1
|
Mirabella G, Pilotto A, Rizzardi A, Montalti M, Olivola E, Zatti C, Di Caprio V, Ferrari E, Modugno N, Padovani A. Effects of dopaminergic treatment on inhibitory control differ across Hoehn and Yahr stages of Parkinson's disease. Brain Commun 2023; 6:fcad350. [PMID: 38162902 PMCID: PMC10757450 DOI: 10.1093/braincomms/fcad350] [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: 07/28/2023] [Revised: 11/23/2023] [Accepted: 12/19/2023] [Indexed: 01/03/2024] Open
Abstract
Motor inhibitory control, a core component of cognitive control, is impaired in Parkinson's disease, dramatically impacting patients' abilities to implement goal-oriented adaptive strategies. A progressive loss of the midbrain's dopamine neurons characterizes Parkinson's disease and causes motor features responsive to dopaminergic treatments. Although such treatments restore motor symptoms, their impact on response inhibition is controversial. Most studies failed to show any effect of dopaminergic medicaments, although three studies found that these drugs selectively improved inhibitory control in early-stage patients. Importantly, all previous studies assessed only one domain of motor inhibition, i.e. reactive inhibition (the ability to react to a stop signal). The other domain, i.e. proactive inhibition (the ability to modulate reactive inhibition pre-emptively according to the current context), was utterly neglected. To re-examine this issue, we recruited cognitively unimpaired Parkinson's patients under dopaminergic treatment in the early (Hoehn and Yahr, 1-1.5, n = 20), intermediate (Hoehn and Yahr 2, n = 20), and moderate/advanced (Hoehn and Yahr, 2.5-3, n = 20) stages of the disease. Using a cross-sectional study design, we compared their performance on a simple reaction-time task and a stop-signal task randomly performed twice on dopaminergic medication (ON) and after medication withdrawal (OFF). Normative data were collected on 30 healthy controls. Results suggest that medication effects are stage-dependent. In Hoehn and Yahr 1-1.5 patients, drugs selectively impair reactive inhibition, leaving proactive inhibition unaffected. In the ON state, Hoehn and Yahr two patients experienced impaired proactive inhibition, whereas reactive inhibition is no longer affected, as it deteriorates even during the OFF state. By contrast, Hoehn and Yahr 2.5-3 patients exhibited less efficient reactive and proactive inhibition in the OFF state, and medication slightly improved proactive inhibition. This evidence aligns with the dopamine overdose hypothesis, indicating that drug administration may overdose intact dopamine circuitry in the earliest stages, impairing associated cognitive functions. In later stages, the progressive degeneration of dopaminergic neurons prevents the overdose and can exert some beneficial effects. Thus, our findings suggest that inhibitory control assessment might help tailor pharmacological therapy across the disease stage to enhance Parkinson's disease patients' quality of life by minimizing the hampering of inhibitory control and maximizing the reduction of motor symptoms.
Collapse
Affiliation(s)
- Giovanni Mirabella
- Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, BS, Italy
- IRCCS Neuromed, 86077 Pozzilli, IS, Italy
| | - Andrea Pilotto
- Department of Clinical and Experimental Sciences, Neurology Unit, University of Brescia, 25123 Brescia, BS, Italy
- Laboratory of Digital Neurology and Biosensors, University of Brescia, 25123 Brescia, BS, Italy
- Department of Continuity of Care and Frailty, Neurology Unit, ASST Spedali Civili Brescia Hospital, 25123 Brescia, BS, Italy
| | - Andrea Rizzardi
- Department of Clinical and Experimental Sciences, Neurology Unit, University of Brescia, 25123 Brescia, BS, Italy
- Laboratory of Digital Neurology and Biosensors, University of Brescia, 25123 Brescia, BS, Italy
| | - Martina Montalti
- Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, BS, Italy
| | | | - Cinzia Zatti
- Department of Clinical and Experimental Sciences, Neurology Unit, University of Brescia, 25123 Brescia, BS, Italy
- Laboratory of Digital Neurology and Biosensors, University of Brescia, 25123 Brescia, BS, Italy
- Department of Continuity of Care and Frailty, Neurology Unit, ASST Spedali Civili Brescia Hospital, 25123 Brescia, BS, Italy
| | | | - Elisabetta Ferrari
- Department of Clinical and Experimental Sciences, Neurology Unit, University of Brescia, 25123 Brescia, BS, Italy
| | | | - Alessandro Padovani
- Department of Clinical and Experimental Sciences, Neurology Unit, University of Brescia, 25123 Brescia, BS, Italy
- Laboratory of Digital Neurology and Biosensors, University of Brescia, 25123 Brescia, BS, Italy
