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Gcwensa NZ, Russell DL, Long KY, Brzozowski CF, Liu X, Gamble KL, Cowell RM, Volpicelli-Daley LA. Cortico-amygdala synaptic structural abnormalities produced by templated aggregation of α-synuclein. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.05.15.594419. [PMID: 38798467 PMCID: PMC11118572 DOI: 10.1101/2024.05.15.594419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
Parkinson's disease (PD) and Dementia with Lewy bodies (DLB) are characterized by neuronal α-synuclein (α-syn) inclusions termed Lewy Pathology, which are abundant in the amygdala. The basolateral amygdala (BLA), in particular, receives projections from the thalamus and cortex. These projections play a role in cognition and emotional processing, behaviors which are impaired in α-synucleinopathies. To understand if and how pathologic α-syn impacts the BLA requires animal models of α-syn aggregation. Injection of α-synuclein pre-formed fibrils (PFFs) into the striatum induces robust α-synuclein aggregation in excitatory neurons in the BLA that corresponds with reduced contextual fear conditioning. At early time points after aggregate formation, cortico-amygdala excitatory transmission is abolished. The goal of this project was to determine if α-syn inclusions in the BLA induce synaptic degeneration and/or morphological changes. In this study, we used C57BL/6J mice injected bilaterally with PFFs in the dorsal striatum to induce α-syn aggregate formation in the BLA. A method was developed using immunofluorescence and three-dimensional reconstruction to analyze excitatory cortico-amygdala and thalamo-amygdala presynaptic terminals closely juxtaposed to postsynaptic densities. The abundance and morphology of synapses were analyzed at 6- or 12-weeks post-injection of PFFs. α-Syn aggregate formation in the BLA did not cause a significant loss of synapses, but cortico-amygdala and thalamo-amygdala presynaptic terminals and postsynaptic densities with aggregates of α-synuclein show increased volumes, similar to previous findings in human DLB cortex, and in non-human primate models of PD. Transmission electron microscopy showed that PFF-injected mice showed reduced intervesicular distances similar to a recent study showing phospho-serine-129 α-synuclein increases synaptic vesicle clustering. Thus, pathologic α-synuclein causes major alterations to synaptic architecture in the BLA, potentially contributing to behavioral impairment and amygdala dysfunction observed in synucleinopathies.
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van Wegen EEH, van Balkom TD, Hirsch MA, Rutten S, van den Heuvel OA. Non-Pharmacological Interventions for Depression and Anxiety in Parkinson's Disease. JOURNAL OF PARKINSON'S DISEASE 2024:JPD230228. [PMID: 38607762 DOI: 10.3233/jpd-230228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/14/2024]
Affiliation(s)
- Erwin E H van Wegen
- Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Ageing & Vitality, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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| | - Tim D van Balkom
- Department of Anatomy & Neurosciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Compulsivity, Impulsivity & Attention, Neurodegeneration, Amsterdam, The Netherlands
| | - Mark A Hirsch
- Carolinas Medical Center, Atrium Health Carolinas Rehabilitation, Department of Physical Medicine and Rehabilitation, Charlotte, NC, USA
- Wake Forest School of Medicine, Department of Orthopedic Surgery and Rehabilitation, Winston-Salem, NC, USA
| | - Sonja Rutten
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Compulsivity, Impulsivity & Attention, Neurodegeneration, Amsterdam, The Netherlands
| | - Odile A van den Heuvel
- Department of Anatomy & Neurosciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Compulsivity, Impulsivity & Attention, Neurodegeneration, Amsterdam, The Netherlands
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Laurencin C, Lancelot S, Brosse S, Mérida I, Redouté J, Greusard E, Lamberet L, Liotier V, Le Bars D, Costes N, Thobois S, Boulinguez P, Ballanger B. Noradrenergic alterations in Parkinson's disease: a combined 11C-yohimbine PET/neuromelanin MRI study. Brain 2024; 147:1377-1388. [PMID: 37787503 PMCID: PMC10994534 DOI: 10.1093/brain/awad338] [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: 06/27/2023] [Revised: 09/05/2023] [Accepted: 09/19/2023] [Indexed: 10/04/2023] Open
Abstract
Degeneration of the noradrenergic system is now considered a pathological hallmark of Parkinson's disease, but little is known about its consequences in terms of parkinsonian manifestations. Here, we evaluated two aspects of the noradrenergic system using multimodal in vivo imaging in patients with Parkinson's disease and healthy controls: the pigmented cell bodies of the locus coeruleus with neuromelanin sensitive MRI; and the density of α2-adrenergic receptors (ARs) with PET using 11C-yohimbine. Thirty patients with Parkinson's disease and 30 age- and sex-matched healthy control subjects were included. The characteristics of the patients' symptoms were assessed using the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS). Patients showed reduced neuromelanin signal intensity in the locus coeruleus compared with controls and diminished 11C-yohimbine binding in widespread cortical regions, including the motor cortex, as well as in the insula, thalamus and putamen. Clinically, locus coeruleus neuronal loss was correlated with motor (bradykinesia, motor fluctuations, tremor) and non-motor (fatigue, apathy, constipation) symptoms. A reduction of α2-AR availability in the thalamus was associated with tremor, while a reduction in the putamen, the insula and the superior temporal gyrus was associated with anxiety. These results highlight a multifaceted alteration of the noradrenergic system in Parkinson's disease since locus coeruleus and α2-AR degeneration were found to be partly uncoupled. These findings raise important issues about noradrenergic dysfunction that may encourage the search for new drugs targeting this system, including α2-ARs, for the treatment of Parkinson's disease.
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Affiliation(s)
- Chloé Laurencin
- Lyon Neuroscience Research Center (CRNL), INSERM U1028, CNRS UMR5292, University Lyon 1, F-69000 Lyon, France
- Department of Neurology C, Expert Parkinson Centre, Hospices Civils de Lyon, Pierre Wertheimer Neurological Hospital, NS-Park/F-CRIN, 69500 Bron, France
| | - Sophie Lancelot
- Lyon Neuroscience Research Center (CRNL), INSERM U1028, CNRS UMR5292, University Lyon 1, F-69000 Lyon, France
- CERMEP-Imagerie du Vivant, PET-MRI Department, 69500 Bron, France
| | - Sarah Brosse
- Lyon Neuroscience Research Center (CRNL), INSERM U1028, CNRS UMR5292, University Lyon 1, F-69000 Lyon, France
| | - Inés Mérida
- CERMEP-Imagerie du Vivant, PET-MRI Department, 69500 Bron, France
| | - Jérôme Redouté
- CERMEP-Imagerie du Vivant, PET-MRI Department, 69500 Bron, France
| | - Elise Greusard
- CERMEP-Imagerie du Vivant, PET-MRI Department, 69500 Bron, France
| | - Ludovic Lamberet
- CERMEP-Imagerie du Vivant, PET-MRI Department, 69500 Bron, France
| | | | - Didier Le Bars
- CERMEP-Imagerie du Vivant, PET-MRI Department, 69500 Bron, France
| | - Nicolas Costes
- CERMEP-Imagerie du Vivant, PET-MRI Department, 69500 Bron, France
| | - Stéphane Thobois
- Department of Neurology C, Expert Parkinson Centre, Hospices Civils de Lyon, Pierre Wertheimer Neurological Hospital, NS-Park/F-CRIN, 69500 Bron, France
- Institut des Sciences Cognitives Marc Jeannerod, UMR 5229, CNRS, 69500 Bron, France
| | - Philippe Boulinguez
- Lyon Neuroscience Research Center (CRNL), INSERM U1028, CNRS UMR5292, University Lyon 1, F-69000 Lyon, France
| | - Bénédicte Ballanger
- Lyon Neuroscience Research Center (CRNL), INSERM U1028, CNRS UMR5292, University Lyon 1, F-69000 Lyon, France
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Liu X, Fan J, Leong II, Lu W, Zhang Y, Gong M, Zhuang L. Efficacy of acupuncture (Jin's three-needle) on motor symptoms and anxiety in patients with Parkinson's disease: protocol for a multicentre, randomised, assessor-blinded clinical trial. BMJ Open 2024; 14:e081312. [PMID: 38548359 PMCID: PMC10982807 DOI: 10.1136/bmjopen-2023-081312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 02/26/2024] [Indexed: 04/02/2024] Open
Abstract
INTRODUCTION Parkinson's disease (PD) has a significant impact on a substantial number of individuals in China. Notably, 31% of patients with PD also grapple with the additional burden of anxiety. This dual challenge of managing both PD and anxiety underscores the complexity of the condition and the diverse range of symptoms patients may experience. Considering the circumstances, the cost and potential drawbacks associated with traditional antiparkinsonian drugs become increasingly relevant. Acupuncture emerges as a significant non-pharmacological adjunct therapy. Offering a potentially safer and more cost-effective option, acupuncture addresses the pressing need for holistic and complementary treatments that may alleviate both the motor symptoms of PD and the accompanying anxiety. METHODS AND ANALYSIS This is a multicentre, randomised controlled and assessor-blind trial. A total of 210 eligible patients with PD will be randomly assigned (1:1) to Jin's three-needle (JTN) acupuncture group or waitlist (WL) group. Patients in the JTN group will receive acupuncture therapy three times per week for 4 weeks. Patients in the WL group will maintain their original dosage of antiparkinsonian drugs and receive acupuncture therapy after the observation period. The primary outcome measure will be the Unified Parkinson's Disease Rating Scale score. The secondary outcome measures will be the scores of the Hoehn-Yahr Rating Scale, Unified Dyskinesia Rating Scale, Non-Motor Symptoms Scale, 39-item Parkinson's Disease Questionnaire, Parkinson Anxiety Scale, Hamilton Anxiety Scale, Hamilton Depression Scale, Zarit burden interview and the level of cortisol and adrenocorticotropic hormone. The evaluation will be executed at baseline, the end of the treatment and a follow-up period. ETHICS AND DISSEMINATION The study was approved by the Ethics Committee of the First Affiliated Hospital of Guangzhou University of Chinese Medicine (K[2023]014). All patients have to provide written, informed consent. The study will be disseminated through presentations in peer-reviewed international journals and at national and international conferences. TRIAL REGISTRATION NUMBER Chinese Clinical Trial Registry; ChiCTR2300074675.
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Affiliation(s)
- Xin Liu
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jingqi Fan
- Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Ian I Leong
- Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Weijing Lu
- Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Yifan Zhang
- Lingnan Institute of Acupuncture and Rehabilitation, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Mengjiao Gong
- Lingnan Institute of Acupuncture and Rehabilitation, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Lixing Zhuang
- Lingnan Institute of Acupuncture and Rehabilitation, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
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Shan Y, Sun G, Ji J, Li Z, Chen X, Zhang X, Ma Y, Zhang Y, Zhang T, Zhang Y. Brain function abnormalities and neuroinflammation in people living with HIV-associated anxiety disorders. Front Psychiatry 2024; 15:1336233. [PMID: 38563030 PMCID: PMC10984160 DOI: 10.3389/fpsyt.2024.1336233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 03/05/2024] [Indexed: 04/04/2024] Open
Abstract
Background People living with HIV (PLWH) exhibits an increased susceptibility to anxiety disorders, concomitant with heightened vulnerability to aberrant immune activation and inflammatory responses, and endocrine dysfunction. There exists a dearth of scholarly investigations pertaining to the neurological, immune, and endocrine dimensions of HIV-associated anxiety disorders. Method This study aimed to compare a group of 16 individuals diagnosed with HIV-associated anxiety disorders (HIV ANXs) according to the Diagnostic and statistical manual of mental disorders (5th ed.), with a HIV individual control group (HIV control) of 49 PLWH without mental disorders. Muti-modal magnetic resonance was employed to assess the brain function and structure of both groups. Seed-based functional connectivity (FC) was used to assess the regional intrinsic brain activity and the influence of regional disturbances on FC with other brain regions. Peripheral blood cytokines and chemokines concentrations were measured using liquid chip and ELISA. Results Amplitude of low-frequency fluctuations in the right inferior temporal gyrus (ITG) was increased. There is a significant decreased regional homogeneity in HIV ANXs in the right superior occipital gyrus (SOG). The right ITG and the right SOG were separately set as the seed brain region of interest (ROI 1 and ROI 2) to be analyzed the FC. FC decreased in HIV ANXs between ROI1 and the right middle occipital gyrus, the right SOG, FC between ROI2 and left ITG increased in HIV ANXs. No significant structural difference was found between two groups. Pro-inflammatory chemokines showed higher levels in the HIV ANXs. Pro-inflammatory cytokines, neurotrophic factors, and endocrine factors were significantly correlated with alterations in brain function. Conclusion This study suggests that patients with HIV-associated anxiety disorders may exhibit abnormalities in neurologic, immune, and endocrine functioning. Consequently, it is imperative to implement additional screening and intervention measures for anxiety disorders among PLWH.
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Affiliation(s)
- Yunzhu Shan
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Guangqiang Sun
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Jiahao Ji
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Zhen Li
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of HIV/AIDS Research, Beijing, China
| | - Xue Chen
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Xin Zhang
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Yundong Ma
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yang Zhang
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Sexually Transmitted Disease Prevention and Control, Beijing, China
| | - Tong Zhang
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Sexually Transmitted Disease Prevention and Control, Beijing, China
| | - Yulin Zhang
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
- Department of Respiratory and Critical Care Medicine, Beijing Youan Hospital, Capital Medical University, Beijing, China
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Costa V, Prati JM, de Oliveira Barreto Suassuna A, Souza Silva Brito T, Frigo da Rocha T, Gianlorenço AC. Physical Exercise for Treating the Anxiety and Depression Symptoms of Parkinson's Disease: Systematic Review and Meta-Analysis. J Geriatr Psychiatry Neurol 2024:8919887241237223. [PMID: 38445606 DOI: 10.1177/08919887241237223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
BACKGROUND Depression and anxiety are non-motor symptoms of Parkinson's disease (PD). Physical exercise is a promising approach to reducing neuropsychological burden. We aimed to comprehensively synthesize evidence regarding the use of exercise for treating depression and anxiety symptoms in PD. METHODS Systematic review and meta-analysis following PRISMA recommendations. Searches on PubMed, Cochrane Library, Scopus, Web of Science, Embase, and Physiotherapy Evidence Database (PEDro) was conducted. The random-effects model was employed for all analyses with the standardized mean difference as the effect estimate. RESULTS Fifty records were retrieved, but only 17 studies met the criteria for the meta-analyses. A moderate to large effect was observed for depression (-.71 [95% CI = -.96 to -.46], 11 studies, 728 individuals), and a small to moderate effect for anxiety (-.39 [95% CI = -.65 to -.14], 6 studies, 241 individuals), when comparing exercise to non-exercise controls. Subgroup analysis revealed significant effects from aerobic (-.95 [95% CI = -1.60, -.31]), mind-body (-1.85 [95% CI = -2.63, -1.07]), and resistance modalities (-1.61 [95% CI = -2.40, -.83]) for depression, and from mind-body (-.67 [95% CI = -1.19 to -.15]) and resistance exercises (-1.00 [95% CI = -1.70 to -.30]) for anxiety. CONCLUSION Physical exercise has a relevant clinical impact on depression and anxiety in PD. We discuss the level of the evidence, the methodological limitations of the studies, and give recommendations.
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Affiliation(s)
- Valton Costa
- Neurosciences Laboratory, Physical Therapy Graduate Program, Federal University of Sao Carlos, Sao Carlos, Brazil
| | - José Mario Prati
- Neurosciences Laboratory, Physical Therapy Graduate Program, Federal University of Sao Carlos, Sao Carlos, Brazil
| | - Alice de Oliveira Barreto Suassuna
- Centre for Innovation and Technology Assessment in Health, Postgraduate Program in Electrical and Biomedical Engineering, Federal University of Uberlandia, Uberlandia, Brazil
| | - Thanielle Souza Silva Brito
- Neurosciences Laboratory, Physical Therapy Graduate Program, Federal University of Sao Carlos, Sao Carlos, Brazil
| | - Thalita Frigo da Rocha
- Neurosciences Laboratory, Physical Therapy Graduate Program, Federal University of Sao Carlos, Sao Carlos, Brazil
| | - Anna Carolyna Gianlorenço
- Neurosciences Laboratory, Physical Therapy Graduate Program, Federal University of Sao Carlos, Sao Carlos, Brazil
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Samanci B, Tan S, Michielse S, Kuijf ML, Temel Y. The habenula in Parkinson's disease: Anatomy, function, and implications for mood disorders - A narrative review. J Chem Neuroanat 2024; 136:102392. [PMID: 38237746 DOI: 10.1016/j.jchemneu.2024.102392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/07/2024] [Accepted: 01/12/2024] [Indexed: 01/31/2024]
Abstract
Parkinson's disease (PD), a widespread neurodegenerative disorder, often coexists with mood disorders. Degeneration of serotonergic neurons in brainstem raphe nuclei have been linked to depression and anxiety. Additionally, the locus coeruleus and its noradrenergic neurons are among the first areas to degenerate in PD and contribute to stress, emotional memory, motor, sensory, and autonomic symptoms. Another brain region of interest is habenula, which is especially related to anti-reward processing, and its function has recently been linked to PD and to mood-related symptoms. There are several neuroimaging studies that investigated role of the habenula in mood disorders. Differences in habenular size and hemispheric symmetry were found in healthy controls compared to individuals with mood disorders. The lateral habenula, as a link between the dopaminergic and serotonergic systems, is thought to contribute to depressive symptoms in PD. However, there is only one imaging study about role of habenula in mood disorders in PD, although the relationship between PD and mood disorders is known. There is little known about habenula pathology in PD but given these observations, the question arises whether habenular dysfunction could play a role in PD and the development of PD-related mood disorders. In this review, we evaluate neuroimaging techniques and studies that investigated the habenula in the context of PD and mood disorders. Future studies are important to understand habenula's role in PD patients with mood disorders. Thus, new potential diagnostic and treatment opportunities would be found for mood disorders in PD.
