN), and dorsal attention network (DAN). The PH-type pattern in ASL-MRI could be employed as a biomarker of both current cognitive impairment and future cognitive decline in PD.
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Di Tella S, Baglio F, Pelizzari L, Cabinio M, Nemni R, Traficante D, Silveri MC. Uncinate fasciculus and word selection processing in Parkinson's disease. Neuropsychologia 2020; 146:107504. [PMID: 32485199 DOI: 10.1016/j.neuropsychologia.2020.107504] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 05/25/2020] [Accepted: 05/26/2020] [Indexed: 01/13/2023]
Abstract
We explored with Diffusion Tensor Imaging (DTI) technique whether the ability to select words among competitive alternatives during word production is related to the integrity of the left uncinate fasciculus (UF) in Parkinson's disease (PD). Nineteen PD patients (10 right-sided and 9 left-sided) and 17 matched healthy controls (HC) took part in the study. Participants were asked to derive nouns from verbs (reading from to read) or to generate verbs from nouns (to build from building). Noun and verb production, in this task, differ in the number of lexical entries among which the response is selected, as the noun must be selected from a larger number of alternatives compared to the verb, and thus is more demanding of processing resources. DTI evaluation was obtained for each subject. Fractional anisotropy (FA) and mean diffusivity (MD) maps were derived from DTI and median FA and MD values were computed within the left and right UF. Then, FA and MD of the left and right UF were correlated with noun and verb production. Both the left and right UF-FA correlated with the global (noun + verb) production and noun production in the whole PD group. In right-sided PD, correlations were found with the contralateral UF-FA; in left-sided PD the correlations emerged with both the left and right UF-FA. The most difficult task, noun production, significantly correlated with the right UF-FA in left-sided PD. The left UF is involved in word selection processes, and the right UF intervenes when the selection is particularly demanding of attentional resources.
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Affiliation(s)
- Sonia Di Tella
- IRCCS Fondazione Don Carlo Gnocchi, Via A. Capecelatro, 66, 20148, Milan, Italy.
| | - Francesca Baglio
- IRCCS Fondazione Don Carlo Gnocchi, Via A. Capecelatro, 66, 20148, Milan, Italy
| | - Laura Pelizzari
- IRCCS Fondazione Don Carlo Gnocchi, Via A. Capecelatro, 66, 20148, Milan, Italy
| | - Monia Cabinio
- IRCCS Fondazione Don Carlo Gnocchi, Via A. Capecelatro, 66, 20148, Milan, Italy
| | - Raffaello Nemni
- IRCCS Fondazione Don Carlo Gnocchi, Via A. Capecelatro, 66, 20148, Milan, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Via F. Sforza 35, 20122, Milan, Italy
| | - Daniela Traficante
- Department of Psychology, Catholic University, Largo A. Gemelli, 1, 20123, Milan, Italy
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Altered white matter microarchitecture in Parkinson's disease: a voxel-based meta-analysis of diffusion tensor imaging studies. Front Med 2020; 15:125-138. [PMID: 32458190 DOI: 10.1007/s11684-019-0725-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Accepted: 10/12/2019] [Indexed: 02/05/2023]
Abstract
This study aimed to define the most consistent white matter microarchitecture pattern in Parkinson's disease (PD) reflected by fractional anisotropy (FA), addressing clinical profiles and methodology-related heterogeneity. Web-based publication databases were searched to conduct a meta-analysis of whole-brain diffusion tensor imaging studies comparing PD with healthy controls (HC) using the anisotropic effect size-signed differential mapping. A total of 808 patients with PD and 760 HC coming from 27 databases were finally included. Subgroup analyses were conducted considering heterogeneity with respect to medication status, disease stage, analysis methods, and the number of diffusion directions in acquisition. Compared with HC, patients with PD had decreased FA in the left middle cerebellar peduncle, corpus callosum (CC), left inferior fronto-occipital fasciculus, and right inferior longitudinal fasciculus. Most of the main results remained unchanged in subgroup meta-analyses of medicated patients, early stage patients, voxel-based analysis, and acquisition with 30 diffusion directions. The subgroup meta-analysis of medication-free patients showed FA decrease in the right olfactory cortex. The cerebellum and CC, associated with typical motor impairment, showed the most consistent FA decreases in PD. Medication status, analysis approaches, and the number of diffusion directions have an important impact on the findings, needing careful evaluation in future meta-analyses.
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Andica C, Kamagata K, Hatano T, Saito Y, Uchida W, Ogawa T, Takeshige-Amano H, Hagiwara A, Murata S, Oyama G, Shimo Y, Umemura A, Akashi T, Wada A, Kumamaru KK, Hori M, Hattori N, Aoki S. Neurocognitive and psychiatric disorders-related axonal degeneration in Parkinson's disease. J Neurosci Res 2020; 98:936-949. [PMID: 32026517 PMCID: PMC7154645 DOI: 10.1002/jnr.24584] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 12/05/2019] [Accepted: 01/06/2020] [Indexed: 11/30/2022]
Abstract
Neurocognitive and psychiatric disorders have significant consequences for quality of life in patients with Parkinson's disease (PD). In the current study, we evaluated microstructural white matter (WM) alterations associated with neurocognitive and psychiatric disorders in PD using neurite orientation dispersion and density imaging (NODDI) and linked independent component analysis (LICA). The indices of NODDI were compared between 20 and 19 patients with PD with and without neurocognitive and psychiatric disorders, respectively, and 25 healthy controls using tract‐based spatial statistics and tract‐of‐interest analyses. LICA was applied to model inter‐subject variability across measures. A widespread reduction in axonal density (indexed by intracellular volume fraction [ICVF]) was demonstrated in PD patients with and without neurocognitive and psychiatric disorders, as compared with healthy controls. Compared with patients without neurocognitive and psychiatric disorders, patients with neurocognitive and psychiatric disorders exhibited more extensive (posterior predominant) decreases in axonal density. Using LICA, ICVF demonstrated the highest contribution (59% weight) to the main effects of diagnosis that reflected widespread decreases in axonal density. These findings suggest that axonal loss is a major factor underlying WM pathology related to neurocognitive and psychiatric disorders in PD, whereas patients with neurocognitive and psychiatric disorders had broader axonal pathology, as compared with those without. LICA suggested that the ICVF can be used as a useful biomarker of microstructural changes in the WM related to neurocognitive and psychiatric disorders in PD.
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Affiliation(s)
- Christina Andica
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Koji Kamagata
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Taku Hatano
- Department of Neurology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yuya Saito
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Radiological Sciences, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
| | - Wataru Uchida
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Radiological Sciences, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
| | - Takashi Ogawa
- Department of Neurology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | | | - Akifumi Hagiwara
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Syo Murata
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Genko Oyama
- Department of Neurology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yashushi Shimo
- Department of Neurology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Atsushi Umemura
- Department of Neurosurgery, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Toshiaki Akashi
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Akihiko Wada
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kanako K Kumamaru
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Masaaki Hori
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Radiology, Toho University Omori Medical Center, Tokyo, Japan
| | - Nobutaka Hattori
- Department of Neurology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shigeki Aoki
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
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