- Department of Continuity of Care and Frailty, Neurology Unit, ASST Spedali Civili Brescia Hospital, 25123 Brescia, BS, Italy
| |
Collapse
|
2
|
Bhat SG, Shin AY, Kaufman KR. Upper extremity asymmetry due to nerve injuries or central neurologic conditions: a scoping review. J Neuroeng Rehabil 2023; 20:151. [PMID: 37940959 PMCID: PMC10634143 DOI: 10.1186/s12984-023-01277-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 11/01/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Peripheral nerve injuries and central neurologic conditions can result in extensive disabilities. In cases with unilateral impairment, assessing the asymmetry between the upper extremity has been used to assess outcomes of treatment and severity of injury. A wide variety of validated and novel tests and sensors have been utilized to determine the upper extremity asymmetry. The purpose of this article is to review the literature and define the current state of the art for describing upper extremity asymmetry in patients with peripheral nerve injuries or central neurologic conditions. METHOD An electronic literature search of PubMed, Scopus, Web of Science, OVID was performed for publications between 2000 to 2022. Eligibility criteria were subjects with neurological conditions/injuries who were analyzed for dissimilarities in use between the upper extremities. Data related to study population, target condition/injury, types of tests performed, sensors used, real-world data collection, outcome measures of interest, and results of the study were extracted. Sackett's Level of Evidence was used to judge the quality of the articles. RESULTS Of the 7281 unique articles, 112 articles met the inclusion criteria for the review. Eight target conditions/injuries were identified (Brachial Plexus Injury, Cerebral Palsy, Multiple Sclerosis, Parkinson's Disease, Peripheral Nerve Injury, Spinal Cord Injury, Schizophrenia, and stroke). The tests performed were classified into thirteen categories based on the nature of the test and data collected. The general results related to upper extremity asymmetry were listed for all the reviewed articles. Stroke was the most studied condition, followed by cerebral palsy, with kinematics and strength measurement tests being the most frequently used tests. Studies with a level of evidence level II and III increased between 2000 and 2021. The use of real-world evidence-based data, and objective data collection tests also increased in the same period. CONCLUSION Adequately powered randomized controlled trials should be used to study upper extremity asymmetry. Neurological conditions other than stroke should be studied further. Upper extremity asymmetry should be measured using objective outcome measures like motion tracking and activity monitoring in the patient's daily living environment.
Collapse
Affiliation(s)
- Sandesh G Bhat
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, 55905, USA
| | - Alexander Y Shin
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, 55905, USA
| | - Kenton R Kaufman
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, 55905, USA.
- Motion Analysis Laboratory, Mayo Clinic, DAHLC 4-214A, 200 First Street SW, Rochester, MN, 55905, USA.
| |
Collapse
|
3
|
van den Wildenberg WPM, Ridderinkhof KR, Wylie SA. Towards Conceptual Clarification of Proactive Inhibitory Control: A Review. Brain Sci 2022; 12:brainsci12121638. [PMID: 36552098 PMCID: PMC9776056 DOI: 10.3390/brainsci12121638] [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: 07/13/2022] [Revised: 11/24/2022] [Accepted: 11/25/2022] [Indexed: 12/05/2022] Open
Abstract
The aim of this selective review paper is to clarify potential confusion when referring to the term proactive inhibitory control. Illustrated by a concise overview of the literature, we propose defining reactive inhibition as the mechanism underlying stopping an action. On a stop trial, the stop signal initiates the stopping process that races against the ongoing action-related process that is triggered by the go signal. Whichever processes finishes first determines the behavioral outcome of the race. That is, stopping is either successful or unsuccessful in that trial. Conversely, we propose using the term proactive inhibition to explicitly indicate preparatory processes engaged to bias the outcome of the race between stopping and going. More specifically, these proactive processes include either pre-amping the reactive inhibition system (biasing the efficiency of the stopping process) or presetting the action system (biasing the efficiency of the go process). We believe that this distinction helps meaningful comparisons between various outcome measures of proactive inhibitory control that are reported in the literature and extends to experimental research paradigms other than the stop task.