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Affiliation(s)
- Bedia Samanci
- School for Mental Health and Neurosciences, Maastricht University, Maastricht, the Netherlands; Behavioral Neurology and Movement Disorders Unit, Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
| | - Sonny Tan
- School for Mental Health and Neurosciences, Maastricht University, Maastricht, the Netherlands; Department of Neurosurgery, Antwerp University Hospital, Edegem, Belgium
| | - Stijn Michielse
- School for Mental Health and Neurosciences, Maastricht University, Maastricht, the Netherlands
| | - Mark L Kuijf
- School for Mental Health and Neurosciences, Maastricht University, Maastricht, the Netherlands; Department of Neurology, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Yasin Temel
- School for Mental Health and Neurosciences, Maastricht University, Maastricht, the Netherlands; Department of Neurosurgery, Maastricht University Medical Centre, Maastricht, the Netherlands
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Al‐kuraishy HM, Al‐Gareeb AI, Albuhadily AK, Elewa YHA, AL‐Farga A, Aqlan F, Zahran MH, Batiha GE. Sleep disorders cause Parkinson's disease or the reverse is true: Good GABA good night. CNS Neurosci Ther 2024; 30:e14521. [PMID: 38491789 PMCID: PMC10943276 DOI: 10.1111/cns.14521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 10/03/2023] [Accepted: 10/23/2023] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Parkinson's disease (PD) is a progressive neurodegenerative brain disease due to degeneration of dopaminergic neurons (DNs) presented with motor and non-motor symptoms. PD symptoms are developed in response to the disturbance of diverse neurotransmitters including γ-aminobutyric acid (GABA). GABA has a neuroprotective effect against PD neuropathology by protecting DNs in the substantia nigra pars compacta (SNpc). It has been shown that the degeneration of GABAergic neurons is linked with the degeneration of DNs and the progression of motor and non-motor PD symptoms. GABA neurotransmission is a necessary pathway for normal sleep patterns, thus deregulation of GABAergic neurotransmission in PD could be the potential cause of sleep disorders in PD. AIM Sleep disorders affect GABA neurotransmission leading to memory and cognitive dysfunction in PD. For example, insomnia and short sleep duration are associated with a reduction of brain GABA levels. Moreover, PD-related disorders including rigidity and nocturia influence sleep patterns leading to fragmented sleep which may also affect PD neuropathology. However, the mechanistic role of GABA in PD neuropathology regarding motor and non-motor symptoms is not fully elucidated. Therefore, this narrative review aims to clarify the mechanistic role of GABA in PD neuropathology mainly in sleep disorders, and how good GABA improves PD. In addition, this review of published articles tries to elucidate how sleep disorders such as insomnia and REM sleep behavior disorder (RBD) affect PD neuropathology and severity. The present review has many limitations including the paucity of prospective studies and most findings are taken from observational and preclinical studies. GABA involvement in the pathogenesis of PD has been recently discussed by recent studies. Therefore, future prospective studies regarding the use of GABA agonists in the management of PD are suggested to observe their distinct effects on motor and non-motor symptoms. CONCLUSION There is a bidirectional relationship between the pathogenesis of PD and sleep disorders which might be due to GABA deregulation.
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Affiliation(s)
- Hayder M. Al‐kuraishy
- Department of Clinical Pharmacology and Medicine, College of MedicineAl‐Mustansiriya UniversityBaghdadIraq
| | - Ali I. Al‐Gareeb
- Department of Clinical Pharmacology and Medicine, College of MedicineAl‐Mustansiriya UniversityBaghdadIraq
| | - Ali K. Albuhadily
- Department of Clinical Pharmacology and Medicine, College of MedicineAl‐Mustansiriya UniversityBaghdadIraq
| | - Yaser Hosny Ali Elewa
- Department of Histology and Cytology, Faculty of Veterinary MedicineZagazig UniversityZagazigEgypt
- Faculty of Veterinary MedicineHokkaido UniversitySapporoJapan
| | - Ammar AL‐Farga
- Biochemistry Department, College of SciencesUniversity of JeddahJeddahSaudia Arbia
| | - Faisal Aqlan
- Department of Chemistry, College of SciencesIbb UniversityIbb GovernorateYemen
| | | | - Gaber El‐Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary MedicineDamanhur UniversityDamanhurEgypt
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Hinkle JT, Mills KA, Morrow CB, Pontone GM. Anxiety Change After Dopamine Therapy in Parkinson Disease is Independent of Motor Improvement. Am J Geriatr Psychiatry 2024; 32:220-229. [PMID: 37867011 PMCID: PMC10846408 DOI: 10.1016/j.jagp.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 08/30/2023] [Accepted: 09/01/2023] [Indexed: 10/24/2023]
Abstract
BACKGROUND Several anxiety syndromes have been associated with Parkinson disease (PD), but their interactions with dopamine replacement therapy (DRT) and motor function dynamics are not completely understood. We sought to delineate how DRT impacts anxiety phenomenology in PD and whether these changes are dissociable from improved motoric function. METHODS We compared anxiety responses to DRT in two cohorts: 1) a study of 200 PD participants who completed neuropsychiatric assessments before and after taking their dopaminergic medications ("On-Off"); 2) participants in the Parkinson's Progression Markers Initiative (PPMI) de novo PD cohort who completed the State-Trait Anxiety Inventory (STAI) at the time of DRT initiation and a subsequent study visit (n = 113, mean 8-month interval). RESULTS Among On-Off participants transitioning acutely to the On-state, scores on the Hamilton anxiety rating scale decreased by 37% (t = 14.8, df = 199, p <0.0001). Among PPMI participants, STAI-state scores decreased by 10.4% following DRT initiation (t = 4.5, df = 112, p <0.0001). Item-level anxiety changes exhibited weak and nonsignificant correlations (Spearman ρ: -0.24 to 0.33) with objective MDS-UPDRS motor improvements in both immediate and sustained dopamine replacement contexts. CONCLUSION Dopamine repletion effected immediate relief of anxiety in an On-Off state comparison. A similar benefit was observed in the longitudinal PPMI cohort by comparing anxiety before and after DRT initiation, suggesting DRT confers sustained anxiolytic effects in early PD. The weak correlations between improvements to anxiety and motor function on both timescales support the view that these changes are not mediated by improved motor function.
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Affiliation(s)
- Jared T Hinkle
- Medical Scientist Training Program (JTH), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Psychiatry and Behavioral Sciences (JTH, CBM), Johns Hopkins University School of Medicine, Baltimore, MD.
| | - Kelly A Mills
- Department of Neurology (KAM, GMP), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Christopher B Morrow
- Department of Psychiatry and Behavioral Sciences (JTH, CBM), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Gregory M Pontone
- Department of Psychiatry and Behavioral Sciences (JTH, CBM), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Neurology (KAM, GMP), Johns Hopkins University School of Medicine, Baltimore, MD
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Yassine S, Almarouk S, Gschwandtner U, Auffret M, Fuhr P, Verin M, Hassan M. Electrophysiological signatures of anxiety in Parkinson's disease. Transl Psychiatry 2024; 14:66. [PMID: 38280864 PMCID: PMC10821912 DOI: 10.1038/s41398-024-02745-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 12/19/2023] [Accepted: 01/08/2024] [Indexed: 01/29/2024] Open
Abstract
Anxiety is a common non-motor symptom in Parkinson's disease (PD) occurring in up to 31% of the patients and affecting their quality of life. Despite the high prevalence, anxiety symptoms in PD are often underdiagnosed and, therefore, undertreated. To date, functional and structural neuroimaging studies have contributed to our understanding of the motor and cognitive symptomatology of PD. Yet, the underlying pathophysiology of anxiety symptoms in PD remains largely unknown and studies on their neural correlates are missing. Here, we used resting-state electroencephalography (RS-EEG) of 68 non-demented PD patients with or without clinically-defined anxiety and 25 healthy controls (HC) to assess spectral and functional connectivity fingerprints characterizing the PD-related anxiety. When comparing the brain activity of the PD anxious group (PD-A, N = 18) to both PD non-anxious (PD-NA, N = 50) and HC groups (N = 25) at baseline, our results showed increased fronto-parietal delta power and decreased frontal beta power depicting the PD-A group. Results also revealed hyper-connectivity networks predominating in delta, theta and gamma bands against prominent hypo-connectivity networks in alpha and beta bands as network signatures of anxiety in PD where the frontal, temporal, limbic and insular lobes exhibited the majority of significant connections. Moreover, the revealed EEG-based electrophysiological signatures were strongly associated with the clinical scores of anxiety and followed their progression trend over the course of the disease. We believe that the identification of the electrophysiological correlates of anxiety in PD using EEG is conducive toward more accurate prognosis and can ultimately support personalized psychiatric follow-up and the development of new therapeutic strategies.
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Affiliation(s)
- Sahar Yassine
- MRC Brain Dynamic Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom.
- University of Rennes, LTSI - U1099, F-35000, Rennes, France.
- Behavior & Basal Ganglia, CIC1414, CIC-IT, CHU Rennes, Rennes, France.
| | - Sourour Almarouk
- University of Rennes, LTSI - U1099, F-35000, Rennes, France
- Behavior & Basal Ganglia, CIC1414, CIC-IT, CHU Rennes, Rennes, France
- Neuroscience Research Centre, Lebanese University, Faculty of Medicine, Beirut, Lebanon
| | - Ute Gschwandtner
- Dept. of Neurology, Hospitals of the University of Basel, Basel, Switzerland
| | - Manon Auffret
- University of Rennes, LTSI - U1099, F-35000, Rennes, France
- Behavior & Basal Ganglia, CIC1414, CIC-IT, CHU Rennes, Rennes, France
- Institut des Neurosciences Cliniques de Rennes (INCR), Rennes, France
- France Développement Electronique, Monswiller, France
| | - Peter Fuhr
- Dept. of Neurology, Hospitals of the University of Basel, Basel, Switzerland
| | - Marc Verin
- University of Rennes, LTSI - U1099, F-35000, Rennes, France
- Behavior & Basal Ganglia, CIC1414, CIC-IT, CHU Rennes, Rennes, France
- Institut des Neurosciences Cliniques de Rennes (INCR), Rennes, France
- Movement Disorders Unit, Neurology Department, Pontchaillou University Hospital, Rennes, France
| | - Mahmoud Hassan
- Behavior & Basal Ganglia, CIC1414, CIC-IT, CHU Rennes, Rennes, France
- School of Science and Engineering, Reykjavik University, Reykjavik, Iceland
- MINDIG, F-35000, Rennes, France
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11
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Sang S, Ba Y, Yang N. Longitudinal faster anxiety progression of GBA variant carriers in the early Parkinson's disease cohort. Front Neurosci 2024; 18:1353759. [PMID: 38327847 PMCID: PMC10847242 DOI: 10.3389/fnins.2024.1353759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 01/02/2024] [Indexed: 02/09/2024] Open
Abstract
Objective Anxiety symptoms are prevalent neuropsychiatric manifestations in Parkinson's disease (PD) and impact the development of motor complications. Our aim was to evaluate the association of GBA variants with the anxiety development in early PD cohort. Methods This cohort study used data from the Parkinson Progression Marker Initiative. The primary outcome anxiety was assessed by State-Trait Anxiety Inventory (STAI). The association between GBA and longitudinal change in the STAI total score was examined using linear mixed-effects model, and the association between GBA and anxiety progression was examined using Cox survival analysis. Results A total of 385 patients with PD were included in this study, 39 of them were GBA variant carriers and 346 were idiopathic PD without GBA variants. Patients with GBA variants had faster annual increase in anxiety score (β = 0.44; 95% CI, 0.18 to 0.71; p < 0.001) and were at higher risk of anxiety progression (HR 1.87; 95% CI, 1.03 to 3.41; p = 0.03,). Higher baseline scores for Scales for Outcomes in Parkinson's Disease-Autonomic (SCOPA-AUT), which indicated the autonomic dysfunction, also independently predicted faster increase in anxiety score (β = 0.48; 95%CI, 0.19 to 0.69; p < 0.001) and higher incidence of anxiety development (HR = 1.05; 95% CI, 1.01 to 1.08; p = 0.008). Interpretation These findings suggest that longitudinal anxiety symptoms worsening was faster in PD patients who were GBA variant carriers and have dysautonomia, and this association was enhanced if they have both.
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Affiliation(s)
- Shushan Sang
- Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yunpeng Ba
- Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Nannan Yang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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12
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Hong J, Xie H, Chen Y, Liu D, Wang T, Xiong K, Mao Z. Effects of STN-DBS on cognition and mood in young-onset Parkinson's disease: a two-year follow-up. Front Aging Neurosci 2024; 15:1177889. [PMID: 38292047 PMCID: PMC10824910 DOI: 10.3389/fnagi.2023.1177889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 12/26/2023] [Indexed: 02/01/2024] Open
Abstract
Background The effects of subthalamic nucleus deep brain stimulation (STN-DBS) on the cognition and mood of patients with PD are still not uniformly concluded, and young-onset Parkinson's disease (YOPD) is even less explored. Objective To observe the effectiveness of STN-DBS on the cognition and mood of YOPD patients. Methods A total of 27 subjects, with a mean age at onset of 39.48 ± 6.24 and age at surgery for STN-DBS of 48.44 ± 4.85, were followed up preoperatively and for 2 years postoperatively. Using the Unified Parkinson disease rating scale (UPDRS), H&Y(Hoehn and Yahr stage), 39-Item Parkinson's Disease Questionnaire (PDQ-39), Mini-mental state examination (MMSE), Montreal Cognitive Assessment (MoCA), Hamilton depression scale (HAMD), Hamilton anxiety scale (HAMA) to assess motor, cognition, and mood. Results At the 2-year follow-up after STN-DBS, YOPD patients showed significant improvements in motor and quality of life (UPDRS III: p < 0.001, PDQ-39: p < 0.001); overall cognition was not significantly different from preoperative (MMSE: p = 0.275, MoCA: p = 0.913), although language function was significantly impaired compared to preoperative (MMSE: p = 0.004, MoCA: p = 0.009); depression and anxiety symptoms also improved significantly (HAMD: p < 0.001, HAMA: p < 0.001) and the depression score correlated significantly with motor (preoperative: r = 0.493, p = 0.009), disease duration (preoperative: r = 0.519, p = 0.006; postoperative: r = 0.406, p = 0.036) and H&Y (preoperative: r = 0.430, p = 0.025; postoperative: r = 0.387, p = 0.046); total anxiety scores were also significantly correlated with motor (preoperative: r = 0.553, p = 0.003; postoperative: r = 0.444, p = 0.020), disease duration (preoperative: r = 0.417, p = 0.031), PDQ-39 (preoperative: r = 0.464, p = 0.015) and H&Y (preoperative: r = 0.440, p = 0.022; postoperative: r = 0.526, p = 0.005). Conclusion STN-DBS is a safe and effective treatment for YOPD. The mood improved significantly, and overall cognition was not impaired, were only verbal fluency decreased but did not affect the improvement in quality of life.
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Affiliation(s)
- Jun Hong
- Department of Anatomy and Neurobiology, School of Basic Medical Science, Central South University, Changsha, China
- Department of Neurosurgery, The First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Huimin Xie
- Department of Neurosurgery, The First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Yuhua Chen
- Department of Anatomy and Neurobiology, School of Basic Medical Science, Central South University, Changsha, China
| | - Di Liu
- Department of Neurosurgery, The First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Tianyu Wang
- Department of Neurosurgery, The First Medical Centre, Chinese PLA General Hospital, Beijing, China
- Hebei Key Laboratory of Nerve Injury and Repair, Chengde Medical University, Chengde, China
| | - Kun Xiong
- Department of Anatomy and Neurobiology, School of Basic Medical Science, Central South University, Changsha, China
- Key Laboratory of Emergency and Trauma, Ministry of Education, College of Emergency and Trauma, Hainan Medical University, Haikou, China
- Hunan Key Laboratory of Ophthalmology, Central South University, Changsha, China
| | - Zhiqi Mao
- Department of Neurosurgery, The First Medical Centre, Chinese PLA General Hospital, Beijing, China
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13
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Batzu L, Podlewska A, Gibson L, Chaudhuri KR, Aarsland D. A general clinical overview of the non-motor symptoms in Parkinson's disease: Neuropsychiatric symptoms. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2024; 174:59-97. [PMID: 38341232 DOI: 10.1016/bs.irn.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
Abstract
The heterogeneity of non-motor features observed in people with Parkinson's disease (PD) is often dominated by one or more symptoms belonging to the neuropsychiatric spectrum, such as cognitive impairment, psychosis, depression, anxiety, and apathy. Due to their high prevalence in people with PD (PwP) and their occurrence in every stage of the disease, from the prodromal to the advanced stage, it is not surprising that PD can be conceptualised as a complex neuropsychiatric disorder. Despite progress in understanding the pathophysiological mechanisms underlying the neuropsychiatric signs and symptoms in PD, and better identification and diagnosis of these symptoms, effective treatments are still a major unmet need. The impact of these symptoms on the quality of life of PwP and caregivers, as well as their contribution to the overall non-motor symptom burden can be greater than that of motor symptoms and require a personalised, holistic approach. In this chapter, we provide a general clinical overview of the major neuropsychiatric symptoms of PD.
