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Yuzkan S, Hasimoglu O, Balsak S, Mutlu S, Karagulle M, Kose F, Altinkaya A, Tugcu B, Kocak B. Utility of diffusion tensor imaging and generalized q-sampling imaging for predicting short-term clinical effect of deep brain stimulation in Parkinson's disease. Acta Neurochir (Wien) 2024; 166:217. [PMID: 38748304 PMCID: PMC11096246 DOI: 10.1007/s00701-024-06096-w] [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: 02/15/2024] [Accepted: 04/16/2024] [Indexed: 05/18/2024]
Abstract
PURPOSE To assess whether diffusion tensor imaging (DTI) and generalized q-sampling imaging (GQI) metrics could preoperatively predict the clinical outcome of deep brain stimulation (DBS) in patients with Parkinson's disease (PD). METHODS In this single-center retrospective study, from September 2021 to March 2023, preoperative DTI and GQI examinations of 44 patients who underwent DBS surgery, were analyzed. To evaluate motor functions, the Unified Parkinson's Disease Rating Scale (UPDRS) during on- and off-medication and Parkinson's Disease Questionnaire-39 (PDQ-39) scales were used before and three months after DBS surgery. The study population was divided into two groups according to the improvement rate of scales: ≥ 50% and < 50%. Five target regions, reported to be affected in PD, were investigated. The parameters having statistically significant difference were subjected to a receiver operating characteristic (ROC) analysis. RESULTS Quantitative anisotropy (qa) values from globus pallidus externus, globus pallidus internus (qa_Gpi), and substantia nigra exhibited significant distributional difference between groups in terms of the improvement rate of UPDRS-3 scale during on-medication (p = 0.003, p = 0.0003, and p = 0.0008, respectively). In ROC analysis, the best parameter in predicting DBS response included qa_Gpi with a cut-off value of 0.01370 achieved an area under the ROC curve, accuracy, sensitivity, and specificity of 0.810, 73%, 62.5%, and 85%, respectively. Optimal cut-off values of ≥ 0.01864 and ≤ 0.01162 yielded a sensitivity and specificity of 100%, respectively. CONCLUSION The imaging parameters acquired from GQI, particularly qa_Gpi, may have the ability to non-invasively predict the clinical outcome of DBS surgery.
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Affiliation(s)
| | - Ozan Hasimoglu
- Department of Neurosurgery, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
| | - Serdar Balsak
- Department of Radiology, Bezmialem Vakif University Hospital, Istanbul, Turkey
| | - Samet Mutlu
- Department of Radiology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Basaksehir, Istanbul, 34480, Turkey
| | - Mehmet Karagulle
- Department of Radiology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Basaksehir, Istanbul, 34480, Turkey
| | - Fadime Kose
- Department of Radiology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Basaksehir, Istanbul, 34480, Turkey
| | - Ayca Altinkaya
- Department of Neurosurgery, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
| | - Bekir Tugcu
- Department of Neurosurgery, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
| | - Burak Kocak
- Department of Radiology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Basaksehir, Istanbul, 34480, Turkey.
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Reddy S, Giri D, Patel R. Artificial Intelligence Diagnosis of Parkinson's Disease From MRI Scans. Cureus 2024; 16:e58841. [PMID: 38784299 PMCID: PMC11114626 DOI: 10.7759/cureus.58841] [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] [Accepted: 04/23/2024] [Indexed: 05/25/2024] Open
Abstract
Parkinson's disease (PD) is a prevalent neurodegenerative disorder characterized by motor symptoms such as tremors, rigidity, and bradykinesia, affecting approximately 6.1 million people worldwide, according to estimates from the Parkinson's Foundation. Early and accurate diagnosis of PD is crucial for effective management and treatment. In this study, we aimed to develop an artificial intelligence (AI) model capable of distinguishing between magnetic resonance imaging (MRI) scans of individuals with PD and those without PD. A total of 442 MRI scans were utilized for training the AI model, comprising 221 scans of individuals diagnosed with PD and 221 scans of healthy controls. The dataset, obtained from a publicly available image dataset on Kaggle.com, was randomly split into three sets: training, validation, and testing, with 80%, 10%, and 10% of the data allocated to each set, respectively. Leveraging Google's Collaboration platform for model training, the AI model achieved exceptional performance, with accuracy, precision, recall (sensitivity), specificity, and F1-score all measuring at high levels. Additionally, the area under the receiver operating characteristic curve (AUC) for the model was found to be 1, indicating strong discrimination between PD and non-PD cases. This study presents a novel AI model capable of accurately identifying PD from MRI scans with high precision and reliability, offering promise for enhancing early diagnosis and personalized treatment strategies for individuals affected by PD.
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Affiliation(s)
- Shreya Reddy
- Biomedical Sciences, Creighton University, Omaha, USA
| | - Dinesh Giri
- Research, California Northstate University College of Medicine, Elk Grove, USA
| | - Rakesh Patel
- Internal Medicine, East Tennessee State University Quillen College of Medicine, Johnson City, USA
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Camacho M, Wilms M, Almgren H, Amador K, Camicioli R, Ismail Z, Monchi O, Forkert ND. Exploiting macro- and micro-structural brain changes for improved Parkinson's disease classification from MRI data. NPJ Parkinsons Dis 2024; 10:43. [PMID: 38409244 PMCID: PMC10897162 DOI: 10.1038/s41531-024-00647-9] [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: 07/14/2023] [Accepted: 01/22/2024] [Indexed: 02/28/2024] Open
Abstract
Parkinson's disease (PD) is the second most common neurodegenerative disease. Accurate PD diagnosis is crucial for effective treatment and prognosis but can be challenging, especially at early disease stages. This study aimed to develop and evaluate an explainable deep learning model for PD classification from multimodal neuroimaging data. The model was trained using one of the largest collections of T1-weighted and diffusion-tensor magnetic resonance imaging (MRI) datasets. A total of 1264 datasets from eight different studies were collected, including 611 PD patients and 653 healthy controls (HC). These datasets were pre-processed and non-linearly registered to the MNI PD25 atlas. Six imaging maps describing the macro- and micro-structural integrity of brain tissues complemented with age and sex parameters were used to train a convolutional neural network (CNN) to classify PD/HC subjects. Explainability of the model's decision-making was achieved using SmoothGrad saliency maps, highlighting important brain regions. The CNN was trained using a 75%/10%/15% train/validation/test split stratified by diagnosis, sex, age, and study, achieving a ROC-AUC of 0.89, accuracy of 80.8%, specificity of 82.4%, and sensitivity of 79.1% on the test set. Saliency maps revealed that diffusion tensor imaging data, especially fractional anisotropy, was more important for the classification than T1-weighted data, highlighting subcortical regions such as the brainstem, thalamus, amygdala, hippocampus, and cortical areas. The proposed model, trained on a large multimodal MRI database, can classify PD patients and HC subjects with high accuracy and clinically reasonable explanations, suggesting that micro-structural brain changes play an essential role in the disease course.
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Affiliation(s)
- Milton Camacho
- Biomedical Engineering Graduate Program, University of Calgary, Calgary, AB, Canada.
- Department of Radiology, University of Calgary, Calgary, AB, Canada.
| | - Matthias Wilms
- Department of Radiology, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- Department of Pediatrics and Community Health Sciences, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Hannes Almgren
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
| | - Kimberly Amador
- Biomedical Engineering Graduate Program, University of Calgary, Calgary, AB, Canada
- Department of Radiology, University of Calgary, Calgary, AB, Canada
| | - Richard Camicioli
- Neuroscience and Mental Health Institute and Department of Medicine (Neurology), University of Alberta, Edmonton, AB, Canada
| | - Zahinoor Ismail
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Oury Monchi
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
- Department of Radiology, Radio-oncology and Nuclear Medicine, Université de Montréal, Montréal, QC, Canada
- Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada
| | - Nils D Forkert
- Department of Radiology, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
- Department of Pediatrics and Community Health Sciences, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
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Huang CC, Chen PH, Tsai CC, Chiang HF, Hsieh CC, Chen TL, Liao WH, Chen YL, Wang JJ. Diffusion and structural MRI as potential biomarkers in people with Parkinson's disease and cognitive impairment. Eur Radiol 2024; 34:126-135. [PMID: 37572194 DOI: 10.1007/s00330-023-10012-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 06/06/2023] [Accepted: 06/09/2023] [Indexed: 08/14/2023]
Abstract
OBJECTIVE To explore the neuroimage change in Parkinson's disease (PD) patients with cognitive impairments, this study investigated the correlation between plasma biomarkers and morphological brain changes in patients with normal cognition and mild cognitive impairment. The objective was to identify the potential target deposition regions of the plasma biomarkers and to search for the relevant early neuroimaging biomarkers on the basis of different cognitive domains. METHODS Structural brain MRI and diffusion weighted images were analyzed from 49 eligible PD participants (male/female: 27/22; mean age: 73.4 ± 8.5 years) from a retrospective analysis. Plasma levels of α-synuclein, amyloid beta peptide, and total tau were collected. A comprehensive neuropsychological assessment of the general and specific cognitive domains was performed. Difference between PD patients with normal cognition and impairment was examined. Regression analysis was performed to evaluate the correlation between image-derived index and plasma biomarkers or neuropsychological assessments. RESULTS Significant correlation was found between plasma Aβ-42 level and fractional anisotropy of the middle occipital, angular, and middle temporal gyri of the left brain, as well as plasma T-tau level and the surface area of the isthmus or the average thickness of the posterior part of right cingulate gyrus. Visuospatial and executive function is positively correlated with axial diffusivity in bilateral cingulate gyri. CONCLUSION In nondemented PD patients, the target regions for plasma deposition might be located in the cingulate, middle occipital, angular, and middle temporal gyri. Changes from multiple brain regions can be correlated to the performance of different cognitive domains. CLINICAL RELEVANCE STATEMENT Cognitive impairment in Parkinson's disease is primarily linked to biomarkers associated with Alzheimer's disease rather than those related to Parkinson's disease and resembles the frontal variant of Alzheimer's disease, which may guide management strategies for cognitive impairment in Parkinson's disease. KEY POINTS • Fractional anisotropy, surface area, and thickness in the cingulate, middle occipital, angular, and middle temporal gyri can be significantly correlated with plasma Aβ-42 and T-tau level. • Axial diffusivity in the cingulate gyri was correlated with visuospatial and executive function. • The pattern of cognitive impairment in Parkinson's disease can be similar to the frontal variant than typical Alzheimer's disease.