Collapse
Affiliation(s)
- Wery P. M. van den Wildenberg
- Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129 B, 1018 WS Amsterdam, The Netherlands
- Amsterdam Brain and Cognition (ABC), University of Amsterdam, Nieuwe Achtergracht 129 B, P.O. Box 15900, 1001 NK Amsterdam, The Netherlands
- Correspondence: ; Tel.: +31-20-5256686
| | - K. Richard Ridderinkhof
- Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129 B, 1018 WS Amsterdam, The Netherlands
- Amsterdam Brain and Cognition (ABC), University of Amsterdam, Nieuwe Achtergracht 129 B, P.O. Box 15900, 1001 NK Amsterdam, The Netherlands
| | - Scott A. Wylie
- Department of Neurosurgery, University of Louisville, Louisville, KY 40202, USA
| |
Collapse
|
4
|
Wessel JR, Diesburg DA, Chalkley NH, Greenlee JDW. A causal role for the human subthalamic nucleus in non-selective cortico-motor inhibition. Curr Biol 2022; 32:3785-3791.e3. [PMID: 35841891 PMCID: PMC9511894 DOI: 10.1016/j.cub.2022.06.067] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 06/07/2022] [Accepted: 06/22/2022] [Indexed: 11/22/2022]
Abstract
Common cortico-basal ganglia models of motor control suggest a key role for the subthalamic nucleus (STN) in motor inhibition.1-3 In particular, when already-initiated actions have to be suddenly stopped, the STN is purportedly recruited via a hyperdirect pathway to net inhibit the cortico-motor system in a broad, non-selective fashion.4 Indeed, the suppression of cortico-spinal excitability (CSE) during rapid action stopping extends beyond the stopped muscle and affects even task-irrelevant motor representations.5,6 Although such non-selective CSE suppression has long been attributed to the broad inhibitory influence of STN on the motor system, causal evidence for this association is hitherto lacking. Here, 20 Parkinson's disease patients treated with STN deep-brain stimulation (DBS) and 20 matched healthy controls performed a verbal stop-signal task while CSE was measured from a task-unrelated hand muscle. DBS allowed a causal manipulation of STN, while CSE was measured using transcranial magnetic stimulation (TMS) over primary motor cortex and concurrent electromyography. In patients OFF-DBS and controls, the CSE of the hand was non-selectively suppressed when the verbal response was successfully stopped. Crucially, this effect disappeared when STN was disrupted via DBS in the patient group. Using this unique combination of DBS and TMS during human behavior, the current study provides first causal evidence that STN is likely involved in non-selectively suppressing the physiological excitability of the cortico-motor system during action stopping. This confirms a core prediction of long-held cortico-basal ganglia circuit models of movement. The absence of cortico-motor inhibition during STN-DBS may also provide potential insights into the common side effects of STN-DBS, such as increased impulsivity.7-11.
Collapse
Affiliation(s)
- Jan R Wessel
- Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA; Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA 52245, USA; Cognitive Control Collaborative, University of Iowa, Iowa City, IA 52245, USA; Iowa Neuroscience Institute, University of Iowa, Iowa City, IA 52242, USA.