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Affiliation(s)
- Lucia Batzu
- Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Parkinson's Foundation Centre of Excellence, King's College Hospital, London, United Kingdom
| | - Aleksandra Podlewska
- Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Parkinson's Foundation Centre of Excellence, King's College Hospital, London, United Kingdom
| | - Lucy Gibson
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - K Ray Chaudhuri
- Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Parkinson's Foundation Centre of Excellence, King's College Hospital, London, United Kingdom
| | - Dag Aarsland
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Centre for Age-Related Diseases, Stavanger University Hospital, Stavanger, Norway.
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14
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Citro S, Lazzaro GD, Cimmino AT, Giuffrè GM, Marra C, Calabresi P. A multiple hits hypothesis for memory dysfunction in Parkinson disease. Nat Rev Neurol 2024; 20:50-61. [PMID: 38052985 DOI: 10.1038/s41582-023-00905-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2023] [Indexed: 12/07/2023]
Abstract
Cognitive disorders are increasingly recognized in Parkinson disease (PD), even in early disease stages, and memory is one of the most affected cognitive domains. Classically, hippocampal cholinergic system dysfunction was associated with memory disorders, whereas nigrostriatal dopaminergic system impairment was considered responsible for executive deficits. Evidence from PD studies now supports involvement of the amygdala, which modulates emotional attribution to experiences. Here, we propose a tripartite model including the hippocampus, striatum and amygdala as key structures for cognitive disorders in PD. First, the anatomo-functional relationships of these structures are explored and experimental evidence supporting their role in cognitive dysfunction in PD is summarized. We then discuss the potential role of α-synuclein, a pathological hallmark of PD, in the tripartite memory system as a key mechanism in the pathogenesis of memory disorders in the disease.
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Affiliation(s)
- Salvatore Citro
- Neurology Section, Department of Neuroscience, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giulia Di Lazzaro
- Neurology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Angelo Tiziano Cimmino
- Neurology Section, Department of Neuroscience, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Guido Maria Giuffrè
- Neurology Section, Department of Neuroscience, Università Cattolica del Sacro Cuore, Rome, Italy
- Neurology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Camillo Marra
- Neurology Section, Department of Neuroscience, Università Cattolica del Sacro Cuore, Rome, Italy
- Neurology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Paolo Calabresi
- Neurology Section, Department of Neuroscience, Università Cattolica del Sacro Cuore, Rome, Italy.
- Neurology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
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15
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Zhang L, Zhang P, Dong Q, Zhao Z, Zheng W, Zhang J, Hu X, Yao Z, Hu B. Fine-grained features characterize hippocampal and amygdaloid change pattern in Parkinson's disease and discriminate cognitive-deficit subtype. CNS Neurosci Ther 2024; 30:e14480. [PMID: 37849445 PMCID: PMC10805398 DOI: 10.1111/cns.14480] [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: 07/03/2023] [Revised: 09/08/2023] [Accepted: 09/14/2023] [Indexed: 10/19/2023] Open
Abstract
AIMS To extract vertex-wise features of the hippocampus and amygdala in Parkinson's disease (PD) with mild cognitive impairment (MCI) and normal cognition (NC) and further evaluate their discriminatory efficacy. METHODS High-resolution 3D-T1 data were collected from 68 PD-MCI, 211 PD-NC, and 100 matched healthy controls (HC). Surface geometric features were captured using surface conformal representation, and surfaces were registered to a common template using fluid registration. The statistical tests were performed to detect differences between groups. The disease-discriminatory ability of features was also tested in the ensemble classifiers. RESULTS The amygdala, not the hippocampus, showed significant overall differences among the groups. Compared with PD-NC, the right amygdala in MCI patients showed expansion (anterior cortical, anterior amygdaloid, and accessory basal areas) and atrophy (basolateral ventromedial area) subregions. There was notable atrophy in the right CA1 and hippocampal subiculum of PD-MCI. The accuracy of classifiers with multivariate morphometry statistics as features exceeded 85%. CONCLUSION PD-MCI is associated with multiscale morphological changes in the amygdala, as well as subtle atrophy in the hippocampus. These novel metrics demonstrated the potential to serve as biomarkers for PD-MCI diagnosis. Overall, these findings from this study help understand the role of subcortical structures in the neuropathological mechanisms of PD cognitive impairment.
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Affiliation(s)
- Lingyu Zhang
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and EngineeringLanzhou UniversityLanzhouChina
| | - Pengfei Zhang
- Department of Magnetic ResonanceLanzhou University Second HospitalLanzhouChina
- Gansu Province Clinical Research Center for Functional and Molecular ImagingLanzhouChina
| | - Qunxi Dong
- School of Medical TechnologyBeijing Institute of TechnologyBeijingChina
| | - Ziyang Zhao
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and EngineeringLanzhou UniversityLanzhouChina
| | - Weihao Zheng
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and EngineeringLanzhou UniversityLanzhouChina
| | - Jing Zhang
- Department of Magnetic ResonanceLanzhou University Second HospitalLanzhouChina
- Gansu Province Clinical Research Center for Functional and Molecular ImagingLanzhouChina
| | - Xiping Hu
- School of Medical TechnologyBeijing Institute of TechnologyBeijingChina
| | - Zhijun Yao
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and EngineeringLanzhou UniversityLanzhouChina
| | - Bin Hu
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and EngineeringLanzhou UniversityLanzhouChina
- School of Medical TechnologyBeijing Institute of TechnologyBeijingChina
- CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai Institutes for Biological SciencesChinese Academy of SciencesShanghaiChina
- Joint Research Center for Cognitive Neurosensor Technology of Lanzhou University & Institute of SemiconductorsChinese Academy of SciencesLanzhouChina
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16
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Zhang T, Liu W, Bai Q, Gao S. The therapeutic effects of yoga in people with Parkinson's disease: a mini-review. Ann Med 2023; 55:2294935. [PMID: 38109929 PMCID: PMC10732191 DOI: 10.1080/07853890.2023.2294935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 12/08/2023] [Indexed: 12/20/2023] Open
Abstract
Parkinson's disease (PD) is one of the most common neurodegenerative diseases, second only to Alzheimer's disease. Drugs and deep brain stimulation (DBS) are the main treatments for PD. However, the long-term side effects of drugs and the risks of surgery cannot be ignored. It is therefore important to research safe and effective complementary and alternative therapies for PD. Yoga, an ancient mind-body exercise, has been widely used in health promotion. Although, yoga can address a range of health problems, little is known about its role in people with PD. This article reviews the evidence that yoga improves PD symptoms, including movement disorders, balance function and emotional disturbance. The authors analyze the role and shortcomings of the yoga intervention process, with the aim of providing a scientific basis for the application of yoga training to people with PD.
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Affiliation(s)
- Ting Zhang
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, China
- University Hospital, Zhejiang Normal University, Jinhua, China
| | - Wei Liu
- Physical Education College, Guangxi University of Science and Technology, Liuzhou, China
| | - Qingping Bai
- Physical Education College, Guangxi University of Science and Technology, Liuzhou, China
| | - Song Gao
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, China
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17
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Villar-Conde S, Astillero-Lopez V, Gonzalez-Rodriguez M, Saiz-Sanchez D, Martinez-Marcos A, Ubeda-Banon I, Flores-Cuadrado A. Synaptic Involvement of the Human Amygdala in Parkinson's Disease. Mol Cell Proteomics 2023; 22:100673. [PMID: 37947401 PMCID: PMC10700869 DOI: 10.1016/j.mcpro.2023.100673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 10/18/2023] [Accepted: 10/24/2023] [Indexed: 11/12/2023] Open
Abstract
α-Synuclein, a protein mostly present in presynaptic terminals, accumulates neuropathologically in Parkinson's disease in a 6-stage sequence and propagates in the nervous system in a prion-like manner through neurons and glia. In stage 3, the substantia nigra are affected, provoking motor symptoms and the amygdaloid complex, leading to different nonmotor symptoms; from here, synucleinopathy spreads to the temporal cortex and beyond. The expected increase in Parkinson's disease incidence accelerates the need for detection biomarkers; however, the heterogeneity of this disease, including pathological aggregates and pathophysiological pathways, poses a challenge in the search for new therapeutic targets and biomarkers. Proteomic analyses are lacking, and the literature regarding synucleinopathy, neural and glial involvement, and volume of the human amygdaloid complex is controversial. Therefore, the present study combines both proteomic and stereological probes. Data-independent acquisition-parallel accumulation of serial fragmentation proteomic analysis revealed a remarkable proteomic impact, especially at the synaptic level in the human amygdaloid complex in Parkinson's disease. Among the 199 differentially expressed proteins, guanine nucleotide-binding protein G(i) subunit alpha-1 (GNAI1), elongation factor 1-alpha 1 (EEF1A1), myelin proteolipid protein (PLP1), neuroplastin (NPTN), 14-3-3 protein eta (YWHAH), gene associated with retinoic and interferon-induced mortality 19 protein (GRIM19), and orosomucoid-2 (ORM2) stand out as potential biomarkers in Parkinson's disease. Stereological analysis, however, did not reveal alterations regarding synucleinopathy, neural or glial populations, or volume changes. To our knowledge, this is the first proteomic study of the human amygdaloid complex in Parkinson's disease, and it identified possible biomarkers of the disease. Lewy pathology could not be sufficient to cause neurodegeneration or alteration of microglial and astroglial populations in the human amygdaloid complex in Parkinson's disease. Nevertheless, damage at the proteomic level is manifest, showing up significant synaptic involvement.
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Affiliation(s)
- Sandra Villar-Conde
- Grupo de Neuroplasticidad y Neurodegeneración, CRIB, Facultad de Medicina de Ciudad Real, Universidad de Castilla-La Mancha (UCLM), Spain; Grupo de Neuroplasticidad y Neurodegeneración, Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Spain
| | - Veronica Astillero-Lopez
- Grupo de Neuroplasticidad y Neurodegeneración, CRIB, Facultad de Medicina de Ciudad Real, Universidad de Castilla-La Mancha (UCLM), Spain; Grupo de Neuroplasticidad y Neurodegeneración, Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Spain
| | - Melania Gonzalez-Rodriguez
- Grupo de Neuroplasticidad y Neurodegeneración, CRIB, Facultad de Medicina de Ciudad Real, Universidad de Castilla-La Mancha (UCLM), Spain; Grupo de Neuroplasticidad y Neurodegeneración, Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Spain
| | - Daniel Saiz-Sanchez
- Grupo de Neuroplasticidad y Neurodegeneración, CRIB, Facultad de Medicina de Ciudad Real, Universidad de Castilla-La Mancha (UCLM), Spain; Grupo de Neuroplasticidad y Neurodegeneración, Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Spain
| | - Alino Martinez-Marcos
- Grupo de Neuroplasticidad y Neurodegeneración, CRIB, Facultad de Medicina de Ciudad Real, Universidad de Castilla-La Mancha (UCLM), Spain; Grupo de Neuroplasticidad y Neurodegeneración, Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Spain.
| | - Isabel Ubeda-Banon
- Grupo de Neuroplasticidad y Neurodegeneración, CRIB, Facultad de Medicina de Ciudad Real, Universidad de Castilla-La Mancha (UCLM), Spain; Grupo de Neuroplasticidad y Neurodegeneración, Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Spain.
| | - Alicia Flores-Cuadrado
- Grupo de Neuroplasticidad y Neurodegeneración, CRIB, Facultad de Medicina de Ciudad Real, Universidad de Castilla-La Mancha (UCLM), Spain; Grupo de Neuroplasticidad y Neurodegeneración, Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Spain
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18
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Béreau M, Castrioto A, Servant M, Lhommée E, Desmarets M, Bichon A, Pélissier P, Schmitt E, Klinger H, Longato N, Phillipps C, Wirth T, Fraix V, Benatru I, Durif F, Azulay JP, Moro E, Broussolle E, Thobois S, Tranchant C, Krack P, Anheim M. Imbalanced motivated behaviors according to motor sign asymmetry in drug-naïve Parkinson's disease. Sci Rep 2023; 13:21234. [PMID: 38040775 PMCID: PMC10692157 DOI: 10.1038/s41598-023-48188-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 11/23/2023] [Indexed: 12/03/2023] Open
Abstract
Few studies have considered the influence of motor sign asymmetry on motivated behaviors in de novo drug-naïve Parkinson's disease (PD). We tested whether motor sign asymmetry could be associated with different motivated behavior patterns in de novo drug-naïve PD. We performed a cross-sectional study in 128 de novo drug-naïve PD patients and used the Ardouin Scale of Behavior in Parkinson's disease (ASBPD) to assess a set of motivated behaviors. We assessed motor asymmetry based on (i) side of motor onset and (ii) MDS-UPDRS motor score, then we compared right hemibody Parkinson's disease to left hemibody Parkinson's disease. According to the MDS-UPDRS motor score, patients with de novo right hemibody PD had significantly lower frequency of approach behaviors (p = 0.031), including nocturnal hyperactivity (p = 0.040), eating behavior (p = 0.040), creativity (p = 0.040), and excess of motivation (p = 0.017) than patients with de novo left hemibody PD. Patients with de novo left hemibody PD did not significantly differ from those with de novo right hemibody PD regarding avoidance behaviors including apathy, anxiety and depression. Our findings suggest that motor sign asymmetry may be associated with an imbalance between motivated behaviors in de novo drug-naïve Parkinson's disease.
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Affiliation(s)
- Matthieu Béreau
- Neurology Department, University Hospital of Besançon, CHRU de Besançon, 3 Bd Alexandre Fleming, 25030, Besançon Cedex, France.
- Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive - UR LINC, Université Bourgogne Franche-Comté, Besançon, France.
| | - Anna Castrioto
- Inserm, U1216, Grenoble Institut Neurosciences, CHU Grenoble Alpes, University Grenoble Alpes, 38000, Grenoble, France
| | - Mathieu Servant
- Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive - UR LINC, Université Bourgogne Franche-Comté, Besançon, France
| | - Eugénie Lhommée
- Inserm, U1216, Grenoble Institut Neurosciences, CHU Grenoble Alpes, University Grenoble Alpes, 38000, Grenoble, France
| | - Maxime Desmarets
- Unité de Méthodologie, CIC INSERM 1431, CHU de Besançon, Besançon, France
| | - Amélie Bichon
- Inserm, U1216, Grenoble Institut Neurosciences, CHU Grenoble Alpes, University Grenoble Alpes, 38000, Grenoble, France
| | - Pierre Pélissier
- Inserm, U1216, Grenoble Institut Neurosciences, CHU Grenoble Alpes, University Grenoble Alpes, 38000, Grenoble, France
| | - Emmanuelle Schmitt
- Inserm, U1216, Grenoble Institut Neurosciences, CHU Grenoble Alpes, University Grenoble Alpes, 38000, Grenoble, France
| | - Hélène Klinger
- Movement Disorders Unit, Neurology Department, Hospices Civils de Lyon, Lyon, France
- Faculté de Médecine Lyon Sud, Université Claude Bernard Lyon 1, University of Lyon, Lyon, France
- CNRS, Institut des Sciences Cognitives Marc Jeannerod, UMR 5229, Bron, France
| | - Nadine Longato
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Clélie Phillipps
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Thomas Wirth
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104, Université de Strasbourg, Illkirch, France
- Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France
| | - Valérie Fraix
- Inserm, U1216, Grenoble Institut Neurosciences, CHU Grenoble Alpes, University Grenoble Alpes, 38000, Grenoble, France
| | - Isabelle Benatru
- Neurology Department, University Hospital of Poitiers, Poitiers, France
- INSERM, CHU de Poitiers, Centre d'Investigation Clinique CIC1402, University of Poitiers, Poitiers, France
| | - Franck Durif
- EA7280 NPsy-Sydo, Université Clermont Auvergne, Clermont-Ferrand, France
- Neurology Department, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Jean-Philippe Azulay
- Movement Disorders Unit, Neurology Department, University Hospital of Marseille, Marseille, France
| | - Elena Moro
- Inserm, U1216, Grenoble Institut Neurosciences, CHU Grenoble Alpes, University Grenoble Alpes, 38000, Grenoble, France
| | - Emmanuel Broussolle
- Movement Disorders Unit, Neurology Department, Hospices Civils de Lyon, Lyon, France
- Faculté de Médecine Lyon Sud, Université Claude Bernard Lyon 1, University of Lyon, Lyon, France
- CNRS, Institut des Sciences Cognitives Marc Jeannerod, UMR 5229, Bron, France
| | - Stéphane Thobois
- Movement Disorders Unit, Neurology Department, Hospices Civils de Lyon, Lyon, France
- Faculté de Médecine Lyon Sud, Université Claude Bernard Lyon 1, University of Lyon, Lyon, France
- CNRS, Institut des Sciences Cognitives Marc Jeannerod, UMR 5229, Bron, France
| | - Christine Tranchant
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Paul Krack
- Department of Neurology, Movement Disorders Center, University Hospital of Bern, Bern, Switzerland
| | - Mathieu Anheim
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104, Université de Strasbourg, Illkirch, France
- Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France
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Pronina MV, Ponomarev VA, Poliakov YI, Martins-Mourao A, Plotnikova IV, Müller A, Kropotov YD. Event-related EEG synchronization and desynchronization in patients with obsessive-compulsive disorder. Psychophysiology 2023; 60:e14403. [PMID: 37578353 DOI: 10.1111/psyp.14403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 04/09/2023] [Accepted: 07/07/2023] [Indexed: 08/15/2023]
Abstract
Symptoms in patients with obsessive-compulsive disorder (OCD) are associated with impairment in cognitive control, attention, and action inhibition. We investigated OCD group differences relative to healthy subjects in terms of event-related alpha and beta range synchronization (ERS) and desynchronization (ERD) during a visually cued Go/NoGo task. Subjects were 62 OCD patients and 296 healthy controls (HC). The OCD group in comparison with HC, showed a changed value of alpha/beta oscillatory power over the central cortex, in particular, an increase in the alpha/beta ERD over the central-parietal cortex during the interstimulus interval (Cue condition) as well as changes in the postmovement beta synchronization topography and frequency. Over the frontal cortex, the OCD group showed an increase in magnitude of the beta ERS in NoGo condition. Within the parietal-occipital ERS/ERD modulations, the OCD group showed an increase in the alpha/beta ERD over the parietal cortex after the presentation of the visual stimuli as well as a decrease in the beta ERD over the occipital cortex after the presentation of the Cue and Go stimuli. The specific properties in the ERS/ERD patterns observed in the OCD group may reflect high involvement of the frontal and central cortex in action preparation and action inhibition processes and, possibly, in maintaining the motor program, which might be a result of the dysfunction of the cortico-striato-thalamo-cortical circuits involving prefrontal cortex. The data about enhanced involvement of the parietal cortex in the evaluation of the visual stimuli are in line with the assumption about overfocused attention in OCD.