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Affiliation(s)
- Chun-Chao Huang
- Department of Radiology, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
| | - Pei-Hao Chen
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
- Department of Neurology, MacKay Memorial Hospital, Taipei, Taiwan
- Graduate Institute of Mechanical and Electrical Engineering, National Taipei University of Technology, Taipei, Taiwan
| | - Chih-Chien Tsai
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
| | - Hsin-Fan Chiang
- Department of Radiology, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
| | - Cheng-Chih Hsieh
- Department of Radiology, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
| | - Ting-Lin Chen
- Department of Radiology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Wei-Hsin Liao
- Department of Radiology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Yao-Liang Chen
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
| | - Jiun-Jie Wang
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan.
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan.
- Institute for Radiological Research, Chang Gung University, Taoyuan, Taiwan.
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Zuo C, Suo X, Lan H, Pan N, Wang S, Kemp GJ, Gong Q. Global Alterations of Whole Brain Structural Connectome in Parkinson's Disease: A Meta-analysis. Neuropsychol Rev 2023; 33:783-802. [PMID: 36125651 PMCID: PMC10770271 DOI: 10.1007/s11065-022-09559-y] [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: 10/29/2021] [Accepted: 06/14/2022] [Indexed: 10/14/2022]
Abstract
Recent graph-theoretical studies of Parkinson's disease (PD) have examined alterations in the global properties of the brain structural connectome; however, reported alterations are not consistent. The present study aimed to identify the most robust global metric alterations in PD via a meta-analysis. A comprehensive literature search was conducted for all available diffusion MRI structural connectome studies that compared global graph metrics between PD patients and healthy controls (HC). Hedges' g effect sizes were calculated for each study and then pooled using a random-effects model in Comprehensive Meta-Analysis software, and the effects of potential moderator variables were tested. A total of 22 studies met the inclusion criteria for review. Of these, 16 studies reporting 10 global graph metrics (916 PD patients; 560 HC) were included in the meta-analysis. In the structural connectome of PD patients compared with HC, we found a significant decrease in clustering coefficient (g = -0.357, P = 0.005) and global efficiency (g = -0.359, P < 0.001), and a significant increase in characteristic path length (g = 0.250, P = 0.006). Dopaminergic medication, sex and age of patients were potential moderators of global brain network changes in PD. These findings provide evidence of decreased global segregation and integration of the structural connectome in PD, indicating a shift from a balanced small-world network to 'weaker small-worldization', which may provide useful markers of the pathophysiological mechanisms underlying PD.
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Affiliation(s)
- Chao Zuo
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Xueling Suo
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Huan Lan
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Nanfang Pan
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Song Wang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
| | - Graham J Kemp
- Liverpool Magnetic Resonance Imaging Centre (LiMRIC) and Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, Sichuan, China.
- Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
- Department of Radiology, West China Xiamen Hospital of Sichuan University, Xiamen, Fujian, China.
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Hu Z, Sun P, George A, Zeng X, Li M, Lin TH, Ye Z, Wei X, Jiang X, Song SK, Yang R. Diffusion basis spectrum imaging detects pathological alterations in substantia nigra and white matter tracts with early-stage Parkinson's disease. Eur Radiol 2023; 33:9109-9119. [PMID: 37438642 DOI: 10.1007/s00330-023-09780-0] [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: 08/31/2022] [Revised: 03/13/2023] [Accepted: 03/30/2023] [Indexed: 07/14/2023]
Abstract
OBJECTIVES Using diffusion basis spectrum imaging (DBSI) to examine the microstructural changes in the substantia nigra (SN) and global white matter (WM) tracts of patients with early-stage PD. METHODS Thirty-seven age- and sex-matched patients with early-stage PD and 22 healthy controls (HCs) were enrolled in this study. All participants underwent clinical assessments and diffusion-weighted MRI scans, analyzed by diffusion tensor imaging (DTI) and DBSI to assess the pathologies of PD in SN and global WM tracts. RESULTS The lower DTI fraction anisotropy (FA) was seen in SN of PD patients (PD: 0.316 ± 0.034 vs HCs: 0.331 ± 0.019, p = 0.015). The putative cells marker-DBSI-restricted fraction (PD: 0.132 ± 0.051 vs HCs: 0.105 ± 0.039, p = 0.031) and the edema/extracellular space marker-DBSI non-restricted-fraction (PD: 0.150 ± 0.052 vs HCs: 0.122 ± 0.052, p = 0.020) were both significantly higher and the density of axons/dendrites marker-DBSI fiber-fraction (PD: 0.718 ± 0.073 vs HCs: 0.773 ± 0.071, p = 0.003) was significantly lower in SN of PD patients. DBSI-restricted fraction in SN was negatively correlated with HAMA scores (r = - 0.501, p = 0.005), whereas DTI-FA was not correlated with any clinical scales. In WM tracts, only higher DTI axial diffusivity (AD) among DTI metrics was found in multiple WM regions in PD, while lower DBSI fiber-fraction and higher DBSI non-restricted-fraction were detected in multiple WM regions. DBSI non-restricted-fraction in both left fornix (cres)/stria terminalis (r = -0.472, p = 0.004) and right posterior thalamic radiation (r = - 0.467, p = 0.005) was negatively correlated with MMSE scores. CONCLUSION DBSI could potentially detect and quantify the extent of inflammatory cell infiltration, fiber/dendrite loss, and edema in both SN and WM tracts in patients with early-stage PD, a finding remains to be further investigated through more extensive longitudinal DBSI analysis. CLINICAL RELEVANCE STATEMENT Our study shows that DBSI indexes can potentially detect early-stage PD's pathological changes, with a notable ability to distinguish between inflammation and edema. This implies that DBSI has the potential to be an imaging biomarker for early PD diagnosis. KEY POINTS • Diffusion basis spectrum imaging detected higher restricted-fraction in Parkinson's disease, potentially reflecting inflammatory cell infiltration. • Diffusion basis spectrum imaging detected higher non-restricted-fraction and lower fiber-fraction in Parkinson's disease, indicating the presence of edema and/or dopaminergic neuronal/dendritic loss. • Diffusion basis spectrum imaging metrics correlated with non-motor symptoms, suggesting its potential diagnostic role to detect early-stage PD dysfunctions.
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Affiliation(s)
- Zexuan Hu
- Department of Radiology, Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, Guangdong, 510310, Guangzhou, China
| | - Peng Sun
- Biomedical MR Laboratory, Mallinckrodt Institute of Radiology, Washington University School of Medicine, Room 2313, 4525 Scott Ave, Campus Box 8227, St. Louis, MO, 63110-1093, USA
| | - Ajit George
- Biomedical MR Laboratory, Mallinckrodt Institute of Radiology, Washington University School of Medicine, Room 2313, 4525 Scott Ave, Campus Box 8227, St. Louis, MO, 63110-1093, USA
| | - Xiangling Zeng
- Department of Radiology, the Second Affiliated Hospital, School of Medicine, South China University of Technology, #1 Panfu Road, Yuexiu District, Guangdong, 510180, Guangzhou, China
| | - Mengyan Li
- Department of Neurology, the Second Affiliated Hospital, School of Medicine, South China University of Technology, #1 Panfu Road, Yuexiu District, Guangdong, 510180, Guangzhou, China
| | - Tsen-Hsuan Lin
- Biomedical MR Laboratory, Mallinckrodt Institute of Radiology, Washington University School of Medicine, Room 2313, 4525 Scott Ave, Campus Box 8227, St. Louis, MO, 63110-1093, USA
| | - Zezhong Ye
- Biomedical MR Laboratory, Mallinckrodt Institute of Radiology, Washington University School of Medicine, Room 2313, 4525 Scott Ave, Campus Box 8227, St. Louis, MO, 63110-1093, USA
| | - Xinhua Wei
- Department of Radiology, the Second Affiliated Hospital, School of Medicine, South China University of Technology, #1 Panfu Road, Yuexiu District, Guangdong, 510180, Guangzhou, China
| | - Xinqing Jiang
- Department of Radiology, the Second Affiliated Hospital, School of Medicine, South China University of Technology, #1 Panfu Road, Yuexiu District, Guangdong, 510180, Guangzhou, China
| | - Sheng-Kwei Song
- Biomedical MR Laboratory, Mallinckrodt Institute of Radiology, Washington University School of Medicine, Room 2313, 4525 Scott Ave, Campus Box 8227, St. Louis, MO, 63110-1093, USA.
| | - Ruimeng Yang
- Department of Radiology, the Second Affiliated Hospital, School of Medicine, South China University of Technology, #1 Panfu Road, Yuexiu District, Guangdong, 510180, Guangzhou, China.