| | - Darcy A Diesburg
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA 52245, USA; Cognitive Control Collaborative, University of Iowa, Iowa City, IA 52245, USA
| | - Nathan H Chalkley
- Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA; Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA 52245, USA
| | - Jeremy D W Greenlee
- Iowa Neuroscience Institute, University of Iowa, Iowa City, IA 52242, USA; Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA
| |
Collapse
|
5
|
Relating Response Inhibition, Brain Connectivity, and Freezing of Gait in People with Parkinson's Disease. J Int Neuropsychol Soc 2021; 27:733-743. [PMID: 33292899 PMCID: PMC8187475 DOI: 10.1017/s135561772000123x] [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: 11/07/2022]
Abstract
OBJECTIVE Freezing of gait (FoG) in Parkinson's disease (PD) has been associated with response inhibition. However, the relationship between response inhibition, neural dysfunction, and PD remains unclear. We assessed response inhibition and microstructural integrity of brain regions involved in response inhibition [right hemisphere inferior frontal cortex (IFC), bilateral pre-supplementary motor areas (preSMA), and subthalamic nuclei (STN)] in PD subjects with and without FoG and elderly controls. METHOD Twenty-one people with PD and FoG (PD-FoG), 18 without FoG (PD-noFoG), and 19 age-matched controls (HC) completed a Stop-Signal Task (SST) and MRI scan. Probabilistic fiber tractography assessed structural integrity (fractional anisotropy, FA) among IFC, preSMA, and STN regions. RESULTS Stop-signal performance did not differ between PD and HC, nor between PD-FoG and PD-noFoG. Differences in white matter integrity were observed across groups (.001 < p < .064), but were restricted to PD versus HC groups; no differences in FA were observed between PD-FoG and PD-noFoG (p > .096). Interestingly, worse FoG was associated with higher (better) mean FA in the r-preSMA, (β = .547, p = .015). Microstructural integrity of the r-IFC, r-preSMA, and r-STN tracts correlated with stop-signal performance in HC (p ≤ .019), but not people with PD. CONCLUSION These results do not support inefficient response inhibition in PD-FoG. Those with PD exhibited white matter loss in the response inhibition network, but this was not associated with FoG, nor with response inhibition deficits, suggesting FoG-specific neural changes may occur outside the response inhibition network. As shown previously, white matter loss was associated with response inhibition in elderly controls, suggesting PD may disturb this relationship.
Collapse
|
6
|
Ruitenberg MFL, van Wouwe NC, Wylie SA, Abrahamse EL. The role of dopamine in action control: Insights from medication effects in Parkinson's disease. Neurosci Biobehav Rev 2021; 127:158-170. [PMID: 33905788 DOI: 10.1016/j.neubiorev.2021.04.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 02/26/2021] [Accepted: 04/18/2021] [Indexed: 01/14/2023]
Abstract
Parkinson's disease (PD) is a neurological disorder associated primarily with overt motor symptoms. Several studies show that PD is additionally accompanied by impairments in covert cognitive processes underlying goal-directed motor functioning (e.g., action planning, conflict adaptation, inhibition), and that dopaminergic medication may modulate these action control components. In this review we aim to leverage findings from studies in this domain to elucidate the role of dopamine (DA) in action control. A qualitative review of studies that investigated the effects of medication status (on vs. off) on action control in PD suggests a component-specific role for DA in action control, although the expression of medication effects depends on characteristics of both the patients and experimental tasks used to measure action control. We discuss these results in the light of findings from other research lines examining the role of DA in action control (e.g., animal research, pharmacology), and recommend that future studies use multi-method, within-subject approaches to model DA effects on action control across different components as well as underlying striatal pathways (ventral vs. dorsal).
Collapse
Affiliation(s)
- M F L Ruitenberg
- Department of Health, Medical and Neuropsychology, Leiden University, Leiden, the Netherlands; Leiden Institute for Brain and Cognition, Leiden, the Netherlands; Department of Experimental Psychology, Ghent University, Ghent, Belgium.
| | - N C van Wouwe
- Department of Neurological Surgery, University of Louisville, Louisville, KY, USA
| | - S A Wylie
- Department of Neurological Surgery, University of Louisville, Louisville, KY, USA
| | - E L Abrahamse
- Department of Communication and Cognition, Tilburg University, Tilburg, the Netherlands
| |
Collapse
|
7
|
Hirano S. Clinical implications for dopaminergic and functional neuroimage research in cognitive symptoms of Parkinson's disease. Mol Med 2021; 27:40. [PMID: 33858320 PMCID: PMC8048076 DOI: 10.1186/s10020-021-00301-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 04/06/2021] [Indexed: 12/12/2022] Open
Abstract
Evidence from dopaminergic image and cerebral blood flow/metabolism images have shed light on symptomatology of cognitive aspects in brain physiology of healthy human as well as patients with Parkinson's disease. Cognitive impairment in Parkinson's disease is characterized by executive, visuospatial, attentional disturbances. Dopaminergic system includes triadic parallel pathways. The mesostriatal pathway consist of posterolateral putamen and motor areas, the mesocortical pathway of dorsal caudate nucleus and dorsolateral prefrontal cortex, and the mesolimbic pathway of ventral striatum, anterior cingulate cortex. The mesocortical pathway is responsible for the executive function which may change by administration of dopaminergic medication. The mesolimbic pathway is associated with motivation and reward prediction which may result in depression or apathy when dopamine level was suboptimal, impulse control disorder and punding when dopamine was over the optimal level. Abnormal brain metabolism/perfusion related to cognitive impairment in Parkinson's disease are relatively reduced activity located in frontal and parietal association areas and relatively increased activity in the cerebellum. In the anterior brain, the mesocortical pathway, is responsible for verbal memory and executive function, which originates with caudate dopaminergic system and account for mild cognitive impairment of Parkinson's disease. The posterior brain system which includes the parietal, temporal, and occipital cortices, is responsible for the memory and visuospatial function, and related to cholinergic dysfunction and possibly glucocerebrosidase gene variants, relating to dementia in Parkinson's disease. The role of cerebellum in Parkinson's disease remains unclear but emerging evidence suggests that it may relate to the sequencing detection and affective symptoms. The dual syndrome hypothesis is helpful for understanding the mechanism of cognitive impairment in Parkinson's disease and optimal symptom management.