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Affiliation(s)
- Marina V Pronina
- N.P. Bechtereva Institute of the Human Brain of Russian Academy of Sciences, Saint-Petersburg, Russia
| | - Valery A Ponomarev
- N.P. Bechtereva Institute of the Human Brain of Russian Academy of Sciences, Saint-Petersburg, Russia
| | - Yury I Poliakov
- Pavlov First Saint-Petersburg State Medical University, Saint-Petersburg, Russia
- Pavlov Institute of Physiology of the Russian Academy of Sciences, Saint-Petersburg, Russia
| | - Antonio Martins-Mourao
- QEEG & Brain Research Lab, Life, Health and Chemical Sciences, Open University, Milton Keynes, UK
| | - Irina V Plotnikova
- N.P. Bechtereva Institute of the Human Brain of Russian Academy of Sciences, Saint-Petersburg, Russia
| | | | - Yury D Kropotov
- N.P. Bechtereva Institute of the Human Brain of Russian Academy of Sciences, Saint-Petersburg, Russia
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Marques A, Macias E, Pereira B, Durand E, Chassain C, Vidal T, Defebvre L, Carriere N, Fraix V, Moro E, Thobois S, Metereau E, Mangone G, Vidailhet M, Corvol JC, Lehéricy S, Menjot de Champfleur N, Geny C, Spampinato U, Meissner WG, Frismand S, Schmitt E, Doé de Maindreville A, Portefaix C, Remy P, Fénelon G, Houeto JL, Colin O, Rascol O, Peran P, Bonny JM, Fantini ML, Durif F. Volumetric changes and clinical trajectories in Parkinson's disease: a prospective multicentric study. J Neurol 2023; 270:6033-6043. [PMID: 37648911 DOI: 10.1007/s00415-023-11947-0] [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: 03/15/2023] [Revised: 05/15/2023] [Accepted: 08/16/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Longitudinal measures of structural brain changes using MRI in relation to clinical features and progression patterns in PD have been assessed in previous studies, but few were conducted in well-defined and large cohorts, including prospective clinical assessments of both motor and non-motor symptoms. OBJECTIVE We aimed to identify brain volumetric changes characterizing PD patients, and determine whether regional brain volumetric characteristics at baseline can predict motor, psycho-behavioral and cognitive evolution at one year in a prospective cohort of PD patients. METHODS In this multicentric 1 year longitudinal study, PD patients and healthy controls from the MPI-R2* cohort were assessed for demographical, clinical and brain volumetric characteristics. Distinct subgroups of PD patients according to motor, cognitive and psycho-behavioral evolution were identified at the end of follow-up. RESULTS One hundred and fifty PD patients and 73 control subjects were included in our analysis. Over one year, there was no significant difference in volume variations between PD and control subjects, regardless of the brain region considered. However, we observed a reduction in posterior cingulate cortex volume at baseline in PD patients with motor deterioration at one year (p = 0.017). We also observed a bilateral reduction of the volume of the amygdala (p = 0.015 and p = 0.041) and hippocampus (p = 0.015 and p = 0.053) at baseline in patients with psycho-behavioral deterioration, regardless of age, dopaminergic treatment and center. CONCLUSION Brain volumetric characteristics at baseline may predict clinical trajectories at 1 year in PD as posterior cingulate cortex atrophy was associated with motor decline, while amygdala and hippocampus atrophy were associated with psycho-behavioral decline.
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Affiliation(s)
- Ana Marques
- University Clermont Auvergne, CNRS, Clermont Auvergne INP, IGCNC, Institute Pascal, Clermont-Ferrand, France.
- Neurology Department and NS-PARK/FCRIN Network, Clermont-Ferrand University Hospital, Clermont-Ferrand, France.
- Neurology Department, Parkinson Expert Center, CHRU Gabriel Montpied, 63000, Clermont-Ferrand, France.
| | - Elise Macias
- University Clermont Auvergne, CNRS, Clermont Auvergne INP, IGCNC, Institute Pascal, Clermont-Ferrand, France
- Neurology Department and NS-PARK/FCRIN Network, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Bruno Pereira
- Clermont-Ferrand University Hospital, Biostatistics Unit (DRCI), Clermont-Ferrand, France
| | - Elodie Durand
- University Clermont Auvergne, CNRS, Clermont Auvergne INP, IGCNC, Institute Pascal, Clermont-Ferrand, France
- Neurology Department and NS-PARK/FCRIN Network, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Carine Chassain
- University Clermont Auvergne, CNRS, Clermont Auvergne INP, IGCNC, Institute Pascal, Clermont-Ferrand, France
- Neurology Department and NS-PARK/FCRIN Network, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Tiphaine Vidal
- University Clermont Auvergne, CNRS, Clermont Auvergne INP, IGCNC, Institute Pascal, Clermont-Ferrand, France
- Neurology Department and NS-PARK/FCRIN Network, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Luc Defebvre
- Department of Movement Disorder and NS-PARK/FCRIN Network, Inserm 1172, University of Lille, Lille, France
| | - Nicolas Carriere
- Department of Movement Disorder and NS-PARK/FCRIN Network, Inserm 1172, University of Lille, Lille, France
| | - Valerie Fraix
- Université Grenoble Alpes, CHU de Grenoble, Service de Neurologie, Grenoble Institute of Neuroscience, and NS-PARK/FCRIN Network, Grenoble, France
| | - Elena Moro
- Université Grenoble Alpes, CHU de Grenoble, Service de Neurologie, Grenoble Institute of Neuroscience, and NS-PARK/FCRIN Network, Grenoble, France
| | - Stéphane Thobois
- CNRS, Institut des Sciences Cognitives Marc Jeannerod, UMR 5229 CNRS, Lyon, France
- Université Claude Bernard, Lyon I, Lyon, France
- Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C and NS-PARK/FCRIN Network, Lyon, France
| | - Elise Metereau
- CNRS, Institut des Sciences Cognitives Marc Jeannerod, UMR 5229 CNRS, Lyon, France
- Université Claude Bernard, Lyon I, Lyon, France
- Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C and NS-PARK/FCRIN Network, Lyon, France
| | - Graziella Mangone
- Département de Neurologie and NS-PARK/FCRIN Network, Sorbonne Université; Institut du Cerveau-ICM, Assistance Publique Hôpitaux de Paris; Inserm 1127, CNRS 7225, CIC Neurosciences, Hôpital Pitié-Salpêtrière, Paris, France
| | - Marie Vidailhet
- Département de Neurologie and NS-PARK/FCRIN Network, Sorbonne Université; Institut du Cerveau-ICM, Assistance Publique Hôpitaux de Paris; Inserm 1127, CNRS 7225, CIC Neurosciences, Hôpital Pitié-Salpêtrière, Paris, France
| | - Jean-Christophe Corvol
- Département de Neurologie and NS-PARK/FCRIN Network, Sorbonne Université; Institut du Cerveau-ICM, Assistance Publique Hôpitaux de Paris; Inserm 1127, CNRS 7225, CIC Neurosciences, Hôpital Pitié-Salpêtrière, Paris, France
| | - Stéphane Lehéricy
- Département de Neuroradiologie and NS-PARK/FCRIN Network, Sorbonne Université; Institut du Cerveau-ICM, Assistance Publique Hôpitaux de Paris; Inserm 1127, CNRS 7225; Hôpital Pitié-Salpêtrière, Paris, France
| | - Nicolas Menjot de Champfleur
- Department of Neuroradiology, Montpellier University Hospital Center, Gui de Chauliac Hospital, Montpellier, France
- I2FH, Institut d'Imagerie Fonctionnelle Humaine, Hôpital Gui de Chauliac, CHRU de Montpellier, Montpellier, France
| | - Christian Geny
- Department of Geriatrics and NS-PARK/FCRIN Network, Montpellier University Hospital, Montpellier University, Montpellier, France
| | - Umberto Spampinato
- Service de Neurologie-Maladies Neurodégénératives and NS-PARK/FCRIN Network, CHU Bordeaux, 33000, Bordeaux, France
- INCIA-UMR 5287, Team P3TN, CNRS/Université de Bordeaux, Bordeaux, France
| | - Wassilios G Meissner
- Service de Neurologie-Maladies Neurodégénératives and NS-PARK/FCRIN Network, CHU Bordeaux, 33000, Bordeaux, France
- Univ. Bordeaux, CNRS, IMN, UMR 5293, Bordeaux, 33000, Bordeaux, France
- Dept. Medicine, University of Otago, Christchurch, New Zealand
- New Zealand Brain Research Institute, Christchurch, New Zealand
| | - Solène Frismand
- Department of Neurology and NS-PARK/FCRIN Network, Nancy University Hospital Center, Nancy, France
| | - Emmanuelle Schmitt
- Department of Neuroradiology, Nancy University Hospital Center, Nancy, France
| | | | - Christophe Portefaix
- Department of Radiology, Hôpital Maison Blanche, Reims, France
- CReSTIC Laboratory, University of Reims Champagne-Ardenne, Reims, France
| | - Philippe Remy
- Centre Expert Parkinson and NS-PARK/FCRIN Network, CHU Henri Mondor; AP-HP et Equipe Neuropsychologie Interventionnelle, INSERM-IMRB, Faculté de Santé, Université Paris-Est Créteil et Ecole Normale Supérieure Paris Sorbonne Université, Créteil, France
| | - Gilles Fénelon
- Centre Expert Parkinson and NS-PARK/FCRIN Network, CHU Henri Mondor; AP-HP et Equipe Neuropsychologie Interventionnelle, INSERM-IMRB, Faculté de Santé, Université Paris-Est Créteil et Ecole Normale Supérieure Paris Sorbonne Université, Créteil, France
| | - Jean Luc Houeto
- INSERM, CHU de Poitiers, Université de Poitiers, Centre d'Investigation Clinique CIC1402; Service de Neurologie and NS-PARK/FCRIN Network, Poitiers, France
- CHU-Centre Expert Parkinson de Limoges, Limoges, France
| | - Olivier Colin
- INSERM, CHU de Poitiers, Université de Poitiers, Centre d'Investigation Clinique CIC1402; Service de Neurologie and NS-PARK/FCRIN Network, CH Brive la Gaillarde, Poitiers, France
| | - Olivier Rascol
- Centre Expert Parkinson, Départements de Pharmacologie Clinique et Neurosciences, Centre d'Investigation Clinique CIC 1436, UMR 1214 TONIC, NeuroToul and NS-PARK/FCRIN Network, INSERM, CHU de Toulouse et Université de Toulouse3, Toulouse, France
| | - Patrice Peran
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, INSERM, UPS, Toulouse, France
| | - Jean-Marie Bonny
- INRAE, UR QuaPA, 63122, Saint-Genès-Champanelle, France
- Nuclear Magnetic Resonance Facility for Agronomy, Food and Health, AgroResonance, INRAE, 2018, Saint-Genès-Champanelle, France
| | - Maria Livia Fantini
- University Clermont Auvergne, CNRS, Clermont Auvergne INP, IGCNC, Institute Pascal, Clermont-Ferrand, France
- Neurology Department and NS-PARK/FCRIN Network, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Franck Durif
- University Clermont Auvergne, CNRS, Clermont Auvergne INP, IGCNC, Institute Pascal, Clermont-Ferrand, France
- Neurology Department and NS-PARK/FCRIN Network, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
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Hillyer A, Sharma M, Kuurstra A, Rosehart H, Menon R, Morrow SA. Association between limbic system lesions and anxiety in persons with multiple sclerosis. Mult Scler Relat Disord 2023; 79:105021. [PMID: 37801955 DOI: 10.1016/j.msard.2023.105021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 08/21/2023] [Accepted: 09/23/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND Persons with Multiple Sclerosis (PwMS) have a higher rate of anxiety and depression than the general population. Depression has been associated with clinical relapses; temporal lesions were shown to predict depression severity. Anxiety is considerably understudied. The role of MS lesions in the limbic system is also understudied, partly due to difficulties identifying limbic lesions on standard 1.5 and 3 Tesla MRI. METHODS This is a retrospective study of 23 PwMS who underwent 7T MRI on the same day as completing the Hospital Anxiety and Depression Scale (HADS). MRI was performed on a Siemens 7T MRI Plus and an 8-channel transmit coil with 32 receiver channels operating in pTx mode. MP2RAGE and DIR-SPACE sequences were analyzed to determine the number of lesions within the limbic system. RESULTS The median number of lesions in the limbic system was 2.0 (range 0-7). When comparing the presence or absence of lesions in the limbic system, there was a significant relationship with anxiety (X2 (1, N = 23)=4.44, p = 0.035), but not for depression. CONCLUSION Although only a small sample size, this study provides preliminary evidence that lesions in the limbic system are associated with the presence of anxiety in PwMS. This relationship warrants further investigation.
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Affiliation(s)
| | - Manas Sharma
- Western University Schulich School of Medicine & Dentistry, Canada
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22
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DeMarco EC, Zhang Z, Robinson H, Hinyard L. Anxiety in Parkinson's Patients: What's Timing Got to Do with It? J Geriatr Psychiatry Neurol 2023; 36:496-504. [PMID: 37839809 DOI: 10.1177/08919887231163293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
Background: Parkinson's Disease (PD) affects over 10 million people worldwide. Many PD patients experience comorbid anxiety disorders, which have been correlated with reduced quality of life and can manifest at any time during the course of PD, including prior to motor symptom onset. Purpose: Prior work has demonstrated that patients diagnosed with depression following a PD diagnosis are less likely to receive depression treatment, but no such study has been conducted for anxiety. Research Design: A cross-sectional analysis of secondary electronhic health record data was conducted. Study Sample: Data was obtained through Optum® de-identified Electronic Health Record dataset, using ICD-9 and ICD-10 diagnosis codes to determine PD status and comparing index date of anxiety and PD diagnoses to classify patients by relative time of diagnosis. Data Analysis: Multivariate logistic regression was performed to assess factors associated with receipt of mental health treatment. Results: Of PD patients with anxiety, 52% documented a diagnosis of anxiety prior to PD. Overall, 69% documented some treatment, with 79% of those diagnosed with anxiety prior to PD receiving some treatment compared to 59% of those diagnosed with anxiety on or after PD (P < 0.001). Conclusion: Patients with PD and subsequent anxiety diagnoses are less likely to receive treatment. Further study could explore reasons for variations in mental health care within the context of an existing PD diagnosis.