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Zhong Y, Liu H, Liu G, Liang Y, Dai C, Zhao L, Lai H, Mo L, Tan C, Deng F, Liu X, Chen L. Cerebellar and cerebral white matter changes in Parkinson's disease with resting tremor. Neuroradiology 2023; 65:1497-1506. [PMID: 37548715 DOI: 10.1007/s00234-023-03206-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 07/28/2023] [Indexed: 08/08/2023]
Abstract
PURPOSE Cerebellum modulates the amplitude of resting tremor in Parkinson's disease (PD) via cerebello-thalamo-cortical (CTC) circuit. Tremor-related white matter alterations have been identified in PD patients by pathological studies, but in vivo evidence is limited; the influence of such cerebellar white matter alterations on tremor-related brain network, including CTC circuit, is also unclear. In this study, we investigated the cerebral and cerebellar white matter alterations in PD patients with resting tremor using diffusion tensor imaging (DTI). METHODS In this study, 30 PD patients with resting tremor (PDWR), 26 PD patients without resting tremor (PDNR), and 30 healthy controls (HCs) from the Parkinson's Progression Markers Initiative (PPMI) cohort were included. Tract-based spatial statistics (TBSS) and region of interest-based analyses were conducted to determine white matter difference. Correlation analysis between DTI measures and clinical characteristics was also performed. RESULTS In the whole brain, TBSS and region of interest-based analyses identified higher fractional anisotropy (FA) value, lower mean diffusivity (MD) value, and lower radial diffusivity (RD) in multiple fibers. In the cerebellum, TBSS analysis revealed significantly higher FA value, decreased RD value as well as MD value in multiple cerebellar tracts including the inferior cerebellar peduncle (ICP) and middle cerebellar peduncle (MCP) when comparing the PDWR with HC, and higher FA value in the MCP when compared with PDNR. CONCLUSION We identified better white matter integrity in the cerebrum and cerebellum in PDWR indicating a potential association between the cerebral and cerebellar white matter and resting tremor in PD.
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Affiliation(s)
- Yuke Zhong
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, 74 Linjiang Road, Yuzhong District, Chongqing, 400010, China
| | - Hang Liu
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, 74 Linjiang Road, Yuzhong District, Chongqing, 400010, China
| | - Guohui Liu
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, 74 Linjiang Road, Yuzhong District, Chongqing, 400010, China
| | - Yi Liang
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, 74 Linjiang Road, Yuzhong District, Chongqing, 400010, China
| | - Chengcheng Dai
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, 74 Linjiang Road, Yuzhong District, Chongqing, 400010, China
| | - Lili Zhao
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, 74 Linjiang Road, Yuzhong District, Chongqing, 400010, China
| | - Hongyu Lai
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, 74 Linjiang Road, Yuzhong District, Chongqing, 400010, China
| | - Lijuan Mo
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, 74 Linjiang Road, Yuzhong District, Chongqing, 400010, China
| | - Changhong Tan
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, 74 Linjiang Road, Yuzhong District, Chongqing, 400010, China
| | - Fen Deng
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, 74 Linjiang Road, Yuzhong District, Chongqing, 400010, China
| | - Xi Liu
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, 74 Linjiang Road, Yuzhong District, Chongqing, 400010, China.
| | - Lifen Chen
- Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, 74 Linjiang Road, Yuzhong District, Chongqing, 400010, China.
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Zawiślak-Fornagiel K, Ledwoń D, Bugdol M, Romaniszyn-Kania P, Małecki A, Gorzkowska A, Mitas AW. Specific patterns of coherence and phase lag index in particular regions as biomarkers of cognitive impairment in Parkinson's disease. Parkinsonism Relat Disord 2023; 111:105436. [PMID: 37167834 DOI: 10.1016/j.parkreldis.2023.105436] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 04/25/2023] [Accepted: 05/01/2023] [Indexed: 05/13/2023]
Abstract
INTRODUCTION Cognitive impairment is a persistent and increasingly reported symptom of patients with Parkinson's disease (PD), significantly affecting daily functioning quality. This study aims to evaluate the functional connectivity of the brain network in patients with Parkinson's disease with various severities of cognitive decline using quantitative electroencephalography (EEG) analysis. METHODS Based on the EEG recorded in the resting state, the coherence and phase lag index were calculated to evaluate functional connectivity in 108 patients with Parkinson's disease divided into three groups according to their cognitive condition: dementia due to PD (PD-D), PD and mild cognitive impairment (PD-MCI) and cognitively normal patients (PD-CogN). RESULTS It was found that there were significantly different coherence values in the PD-D group compared to PD-CogN in different frequency bands. In most cases, there was a decrease in coherence in PD-D compared to PD-CogN. The most specific changes were revealed in the theta frequency band in the temporal right-frontal left and temporal right-frontal right regions. In the alpha frequency band, the most significant decreases were shown in the occipital right-frontal left and occipital left-frontal right areas. There were also statistically significant differences in phase lag index between many areas, especially in the theta frequency range. CONCLUSIONS These findings indicate that the functional connectivity patterns of coherence and phase lag index - found in a particular frequency band and region - could become a reliable biomarker for identifying cognitive impairment and differentiating its severity in PD patients.
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Affiliation(s)
- Katarzyna Zawiślak-Fornagiel
- Department of Neurology, University Clinical Center prof. K. Gibiński of the Medical University of Silesia, 40-752, Katowice, Poland
| | - Daniel Ledwoń
- Faculty of Biomedical Engineering, Silesian University of Technology, Roosevelta 40, 41-800, Zabrze, Poland.
| | - Monika Bugdol
- Faculty of Biomedical Engineering, Silesian University of Technology, Roosevelta 40, 41-800, Zabrze, Poland
| | - Patrycja Romaniszyn-Kania
- Faculty of Biomedical Engineering, Silesian University of Technology, Roosevelta 40, 41-800, Zabrze, Poland
| | - Andrzej Małecki
- Institute of Physiotherapy and Health Science, Academy of Physical Education in Katowice, Mikołowska 72A, 40-065, Katowice, Poland
| | - Agnieszka Gorzkowska
- Department of Neurorehabilitation, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752, Katowice, Poland
| | - Andrzej W Mitas
- Faculty of Biomedical Engineering, Silesian University of Technology, Roosevelta 40, 41-800, Zabrze, Poland
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9
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Brabenec L, Simko P, Sejnoha Minsterova A, Kostalova M, Rektorova I. Repetitive transcranial magnetic stimulation for hypokinetic dysarthria in Parkinson's disease enhances white matter integrity of the auditory-motor loop. Eur J Neurol 2023; 30:881-886. [PMID: 36529528 DOI: 10.1111/ene.15665] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 12/08/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND PURPOSE In our previous study, repeated sessions of repetitive transcranial magnetic stimulation (rTMS) over the auditory feedback area were shown to improve hypokinetic dysarthria (HD) in Parkinson's disease (PD) and led to changes in functional connectivity within the left-sided articulatory networks. We analyzed data from this previous study and assessed the effects of rTMS for HD in PD on the diffusion parameters of the left anterior arcuate fasciculus (AAF), which connects the auditory feedback area with motor regions involved in articulation. METHODS Patients were assigned to 10 sessions of real or sham 1-Hz stimulation over the right posterior superior temporal gyrus. Stimulation effects were evaluated using magnetic resonance diffusion tensor imaging and by a speech therapist using a validated tool (Phonetics score of the Dysarthric Profile) at baseline, immediately after 2 weeks of stimulation, and at follow-up visits at Weeks 6 and 10 after the baseline. RESULTS Altogether, data from 33 patients were analyzed. A linear mixed model revealed significant time-by-group interaction (p = 0.006) for the relative changes of fractional anisotropy of the AAF; the value increases were associated with the temporal evolution of the Phonetics score (R = 0.367, p = 0.028) in the real stimulation group. CONCLUSIONS Real rTMS treatment for HD in PD as compared to sham stimulation led to increases of white matter integrity of the auditory-motor loop during the 2-month follow-up period. The changes were related to motor speech improvements.
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Affiliation(s)
- Lubos Brabenec
- Applied Neuroscience Research Group, Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Patrik Simko
- Applied Neuroscience Research Group, Central European Institute of Technology, Masaryk University, Brno, Czech Republic
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Alzbeta Sejnoha Minsterova
- Applied Neuroscience Research Group, Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Milena Kostalova
- Applied Neuroscience Research Group, Central European Institute of Technology, Masaryk University, Brno, Czech Republic
- Department of Neurology, University Hospital Brno, Brno, Czech Republic
| | - Irena Rektorova
- Applied Neuroscience Research Group, Central European Institute of Technology, Masaryk University, Brno, Czech Republic
- First Department of Neurology, Faculty of Medicine and St. Anne's University Hospital, Masaryk University, Brno, Czech Republic
- International Clinical Research Center, Faculty of Medicine and St. Anne's University Hospital, Masaryk University, Brno, Czech Republic
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10
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Sarasso E, Filippi M, Agosta F. Clinical and MRI features of gait and balance disorders in neurodegenerative diseases. J Neurol 2023; 270:1798-1807. [PMID: 36577818 DOI: 10.1007/s00415-022-11544-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 12/29/2022]
Abstract
Gait and balance disorders are common signs in several neurodegenerative diseases such as Parkinson's disease, atypical parkinsonism, idiopathic normal pressure hydrocephalus, cerebrovascular disease, dementing disorders and multiple sclerosis. According to each condition, patients present with different gait and balance alterations depending on the structural and functional brain changes through the disease course. In this review, we will summarize the main clinical characteristics of gait and balance disorders in the major neurodegenerative conditions, providing an overview of the significant structural and functional MRI brain alterations underlying these deficits. We also will discuss the role of neurorehabilitation strategies in promoting brain plasticity and gait/balance improvements in these patients.
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Affiliation(s)
- Elisabetta Sarasso
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genoa, Genoa, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Federica Agosta
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy.
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
- Vita-Salute San Raffaele University, Milan, Italy.