Collapse
Affiliation(s)
- Shigeki Hirano
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan.
| |
Collapse
|
8
|
van den Wildenberg WPM, van Wouwe NC, Ridderinkhof KR, Neimat JS, Elias WJ, Bashore TR, Wylie SA. Deep-brain stimulation of the subthalamic nucleus improves overriding motor actions in Parkinson's disease. Behav Brain Res 2021; 402:113124. [PMID: 33422595 DOI: 10.1016/j.bbr.2021.113124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 01/04/2021] [Accepted: 01/04/2021] [Indexed: 11/17/2022]
Abstract
Findings from previous research using the classic stop-signal task indicate that the subthalamic nucleus (STN) plays an important role in the ability to inhibit motor actions. Here we extend these findings using a stop-change task that requires voluntary action override to stop an ongoing motor response and change to an alternative response. Sixteen patients diagnosed with Parkinson's disease (PD) and 16 healthy control participants (HC) performed the stop-change task. PD patients completed the task when deep-brain stimulation (DBS) of the STN was turned on and when it was turned off. Behavioral results indicated that going, stopping, and changing latencies were shortened significantly among PD patients during STN DBS, the former two reductions replicating findings from previous DBS studies using the classic stop-signal task. The shortened go latencies observed among PD patients fell within the control range. In contrast, stopping latencies among PD patients, although reduced significantly, continued to be significantly longer than those of the HC. Like go latencies, stop-change latencies were reduced sufficiently among PD patients for them to fall within the control range, a novel finding. In conclusion, STN DBS produced a general, but differential, improvement in the ability of PD patients to override motor actions. Going, stopping, and stop-change latencies were all shortened, but only going and stop-change latencies were normalized.
Collapse
Affiliation(s)
- Wery P M van den Wildenberg
- Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Brain and Cognition (ABC), University of Amsterdam, Amsterdam, the Netherlands.
| | | | - K Richard Ridderinkhof
- Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Brain and Cognition (ABC), University of Amsterdam, Amsterdam, the Netherlands
| | - Joseph S Neimat
- Department of Neurosurgery, University of Louisville, Louisville, KY, USA
| | - W Jeffrey Elias
- Department of Neurosurgery, University of Virginia Health Systems, Charlottesville, VA, USA
| | - Theodore R Bashore
- Department of Neurosurgery, University of Louisville, Louisville, KY, USA; School of Psychological Sciences, University of Northern Colorado, Greeley, CO, USA
| | - Scott A Wylie
- Department of Neurosurgery, University of Louisville, Louisville, KY, USA
| |
Collapse
|
9
|
Aumann MA, Stark AJ, Hughes SB, Lin Y, Kang H, Bradley E, Zald DH, Claassen DO. Self-reported rates of impulsivity in Parkinson's Disease. Ann Clin Transl Neurol 2020; 7:437-448. [PMID: 32227451 PMCID: PMC7187703 DOI: 10.1002/acn3.51016] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 02/05/2020] [Accepted: 02/19/2020] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE Impulsive decision-making is characterized by actions taken without considering consequences. Patients with Parkinson's disease (PD) who receive dopaminergic treatment, especially dopamine agonists, are at risk of developing impulsive-compulsive behaviors (ICBs). We assessed impulse-related changes across a large heterogeneous PD population using the Barratt impulsivity scale (BIS-11) by evaluating BIS-11 first- and second-order factors. METHODS We assessed a total of 204 subjects: 93 healthy controls (HCs), and 68 ICB- and 43 ICB + PD patients who completed the BIS-11. Using a general linear model and a least absolute shrinkage and selection operation regression, we compared BIS-11 scores between the HC, ICB- PD, and ICB + PD groups. RESULTS Patients with PD rated themselves as more impulsive than HCs in the BIS-11 total score, second-order attention domain, and first-order attention and self-control domains. ICB + patients recorded higher total scores as well as higher scores in the second-order non-planning domain and in self-control and cognitive complexity than ICB- patients. INTERPRETATION These results indicate that the patients with PD show particular problems with attentional control, whereas ICB + patients show a distinct problem in cognitive control and complexity. Additionally, it appears that all patients with PD are more impulsive than their age- and sex-matched healthy peers. Increased impulsivity may be a result of the disease course, or attributed to dopaminergic medication use, but these results emphasize the importance of the cognitive components of impulsivity in patients with PD.