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Affiliation(s)
- Elisabeth C DeMarco
- Department of Health & Clinical Outcomes Research, Saint Louis University School of Medicine, St. Louis, MO, USA
- Advanced HEAlth Data (AHEAD) Institute, Saint Louis University School of Medicine, St. Louis, MO, USA
| | - Zidong Zhang
- Department of Health & Clinical Outcomes Research, Saint Louis University School of Medicine, St. Louis, MO, USA
- Advanced HEAlth Data (AHEAD) Institute, Saint Louis University School of Medicine, St. Louis, MO, USA
| | - Hunter Robinson
- Department of Health & Clinical Outcomes Research, Saint Louis University School of Medicine, St. Louis, MO, USA
- Advanced HEAlth Data (AHEAD) Institute, Saint Louis University School of Medicine, St. Louis, MO, USA
| | - Leslie Hinyard
- Department of Health & Clinical Outcomes Research, Saint Louis University School of Medicine, St. Louis, MO, USA
- Advanced HEAlth Data (AHEAD) Institute, Saint Louis University School of Medicine, St. Louis, MO, USA
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23
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Zhu X, Gan J, Wu N, Wan Y, Song L, Liu Z, Zhang Y. Assessing impulse control behaviors in early Parkinson's disease: a longitudinal study. Front Neurol 2023; 14:1275170. [PMID: 37954646 PMCID: PMC10634396 DOI: 10.3389/fneur.2023.1275170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 10/12/2023] [Indexed: 11/14/2023] Open
Abstract
Objective Impulse control behaviors (ICBs) frequently coexist with Parkinson's disease (PD). However, the predictors of ICBs in PD remain unclear, and there is limited data on the biological correlates of ICBs in PD. In this study, we examined clinical, imaging, and biological variables to identify factors associated with longitudinal changes in ICBs in early-stage PD. Methods The data for this study were obtained from the Parkinson's Progression Markers Initiative, an international prospective cohort study that evaluates markers of disease progression in PD. We examined clinical, imaging, and biological variables to determine their associations with ICBs over a period of up to 5 years. Cox regression models were employed to investigate the predictors of ICBs in early-stage, untreated PD. Results The study enrolled 401 individuals with PD and 185 healthy controls (HC). At baseline, 83 PD subjects (20.7%) and 36 HC (19.5%) exhibited ICBs. Over the course of 5 years, the prevalence of ICBs increased in PD (from 20.7% to 27.3%, p < 0.001), while it decreased in HC (from 19.5% to 15.2%, p < 0.001). Longitudinally, the presence of ICBs in PD was associated with depression, anxiety, autonomic dysfunction, and excessive daytime sleepiness (EDS). However, there was no significant association observed with cognitive dysfunction or motor severity. Treatment with dopamine agonists was linked to ICBs at years 3 and 4. Conversely, there was no association found between ICBs and presynaptic dopaminergic dysfunction. Additionally, biofluid markers in baseline and the first year did not show a significant association with ICBs. A predictive index for ICBs was generated, incorporating three baseline characteristics: anxiety, rapid eye movement sleep behavior disorder (RBD), and p-tau levels in cerebrospinal fluid (CSF). Conclusion During the early stages of PD, there is a notable increase in ICBs over time. These ICBs are associated with depression, anxiety, autonomic dysfunction, EDS, and the use of dopaminergic medications, particularly dopamine agonists. Anxiety, RBD, and p-tau levels in CSF are identified as predictors for the incident development of ICBs in early PD. Further longitudinal analyses will provide a more comprehensive understanding of the associations between ICBs and imaging findings, as well as biomarkers. These analyses will help to better characterize the relationships and implications of these factors in the context of ICBs in early PD.
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24
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Zhang H, Tian Y, Yu W, Tong D, Ji Y, Qu X, Deng T, Li X, Xu Y. TMEM175 downregulation participates in impairment of the autophagy related lysosomal dynamics following neonatal hypoxic-ischemic brain injury. J Cell Physiol 2023; 238:2512-2527. [PMID: 37566721 DOI: 10.1002/jcp.31096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 07/27/2023] [Accepted: 08/01/2023] [Indexed: 08/13/2023]
Abstract
The mechanism underlying long-term cognitive impairment caused by neonatal hypoxic-ischemic brain injury (HIBI) remains unclear. Autophagy is a closely related mechanism and may play a role in this process. We aimed to investigate the role of lysosomal transmembrane protein 175 (TMEM175) in the autophagy-lysosome pathway in neonatal rats with HIBI. A neonatal rat model of HIBI was established, hypoxia was induced, followed by left common carotid artery ligation. Expression levels of TMEM175 and the corresponding proteins involved in autophagy flux and the endolysosomal system fusion process were measured. Rats were administered TMEM175 plasmid via intracerebroventricular injection to induce overexpression. Brain damage and cognitive function were then assessed. TMEM175 was downregulated in the hippocampal tissue, and the autophagy-lysosome pathway was impaired following HIBI in neonatal rats. Overexpression of TMEM175 significantly mitigated neuronal injury and improved long-term cognitive and memory function in neonatal rats with HIBI. We found that improvement in the autophagy-lysosome pathway and endolysosomal system homeostasis, which are TMEM175 related, occurred via regulation of lysosomal membrane dynamic fusion. TMEM175 plays a critical role in maintaining the autophagy-lysosome pathway and endolysosomal homeostasis, contributing to the amelioration of neuronal injury and impaired long-term cognitive function following neonatal HIBI.
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Affiliation(s)
- Huiyi Zhang
- Department of Anesthesiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ye Tian
- Department of Orthopedics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Weiwei Yu
- Department of Anesthesiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Dongyi Tong
- Department of Anesthesiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yichen Ji
- Department of Anesthesiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xinrui Qu
- Department of Anesthesiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Tianjiao Deng
- The First Clinical College, China Medical University, Shenyang, China
| | - Xinsheng Li
- The First Clinical College, China Medical University, Shenyang, China
| | - Ying Xu
- Department of Anesthesiology, Shengjing Hospital of China Medical University, Shenyang, China
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Krohn F, Lancini E, Ludwig M, Leiman M, Guruprasath G, Haag L, Panczyszyn J, Düzel E, Hämmerer D, Betts M. Noradrenergic neuromodulation in ageing and disease. Neurosci Biobehav Rev 2023; 152:105311. [PMID: 37437752 DOI: 10.1016/j.neubiorev.2023.105311] [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: 04/29/2023] [Revised: 06/29/2023] [Accepted: 07/07/2023] [Indexed: 07/14/2023]
Abstract
The locus coeruleus (LC) is a small brainstem structure located in the lower pons and is the main source of noradrenaline (NA) in the brain. Via its phasic and tonic firing, it modulates cognition and autonomic functions and is involved in the brain's immune response. The extent of degeneration to the LC in healthy ageing remains unclear, however, noradrenergic dysfunction may contribute to the pathogenesis of Alzheimer's (AD) and Parkinson's disease (PD). Despite their differences in progression at later disease stages, the early involvement of the LC may lead to comparable behavioural symptoms such as preclinical sleep problems and neuropsychiatric symptoms as a result of AD and PD pathology. In this review, we draw attention to the mechanisms that underlie LC degeneration in ageing, AD and PD. We aim to motivate future research to investigate how early degeneration of the noradrenergic system may play a pivotal role in the pathogenesis of AD and PD which may also be relevant to other neurodegenerative diseases.
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Affiliation(s)
- F Krohn
- German Center for Neurodegenerative Diseases (DZNE), Otto-von-Guericke University Magdeburg, Magdeburg, Germany; Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - E Lancini
- German Center for Neurodegenerative Diseases (DZNE), Otto-von-Guericke University Magdeburg, Magdeburg, Germany; Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University Magdeburg, Magdeburg, Germany.
| | - M Ludwig
- Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University Magdeburg, Magdeburg, Germany; CBBS Center for Behavioral Brain Sciences, University of Magdeburg, Magdeburg, Germany
| | - M Leiman
- German Center for Neurodegenerative Diseases (DZNE), Otto-von-Guericke University Magdeburg, Magdeburg, Germany; Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - G Guruprasath
- German Center for Neurodegenerative Diseases (DZNE), Otto-von-Guericke University Magdeburg, Magdeburg, Germany; Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - L Haag
- Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - J Panczyszyn
- Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - E Düzel
- German Center for Neurodegenerative Diseases (DZNE), Otto-von-Guericke University Magdeburg, Magdeburg, Germany; Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University Magdeburg, Magdeburg, Germany; Institute of Cognitive Neuroscience, University College London, London UK-WC1E 6BT, UK; CBBS Center for Behavioral Brain Sciences, University of Magdeburg, Magdeburg, Germany
| | - D Hämmerer
- German Center for Neurodegenerative Diseases (DZNE), Otto-von-Guericke University Magdeburg, Magdeburg, Germany; Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University Magdeburg, Magdeburg, Germany; Institute of Cognitive Neuroscience, University College London, London UK-WC1E 6BT, UK; CBBS Center for Behavioral Brain Sciences, University of Magdeburg, Magdeburg, Germany; Department of Psychology, University of Innsbruck, A-6020 Innsbruck, Austria
| | - M Betts
- German Center for Neurodegenerative Diseases (DZNE), Otto-von-Guericke University Magdeburg, Magdeburg, Germany; Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University Magdeburg, Magdeburg, Germany; CBBS Center for Behavioral Brain Sciences, University of Magdeburg, Magdeburg, Germany
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Wang H, Zhao Y, Schrag A. Development of anxiety in early Parkinson's disease: A clinical and biomarker study. Eur J Neurol 2023; 30:2661-2668. [PMID: 37227928 DOI: 10.1111/ene.15890] [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: 11/24/2022] [Revised: 04/28/2023] [Accepted: 05/21/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND Anxiety affects approximately 40% of Parkinson's disease (PD) patients. However, little is known about its predictors and development over time. OBJECTIVE To identify the clinical factors and biomarkers associated with development of anxiety in patients with newly diagnosed PD, and to test which risk factors predict increases in anxiety over time. METHODS Data from the Parkinson's Progression Markers Initiative (PPMI) were utilized. The primary outcome was the State-Trait Anxiety Inventory (STAI). Covariates were demographics, motor and non-motor symptoms, cognitive functions, dopamine transporter imaging data, and cerebrospinal fluid (CSF) biomarkers. We examined the association of risk factors at baseline and over 4 years with changes in anxiety scores over time. RESULTS A total of 252 patients met the inclusion criteria (mean age: 61.36 years, SD 9.53). At year 4, 42 patients had developed anxiety. Baseline predictors of increase in anxiety scores were greater autonomic dysfunction, dysexecutive function, CSF t-tau levels, excessive daytime sleepiness, and lower olfactory function scores but not motor scores. Over 4 years, change in anxiety scores correlated with deterioration in overall cognitive function, excessive daytime sleepiness, as well as depression and disability, and to a lesser degree worsening of Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) motor scores and caudate dopaminergic uptake changes. CONCLUSIONS These findings suggest that development of anxiety in PD is not primarily based on a dopaminergic deficit in the basal ganglia but related to non-dopaminergic or extrastriatal pathology. Early dysexecutive function predicts development of anxiety but increase in anxiety levels correlates most strongly with more global cognitive decline.
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Affiliation(s)
- Hanyuying Wang
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK
| | - Yibo Zhao
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK
- School of Pharmacy, UCL, London, UK
| | - Anette Schrag
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK
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27
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Calabresi P, Di Lazzaro G, Marino G, Campanelli F, Ghiglieri V. Advances in understanding the function of alpha-synuclein: implications for Parkinson's disease. Brain 2023; 146:3587-3597. [PMID: 37183455 PMCID: PMC10473562 DOI: 10.1093/brain/awad150] [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: 01/28/2023] [Revised: 03/13/2023] [Accepted: 03/29/2023] [Indexed: 05/16/2023] Open
Abstract
The critical role of alpha-synuclein in Parkinson's disease represents a pivotal discovery. Some progress has been made over recent years in identifying disease-modifying therapies for Parkinson's disease that target alpha-synuclein. However, these treatments have not yet shown clear efficacy in slowing the progression of this disease. Several explanations exist for this issue. The pathogenesis of Parkinson's disease is complex and not yet fully clarified and the heterogeneity of the disease, with diverse genetic susceptibility and risk factors and different clinical courses, adds further complexity. Thus, a deep understanding of alpha-synuclein physiological and pathophysiological functions is crucial. In this review, we first describe the cellular and animal models developed over recent years to study the physiological and pathological roles of this protein, including transgenic techniques, use of viral vectors and intracerebral injections of alpha-synuclein fibrils. We then provide evidence that these tools are crucial for modelling Parkinson's disease pathogenesis, causing protein misfolding and aggregation, synaptic dysfunction, brain plasticity impairment and cell-to-cell spreading of alpha-synuclein species. In particular, we focus on the possibility of dissecting the pre- and postsynaptic effects of alpha-synuclein in both physiological and pathological conditions. Finally, we show how vulnerability of specific neuronal cell types may facilitate systemic dysfunctions leading to multiple network alterations. These functional alterations underlie diverse motor and non-motor manifestations of Parkinson's disease that occur before overt neurodegeneration. However, we now understand that therapeutic targeting of alpha-synuclein in Parkinson's disease patients requires caution, since this protein exerts important physiological synaptic functions. Moreover, the interactions of alpha-synuclein with other molecules may induce synergistic detrimental effects. Thus, targeting only alpha-synuclein might not be enough. Combined therapies should be considered in the future.
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Affiliation(s)
- Paolo Calabresi
- Sezione di Neurologia, Dipartimento di Neuroscienze, Facoltà di Medicina e Chirurgia, Università Cattolica del Sacro Cuore, Rome, 00168, Italy
- Neurologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, 00168, Italy
| | - Giulia Di Lazzaro
- Neurologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, 00168, Italy
| | - Gioia Marino
- Sezione di Neurologia, Dipartimento di Neuroscienze, Facoltà di Medicina e Chirurgia, Università Cattolica del Sacro Cuore, Rome, 00168, Italy
| | - Federica Campanelli
- Sezione di Neurologia, Dipartimento di Neuroscienze, Facoltà di Medicina e Chirurgia, Università Cattolica del Sacro Cuore, Rome, 00168, Italy
| | - Veronica Ghiglieri
- Neurologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, 00168, Italy
- Department of Human Sciences and Promotion of the Quality of Life, Università Telematica San Raffaele, Rome, 00166, Italy
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28
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Chang B, Mei J, Ni C, Niu C. Functional Connectivity and Anxiety Improvement After Subthalamic Nucleus Deep Brain Stimulation in Parkinson's Disease. Clin Interv Aging 2023; 18:1437-1445. [PMID: 37663121 PMCID: PMC10474892 DOI: 10.2147/cia.s422605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 08/23/2023] [Indexed: 09/05/2023] Open
Abstract
Background Anxiety is one of the most common and disturbing non-motor symptoms of Parkinson's disease (PD). However, few studies have explored the relationship between functional connectivity (FC) and the rate of anxiety improvement after subthalamic nucleus deep brain stimulation (STN-DBS). Therefore, in this study, we aimed to explore the correlation between FC and the rate of anxiety improvement in patients with PD who underwent STN-DBS. Methods The resting-state functional magnetic resonance imaging (rs-fMRI) data of 62 patients with anxious PD (aPD), 68 patients with PD without anxiety (naPD), and 64 healthy controls (HCs) were analyzed according to FC. Intergroup comparison and correlation analyses of anxiety improvement rates were performed. Results The HC, aPD and naPD groups of zFCs were then used for the ANOVA test, and the results were FDR-corrected. There were 24 significant differences in FCs between the three groups. Post tests were conducted between groups found that 15 significantly different FCs were observed between the naPD and aPD groups. In addition, the two FCs in patients with aPD were significantly correlated with the rate of improvement in anxiety. Conclusion We found that the two FCs in patients with aPD (olfactory cortex and inferior frontal gyrus [IFG] pars orbitalis; inferior temporal gyrus and posterior orbital gyrus) were significantly correlated with the rate of improvement in anxiety. Our study may help us understand the underlying mechanisms by which STN-DBS improves anxiety in PD patients and identify more effective treatment strategies.
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Affiliation(s)
- Bowen Chang
- Department of Neurosurgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, People’s Republic of China
- Anhui Province Key Laboratory of Brain Function and Brain Disease, Hefei, People’s Republic of China
| | - Jiaming Mei
- Department of Neurosurgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, People’s Republic of China
- Anhui Province Key Laboratory of Brain Function and Brain Disease, Hefei, People’s Republic of China
| | - Chen Ni
- Department of Neurosurgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, People’s Republic of China
- Anhui Province Key Laboratory of Brain Function and Brain Disease, Hefei, People’s Republic of China
| | - Chaoshi Niu
- Department of Neurosurgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, People’s Republic of China
- Anhui Province Key Laboratory of Brain Function and Brain Disease, Hefei, People’s Republic of China
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29
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Uceda S, Echeverry-Alzate V, Reiriz-Rojas M, Martínez-Miguel E, Pérez-Curiel A, Gómez-Senent S, Beltrán-Velasco AI. Gut Microbial Metabolome and Dysbiosis in Neurodegenerative Diseases: Psychobiotics and Fecal Microbiota Transplantation as a Therapeutic Approach-A Comprehensive Narrative Review. Int J Mol Sci 2023; 24:13294. [PMID: 37686104 PMCID: PMC10487945 DOI: 10.3390/ijms241713294] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/22/2023] [Accepted: 08/25/2023] [Indexed: 09/10/2023] Open
Abstract
The comprehensive narrative review conducted in this study delves into the mechanisms of communication and action at the molecular level in the human organism. The review addresses the complex mechanism involved in the microbiota-gut-brain axis as well as the implications of alterations in the microbial composition of patients with neurodegenerative diseases. The pathophysiology of neurodegenerative diseases with neuronal loss or death is analyzed, as well as the mechanisms of action of the main metabolites involved in the bidirectional communication through the microbiota-gut-brain axis. In addition, interventions targeting gut microbiota restructuring through fecal microbiota transplantation and the use of psychobiotics-pre- and pro-biotics-are evaluated as an opportunity to reduce the symptomatology associated with neurodegeneration in these pathologies. This review provides valuable information and facilitates a better understanding of the neurobiological mechanisms to be addressed in the treatment of neurodegenerative diseases.