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11
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Structural and metabolic correlates of neuropsychological profiles in multiple system atrophy and Parkinson's disease. Parkinsonism Relat Disord 2023; 107:105277. [PMID: 36621156 DOI: 10.1016/j.parkreldis.2022.105277] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 12/27/2022] [Accepted: 12/31/2022] [Indexed: 01/03/2023]
Abstract
BACKGROUND Despite increased recognition of cognitive impairment in Multiple System Atrophy (MSA), its neuroanatomical correlates are not well defined. We aimed to explore cognitive profiles in MSA with predominant parkinsonism (MSA-P) and Parkinson's disease (PD) and their relationship to frontostriatal structural and metabolic changes. METHODS Detailed clinical and neuropsychological evaluation was performed together with diffusion tensor imaging (DTI) and [18F]-fluoro-deoxyglucose positron emission tomography ([18F]-FDG-PET) in patients with MSA-P (n = 11) and PD (n = 11). We compared clinical and neuropsychological data to healthy controls (n = 9) and correlated neuropsychological data with imaging findings in MSA-P and PD. RESULTS Patients with MSA-P showed deficits in executive function (Trail Making Test B-A) and scored higher in measures of depression and anxiety compared to those with PD and healthy controls. Widespread frontostriatal white matter tract reduction in fractional anisotropy was seen in MSA-P and PD compared to an imaging control group. Stroop Test interference performance correlated with [18F]-FDG uptake in the bilateral dorsolateral prefrontal cortex (DLPFC) and with white matter integrity between the striatum and left inferior frontal gyrus (IFG) in PD. Trail Making Test performance correlated with corticostriatal white matter integrity along tracts from the bilateral IFG in MSA-P and from the right DLPFC in both groups. CONCLUSION Executive dysfunction was more prominent in patients with MSA-P compared to PD. DLPFC metabolism and frontostriatal white matter integrity seem to be a driver of executive function in PD, whereas alterations in corticostriatal white matter integrity may contribute more to executive dysfunction in MSA-P.
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12
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Contaldi E, Magistrelli L, Cosentino M, Marino F, Comi C. Lymphocyte Count and Neutrophil-to-Lymphocyte Ratio Are Associated with Mild Cognitive Impairment in Parkinson’s Disease: A Single-Center Longitudinal Study. J Clin Med 2022; 11:jcm11195543. [PMID: 36233411 PMCID: PMC9571051 DOI: 10.3390/jcm11195543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 09/13/2022] [Accepted: 09/20/2022] [Indexed: 11/24/2022] Open
Abstract
Lymphocyte count and neutrophil-to-lymphocyte ratio (NLR) may represent useful biomarkers of Parkinson’s disease (PD), but their role in PD-related mild cognitive impairment (MCI) has not been fully elucidated. The present study aimed to confirm whether these immunological measures can discriminate PD patients from healthy controls (HC) and establish their feasibility as prognostic biomarkers of MCI in PD. Immunological data at baseline were analyzed in 58 drug-naïve PD patients and 58 HC matched 1:1 for age, sex, and cardiovascular comorbidities. We selected a subgroup of 51 patients from this initial cohort who underwent longitudinal neuropsychological assessments through the Addenbrooke’s Cognitive Examination Revised (ACE-R) test. We considered the last examination available to analyze the relationship between ACE-R test scores and immunological measures. We found that lymphocyte count was lower and NLR higher in PD than HC (p = 0.006, p = 0.044), with AUC = 0.649 and 0.608, respectively. Secondly, in PD-MCI there were significantly higher levels of circulating lymphocytes (p = 0.002) and lower NLR (p = 0.020) than PD with normal cognitive status (PD-NC). Correlations between lymphocyte count and ACE-R total score and memory subitem (r = −0.382, p = 0.006; r = −0.362, p = 0.01), as well as between NLR and ACE-R total score and memory subitem (r = 0.325, p = 0.02; r = 0.374, p = 0.007), were also found. ROC curve analysis showed that lymphocyte count and NLR displayed acceptable discrimination power of PD-MCI with AUC = 0.759 and 0.691, respectively. In conclusion, we suggest that an altered peripheral immune phenotype could foster cognitive decline development in PD, thus opening the possibility of immune-targeting strategies to tackle this disabling non-motor feature.
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Affiliation(s)
- Elena Contaldi
- Movement Disorders Centre, Neurology Unit, Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy
- PhD Program in Medical Sciences and Biotechnology, University of Piemonte Orientale, 28100 Novara, Italy
| | - Luca Magistrelli
- Movement Disorders Centre, Neurology Unit, Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy
- PhD Program in Clinical and Experimental Medicine and Medical Humanities, University of Insubria, 21100 Varese, Italy
| | - Marco Cosentino
- Center of Research in Medical Pharmacology, University of Insubria, 21100 Varese, Italy
- Center for Research in Neuroscience, University of Insubria, 21100 Varese, Italy
| | - Franca Marino
- Center of Research in Medical Pharmacology, University of Insubria, 21100 Varese, Italy
- Center for Research in Neuroscience, University of Insubria, 21100 Varese, Italy
| | - Cristoforo Comi
- Center of Research in Medical Pharmacology, University of Insubria, 21100 Varese, Italy
- Department of Translational Medicine, Neurology Unit, S. Andrea Hospital, University of Piemonte Orientale, 13100 Vercelli, Italy
- Correspondence:
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13
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Longitudinal corpus callosum microstructural decline in early-stage Parkinson’s disease in association with akinetic-rigid symptom severity. NPJ Parkinsons Dis 2022; 8:108. [PMID: 36038586 PMCID: PMC9424284 DOI: 10.1038/s41531-022-00372-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 08/02/2022] [Indexed: 12/26/2022] Open
Abstract
Previous diffusion tensor imaging (DTI) studies of Parkinson’s disease (PD) show reduced microstructural integrity of the corpus callosum (CC) relative to controls, although the characteristics of such callosal degradation remain poorly understood. Here, we utilized a longitudinal approach to identify microstructural decline in the entire volume of the CC and its functional subdivisions over 2 years and related the callosal changes to motor symptoms in early-stage PD. The study sample included 61 PD subjects (N = 61, aged 45–82, 38 M & 23 F, H&Y ≤ 2) from the Parkinson’s Progressive Markers Initiative database (PPMI). Whole-brain voxel-wise results revealed significant fractional anisotropy (FA) and mean diffusivity (MD) changes in the CC, especially in the genu and splenium. Using individually drawn CC regions of interest (ROI), our analysis further revealed that almost all subdivisions of the CC show significant decline in FA to certain extents over the two-year timeframe. Additionally, FA seemed lower in the right hemisphere of the CC at both time-points, and callosal FA decline was associated with FA and MD decline in widespread cortical and subcortical areas. Notably, multiple regression analysis revealed that across-subject akinetic-rigid severity was negatively associated with callosal FA at baseline and 24 months follow-up, and the effect was strongest in the anterior portion of the CC. These results suggest that callosal microstructure alterations in the anterior CC may serve as a viable biomarker for akinetic-rigid symptomology and disease progression, even in early PD.
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14
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Donahue EK, Bui V, Foreman RP, Duran JJ, Venkadesh S, Choupan J, Van Horn JD, Alger JR, Jakowec MW, Petzinger GM, O'Neill J. Magnetic resonance spectroscopy shows associations between neurometabolite levels and perivascular space volume in Parkinson's disease: a pilot and feasibility study. Neuroreport 2022; 33:291-296. [PMID: 35594442 DOI: 10.1097/wnr.0000000000001781] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Higher volume fraction of perivascular space (PVS) has recently been reported in Parkinson's disease (PD) and related disorders. Both elevated PVS and altered levels of neurometabolites, assayed by proton magnetic resonance spectroscopy (MRS), are suspected indicators of neuroinflammation, but no published reports have concurrently examined PVS and MRS neurometabolites. METHODS In an exploratory pilot study, we acquired multivoxel 3-T MRS using a semi-Localization by Adiabatic SElective Refocusing (sLASER) pulse-sequence (repetition time/echo time = 2810/60 ms, voxels 10 × 10 × 10 mm3) from a 2D slab sampling bilateral frontal white matter (FWM) and anterior middle cingulate cortex (aMCC). PVS maps obtained from high-resolution (0.8 × 0.8 × 0.8 mm3) T1-weighted MRI were co-registered with MRS. In each MRS voxel, PVS volume and neurometabolite levels were measured. RESULTS Linear regression accounting for age, sex, and BMI found greater PVS volume for higher levels of choline-containing compounds (Cho; P = 0.047) in FWM and lower PVS volume for higher levels of N-acetyl compounds (NAA; P = 0.012) in aMCC. Since (putatively) higher Cho is associated with inflammation while NAA has anti-inflammatory properties, these observations add to evidence that higher PVS load is a sign of inflammation. Additionally, lower Montreal Cognitive Assessment scores were associated with lower NAA in aMCC (P = 0.002), suggesting that local neuronal dysfunction and inflammation contribute to cognitive impairment in PD. CONCLUSION These exploratory findings indicate that co-analysis of PVS and MRS is feasible and may help elucidate the cellular and metabolic substrates of glymphatic and inflammatory processes in PD.