Collapse
Affiliation(s)
- Megan A. Aumann
- Vanderbilt Brain InstituteDepartment of PsychologyVanderbilt UniversityNashvilleTennessee
- Department of NeurologyVanderbilt University Medical CenterNashvilleTennessee
| | - Adam J. Stark
- Department of NeurologyVanderbilt University Medical CenterNashvilleTennessee
| | - Shelby B. Hughes
- Department of NeurologyVanderbilt University Medical CenterNashvilleTennessee
| | - Ya‐Chen Lin
- Department of BiostatisticsVanderbilt University Medical CenterNashvilleTennessee
| | - Hakmook Kang
- Department of BiostatisticsVanderbilt University Medical CenterNashvilleTennessee
| | - Elise Bradley
- Department of NeurologyVanderbilt University Medical CenterNashvilleTennessee
| | - David H. Zald
- Department of PsychiatryVanderbilt University Medical SchoolNashvilleTennessee
- Department of PsychologyVanderbilt UniversityNashvilleTennessee
| | - Daniel O. Claassen
- Department of NeurologyVanderbilt University Medical CenterNashvilleTennessee
| |
Collapse
|
10
|
Di Caprio V, Modugno N, Mancini C, Olivola E, Mirabella G. Early‐Stage Parkinson's Patients Show Selective Impairment in Reactive But Not Proactive Inhibition. Mov Disord 2019; 35:409-418. [DOI: 10.1002/mds.27920] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 09/27/2019] [Accepted: 10/23/2019] [Indexed: 11/08/2022] Open
Affiliation(s)
- Veronica Di Caprio
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Neuromed, Pozzilli (IS) Italy
| | - Nicola Modugno
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Neuromed, Pozzilli (IS) Italy
| | - Christian Mancini
- Department of Anatomy, Histology, Forensic Medicine & OrthopedicsSapienza University Rome Italy
| | - Enrica Olivola
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Neuromed, Pozzilli (IS) Italy
| | - Giovanni Mirabella
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Neuromed, Pozzilli (IS) Italy
- Department of Anatomy, Histology, Forensic Medicine & OrthopedicsSapienza University Rome Italy
| |
Collapse
|
11
|
Canário N, Sousa M, Moreira F, Duarte IC, Oliveira F, Januário C, Castelo-Branco M. Impulsivity across reactive, proactive and cognitive domains in Parkinson's disease on dopaminergic medication: Evidence for multiple domain impairment. PLoS One 2019; 14:e0210880. [PMID: 30759108 PMCID: PMC6373905 DOI: 10.1371/journal.pone.0210880] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 01/03/2019] [Indexed: 11/24/2022] Open
Abstract
Impulse control disorders (ICD) may occur in Parkinson’s disease (PD) although it remains to be understood if such deficits may occur even in the absence of a formal ICD diagnosis. Moreover, studies addressing simultaneously distinct neurobehavioral domains, such as cognitive, proactive and reactive motor impulsivity, are still lacking. Here, we aimed to investigate if reactive, proactive and cognitive impulsivity involving risk taking are concomitantly affected in medicated PD patients, and whether deficits were dependent on response strategies, such as speed accuracy tradeoffs, or the proportion of omission vs. commission errors. We assessed three different impulsivity domains in a sample of 21 PD patients and 13 matched controls. We found impaired impulsivity in both reactive (p = 0.042) and cognitive domains (p = 0.015) for the PD patients, irrespective of response strategy. For the latter, effect sizes were larger for the actions related with reward processing (p = 0.017, dCohen = 0.9). In the proactive impulsivity task, PD patients showed significantly increased number of omissions (p = 0.041), a response strategy which was associated with preserved number of commission errors. Moreover, the number of premature and proactive response errors were correlated with disease stage. Our findings suggest that PD ON medication is characterized compared to healthy controls by impairment across several impulsivity domains, which is moderated in the proactive domain by the response strategy.