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Affiliation(s)
- Sara Uceda
- BRABE Group, Psychology Department, School of Life and Nature Sciences, Nebrija University, 28240 Madrid, Spain
| | - Víctor Echeverry-Alzate
- BRABE Group, Psychology Department, School of Life and Nature Sciences, Nebrija University, 28240 Madrid, Spain
| | - Manuel Reiriz-Rojas
- BRABE Group, Psychology Department, School of Life and Nature Sciences, Nebrija University, 28240 Madrid, Spain
| | - Esther Martínez-Miguel
- Health Department, School of Life and Nature Sciences, Nebrija University, 28240 Madrid, Spain
| | - Ana Pérez-Curiel
- Health Department, School of Life and Nature Sciences, Nebrija University, 28240 Madrid, Spain
| | - Silvia Gómez-Senent
- Health Department, School of Life and Nature Sciences, Nebrija University, 28240 Madrid, Spain
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Li R, Wang Y, Yang Y, Wu Z, Wang L, Tang G, Yang J, Liu J. The α1 and γ2 subunit-containing GABA A receptor-mediated inhibitory transmission in the anteroventral bed nucleus of stria terminalis is involved in the regulation of anxiety in rats with substantia nigra lesions. Neuropharmacology 2023:109645. [PMID: 37392819 DOI: 10.1016/j.neuropharm.2023.109645] [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: 03/17/2023] [Revised: 06/08/2023] [Accepted: 06/22/2023] [Indexed: 07/03/2023]
Abstract
The anteroventral bed nucleus of the stria terminalis (avBNST) is widely acknowledged as a key brain structure that regulates negative emotional states, such as anxiety. At present, it is still unclear whether GABAA receptor-mediated inhibitory transmission in the avBNST is involved in Parkinson's disease (PD)-related anxiety. In this study, unilateral 6-hydroxydopamine (6-OHDA) lesions of the substantia nigra pars compacta (SNc) in rats induced anxiety-like behaviors, increased GABA synthesis and release, and upregulated expression of GABAA receptor subunits in the avBNST, as well as decreased level of dopamine (DA) in the basolateral amygdala (BLA). In both sham and 6-OHDA rats, intra-avBNST injection of GABAA receptor agonist muscimol induced the following changes: (i) anxiolytic-like responses, (ii) inhibition of the firing activity of GABAergic neurons in the avBNST, (iii) excitation of dopaminergic neurons in the ventral tegmental area (VTA) and serotonergic neurons in the dorsal raphe nucleus (DRN), and (iv) increase of DA and 5-HT release in the BLA, whereas antagonist bicuculline induced the opposite effects. Collectively, these findings suggest that degeneration of the nigrostriatal pathway enhances GABAA receptor-mediated inhibitory transmission in the avBNST, which is involved in PD-related anxiety. Further, activation and blockade of avBNST GABAA receptors affect the firing activity of VTA dopaminergic and DRN serotonergic neurons, and then change release of BLA DA and 5-HT, thereby regulating anxiety-like behaviors.
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Affiliation(s)
- Ruotong Li
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, China
| | - Yong Wang
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, China
| | - Yaxin Yang
- Department of Rehabilitation Medicine, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, 710004, China
| | - Zhongheng Wu
- Department of Rehabilitation Medicine, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, 710004, China
| | - Ling Wang
- Department of Rehabilitation Medicine, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, 710004, China
| | - Guoyi Tang
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, China
| | - Jie Yang
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, China
| | - Jian Liu
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, China.
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31
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Zhang T, Yang R, Pan J, Huang S. Parkinson's Disease Related Depression and Anxiety: A 22-Year Bibliometric Analysis (2000-2022). Neuropsychiatr Dis Treat 2023; 19:1477-1489. [PMID: 37404573 PMCID: PMC10317541 DOI: 10.2147/ndt.s403002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 06/14/2023] [Indexed: 07/06/2023] Open
Abstract
Background Parkinson's disease (PD) is one of the common neurodegenerative diseases. Depression and anxiety are the most common psychiatric symptoms of PD. It is important to study the potential relationship between PD and depression or anxiety. Aim This study aimed to use bibliometrics to analyze the papers about parkinson's disease related depression and anxiety over the last 22 years, and to characterize the current status of research and predict future hotspots. Methods In the Web of Science Core Collection (WoSCC) from 2000 to 2022, documents are searched according to specific subject words. The selected literature was retrospectively analyzed and mapped using CiteSpace and Vosviewer software. We analyzed countries, institutions, journals, authors, references and keywords. Results A total of 7368 papers were included from 2000 to 2022, and the number of publications has shown an upward trend year by year. Movement Disorder is the journal with the highest number of publications (391 publications, 5.31%) and citations (30,549 times), with the United States (2055 publications, 27.9%) and the University of Toronto (158 publications) being the countries and institutions with the highest number of publications. The high-frequency keywords focused on "quality of life", "deep brain stimulation" and "non-motor symptoms". "Functional connectivity", "gut microbiota" and "inflammation" may be at the forefront of future research. Conclusion Parkinson's disease related depression and anxiety have been increasingly studied over the past 22 years. Functional connectivity, gut microbiota, and inflammation will be the subject of active research hotspots in the future, and these findings may provide new research ideas for researchers.
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Affiliation(s)
- Tong Zhang
- Research and Development Center of Traditional Chinese Medicine, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, People’s Republic of China
| | - Rui Yang
- Research and Development Center of Traditional Chinese Medicine, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, People’s Republic of China
| | - Juhua Pan
- Research and Development Center of Traditional Chinese Medicine, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, People’s Republic of China
| | - Shijing Huang
- Research and Development Center of Traditional Chinese Medicine, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, People’s Republic of China
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Lai TT, Gericke B, Feja M, Conoscenti M, Zelikowsky M, Richter F. Anxiety in synucleinopathies: neuronal circuitry, underlying pathomechanisms and current therapeutic strategies. NPJ Parkinsons Dis 2023; 9:97. [PMID: 37349373 DOI: 10.1038/s41531-023-00547-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 06/09/2023] [Indexed: 06/24/2023] Open
Abstract
Synucleinopathies are neurodegenerative disorders characterized by alpha-synuclein (αSyn) accumulation in neurons or glial cells, including Parkinson's disease (PD), dementia with Lewy bodies (DLB), and multiple system atrophy (MSA). αSyn-related pathology plays a critical role in the pathogenesis of synucleinopathies leading to the progressive loss of neuronal populations in specific brain regions and the development of motor and non-motor symptoms. Anxiety is among the most frequent non-motor symptoms in patients with PD, but it remains underrecognized and undertreated, which significantly reduces the quality of life for patients. Anxiety is defined as a neuropsychiatric complication with characteristics such as nervousness, loss of concentration, and sweating due to the anticipation of impending danger. In patients with PD, neuropathology in the amygdala, a central region in the anxiety and fear circuitry, may contribute to the high prevalence of anxiety. Studies in animal models reported αSyn pathology in the amygdala together with alteration of anxiety or fear learning response. Therefore, understanding the progression, extent, and specifics of pathology in the anxiety and fear circuitry in synucleinopathies will suggest novel approaches to the diagnosis and treatment of neuropsychiatric symptoms. Here, we provide an overview of studies that address neuropsychiatric symptoms in synucleinopathies. We offer insights into anxiety and fear circuitry in animal models and the current implications for therapeutic intervention. In summary, it is apparent that anxiety is not a bystander symptom in these disorders but reflects early pathogenic mechanisms in the cortico-limbic system which may even contribute as a driver to disease progression.
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Affiliation(s)
- Thuy Thi Lai
- Department of Pharmacology, Toxicology and Pharmacy, University of Veterinary Medicine, Hannover, Germany
- Center for Systems Neuroscience, Hannover, Germany
| | - Birthe Gericke
- Department of Pharmacology, Toxicology and Pharmacy, University of Veterinary Medicine, Hannover, Germany
- Center for Systems Neuroscience, Hannover, Germany
| | - Malte Feja
- Department of Pharmacology, Toxicology and Pharmacy, University of Veterinary Medicine, Hannover, Germany
- Center for Systems Neuroscience, Hannover, Germany
| | | | | | - Franziska Richter
- Department of Pharmacology, Toxicology and Pharmacy, University of Veterinary Medicine, Hannover, Germany.
- Center for Systems Neuroscience, Hannover, Germany.
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Wang K, Fu W, Li S, Chen L, Gan Y, Xiang W, Chen L, Zhou J. Preoperative symptoms of depression, anxiety, and cognitive impairment in glioma patients: A cerebral perfusion CT study. Brain Behav 2023; 13:e3020. [PMID: 37128127 PMCID: PMC10275540 DOI: 10.1002/brb3.3020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 04/01/2023] [Accepted: 04/04/2023] [Indexed: 05/03/2023] Open
Abstract
PURPOSE Glioma patients have varying degrees of psychiatric symptoms, which severely affect the quality of life of patients and their families. The present study investigated the correlation between preoperative psychiatric symptoms and local cerebral perfusion parameters of in glioma patients. PATIENTS AND METHODS The depression, anxiety, and cognitive impairment (CI) scores of 39 patients were assessed separately, and all of the patients underwent a preoperative perfusion computed tomography scan. RESULTS This study found that: (1) The incidence of preoperative symptoms of depression, anxiety, and CI was 46.15%, 48.72%, and 25.64%, respectively. (2) Cerebral blood volume (CBV) (lesion-sided [LS] occipital lobe white matter [WM] and parietal lobe WM and normal-sided temporal lobe WM), permeability surface (PS) (LS temporal lobe gray matter [GM] and parietal lobe WM) in the depression group were significantly decreased (p < .05). (3) CBV (LS occipital lobe WM), cerebral blood flow (LS parietal lobe GM, centrum ovale and frontal lobe WM and normal-sided frontal lobe WM, temporal lobe WM and parietal lobe WM), and mean transition time (MTT) (normal-sided frontal lobe WM and temporal lobe WM) in the anxiety group were significantly increased (p < .05). (4) CBV (LS temporal lobe GM), MTT (LS anterior limb of internal capsule), and PS (LS thalamus) in the CI group were significantly increased (p < .05). CONCLUSION This study showed that glioma patients had different levels of psychological distress in glioma patients before surgery, which may be related to the changes in brain perfusion caused by the tumor.
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Affiliation(s)
- Ke Wang
- Key Laboratory of Advanced Technologies of Materials, Ministry of Education, School of Materials Science and EngineeringSouthwest Jiaotong UniversityChengduChina
- Department of NeurosurgeryThe Affiliated Hospital of Southwest Medical UniversityLuzhouChina
| | - Wanrui Fu
- Huadong HospitalFudan UniversityShanghaiChina
| | - Shenjie Li
- Department of NeurosurgeryThe Affiliated Hospital of Southwest Medical UniversityLuzhouChina
- Neurosurgery Clinical Medical Research Center of Sichuan ProvinceLuzhouChina
- Neurological Diseases and Brain Function LaboratoryLuzhouChina
| | - Lizhen Chen
- Department of Clinical LaboratoryChengdu Women's and Children's Central HospitalChengduChina
| | - Yajie Gan
- Department of NeurosurgeryThe Affiliated Hospital of Southwest Medical UniversityLuzhouChina
| | - Wei Xiang
- Department of NeurosurgeryThe Affiliated Hospital of Southwest Medical UniversityLuzhouChina
- Neurosurgery Clinical Medical Research Center of Sichuan ProvinceLuzhouChina
- Neurological Diseases and Brain Function LaboratoryLuzhouChina
| | - Ligang Chen
- Department of NeurosurgeryThe Affiliated Hospital of Southwest Medical UniversityLuzhouChina
- Neurosurgery Clinical Medical Research Center of Sichuan ProvinceLuzhouChina
- Neurological Diseases and Brain Function LaboratoryLuzhouChina
| | - Jie Zhou
- Department of NeurosurgeryThe Affiliated Hospital of Southwest Medical UniversityLuzhouChina
- Neurosurgery Clinical Medical Research Center of Sichuan ProvinceLuzhouChina
- Neurological Diseases and Brain Function LaboratoryLuzhouChina
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Guo M, Zhong Y, Xu J, Zhang G, Xu A, Kong J, Wang Q, Hang Y, Xie Y, Wu Z, Lang N, Tang Y, Zhang N, Wang C. Altered brain function in patients with acrophobia: A voxel-wise degree centrality analysis. J Psychiatr Res 2023; 164:59-65. [PMID: 37315355 DOI: 10.1016/j.jpsychires.2023.05.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 04/25/2023] [Accepted: 05/16/2023] [Indexed: 06/16/2023]
Abstract
AIM To explore the local spontaneous neural activity and whole-brain functional connectivity patterns in the resting brain of acrophobia patients. METHODS 50 patients with acrophobia and 47 healthy controls were selected for this study. All participants underwent resting-state MRI scans after enrollment. The imaging data were then analyzed using a voxel-based degree centrality (DC) method, and seed-based functional connectivity (FC) correlation analysis was used to explore the correlation between abnormal functional connectivity and clinical symptom scales in acrophobia. The severity of symptoms was evaluated using self-report and behavioral measures. RESULTS Compared to controls, acrophobia patients showed higher DC in the right cuneus and left middle occipital gyrus and significantly lower DC in the right cerebellum and left orbitofrontal cortex (p < 0.01, GRF corrected). Additionally, there were negative correlations between the acrophobia questionnaire avoidance (AQ- Avoidance) scores and right cerebellum-left perirhinal cortex FC (r = -0.317, p = 0.025) and between scores of the 7-item generalized anxiety disorder scale and left middle occipital gyrus-right cuneus FC (r = -0.379, p = 0.007). In the acrophobia group, there was a positive correlation between behavioral avoidance scale and right cerebellum-right cuneus FC (r = 0.377, p = 0.007). CONCLUSIONS The findings indicated that there are local abnormalities in spontaneous neural activity and functional connectivity in the visual cortex, cerebellum, and orbitofrontal cortex in patients with acrophobia.
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Affiliation(s)
- Meilin Guo
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, 210029, China
| | - Yuan Zhong
- School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, 210097, China
| | - Jingren Xu
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, 210029, China
| | - Guojia Zhang
- School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, 210097, China
| | - Aoran Xu
- School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, 210097, China
| | - Jingya Kong
- School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, 210097, China
| | - Qiuyu Wang
- School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, 210097, China
| | - Yaming Hang
- School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, 210097, China
| | - Ya Xie
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, 210029, China
| | - Zhou Wu
- School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, 210097, China
| | - Nan Lang
- School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, 210097, China
| | - Yibin Tang
- College of Internet of Things Engineering, Hohai University, Changzhou, Jiangsu, China
| | - Ning Zhang
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, 210029, China.
| | - Chun Wang
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, 210029, China; School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, 210097, China; Cognitive Behavioral Therapy Institute of Nanjing Medical University, Nanjing, Jiangsu, 210029, China.
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35
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Blundell EK, Grover LE, Stott J, Schrag A. The experience of Anxiety for people with Parkinson's disease. NPJ Parkinsons Dis 2023; 9:75. [PMID: 37198166 DOI: 10.1038/s41531-023-00512-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 04/13/2023] [Indexed: 05/19/2023] Open
Abstract
Anxiety is a common non-motor symptom of Parkinson's disease (PD) associated with increased disability and reduced quality of life. However, anxiety is poorly understood, underdiagnosed, and undertreated. To date, little research has explored how anxiety is experienced by patients themselves. This study explored the experience of anxiety for people with Parkinson's (PWP) to inform future research and interventions. Semi-structured interviews with 22 PWP (aged 43-80, 50% female) were conducted and analysed using inductive thematic analysis. Four main themes were extracted: conceptualising anxiety; anxiety and the body; anxiety and social identity; and coping with anxiety. Sub-themes revealed inconsistent perceptions: anxiety was in body and mind, part of disease and human nature, part of self-identity and a threat to it. The symptoms described were diverse. Many perceived their anxiety as more incapacitating than motor symptoms or capable of amplifying them, and described that anxiety restricted their lifestyle. All perceived anxiety as connected to PD, and ultimately persistent: dominant aspirations were coping and acceptance rather than cures, with medications strongly resisted. Findings highlight the complexity and high importance of anxiety for PWP. Implications for therapeutic approaches are discussed.
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Affiliation(s)
- Emma K Blundell
- Department of Clinical and Movement Neurosciences, University College London, London, UK
- ADAPT Lab, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Laura E Grover
- Department of Clinical and Movement Neurosciences, University College London, London, UK
| | - Joshua Stott
- ADAPT Lab, Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Anette Schrag
- Department of Clinical and Movement Neurosciences, University College London, London, UK.