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Affiliation(s)
- Erin K Donahue
- Department of Neurology, University of Southern California
- Neuroscience Graduate Program, University of Southern California, Los Angeles, California
| | - Vy Bui
- Department of Neurology, University of Southern California
| | - Ryan P Foreman
- Department of Neurology, University of Southern California
| | - Jared J Duran
- Department of Neurology, University of Southern California
| | - Siva Venkadesh
- Department of Psychology, University of Virginia, Charlottesville, Virginia
| | - Jeiran Choupan
- Laboratory of NeuroImaging, USC Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, California
| | - John D Van Horn
- Department of Psychology, University of Virginia, Charlottesville, Virginia
- School of Data Science, University of Virginia, Charlottesville, Virginia
| | - Jeffry R Alger
- Department of Neurology, University of California, Los Angeles
| | | | | | - Joseph O'Neill
- Division of Child Psychiatry, UCLA Semel Institute for Neuroscience, Los Angeles, California, USA
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15
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Wakasugi N, Hanakawa T. It Is Time to Study Overlapping Molecular and Circuit Pathophysiologies in Alzheimer's and Lewy Body Disease Spectra. Front Syst Neurosci 2021; 15:777706. [PMID: 34867224 PMCID: PMC8637125 DOI: 10.3389/fnsys.2021.777706] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 10/28/2021] [Indexed: 12/30/2022] Open
Abstract
Alzheimer's disease (AD) is the leading cause of dementia due to neurodegeneration and is characterized by extracellular senile plaques composed of amyloid β1 - 42 (Aβ) as well as intracellular neurofibrillary tangles consisting of phosphorylated tau (p-tau). Dementia with Lewy bodies constitutes a continuous spectrum with Parkinson's disease, collectively termed Lewy body disease (LBD). LBD is characterized by intracellular Lewy bodies containing α-synuclein (α-syn). The core clinical features of AD and LBD spectra are distinct, but the two spectra share common cognitive and behavioral symptoms. The accumulation of pathological proteins, which acquire pathogenicity through conformational changes, has long been investigated on a protein-by-protein basis. However, recent evidence suggests that interactions among these molecules may be critical to pathogenesis. For example, Aβ/tau promotes α-syn pathology, and α-syn modulates p-tau pathology. Furthermore, clinical evidence suggests that these interactions may explain the overlapping pathology between AD and LBD in molecular imaging and post-mortem studies. Additionally, a recent hypothesis points to a common mechanism of prion-like progression of these pathological proteins, via neural circuits, in both AD and LBD. This suggests a need for understanding connectomics and their alterations in AD and LBD from both pathological and functional perspectives. In AD, reduced connectivity in the default mode network is considered a hallmark of the disease. In LBD, previous studies have emphasized abnormalities in the basal ganglia and sensorimotor networks; however, these account for movement disorders only. Knowledge about network abnormalities common to AD and LBD is scarce because few previous neuroimaging studies investigated AD and LBD as a comprehensive cohort. In this paper, we review research on the distribution and interactions of pathological proteins in the brain in AD and LBD, after briefly summarizing their clinical and neuropsychological manifestations. We also describe the brain functional and connectivity changes following abnormal protein accumulation in AD and LBD. Finally, we argue for the necessity of neuroimaging studies that examine AD and LBD cases as a continuous spectrum especially from the proteinopathy and neurocircuitopathy viewpoints. The findings from such a unified AD and Parkinson's disease (PD) cohort study should provide a new comprehensive perspective and key data for guiding disease modification therapies targeting the pathological proteins in AD and LBD.
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Affiliation(s)
- Noritaka Wakasugi
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Takashi Hanakawa
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Tokyo, Japan
- Department of Integrated Neuroanatomy and Neuroimaging, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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16
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Zhang Y, Huang B, Chen Q, Wang L, Zhang L, Nie K, Huang Q, Huang R. Altered microstructural properties of superficial white matter in patients with Parkinson's disease. Brain Imaging Behav 2021; 16:476-491. [PMID: 34410610 DOI: 10.1007/s11682-021-00522-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2021] [Indexed: 12/31/2022]
Abstract
Parkinson's disease (PD), a chronic neurodegenerative disease, is characterized by sensorimotor and cognitive deficits. Previous diffusion tensor imaging (DTI) studies found abnormal DTI metrics in white matter bundles, such as the corpus callosum, cingulate, and frontal-parietal bundles, in PD patients. These studies mainly focused on alterations in microstructural features of long-range bundles within the deep white matter (DWM) that connects pairs of distant cortical regions. However, less is known about the DTI metrics of the superficial white matter (SWM) that connects local cortical regions in PD patients. To determine whether the DTI metrics of the SWM were different between the PD patients and the healthy controls, we recruited DTI data from 34 PD patients and 29 gender- and age-matched healthy controls. Using a probabilistic tractographic approach, we first defined a population-based SWM mask across all the subjects. Using a tract-based spatial statistical (TBSS) analytic approach, we then identified the SWM bundles showing abnormal DTI metrics in the PD patients. We found that the PD patients showed significantly lower DTI metrics in the SWM bundles connecting the sensorimotor cortex, cingulate cortex, posterior parietal cortex (PPC), and parieto-occipital cortex than the healthy controls. We also found that the clinical measures in the PD patients was significantly negatively correlated with the fractional anisotropy in the SWM (FASWM) that connects core regions in the default mode network (DMN). The FASWM in the bundles that connected the PPC was significantly positively correlated with cognitive performance in the PD patients. Our findings suggest that SWM may serve as the brain structural basis underlying the sensorimotor deficits and cognitive degeneration in PD patients.
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Affiliation(s)
- Yichen Zhang
- Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, 510631, China
| | - Biao Huang
- Department of Radiology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, 510080 , China.
| | - Qinyuan Chen
- Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, 510631, China
| | - Lijuan Wang
- Department of Neurology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, 510080, China
| | - Lu Zhang
- Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, 510631, China
| | - Kun Nie
- Department of Neurology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, 510080, China
| | - Qinda Huang
- Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, 510631, China
| | - Ruiwang Huang
- Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, School of Psychology, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, 510631, China.
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17
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Liu Z, Zhang Y, Wang H, Xu D, You H, Zuo Z, Feng F. Altered cerebral perfusion and microstructure in advanced Parkinson's disease and their associations with clinical features. Neurol Res 2021; 44:47-56. [PMID: 34313185 DOI: 10.1080/01616412.2021.1954842] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To explore the whole cerebral perfusion and microstructure alteration patterns in Parkinson's disease (PD) and the associations of these patterns with clinical features. METHODS Forty-one subjects [20 PD patients and 21 healthy controls (HCs)] underwent arterial spin labeling (ASL), diffusion tensor imaging (DTI) and 3D T1-weighted imaging (T1WI) MRI. The cerebral blood flow (CBF) of the whole brain and the fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD) and mean diffusivity (MD) of subcortical and cerebellar regions were measured and compared between groups. Pearson's correlation was calculated between MRI measurements and clinical features [Unified Parkinson's Disease Rating Scale (UPDRS), UPDRS III, Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA) and olfactory test scores]. RESULTS Compared to HCs, PD patients showed lower CBF in the frontal, parietal and temporal lobes but higher CBF in bilateral hippocampi, red nuclei, right substantia nigra, thalamus and most cerebellar regions. The MD in the right thalamus and several regions in the cerebellum increased in PD compared to HCs. In PD patients, the total UPDRS, UPDRS III, MoCA, MMSE and olfactory test scores were related to FA or CBF in cerebellum. (all p < 0.05). CONCLUSION Hypoperfusion in cortical regions, together with hyperperfusion in subcortical and cerebellar regions may be the characteristic perfusion pattern in advanced PD patients. The microstructures of the right thalamus and cerebellum were changed in PD patients. The cognitive, motor and olfactory performance of PD patients is closely related to the perfusion and microstructure of the brain, especially the cerebellum.
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Affiliation(s)
- Zhaoxi Liu
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Yiwei Zhang
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Han Wang
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Dan Xu
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Hui You
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Zhentao Zuo
- Brain Mapping Center, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China
| | - Feng Feng
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
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18
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Jin C, Qi S, Teng Y, Li C, Yao Y, Ruan X, Wei X. Integrating Structural and Functional Interhemispheric Brain Connectivity of Gait Freezing in Parkinson's Disease. Front Neurol 2021; 12:609866. [PMID: 33935931 PMCID: PMC8081966 DOI: 10.3389/fneur.2021.609866] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 03/04/2021] [Indexed: 11/23/2022] Open
Abstract
Freezing of gait (FOG) has devastating consequences for patients with Parkinson's disease (PD), but the underlying pathophysiological mechanism is unclear. This was investigated in the present study by integrated structural and functional connectivity analyses of PD patients with or without FOG (PD FOG+ and PD FOG-, respectively) and healthy control (HC) subjects. We performed resting-state functional magnetic resonance imaging (fMRI) and diffusion tensor imaging of 24 PD FOG+ patients, 37 PD FOG- patients, and 24 HCs. Tract-based spatial statistics was applied to identify white matter (WM) abnormalities across the whole brain. Fractional anisotropy (FA) and mean diffusivity (MD) of abnormal WM areas were compared among groups, and correlations between these parameters and clinical severity as determined by FOG Questionnaire (FOGQ) score were analyzed. Voxel-mirrored homotopic connectivity (VMHC) was calculated to identify brain regions with abnormal interhemispheric connectivity. Structural and functional measures were integrated by calculating correlations between VMHC and FOGQ score and between FA, MD, and VMHC. The results showed that PD FOG+ and PD FOG- patients had decreased FA in the corpus callosum (CC), cingulum (hippocampus), and superior longitudinal fasciculus and increased MD in the CC, internal capsule, corona radiata, superior longitudinal fasciculus, and thalamus. PD FOG+ patients had more WM abnormalities than PD FOG- patients. FA and MD differed significantly among the splenium, body, and genu of the CC in all three groups (P < 0.05). The decreased FA in the CC was positively correlated with FOGQ score. PD FOG+ patients showed decreased VMHC in the post-central gyrus (PCG), pre-central gyrus, and parietal inferior margin. In PD FOG+ patients, VMHC in the PCG was negatively correlated with FOGQ score but positively correlated with FA in CC. Thus, FOG is associated with impaired interhemispheric brain connectivity measured by FA, MD, and VMHC, which are related to clinical FOG severity. These results demonstrate that integrating structural and functional MRI data can provide new insight into the pathophysiological mechanism of FOG in PD.