Collapse
Affiliation(s)
- Nádia Canário
- Coimbra Institute for Biomedical Imaging and Translational Research (CiBit), ICNAS—Institute for Nuclear Sciences Applied to Health, Brain Imaging Network of Portugal, Coimbra, Portugal
- Laboratory of Biostatistics and Medical Informatics, Institute for Biomedical Imaging and Life Sciences (CNC.IBILI), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Mário Sousa
- Division of Movement Disorders, Department of Neurology, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - Fradique Moreira
- Division of Movement Disorders, Department of Neurology, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - Isabel Catarina Duarte
- Coimbra Institute for Biomedical Imaging and Translational Research (CiBit), ICNAS—Institute for Nuclear Sciences Applied to Health, Brain Imaging Network of Portugal, Coimbra, Portugal
- Laboratory of Biostatistics and Medical Informatics, Institute for Biomedical Imaging and Life Sciences (CNC.IBILI), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Francisco Oliveira
- Coimbra Institute for Biomedical Imaging and Translational Research (CiBit), ICNAS—Institute for Nuclear Sciences Applied to Health, Brain Imaging Network of Portugal, Coimbra, Portugal
| | - Cristina Januário
- Division of Movement Disorders, Department of Neurology, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - Miguel Castelo-Branco
- Coimbra Institute for Biomedical Imaging and Translational Research (CiBit), ICNAS—Institute for Nuclear Sciences Applied to Health, Brain Imaging Network of Portugal, Coimbra, Portugal
- Laboratory of Biostatistics and Medical Informatics, Institute for Biomedical Imaging and Life Sciences (CNC.IBILI), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- * E-mail:
| |
Collapse
|
12
|
Mancini C, Modugno N, Santilli M, Pavone L, Grillea G, Morace R, Mirabella G. Unilateral Stimulation of Subthalamic Nucleus Does Not Affect Inhibitory Control. Front Neurol 2019; 9:1149. [PMID: 30666229 PMCID: PMC6330317 DOI: 10.3389/fneur.2018.01149] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 12/11/2018] [Indexed: 01/06/2023] Open
Abstract
Despite the relevance of inhibitory control in shaping our behavior its neural substrates are still hotly debated. In this regard, it has been suggested that inhibitory control relies upon a right-lateralized network which involves the right subthalamic nucleus (STN). To assess the role of STN, we took advantage of a relatively rare model, i.e., advanced Parkinson's patients who received unilateral deep-brain stimulation (DBS) of the STN either of the left (n = 10) or of the right (n = 10) hemisphere. We gave them a stop-signal reaching task, and we compared patients' performance in two experimental conditions, DBS-ON and DBS-OFF. In addition, we also tested 22 age-matched healthy participants. As expected, we found that inhibitory control is impaired in Parkinson's patients with respect to healthy participants. However, neither reactive nor proactive inhibition is improved when either the right or the left DBS is active. We interpreted these findings in light of the fact that previous studies, exploiting exactly the same task, have shown that only bilateral STN DBS restores a near-normal inhibitory control. Thus, although null results have to be interpreted with caution, our current findings confirm that the right STN does not play a key role in suppressing pending actions. However, on the ground of previous studies, it is very likely that this subcortical structure is part of the brain network subserving inhibition but to implement this executive function both subthalamic nuclei must be simultaneously active. Our findings are of significance to other researchers studying the effects of STN DBS on key executive functions, such as impulsivity and inhibition and they are also of clinical relevance for determining the therapeutic benefits of STN DBS as they suggest that, at least as far as inhibitory control is concerned, it is better to implant DBS bilaterally than unilaterally.