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Chen K, Zhang L, Wang F, Mao H, Tang Q, Shi G, You Y, Yuan Q, Chen B, Fang X. Altered functional connectivity within the brain fear circuit in Parkinson's disease with anxiety: A seed-based functional connectivity study. Heliyon 2023; 9:e15871. [PMID: 37305477 PMCID: PMC10256910 DOI: 10.1016/j.heliyon.2023.e15871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 04/06/2023] [Accepted: 04/24/2023] [Indexed: 06/13/2023] Open
Abstract
Objectives Aimed to investigate whether there are abnormal changes in the functional connectivity (FC) between the amygdala with other brain areas, in Parkinson's disease (PD) patients with anxiety. Methods Participants were enrolled prospectively, and the Hamilton Anxiety Rating (HAMA) Scale was used to quantify anxiety disorder. Rest-state functional MRI (rs-fMRI) was applied to analyze the amygdala FC patterns among anxious PD patients, non-anxious PD patients, and healthy controls. Results Thirty-three PD patients were recruited, 13 with anxiety, 20 without anxiety, and 19 non-anxious healthy controls. In anxious PD patients, FC between the amygdala with the hippocampus, putamen, intraparietal sulcus, and precuneus showed abnormal alterations compared with non-anxious PD patients and healthy controls. In particular, FC between the amygdala and hippocampus negatively correlated with the HAMA score (r = -0.459, p = 0.007). Conclusion Our results support the role of the fear circuit in emotional regulation in PD with anxiety. Also, the abnormal FC patterns of the amygdala could preliminarily explain the neural mechanisms of anxiety in PD.
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Affiliation(s)
- Kaidong Chen
- Department of Radiology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, No. 299, Qingyang Road, Liangxi District, Wuxi, 214023, Jiangsu Province, China
| | - Li Zhang
- Department of Neurology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, No. 299, Qingyang Road, Liangxi District, Wuxi, 214023, Jiangsu Province, China
| | - Feng Wang
- Department of Neurology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, No. 299, Qingyang Road, Liangxi District, Wuxi, 214023, Jiangsu Province, China
| | - Haixia Mao
- Department of Radiology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, No. 299, Qingyang Road, Liangxi District, Wuxi, 214023, Jiangsu Province, China
| | - Qunfeng Tang
- Department of Neurology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, No. 299, Qingyang Road, Liangxi District, Wuxi, 214023, Jiangsu Province, China
| | - Guofeng Shi
- Department of Neurology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, No. 299, Qingyang Road, Liangxi District, Wuxi, 214023, Jiangsu Province, China
| | - Yiping You
- Department of Neurology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, No. 299, Qingyang Road, Liangxi District, Wuxi, 214023, Jiangsu Province, China
| | - Qingfang Yuan
- Department of Neurology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, No. 299, Qingyang Road, Liangxi District, Wuxi, 214023, Jiangsu Province, China
| | - Bixue Chen
- Department of Radiology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, No. 299, Qingyang Road, Liangxi District, Wuxi, 214023, Jiangsu Province, China
| | - Xiangming Fang
- Department of Radiology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, No. 299, Qingyang Road, Liangxi District, Wuxi, 214023, Jiangsu Province, China
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Wang J, Sun L, Chen L, Sun J, Xie Y, Tian D, Gao L, Zhang D, Xia M, Wu T. Common and distinct roles of amygdala subregional functional connectivity in non-motor symptoms of Parkinson's disease. NPJ Parkinsons Dis 2023; 9:28. [PMID: 36806219 PMCID: PMC9938150 DOI: 10.1038/s41531-023-00469-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 02/02/2023] [Indexed: 02/19/2023] Open
Abstract
Neuroimaging studies suggest a pivotal role of amygdala dysfunction in non-motor symptoms (NMS) of Parkinson's disease (PD). However, the relationship between amygdala subregions (the centromedial (CMA), basolateral (BLA) and superficial amygdala (SFA)) and NMS has not been delineated. We used resting-state functional MRI to examine the PD-related alterations in functional connectivity for amygdala subregions. The left three subregions and right BLA exhibited between-group differences, and were commonly hypo-connected with the frontal, temporal, insular cortex, and putamen in PD. Each subregion displayed distinct hypoconnectivity with the limbic systems. Partial least-squares analysis revealed distinct amygdala subregional involvement in diverse NMS. Hypo-connectivity of all four subregions was associated with emotion, pain, olfaction, and cognition. Hypo-connectivity of the left SFA was associated with sleepiness. Our findings highlight the hypofunction of the amygdala subregions in PD and their preliminary associations with NMS, providing new insights into the pathogenesis of NMS.
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Affiliation(s)
- Junling Wang
- grid.24696.3f0000 0004 0369 153XCenter for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070 China
| | - Lianglong Sun
- grid.20513.350000 0004 1789 9964State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100091 China ,grid.20513.350000 0004 1789 9964Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, 100091 China ,grid.20513.350000 0004 1789 9964IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100091 China
| | - Lili Chen
- grid.24696.3f0000 0004 0369 153XCenter for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070 China
| | - Junyan Sun
- grid.24696.3f0000 0004 0369 153XCenter for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070 China
| | - Yapei Xie
- grid.20513.350000 0004 1789 9964State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100091 China ,grid.20513.350000 0004 1789 9964Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, 100091 China ,grid.20513.350000 0004 1789 9964IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100091 China
| | - Dezheng Tian
- grid.20513.350000 0004 1789 9964State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100091 China ,grid.20513.350000 0004 1789 9964Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, 100091 China ,grid.20513.350000 0004 1789 9964IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100091 China
| | - Linlin Gao
- grid.417031.00000 0004 1799 2675Department of General Medicine, Tianjin Union Medical Center, Tianjin, 300122 China
| | - Dongling Zhang
- grid.24696.3f0000 0004 0369 153XCenter for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070 China
| | - Mingrui Xia
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100091, China. .,Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, 100091, China. .,IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100091, China.
| | - Tao Wu
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China.
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Chen K, Zhang L, Mao H, Chen K, Shi Y, Meng X, Wang F, Hu X, Fang X. The impact of iron deposition on the fear circuit of the brain in patients with Parkinson's disease and anxiety. Front Aging Neurosci 2023; 15:1116516. [PMID: 36845658 PMCID: PMC9951615 DOI: 10.3389/fnagi.2023.1116516] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 01/24/2023] [Indexed: 02/11/2023] Open
Abstract
Objective Anxiety is one of the most common psychiatric symptoms of Parkinson's disease (PD), and brain iron deposition is considered to be one of the pathological mechanisms of PD. The objective of this study was to explore alterations in brain iron deposition in PD patients with anxiety compared to PD patients without anxiety, especially in the fear circuit. Methods Sixteen PD patients with anxiety, 23 PD patients without anxiety, and 26 healthy elderly controls were enrolled prospectively. All subjects underwent neuropsychological assessments and brain magnetic resonance imaging (MRI) examinations. Voxel-based morphometry (VBM) was used to study morphological brain differences between the groups. Quantitative susceptibility mapping (QSM), an MRI technique capable of quantifying susceptibility changes in brain tissue, was used to compare susceptibility changes in the whole brain among the three groups. The correlations between brain susceptibility changes and anxiety scores quantified using the Hamilton Anxiety Rating Scale (HAMA) were compared and analyzed. Results PD patients with anxiety had a longer duration of PD and higher HAMA scores than PD patients without anxiety. No morphological brain differences were observed between the groups. In contrast, voxel-based and ROI-based QSM analyses showed that PD patients with anxiety had significantly increased QSM values in the medial prefrontal cortex, anterior cingulate cortex, hippocampus, precuneus, and angular cortex. Furthermore, the QSM values of some of these brain regions were positively correlated with the HAMA scores (medial prefrontal cortex: r = 0.255, p = 0.04; anterior cingulate cortex: r = 0.381, p < 0.01; hippocampus: r = 0.496, p < 0.01). Conclusion Our findings support the idea that anxiety in PD is associated with iron burden in the brain fear circuit, providing a possible new approach to explaining the potential neural mechanism of anxiety in PD.
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Affiliation(s)
- Kaidong Chen
- Department of Radiology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, China
| | - Li Zhang
- Department of Neurology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, China
| | - Haixia Mao
- Department of Radiology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, China
| | - Kefei Chen
- Department of Neurology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, China
| | - Yachen Shi
- Department of Neurology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, China
| | - Xiangpan Meng
- Department of Radiology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, China
| | - Feng Wang
- Department of Neurology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, China,*Correspondence: Xiangming Fang, ✉
| | - Xiaoyun Hu
- Department of Radiology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, China,Feng Wang, ✉
| | - Xiangming Fang
- Department of Radiology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, China,Xiaoyun Hu, ✉
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Carey G, Lopes R, Moonen AJ, Mulders AE, de Jong JJ, Kuchcinski G, Defebvre L, Kuijf ML, Dujardin K, Leentjens AF. Cognitive Behavioral Therapy for Anxiety in Parkinson's Disease Induces Functional Brain Changes. JOURNAL OF PARKINSON'S DISEASE 2023; 13:93-103. [PMID: 36591659 PMCID: PMC9912714 DOI: 10.3233/jpd-223527] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Cognitive behavioral therapy (CBT) reduces anxiety symptoms in patients with Parkinson's disease (PD). OBJECTIVE The objective of this study was to identify changes in functional connectivity in the brain after CBT for anxiety in patients with PD. METHODS Thirty-five patients with PD and clinically significant anxiety were randomized over two groups: CBT plus clinical monitoring (10 CBT sessions) or clinical monitoring only (CMO). Changes in severity of anxiety symptoms were assessed with the Parkinson Anxiety Scale (PAS). Resting-state functional brain MRI was performed at baseline and after the intervention. Functional networks were extracted by an Independent Component Analysis (ICA). Functional connectivity (FC) changes between structures involved in the PD-related anxiety circuits, such as the fear circuit (involving limbic, frontal, and cingulate structures) and the cortico-striato-thalamo-cortical limbic circuit, and both within and between functional networks were compared between groups and regressed with anxiety symptoms changes. RESULTS Compared to CMO, CBT reduced the FC between the right thalamus and the bilateral orbitofrontal cortices and increased the striato-frontal FC. CBT also increased the fronto-parietal FC within the central executive network (CEN) and between the CEN and the salience network. After CBT, improvement of PAS-score was associated with an increased striato-cingulate and parieto-temporal FC, and a decreased FC within the default-mode network and between the dorsal attentional network and the language network. CONCLUSION CBT in PD-patients improves anxiety symptoms and is associated with functional changes reversing the imbalance between PD-related anxiety circuits and reinforcing cognitive control on emotional processing.
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Affiliation(s)
- Guillaume Carey
- School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands,Lille Neuroscience & Cognition, University of Lille, Lille, France,Department of Neurology and Movement Disorders, Lille University Medical Centre, Lille, France,Correspondence to: Guillaume Carey, MD, CHU de Lille, Hôpital Roger Salengro, Avenue du Professeur Emile Laine, Service de Neurologie A, 59037, Lille, France. E-mail:
| | - Renaud Lopes
- Lille Neuroscience & Cognition, University of Lille, Lille, France,Plateformes Lilloises en Biologie & Santé, University of Lille, Lille, France
| | - Anja J.H. Moonen
- School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands,Department of Psychiatry, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Anne E.P. Mulders
- School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands,Department of Psychiatry, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Joost J.A. de Jong
- School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands,Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Gregory Kuchcinski
- Lille Neuroscience & Cognition, University of Lille, Lille, France,Department of Neuroradiology, Lille University Medical Centre, Lille, France,Plateformes Lilloises en Biologie & Santé, University of Lille, Lille, France
| | - Luc Defebvre
- Lille Neuroscience & Cognition, University of Lille, Lille, France,Department of Neurology and Movement Disorders, Lille University Medical Centre, Lille, France
| | - Mark L. Kuijf
- School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands,Department of Neurology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Kathy Dujardin
- Lille Neuroscience & Cognition, University of Lille, Lille, France,Department of Neurology and Movement Disorders, Lille University Medical Centre, Lille, France
| | - Albert F.G. Leentjens
- School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands,Department of Psychiatry, Maastricht University Medical Centre, Maastricht, The Netherlands
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Jiang Y, Jiang Y, Peng T, Wang M, Li M, Zhang M, Li L, Zhang Q. The psychometric properties of the Chinese version of the Parkinson Anxiety Scale (C-PAS) among Parkinson's disease. BMC Neurol 2023; 23:60. [PMID: 36739373 PMCID: PMC9898907 DOI: 10.1186/s12883-023-03095-9] [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: 06/03/2022] [Accepted: 01/29/2023] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Anxiety disorder is a common non-motor symptom among individuals with Parkinson's disease (PD). At present, there are no specific tools in China for assessing the anxiety level of patients with PD. This study aimed to test the reliability and validity of the Chinese version of the Parkinson Anxiety Scale (C-PAS) in Chinese patients with PD. METHODS A total of 158 patients with PD at one hospital in Nanjing were recruited through convenience sampling. The C-PAS was translated into Chinese using a classic 'forward-backward' translation method. Reliability tests included internal consistency and test-reliability. And in addition to content, structure and criterion-related validity were performed for the validity tests. Criterion-related validity was evaluated with the Hospital Anxiety and Depression Scale-Anxiety Subscale (HADS-A). RESULTS Results confirmed the three-factor structure of the original C-PAS with 12 items, including persistent anxiety (5 items), episodic anxiety (4 items) and avoidance behavior (3 items). Significant and positive correlations were obtained between C-PAS and HADS-A (r = 0.82, P<0.01). The Cronbach's α and test-retest reliability of the total scale were 0.89 and 0.84, respectively. CONCLUSION The C-PAS has demonstrated good psychometric properties. Therefore, it can be employed in patients with PD to evaluate the condition of anxiety.
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Affiliation(s)
- Yuanyuan Jiang
- grid.428392.60000 0004 1800 1685Department of Neurology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No.321 Zhongshan Road, Gulou District, 210008 Nanjing, China
| | - Yelin Jiang
- grid.428392.60000 0004 1800 1685Department of Neurology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No.321 Zhongshan Road, Gulou District, 210008 Nanjing, China
| | - Tiantian Peng
- grid.428392.60000 0004 1800 1685Department of Neurology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No.321 Zhongshan Road, Gulou District, 210008 Nanjing, China
| | - Mengyue Wang
- grid.428392.60000 0004 1800 1685Department of Neurology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No.321 Zhongshan Road, Gulou District, 210008 Nanjing, China
| | - Manman Li
- grid.428392.60000 0004 1800 1685Department of Neurology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No.321 Zhongshan Road, Gulou District, 210008 Nanjing, China
| | - Min Zhang
- grid.428392.60000 0004 1800 1685Department of Neurology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No.321 Zhongshan Road, Gulou District, 210008 Nanjing, China
| | - Li Li
- grid.428392.60000 0004 1800 1685Department of Neurology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No.321 Zhongshan Road, Gulou District, 210008 Nanjing, China
| | - Qi Zhang
- grid.11135.370000 0001 2256 9319School of Nursing, Peking University, Beijing, China
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Chang B, Mei J, Ni C, Xiong C, Chen P, Jiang M, Niu C. Development and Validation of a Prediction Model for Anxiety Improvement after Deep Brain Stimulation for Parkinson Disease. Brain Sci 2023; 13:brainsci13020219. [PMID: 36831762 PMCID: PMC9954104 DOI: 10.3390/brainsci13020219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 12/29/2022] [Accepted: 01/25/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Parkinson's disease (PD) represents one of the most frequently seen neurodegenerative disorders, while anxiety accounts for its non-motor symptom (NMS), and it has greatly affected the life quality of PD cases. Bilateral subthalamic nucleus deep brain stimulation (STN-DBS) can effectively treat PD. This study aimed to develop a clinical prediction model for the anxiety improvement rate achieved in PD patients receiving STN-DBS. METHODS The present work retrospectively enrolled 103 PD cases undergoing STN-DBS. Patients were followed up for 1 year after surgery to analyze the improvement in HAMA scores. Univariate and multivariate logistic regression were conducted to select factors affecting the Hamilton Anxiety Scale (HAMA) improvement. A nomogram was established to predict the likelihood of achieving anxiety improvement. Receiver operating characteristic (ROC) curve analysis, decision curve analysis (DCA), and calibration curve analysis were conducted to verify nomogram performance. RESULTS The mean improvement in HAMA score was 23.9% in 103 patients; among them, 68.9% had improved anxiety, 25.2% had worsened (Preop) anxiety, and 5.8% had no significant change in anxiety. Education years, UPDRS-III preoperative score, and HAMA preoperative score were independent risk factors for anxiety improvement. The nomogram-predicted values were consistent with real probabilities. CONCLUSIONS Collectively, a nomogram is built in the present work for predicting anxiety improvement probability in PD patients 1 year after STN-DBS. The model is valuable for determining expected anxiety improvement in PD patients undergoing STN-DBS.