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Affiliation(s)
- Chaoyang Jin
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China
| | - Shouliang Qi
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China
- Key Laboratory of Intelligent Computing in Medical Image, Ministry of Education, Northeastern University, Shenyang, China
| | - Yueyang Teng
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China
| | - Chen Li
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China
| | - Yudong Yao
- Department of Electrical and Computer Engineering, Stevens Institute of Technology, Hoboken, NJ, United States
| | - Xiuhang Ruan
- Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Xinhua Wei
- Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
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Wen C, Yang Y, Xiao Q, Huang M, Pan W. Genome-wide association studies of brain imaging data via weighted distance correlation. Bioinformatics 2021; 36:4942-4950. [PMID: 32619001 DOI: 10.1093/bioinformatics/btaa612] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 06/17/2020] [Accepted: 06/26/2020] [Indexed: 11/13/2022] Open
Abstract
MOTIVATION Imaging genetics is mainly used to reveal the pathogenesis of neuropsychiatric risk genes and understand the relationship between human brain structure, functional and individual differences. Increasingly, the brain-wide imaging phenotypes in voxels are available to test the association with genetic markers. A challenge with analyzing such data is their high dimensionality and complex relationships. RESULTS To tackle this challenge, we introduce a weighed distance correlation (wdCor) that can assess the association between genetic markers and voxel-based imaging data. Importantly, the wdCor test takes the voxel-based data as a whole multivariate phenotype, which preserves the spatial continuity and might enhance the power. Besides, an adaptive permutation procedure is introduced to determine the P-values of the wdCor test and also alleviate the computational burden in GWAS. In extensive simulation studies, wdCor achieves much better performances compared to the original distance correlation. We also successfully apply wdCor to conduct a large-scale analysis on data from the Alzheimer's disease neuroimaging project (ADNI). AVAILABILITY AND IMPLEMENTATION Our wdCor method provides new research directions and ideas for multivariate analysis of high-dimensional data, it can also be used as a tool for scientific analysis of imaging genetics research in practical applications. The R package wdcor, and the code for reproducing all results in this article is available in Github: https://github.com/yangyuhui0129/wdcor. SUPPLEMENTARY INFORMATION Supplementary data are available at Bioinformatics online.
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Affiliation(s)
- Canhong Wen
- Department of Statistics and Finance, School of Management, University of Science and Technology of China, Hefei 230026, China
| | - Yuhui Yang
- Department of Statistics and Finance, School of Management, University of Science and Technology of China, Hefei 230026, China
| | - Quan Xiao
- Department of Statistics and Finance, School of Management, University of Science and Technology of China, Hefei 230026, China
| | - Meiyan Huang
- Guangdong Provincial Key Laboratory of Medical Image Processing, School of Biomedical Engineering, Southern Medical University, Guangzhou 510515, China
| | - Wenliang Pan
- Department of Statistical Science, School of Mathematics, Sun Yat-Sen University, Guangzhou 510275, China
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20
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Yang Q, Nanivadekar S, Taylor PA, Dou Z, Lungu CI, Horovitz SG. Executive function network's white matter alterations relate to Parkinson's disease motor phenotype. Neurosci Lett 2021; 741:135486. [PMID: 33161103 PMCID: PMC7750296 DOI: 10.1016/j.neulet.2020.135486] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 10/28/2020] [Accepted: 10/31/2020] [Indexed: 11/25/2022]
Abstract
Parkinson's disease (PD) patients with postural instability and gait disorder phenotype (PIGD) are at high risk of cognitive deficits compared to those with tremor dominant phenotype (TD). Alterations of white matter (WM) integrity can occur in patients with normal cognitive functions (PD-N). However, the alterations of WM integrity related to cognitive functions in PD-N, especially in these two motor phenotypes, remain unclear. Diffusion tensor imaging (DTI) is a non-invasive neuroimaging method to evaluate WM properties and by applying DTI tractography, one can identify WM tracts connecting functional regions. Here, we 1) compared the executive function (EF) in PIGD phenotype with normal cognitive functions (PIGD-N) and TD phenotype with normal cognitive functions (TD-N) phenotypes; 2) used DTI tractography to evaluated differences in WM alterations between these two phenotypes within a task-based functional network; and 3) examined the WM integrity alterations related to EF in a whole brain network for PD-N patients regardless of phenotypes. Thirty-four idiopathic PD-N patients were classified into two groups based on phenotypes: TD-N and PIGD-N, using an algorithm based on UPDRS part III. Neuropsychological tests were used to evaluate patients' EF, including the Trail making test part A and B, the Stroop color naming, the Stroop word naming, the Stroop color-word interference task, as well as the FAS verbal fluency task and the animal category fluency tasks. DTI measures were calculated among WM regions associated with the verbal fluency network defined from previous task fMRI studies and compared between PIGD-N and TD-N groups. In addition, the relationship of DTI measures and verbal fluency scores were evaluated for our full cohort of PD-N patients within the whole brain network. These values were also correlated with the scores of the FAS verbal fluency task. Only the FAS verbal fluency test showed significant group differences, having lower scores in PIGD-N when compared to TD-N phenotype (p < 0.05). Compared to the TD-N, PIGD-N group exhibited significantly higher MD and RD in the tracts connecting the left superior temporal gyrus and left insula, and those connecting the right pars opercularis and right insula. Moreover, compared to TD-N, PIGD-N group had significantly higher RD in the tracts connecting right pars opercularis and right pars triangularis, and the tracts connecting right inferior temporal gyrus and right middle temporal gyrus. For the entire PD-N cohort, FAS verbal fluency scores positively correlated with MD in the superior longitudinal fasciculus (SLF). This study confirmed that PIGD-N phenotype has more deficits in verbal fluency task than TD-N phenotype. Additionally, our findings suggest: (1) PIGD-N shows more microstructural changes related to FAS verbal fluency task when compared to TD-N phenotype; (2) SLF plays an important role in FAS verbal fluency task in PD-N patients regardless of motor phenotypes.
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Affiliation(s)
- Qinglu Yang
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, United States; The Third Affiliated Hospital of Sun Yat-sen University, Rehabilitation Department, Guangzhou, PR China
| | - Shruti Nanivadekar
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, United States
| | - Paul A Taylor
- Scientific and Statistical Computing Core, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States
| | - Zulin Dou
- The Third Affiliated Hospital of Sun Yat-sen University, Rehabilitation Department, Guangzhou, PR China
| | - Codrin I Lungu
- Parkinson Disease Clinic, OCD, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, United States
| | - Silvina G Horovitz
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, United States.
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21
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Iyer KK, Au TR, Angwin AJ, Copland DA, Dissanayaka NN. Theta and gamma connectivity is linked with affective and cognitive symptoms in Parkinson's disease. J Affect Disord 2020; 277:875-884. [PMID: 33065829 DOI: 10.1016/j.jad.2020.08.086] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 07/16/2020] [Accepted: 08/24/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND The progression of Parkinson's disease (PD) can often exacerbate symptoms of depression, anxiety, and/or cognitive impairment. In this study, we explore the possibility that multiple brain network responses are associated with symptoms of depression, anxiety and cognitive impairment in PD. This association is likely to provide insights into a single multivariate relationship, where common affective symptoms occurring in PD cohorts are related with alterations to electrophysiological response. METHODS 70 PD patients and 21 healthy age-matched controls (HC) participated in a high-density electroencephalography (EEG) study. Functional connectivity differences between PD and HC groups of oscillatory activity at rest and during completion of an emotion-cognition task were examined to identify key brain oscillatory activities. A canonical correlation analysis (CCA) was applied to identify a putative multivariate relationship between connectivity patterns and affective symptoms in PD groups. RESULTS A CCA analysis identified a single mode of co-variation linking theta and gamma connectivity with affective symptoms in PD groups. Increases in frontotemporal gamma, frontal and parietal theta connectivity were related with increased anxiety and cognitive impairment. Decreases in temporal region theta and frontoparietal gamma connectivity were associated with higher depression ratings and PD patient age. LIMITATIONS This study only reports on optimal dosage of dopaminergic treatment ('on' state) in PD and did not investigate at "off" medication". CONCLUSIONS Theta and gamma connectivity during rest and task-states are linked to affective and cognitive symptoms within fronto-temporo-parietal networks, suggesting a potential assessment avenue for understanding brain-behaviour associations in PD with electrophysiological task paradigms.
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Affiliation(s)
- Kartik K Iyer
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Royal Brisbane & Women's Hospital, Herston, QLD 4029, Brisbane, Australia; Clinical Brain Networks group, QIMR Berghofer Medical Research Institute, Australia; School of Health & Rehabilitation Sciences, The University of Queensland, St Lucia, QLD 4067, Brisbane, Australia
| | - Tiffany R Au
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Royal Brisbane & Women's Hospital, Herston, QLD 4029, Brisbane, Australia
| | - Anthony J Angwin
- School of Health & Rehabilitation Sciences, The University of Queensland, St Lucia, QLD 4067, Brisbane, Australia
| | - David A Copland
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Royal Brisbane & Women's Hospital, Herston, QLD 4029, Brisbane, Australia; School of Health & Rehabilitation Sciences, The University of Queensland, St Lucia, QLD 4067, Brisbane, Australia
| | - Nadeeka N Dissanayaka
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Royal Brisbane & Women's Hospital, Herston, QLD 4029, Brisbane, Australia; Department of Neurology, Royal Brisbane & Women's Hospital, Herston, QLD 4029, Brisbane, Australia; School of Psychology, The University of Queensland, St Lucia, QLD 4067, Brisbane, Australia.
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22
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Zhang Y, Burock MA. Diffusion Tensor Imaging in Parkinson's Disease and Parkinsonian Syndrome: A Systematic Review. Front Neurol 2020; 11:531993. [PMID: 33101169 PMCID: PMC7546271 DOI: 10.3389/fneur.2020.531993] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 08/18/2020] [Indexed: 12/21/2022] Open
Abstract
Diffusion tensor imaging (DTI) allows measuring fractional anisotropy and similar microstructural indices of the brain white matter. Lower than normal fractional anisotropy as well as higher than normal diffusivity is associated with loss of microstructural integrity and neurodegeneration. Previous DTI studies in Parkinson's disease (PD) have demonstrated abnormal fractional anisotropy in multiple white matter regions, particularly in the dopaminergic nuclei and dopaminergic pathways. However, DTI is not considered a diagnostic marker for the earliest Parkinson's disease since anisotropic alterations present a temporally divergent pattern during the earliest Parkinson's course. This article reviews a majority of clinically employed DTI studies in PD, and it aims to prove the utilities of DTI as a marker of diagnosing PD, correlating clinical symptomatology, tracking disease progression, and treatment effects. To address the challenge of DTI being a diagnostic marker for early PD, this article also provides a comparison of the results from a longitudinal, early stage, multicenter clinical cohort of Parkinson's research with previous publications. This review provides evidences of DTI as a promising marker for monitoring PD progression and classifying atypical PD types, and it also interprets the possible pathophysiologic processes under the complex pattern of fractional anisotropic changes in the first few years of PD. Recent technical advantages, limitations, and further research strategies of clinical DTI in PD are additionally discussed.