Collapse
Affiliation(s)
- Christian Mancini
- Department of Anatomy, Histology, Forensic Medicine and Orthopedics, Sapienza University, Rome, Italy
| | | | | | | | | | | | - Giovanni Mirabella
- Department of Anatomy, Histology, Forensic Medicine and Orthopedics, Sapienza University, Rome, Italy.,IRCCS Neuromed, Pozzilli, Italy
| |
Collapse
|
13
|
Cools R, Froböse M, Aarts E, Hofmans L. Dopamine and the motivation of cognitive control. HANDBOOK OF CLINICAL NEUROLOGY 2019; 163:123-143. [DOI: 10.1016/b978-0-12-804281-6.00007-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|
14
|
Kim J, Zhang K, Cai W, YorkWilliams S, Ua Cruadhlaoich MAI, Llanes S, Menon V, Poston KL. Dopamine-related dissociation of cortical and subcortical brain activations in cognitively unimpaired Parkinson's disease patients OFF and ON medications. Neuropsychologia 2018; 119:24-33. [PMID: 30040957 PMCID: PMC6191343 DOI: 10.1016/j.neuropsychologia.2018.07.024] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 07/17/2018] [Accepted: 07/20/2018] [Indexed: 12/03/2022]
Abstract
Background: Despite dopaminergic depletion that is severe enough to cause the motor symptoms of Parkinson’s disease (PD), m any patients remain cognitively unimpaired. Little is known about brain mechanism s underlying such preserved cognitive abilities and their alteration by dopaminergic medications. Objectives: We investigated brain activations underlying dopamine-related differences in cognitive function using a unique experimental design with PD patients off and on dopaminergic medications. We tested the dopamine overdose hypothesis, which posits that the excess of exogenous dopamine in the frontal cortical regions can impair cognition. Methods: We used a two-choice forced response Choice Reaction Time (CRT) task to probe cognitive processes underlying response selection and execution. Functional magnetic resonance imaging data Were acquired from 16 cognitively unimpaired (Level-II) PD participants and 15 Well-matched healthy controls (HC). We compared task performance (i.e. reaction time and accuracy) and brain activation of PD participants off dopaminergic medications (PD_OFF) in comparison with HC, and PD_OFF participants with those on dopaminergic medications (PD_ON). Results: PD_OFF and PD_ON groups did not differ from each other, or from the HC group, in reaction time or accuracy. Compared to HC, PD_OFF activated the bilateral putamen less, and this w as compensated by higher activation of the anterior insula. No such differences Were observed in the PD_ON group, Compared to HC. Compared to both HC and PD_OFF, PD_ON participants showed dopamine-related hyperactivation in the frontal cortical regions and hypoactivation in the amygdala. Conclusion: Our data provide further evidence that PD_OFF and PD_ON participants engage different cortical and subcortical systems to achieve similar levels of cognitive performance as HC. Crucially, our findings demonstrate dopamine-related dissociation in brain activation between cortical and subcortical regions, and provide novel support for the dopamine overdose hypothesis.
Collapse
Affiliation(s)
- Jeehyun Kim
- Stanford University Medical Center, Department of Neurology & Neurological Sciences, Stanford, CA 94305, USA
| | - Kai Zhang
- Stanford University Medical Center, Department of Neurology & Neurological Sciences, Stanford, CA 94305, USA
| | - Weidong Cai
- Stanford University Medical Center, Department of Psychiatry & Behavioral Sciences, Stanford, CA 94305, USA
| | - Sophie YorkWilliams
- Stanford University Medical Center, Department of Neurology & Neurological Sciences, Stanford, CA 94305, USA; University of Colorado Boulder, Department of Psychology and Neuroscience, Boulder, CO 80309, USA
| | - Matthew A I Ua Cruadhlaoich
- Stanford University Medical Center, Department of Neurology & Neurological Sciences, Stanford, CA 94305, USA
| | - Seoni Llanes
- Stanford University Medical Center, Department of Neurology & Neurological Sciences, Stanford, CA 94305, USA
| | - Vinod Menon
- Stanford University Medical Center, Department of Neurology & Neurological Sciences, Stanford, CA 94305, USA; Stanford University Medical Center, Department of Psychiatry & Behavioral Sciences, Stanford, CA 94305, USA
| | - Kathleen L Poston
- Stanford University Medical Center, Department of Neurology & Neurological Sciences, Stanford, CA 94305, USA; Stanford University Medical Center, Department of Neurosurgery, Stanford, CA 94305, USA.
| |
Collapse
|