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Affiliation(s)
- Bowen Chang
- Department of Neurosurgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China
- Anhui Province Key Laboratory of Brain Function and Brain Disease, Hefei 230001, China
| | - Jiaming Mei
- Department of Neurosurgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China
- Anhui Province Key Laboratory of Brain Function and Brain Disease, Hefei 230001, China
| | - Chen Ni
- Department of Neurosurgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China
- Anhui Province Key Laboratory of Brain Function and Brain Disease, Hefei 230001, China
| | - Chi Xiong
- Department of Neurosurgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China
- Anhui Province Key Laboratory of Brain Function and Brain Disease, Hefei 230001, China
| | - Peng Chen
- Department of Neurosurgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China
- Anhui Province Key Laboratory of Brain Function and Brain Disease, Hefei 230001, China
| | - Manli Jiang
- Department of Neurosurgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China
- Anhui Province Key Laboratory of Brain Function and Brain Disease, Hefei 230001, China
| | - Chaoshi Niu
- Department of Neurosurgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China
- Anhui Province Key Laboratory of Brain Function and Brain Disease, Hefei 230001, China
- Correspondence:
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Cortical Synaptic Mechanism for Chronic Pain and Anxiety in Parkinson's Disease. J Transl Int Med 2023; 10:300-303. [PMID: 36860635 PMCID: PMC9969574 DOI: 10.2478/jtim-2022-0046] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
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Altered Fractional Amplitude of Low-Frequency Fluctuation in Anxious Parkinson's Disease. Brain Sci 2023; 13:brainsci13010087. [PMID: 36672068 PMCID: PMC9857220 DOI: 10.3390/brainsci13010087] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/17/2022] [Accepted: 12/27/2022] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE Anxiety symptoms are persistent in Parkinson's disease (PD), but the underlying neural substrates are still unclear. In the current study, we aimed to explore the underlying neural mechanisms in PD patients with anxiety symptoms. METHODS 42 PD-A patients, 41 PD patients without anxiety symptoms (PD-NA), and 40 healthy controls (HCs) were recruited in the present study. All the subjects performed 3.0T fMRI scans. The fractional amplitude of low-frequency fluctuation (fALFF) analysis was used to investigate the alterations in neural activity among the three groups. A Pearson correlation analysis was performed between the altered fALFF value of the PD-A group and anxiety scores. RESULTS Compared with HCs, PD-A patients had higher fALFF values in the left cerebellum, cerebellum posterior lobe, bilateral temporal cortex, and brainstem and lower fALFF values in the bilateral inferior gyrus, bilateral basal ganglia areas, and left inferior parietal lobule. Moreover, between the two PD groups, PD-A patients showed higher fALFF values in the right precuneus and lower fALFF values in the bilateral inferior gyrus, bilateral basal ganglia areas, left inferior parietal lobule, and left occipital lobe. Furthermore, Pearson's correlation analysis demonstrated that the right precuneus and left caudate were correlated with the Hamilton Anxiety Rating Scale scores. CONCLUSION Our study found that anxiety symptoms in PD patients may be related to alterations of neurological activities in multiple brain regions. Furthermore, these may be critical radiological biomarkers for PD-A patients. Therefore, these findings can improve our understanding of the pathophysiological mechanisms underlying PD-A.
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Carey G, Viard R, Lopes R, Kuchcinski G, Defebvre L, Leentjens AF, Dujardin K. Anxiety in Parkinson's Disease Is Associated with Changes in Brain Structural Connectivity. JOURNAL OF PARKINSON'S DISEASE 2023; 13:989-998. [PMID: 37599537 PMCID: PMC10578283 DOI: 10.3233/jpd-230035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/02/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND Anxiety in Parkinson's disease (PD) has been associated with grey matter changes and functional changes in anxiety-related neuronal circuits. So far, no study has analyzed white matter (WM) changes in patients with PD and anxiety. OBJECTIVE The aim of this study was to identify WM changes by comparing PD patients with and without anxiety, using diffusion-tensor imaging (DTI). METHODS 108 non-demented PD patients with (n = 31) and without (n = 77) anxiety as defined by their score on the Parkinson Anxiety Scale participated. DTI was used to determine the fractional anisotropy (FA) and mean diffusivity (MD) in specific tracts within anxiety-related neuronal circuits. Mean FA and MD were compared between groups and correlated with the severity of anxiety adjusted by sex, center, Hoehn & Yahr stage, levodopa equivalent daily dosage, and Hamilton depression rating scale. RESULTS Compared to patients without anxiety, PD patients with anxiety showed lower FA within the striato-orbitofrontal, striato-cingulate, cingulate-limbic, and caudate-thalamic tracts; higher FA within the striato-limbic and accumbens-thalamic tracts; higher MD within the striato-thalamic tract and lower MD within the striato-limbic tract. CONCLUSIONS Anxiety in PD is associated with microstructural alterations in anxiety-related neuronal circuits within the WM. This result reinforces the view that PD-related anxiety is linked to structural alteration within the anxiety-related brain circuits.
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Affiliation(s)
- Guillaume Carey
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France
- School for Mental Health and Neurosciences (MHeNS), Maastricht University, Maastricht, The Netherlands
- Department of Neurology and Movement Disorders, Lille University Medical Centre, Lille, France
| | - Romain Viard
- Univ Lille, UMS 2014 – US 41 – PLBS – Plateformes Lilloises en Biologie & Santé, Lille, France
| | - Renaud Lopes
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France
- Univ Lille, UMS 2014 – US 41 – PLBS – Plateformes Lilloises en Biologie & Santé, Lille, France
| | - Gregory Kuchcinski
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France
- Univ Lille, UMS 2014 – US 41 – PLBS – Plateformes Lilloises en Biologie & Santé, Lille, France
- Department of Neuroradiology, Lille University Medical Centre, Lille, France
| | - Luc Defebvre
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France
- Department of Neurology and Movement Disorders, Lille University Medical Centre, Lille, France
| | - Albert F.G. Leentjens
- School for Mental Health and Neurosciences (MHeNS), Maastricht University, Maastricht, The Netherlands
- Department of Psychiatry, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Kathy Dujardin
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France
- Department of Neurology and Movement Disorders, Lille University Medical Centre, Lille, France
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Chawla P, Rana SB, Kaur H, Singh K, Yuvaraj R, Murugappan M. A decision support system for automated diagnosis of Parkinson’s disease from EEG using FAWT and entropy features. Biomed Signal Process Control 2023. [DOI: 10.1016/j.bspc.2022.104116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Mantovani E, Zucchella C, Argyriou AA, Tamburin S. Treatment for cognitive and neuropsychiatric non-motor symptoms in Parkinson's disease: current evidence and future perspectives. Expert Rev Neurother 2023; 23:25-43. [PMID: 36701529 DOI: 10.1080/14737175.2023.2173576] [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] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Non-motor symptoms (NMS) affect patients with Parkinson's disease (PD) from the prodromal to the advanced stages. NMS phenotypes greatly vary and have a huge impact on patients' and caregivers' quality of life (QoL). The management of cognitive and neuropsychiatric NMS remains an unmet need. AREAS COVERED The authors, herein, review the dopaminergic and non-dopaminergic pathogenesis, clinical features, assessment, and pharmacological and non-pharmacological treatments of cognitive and neuropsychiatric NMS in PD. They discuss the current evidence and report the findings of an overview of ongoing trials on pharmacological and selected non-pharmacological strategies. EXPERT OPINION The treatment of cognitive and neuropsychiatric NMS in PD is poorly explored, and therapeutic options are unsatisfactory. Pharmacological treatment of cognitive NMS is based on symptomatic active principles used in Alzheimer's disease. Dopamine agonists, selective serotonin, and serotonin-norepinephrine reuptake inhibitors have some evidence on PD-related depression. Clozapine, quetiapine, and pimavanserin may be considered for psychosis in PD. Evidence on the treatment of other neuropsychiatric NMS is limited or lacking. Addressing pathophysiological and clinical issues, which hamper solid evidence on the treatment of cognitive and neuropsychiatric NMS, may reduce the impact on QoL for PD patients and their caregivers.
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Affiliation(s)
- Elisa Mantovani
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Chiara Zucchella
- Section of Neurology, Department of Neurosciences, Verona University Hospital, Verona, Italy
| | - Andreas A Argyriou
- Department of Neurology, "Agios Andreas" State General Hospital of Patras, Patras, Greece
| | - Stefano Tamburin
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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Tsarouchi M, Fanarioti E, Karathanos VT, Dermon CR. Protective Effects of Currants ( Vitis vinifera) on Corticolimbic Serotoninergic Alterations and Anxiety-like Comorbidity in a Rat Model of Parkinson's Disease. Int J Mol Sci 2022; 24:ijms24010462. [PMID: 36613906 PMCID: PMC9820698 DOI: 10.3390/ijms24010462] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 12/18/2022] [Accepted: 12/19/2022] [Indexed: 12/29/2022] Open
Abstract
Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by the loss of nigral dopaminergic neurons. Increasing evidence supports that PD is not simply a motor disorder but a systemic disease leading to motor and non-motor symptoms, including memory loss and neuropsychiatric conditions, with poor management of the non-motor deficits by the existing dopaminergic medication. Oxidative stress is considered a contributing factor for nigrostriatal degeneration, while antioxidant/anti-inflammatory properties of natural phyto-polyphenols have been suggested to have beneficial effects. The present study aimed to determine the contribution of monoaminergic neurotransmission on the anxiety-like phenotype in a rat rotenone PD model and evaluate the possible neuroprotective effects of black Corinthian currant, Vitis vinifera, consisting of antioxidant polyphenols. Rotenone-treated rats showed anxiety-like behavior and exploratory deficits, accompanied by changes in 5-HT, SERT and β2-ARs expression in the prefrontal cortices, hippocampus and basolateral amygdala. Importantly, the motor and non-motor behavior, as well as 5-HT, SERT and β2-ARs expression patterns of the PD-like phenotype were partially recovered by a supplementary diet with currants. Overall, our results suggest that the neuroprotective effects of Corinthian currants in rotenone-induced anxiety-like behavior may be mediated via corticolimbic serotonergic transmission.
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Affiliation(s)
- Martha Tsarouchi
- Laboratory of Human and Animal Physiology, Department of Biology, University of Patras, 265 00 Patras, Greece
| | - Eleni Fanarioti
- Laboratory of Human and Animal Physiology, Department of Biology, University of Patras, 265 00 Patras, Greece
| | - Vaios T. Karathanos
- Laboratory of Chemistry-Biochemistry-Physical Chemistry of Foods, Department of Dietetics and Nutrition, Harokopio University, 176 76 Kallithea, Greece
- Agricultural Cooperatives’ Union of Aeghion, Corinthou 201, 251 00 Aeghion, Greece
| | - Catherine R. Dermon
- Laboratory of Human and Animal Physiology, Department of Biology, University of Patras, 265 00 Patras, Greece
- Correspondence:
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Zhang P, Zhang Y, Luo Y, Wang L, Wang K. Regional activity alterations in Parkinson's disease patients with anxiety disorders: A resting-state functional magnetic resonance imaging study. Front Aging Neurosci 2022; 14:1055160. [PMID: 36589538 PMCID: PMC9800784 DOI: 10.3389/fnagi.2022.1055160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
Abstract
Background Previous studies have revealed alteration of functional connectivity (FC) in Parkinson's disease patients with anxiety (PD-A), but local brain activities associated with anxiety in Parkinson's disease (PD) patients remain to be elucidated. Regional homogeneity (ReHo) analysis was employed to investigate alterations of regional brain activities in PD-A patients. Methods Resting-state functional magnetic resonance imaging (rs-fMRI) data were acquired from 42 PD-A patients, 41 PD patients without anxiety (PD-NA), and 40 age-and gender-matched healthy control (HC) subjects. ReHo analysis was used to investigate the synchronization of neuronal activities in brain regions in the three groups. The relationship between ReHo value and anxiety score in the PD-A group was also investigated. Results Parkinson's disease patients with anxiety showed increased ReHo values in the bilateral frontal lobes, caudate nucleus, and anterior cingulate gyrus [Gaussian random field (GRF) correction, voxel size p < 0.01, cluster size p < 0.05], compared with PD-NA patients and HC subjects, but the ReHo values of the right cerebellar hemisphere and posterior cerebellar lobe decreased (GRF correction, voxel size p < 0.01, cluster size p < 0.05). The increased ReHo values of the right superior frontal gyrus (r = 0.633, p = 0.001) and anterior cingulate gyrus (r = 0.45, p = 0.01) were positively correlated with anxiety scores in PD-A patients. Conclusion The development of PD-A may be associated with dysfunctional local activities in multiple brain regions, including the frontal cortex, cerebella, basal ganglia, and limbic system. Abnormal ReHo values in these brain regions may serve as neuroimaging markers for the early diagnosis of PD-A. The results suggest that using ReHo analysis to identify functional changes in core regions may advance our understanding of the pathophysiological mechanisms underlying PD-A.
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Affiliation(s)
- Peiyao Zhang
- Department of Radiology, China-Japan Friendship Hospital, Beijing, China
| | - Yanling Zhang
- Department of Radiology, China-Japan Friendship Hospital, Beijing, China
| | - Yuan Luo
- Department of Radiology, China-Japan Friendship Hospital, Beijing, China
| | - Lu Wang
- Department of Neurology, China-Japan Friendship Hospital, Beijing, China
| | - Kang Wang
- Department of Neurology, China-Japan Friendship Hospital, Beijing, China,*Correspondence: Kang Wang,
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Thomas Broome S, Castorina A. Systemic Rotenone Administration Causes Extra-Nigral Alterations in C57BL/6 Mice. Biomedicines 2022; 10:biomedicines10123174. [PMID: 36551930 PMCID: PMC9775048 DOI: 10.3390/biomedicines10123174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/01/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022] Open
Abstract
Systemic administration of rotenone replicates several pathogenic and behavioural features of Parkinson's disease (PD), some of which cannot be explained by deficits of the nigrostriatal pathway. In this study, we provide a comprehensive analysis of several neurochemical alterations triggered by systemic rotenone administration in the CNS of C57BL/6 mice. Mice injected with either 1, 3 or 10 mg/kg rotenone daily via intraperitoneal route for 21 days were assessed weekly for changes in locomotor and exploratory behaviour. Rotenone treatment caused significant locomotor and exploratory impairment at dosages of 3 or 10 mg/kg. Molecular analyses showed reductions of both TH and DAT expression in the midbrain, striatum and spinal cord, accompanied by altered expression of dopamine receptors and brain-derived neurotrophic factor (BDNF). Rotenone also triggered midbrain-restricted inflammatory responses with heightened expression of glial markers, which was not seen in extra-nigral regions. However, widespread alterations of mitochondrial function and increased signatures of oxidative stress were identified in both nigral and extra-nigral regions, along with disruptions of neuroprotective peptides, such as pituitary adenylate cyclase-activating polypeptide (PACAP), vasoactive intestinal peptide (VIP) and activity-dependent neuroprotective protein (ADNP). Altogether, this study shows that systemic rotenone intoxication, similarly to PD, causes a series of neurochemical alterations that extend at multiple CNS levels, reinforcing the suitability of this pre-clinical model for the study extra-nigral defects of PD.
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Sampedro F, Puig-Davi A, Martinez-Horta S, Pagonabarraga J, Horta-Barba A, Aracil-Bolaños I, Kulisevsky J. Cortical macro and microstructural correlates of cognitive and neuropsychiatric symptoms in Parkinson's disease. Clin Neurol Neurosurg 2022; 224:107531. [PMID: 36455303 DOI: 10.1016/j.clineuro.2022.107531] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 11/17/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Cognitive and neuropsychiatric disturbances in Parkinson's disease are as common and as disabling as its well-known motor symptoms. Even though several neural substrates for these symptoms have been suggested, to which extent these symptoms reflect cortical neurodegeneration in Parkinson's disease remains to be fully elucidated. METHODS In a representative sample of 44 Parkinson's disease patients, the data about the following symptoms was recorded: cognitive performance, apathy, depression and anxiety. Surface-based vertexwise multiple regression analyses were performed to investigate the cortical macro (cortical thinning) and microstructural (increased intracortical diffusivity) correlates of each symptom. A group of 18 healthy controls with similar sociodemographics was also included to assess the disease specificity of the neuroimaging results. RESULTS Compared to healthy controls, Parkinson's disease patients showed significantly increased scores in all the considered non-motor scales (p < 0.01). Within the Parkinson's disease group, increased scores in these scales were associated with cortical macro- and microstructural neurodegeneration (p < 0.05 corrected). Each of the considered non-motor scales was associated with a specific pattern of cortical degeneration. When observing both neuroimaging techniques, intracortical diffusivity revealed similar but extensive patterns of cortical compromise than cortical thickness for each symptom, with the exception of anxiety. CONCLUSIONS Cognitive and neuropsychiatric symptoms in Parkinson's disease reflect cortical degeneration. Increases in intracortical diffusivity were able to detect symptom-specific cortical microstructural damage in the absence of cortical thinning. A better understanding of this association may contribute to characterize the brain circuitry and the neurotransmitter pathways underlying these highly prevalent and debilitating symptoms in Parkinson's disease.
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Affiliation(s)
- Frederic Sampedro
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain; Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Spain; Radiology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Arnau Puig-Davi
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain; Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Spain; Institute of Neurosciences, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
| | - Saul Martinez-Horta
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain; Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Javier Pagonabarraga
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain; Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Andrea Horta-Barba
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain; Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Spain; Department of Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Faculty of Health Sciences, Universitat Oberta de Catalunya (UOC), Barcelona, Spain
| | - Ignacio Aracil-Bolaños
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain; Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Jaime Kulisevsky
- Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain; Centro de Investigación en Red-Enfermedades Neurodegenerativas (CIBERNED), Spain.
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