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Affiliation(s)
- Yu Zhang
- Department of Psychiatry, War Related Illness and Injury Study Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, United States
| | - Marc A Burock
- Department of Psychiatry, Mainline Health, Bryn Mawr Hospital, Bryn Mawr, PA, United States
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23
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Le H, Zeng W, Zhang H, Li J, Wu X, Xie M, Yan X, Zhou M, Zhang H, Wang M, Hong G, Shen J. Mean Apparent Propagator MRI Is Better Than Conventional Diffusion Tensor Imaging for the Evaluation of Parkinson's Disease: A Prospective Pilot Study. Front Aging Neurosci 2020; 12:563595. [PMID: 33192458 PMCID: PMC7541835 DOI: 10.3389/fnagi.2020.563595] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 08/31/2020] [Indexed: 12/11/2022] Open
Abstract
Background and Purpose Mean apparent propagator (MAP) MRI is a novel diffusion imaging method to map tissue microstructure. The purpose of this study was to evaluate the diagnostic value of the MAP MRI in Parkinson’s disease (PD) in comparison with conventional diffusion tensor imaging (DTI). Methods 23 PD patients and 22 age- and gender-matched healthy controls were included. MAP MRI and DTI were performed on a 3T MR scanner with a 20-channel head coil. The MAP metrics including mean square displacement (MSD), return to the origin probability (RTOP), return to the axis probability (RTAP), and return to the plane probability (RTPP), and DTI metrics including fractional anisotropy (FA), and mean diffusivity (MD), were measured in subcortical gray matter and compared between the two groups. The receiver operating characteristic (ROC) curve was used to analyze the diagnostic performance of all the metrics. The association between the diffusion metrics and disease severity was assessed by Pearson correlation analysis. Results For MAP MRI, the mean values of MSD in the bilateral caudate, pallidum, putamen, thalamus and substantia nigra (SN) were higher in PD patients than in healthy controls (pFDR ≤ 0.001); the mean values of the zero displacement probabilities (RTOP, RTAP, and RTPP) in the bilateral caudate, pallidum, putamen and thalamus were lower in PD patients (pFDR < 0.001). For DTI, only FA in the bilateral SN was significantly higher in PD patients than those in the controls (pFDR < 0.001). ROC analysis showed that the areas under the curves of MAP MRI metrics (MSD, RTOP, RTAP, and RTPP) in the bilateral caudate, pallidum, putamen and thalamus (range, 0.85–0.94) were greater than those of FA and MD of DTI (range, 0.55–0.69) in discriminating between PD patients and healthy controls. RTAP in the ipsilateral pallidum (r = −0.56, pFDR = 0.027), RTOP in the bilateral and contralateral putamen (r = −0.58, pFDR = 0.019; r = −0.57, pFDR = 0.024) were negatively correlated with UPDRS III motor scores. Conclusion MAP MRI outperformed the conventional DTI in the diagnosis of PD and evaluation of the disease severity.
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Affiliation(s)
- Hongbo Le
- Department of Radiology, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China.,Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Weike Zeng
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Huihong Zhang
- Food Safety and Health Research Center, School of Public Health, Southern Medical University, Guangzhou, China
| | - Jianing Li
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiaoyan Wu
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Mingwei Xie
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xu Yan
- MR Scientific Marketing, Siemens Healthcare, Shanghai, China
| | - Minxiong Zhou
- College of Medical Imaging, Shanghai Key Laboratory of Molecular Imaging, Shanghai University of Medicine and Health Science, Shanghai, China
| | - Huiting Zhang
- MR Scientific Marketing, Siemens Healthcare, Shanghai, China
| | - Mengzhu Wang
- MR Scientific Marketing, Siemens Healthcare, Shanghai, China
| | - Guobin Hong
- Department of Radiology, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
| | - Jun Shen
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
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24
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Wang J, Zhang F, Zhao C, Zeng Q, He J, O'Donnell LJ, Feng Y. Investigation of local white matter abnormality in Parkinson's disease by using an automatic fiber tract parcellation. Behav Brain Res 2020; 394:112805. [PMID: 32673707 DOI: 10.1016/j.bbr.2020.112805] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 07/01/2020] [Accepted: 07/08/2020] [Indexed: 11/18/2022]
Abstract
The deficits of white matter (WM) microstructure are involved during Parkinson's disease (PD) progression. Most current methods identify key WM tracts relying on cortical regions of interest (ROIs). However, such ROI methods can be challenged due to low diffusion anisotropy near the gray matter (GM), which could result in a low sensitivity of tract identification. This work proposes an automatic WM parcellation method to improve the accuracy of WM tract identification and locate abnormal tracts by using sensitive features. The proposed method consists of 1) whole brain WM parcellation using an established fiber clustering method, without using any ROIs, 2) features of fasciculus were calculated to quantify diffusion measures at each equal cross-section along the whole cluster. Then, we use the proposed features to investigate the WM difference in PD compared with healthy controls (HC). We also use these features to investigate the relationship of clinical symptoms and specific fiber tracts. The novelty of the proposed method is that it automatically identifies the abnormal WM fibers in cluster degree. Experiment results indicated that the proposed method had advantage in detecting the local WM abnormality by performing between-group statistical analysis in 30 patients with PD and 28 HC. We found 13 hemisphere clusters and 8 commissural clusters had significant group difference (p < 0.05, corrected by FDR method) in local regions, which belonged to multiple fiber tracts including cingulum bundle (CB), inferior occipito-frontal fasciculus (IoFF), corpus callosum (CC), external capsule (EC), uncinate fasciculus (UF), superior longitudinal fasciculus (SLF) and thalamo front (TF). We also found clusters that had relevance with clinical indices of cognitive function (2 clusters), athletic function (6 clusters), and depressive state (2 clusters) in these significant clusters. From the experiment results, it confirmed the ability of the proposed method to identify potential WM microstructure abnormality.
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Affiliation(s)
- Jingqiang Wang
- College of Information Engineering, Zhejiang University of Technology, Hangzhou, China
| | - Fan Zhang
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Changchen Zhao
- College of Information Engineering, Zhejiang University of Technology, Hangzhou, China
| | - Qingrun Zeng
- College of Information Engineering, Zhejiang University of Technology, Hangzhou, China
| | - Jianzhong He
- College of Information Engineering, Zhejiang University of Technology, Hangzhou, China
| | | | - Yuanjing Feng
- College of Information Engineering, Zhejiang University of Technology, Hangzhou, China
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25
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Pelizzari L, Di Tella S, Rossetto F, Laganà MM, Bergsland N, Pirastru A, Meloni M, Nemni R, Baglio F. Parietal Perfusion Alterations in Parkinson's Disease Patients Without Dementia. Front Neurol 2020; 11:562. [PMID: 32655485 PMCID: PMC7324722 DOI: 10.3389/fneur.2020.00562] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 05/18/2020] [Indexed: 12/23/2022] Open
Abstract
Fronto-parietal regions are involved in cognitive processes that are commonly affected in Parkinson's disease (PD). The aims of this study were to investigate cerebral blood flow (CBF) and gray matter (GM) volume within the regions belonging to the fronto-parietal circuit in people with PD (pwPD) without dementia, and to assess their association with cognitive performance. Twenty-seven pwPD without dementia (mean [SD] age = 67.4 [8.1] years, 20 males, mean [SD] Montreal Cognitive Assessment, MoCA score = 24.2 [2.9], median [IQR] Hoehn and Yahr scale = 1.5 [1–2]) and twenty-six age- and sex-matched healthy controls (HC) were scanned with arterial spin labeling (ASL) and T1-weighted magnetic resonance imaging (MRI) sequences to investigate CBF and GM volume, respectively. The cognitive performance of the enrolled pwPD was assessed with MoCA, Trail Making Test (TMT, part A, B, B-A), phonemic fluency and semantic fluency tests. The scores were adjusted for age and education. After standard preprocessing, CBF differences between pwPD and HC were tested with a voxel-wise approach. Voxel-based morphometry was used to compare pwPD and HC in terms of GM volume. Both voxel-wise comparisons between pwPD and HC were restricted to regions of the fronto-parietal circuit. The following additional voxel-wise analyses were performed within regions showing either perfusion or GM volume alterations: (1) correlation with neuropsychological test scores; (2) subgroup comparison after median split on each neuropsychological test score. Family-wise error-corrected (FWE) p-values lower than 0.05 were considered significant. Significant hypoperfusion was identified in the left inferior parietal lobule (IPL, ppeak = 0.037) and in the bilateral superior parietal lobule (SPL, left hemisphere: ppeak = 0.037; right hemisphere: ppeak = 0.049) of pwPD when compared to HC. No significant GM atrophy was observed. Local hypoperfusion did not correlate with any neuropsychological test scores. However, significantly lower CBF was observed in the left SPL and IPL of the pwPD subgroup who performed poorer on TMT part A in comparison with the pwPD subgroup that performed better. Perfusion alterations may occur in parietal regions of pwPD without dementia, and may be associated with lower visuomotor skills. Parietal CBF may be considered as a suitable early biomarker for longitudinal studies investigating cognitive decline in PD.
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Affiliation(s)
| | | | | | | | - Niels Bergsland
- IRCCS, Fondazione Don Carlo Gnocchi, Milan, Italy.,Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, United States
| | | | - Mario Meloni
- IRCCS, Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Raffaello Nemni
- IRCCS, Fondazione Don Carlo Gnocchi, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
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26
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Altered white matter microarchitecture in Parkinson's disease: a voxel-based meta-analysis of diffusion tensor imaging studies. Front Med 2020; 15:125-138. [PMID: 32458190 DOI: 10.1007/s11684-019-0725-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Accepted: 10/12/2019] [Indexed: 02/05/2023]
Abstract
This study aimed to define the most consistent white matter microarchitecture pattern in Parkinson's disease (PD) reflected by fractional anisotropy (FA), addressing clinical profiles and methodology-related heterogeneity. Web-based publication databases were searched to conduct a meta-analysis of whole-brain diffusion tensor imaging studies comparing PD with healthy controls (HC) using the anisotropic effect size-signed differential mapping. A total of 808 patients with PD and 760 HC coming from 27 databases were finally included. Subgroup analyses were conducted considering heterogeneity with respect to medication status, disease stage, analysis methods, and the number of diffusion directions in acquisition. Compared with HC, patients with PD had decreased FA in the left middle cerebellar peduncle, corpus callosum (CC), left inferior fronto-occipital fasciculus, and right inferior longitudinal fasciculus. Most of the main results remained unchanged in subgroup meta-analyses of medicated patients, early stage patients, voxel-based analysis, and acquisition with 30 diffusion directions. The subgroup meta-analysis of medication-free patients showed FA decrease in the right olfactory cortex. The cerebellum and CC, associated with typical motor impairment, showed the most consistent FA decreases in PD. Medication status, analysis approaches, and the number of diffusion directions have an important impact on the findings, needing careful evaluation in future meta-analyses.
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27
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Andica C, Kamagata K, Hatano T, Saito Y, Uchida W, Ogawa T, Takeshige-Amano H, Hagiwara A, Murata S, Oyama G, Shimo Y, Umemura A, Akashi T, Wada A, Kumamaru KK, Hori M, Hattori N, Aoki S. Neurocognitive and psychiatric disorders-related axonal degeneration in Parkinson's disease. J Neurosci Res 2020; 98:936-949. [PMID: 32026517 PMCID: PMC7154645 DOI: 10.1002/jnr.24584] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 12/05/2019] [Accepted: 01/06/2020] [Indexed: 11/30/2022]
Abstract
Neurocognitive and psychiatric disorders have significant consequences for quality of life in patients with Parkinson's disease (PD). In the current study, we evaluated microstructural white matter (WM) alterations associated with neurocognitive and psychiatric disorders in PD using neurite orientation dispersion and density imaging (NODDI) and linked independent component analysis (LICA). The indices of NODDI were compared between 20 and 19 patients with PD with and without neurocognitive and psychiatric disorders, respectively, and 25 healthy controls using tract‐based spatial statistics and tract‐of‐interest analyses. LICA was applied to model inter‐subject variability across measures. A widespread reduction in axonal density (indexed by intracellular volume fraction [ICVF]) was demonstrated in PD patients with and without neurocognitive and psychiatric disorders, as compared with healthy controls. Compared with patients without neurocognitive and psychiatric disorders, patients with neurocognitive and psychiatric disorders exhibited more extensive (posterior predominant) decreases in axonal density. Using LICA, ICVF demonstrated the highest contribution (59% weight) to the main effects of diagnosis that reflected widespread decreases in axonal density. These findings suggest that axonal loss is a major factor underlying WM pathology related to neurocognitive and psychiatric disorders in PD, whereas patients with neurocognitive and psychiatric disorders had broader axonal pathology, as compared with those without. LICA suggested that the ICVF can be used as a useful biomarker of microstructural changes in the WM related to neurocognitive and psychiatric disorders in PD.
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Affiliation(s)
- Christina Andica
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Koji Kamagata
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Taku Hatano
- Department of Neurology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yuya Saito
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Radiological Sciences, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
| | - Wataru Uchida
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Radiological Sciences, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
| | - Takashi Ogawa
- Department of Neurology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | | | - Akifumi Hagiwara
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Syo Murata
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Genko Oyama
- Department of Neurology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yashushi Shimo
- Department of Neurology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Atsushi Umemura
- Department of Neurosurgery, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Toshiaki Akashi
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Akihiko Wada
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kanako K Kumamaru
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Masaaki Hori
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Radiology, Toho University Omori Medical Center, Tokyo, Japan
| | - Nobutaka Hattori
- Department of Neurology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shigeki Aoki
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
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28
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Huang P, Guan X, Guo T, Zeng Q, Xuan M, Gu Q, Xu X, Zhou C, Wu J, Zhang M. Damaged Insula Network Contributes to Depression in Parkinson's Disease. Front Psychiatry 2020; 11:119. [PMID: 32210851 PMCID: PMC7076072 DOI: 10.3389/fpsyt.2020.00119] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 02/11/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Depression is common in patients with Parkinson's disease (PD). Our previous studies suggest that depressed PD patients have altered insula structures. It is, however, still unknown whether the altered structures cause disruption of insula functional networks, further contributing to depression in PD. METHODS In the present study, 17 depressed PD patients, 17 non-depressed PD patients, and 17 normal controls were enrolled. All subjects went through neurological and psychiatric clinical assessments. Resting-state functional magnetic resonance imaging and seed-based insula functional analyses were performed to examine the insula functional connectivity alterations in PD patients. RESULTS We found that compared with normal controls, PD patients exhibited significantly decreased insula functional connectivity widely across the whole brain. Compared with non-depressed PD patients, depressed patients showed further decreased functional connectivity in the middle frontal gyrus and inferior parietal lobe. Furthermore, connectivity between the left anterior insula and middle frontal gyrus was positively correlated with the cognitive scale score. CONCLUSION These results suggest that insula networks were severely damaged in PD patients, and that the disrupted connection between the salience network and executive control network might contribute to depression in PD.
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Affiliation(s)
- Peiyu Huang
- Department of Radiology, 2nd Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaojun Guan
- Department of Radiology, 2nd Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Tao Guo
- Department of Radiology, 2nd Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qiaoling Zeng
- Department of Radiology, 2nd Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Min Xuan
- Department of Radiology, 2nd Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Quanquan Gu
- Department of Radiology, 2nd Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaojun Xu
- Department of Radiology, 2nd Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Cheng Zhou
- Department of Radiology, 2nd Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jingjing Wu
- Department of Radiology, 2nd Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Minming Zhang
- Department of Radiology, 2nd Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Abbasi N, Fereshtehnejad SM, Zeighami Y, Larcher KMH, Postuma RB, Dagher A. Predicting severity and prognosis in Parkinson's disease from brain microstructure and connectivity. NEUROIMAGE-CLINICAL 2019; 25:102111. [PMID: 31855654 PMCID: PMC6926369 DOI: 10.1016/j.nicl.2019.102111] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 11/26/2019] [Accepted: 11/27/2019] [Indexed: 12/25/2022]
Abstract
White matter disruption occurs in Parkinson's disease across several brain regions. DTI properties could identify clinically distinct subtypes of Parkinson's disease. Structural neural disruption can predict clinical outcomes in Parkinson's disease.
Objectives: Investigating biomarkers to demonstrate progression of Parkinson's disease (PD) is of high priority. We investigated the association of brain structural properties with progression of clinical outcomes and their ability to differentiate clinical subtypes of PD. Methods: A comprehensive set of clinical features was evaluated at baseline and 4.5-year follow-up for 144 de-novo PD patients from the Parkinson's Progression Markers Initiative. We created a global composite outcome (GCO) by combining z-scores of non-motor and motor symptoms, motor signs, overall activities of daily living and global cognition, as a single numeric indicator of prognosis. We classified patients into three subtypes based on multi-domain clinical criteria: ‘mild motor-predominant’, ‘intermediate’ and ‘diffuse-malignant’. We analyzed diffusion-weighted scans at the early drug-naïve stage and extracted fractional anisotropy and mean diffusivity (MD) of basal ganglia and cortical sub-regions. Then, we employed graph theory to calculate network properties and used network-based statistic to investigate our primary hypothesis. Results: Baseline MD of globus pallidus was associated with worsening of motor severity, cognition, and GCO after 4.5 years of follow-up. Connectivity disruption at baseline was correlated with decline in cognition, and increase in GCO. Baseline MD of nucleus accumbens, globus pallidus and basal-ganglia were linked to clinical subtypes at 4.5-year of follow-up. Disruption in sub-cortical networks associated with being subtyped as ‘diffuse-malignant’ versus ‘mild motor-predominant’ after 4.5 years. Conclusions: Diffusion imaging analysis at the early de-novo stage of PD was able to differentiate clinical sub-types of PD after 4.5 years and was highly associated with future clinical outcomes of PD.
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Affiliation(s)
- Nooshin Abbasi
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, 3801 University St., Montreal, Quebec H3A 2B4, Canada.
| | - Seyed-Mohammad Fereshtehnejad
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada; Division of Neurology, Department of Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada; Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institute, Stockholm, Sweden
| | - Yashar Zeighami
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, 3801 University St., Montreal, Quebec H3A 2B4, Canada
| | | | - Ronald B Postuma
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada; Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada
| | - Alain Dagher
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, 3801 University St., Montreal, Quebec H3A 2B4, Canada
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30
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Age- and disease-related cerebral white matter changes in patients with Parkinson's disease. Neurobiol Aging 2019; 80:203-209. [DOI: 10.1016/j.neurobiolaging.2019.05.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 04/26/2019] [Accepted: 05/06/2019] [Indexed: 11/18/2022]
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31
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Koirala N, Anwar AR, Ciolac D, Glaser M, Pintea B, Deuschl G, Muthuraman M, Groppa S. Alterations in White Matter Network and Microstructural Integrity Differentiate Parkinson's Disease Patients and Healthy Subjects. Front Aging Neurosci 2019; 11:191. [PMID: 31404311 PMCID: PMC6676803 DOI: 10.3389/fnagi.2019.00191] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Accepted: 07/15/2019] [Indexed: 01/15/2023] Open
Abstract
Parkinson’s disease (PD) is a neurodegenerative disease, neuropathologically characterized by progressive loss of neurons in distinct brain areas. We hypothesize that quantifiable network alterations are caused by neurodegeneration. The primary motivation of this study was to assess the specific network alterations in PD patients that are distinct but appear in conjunction with physiological aging. 178 subjects (130 females) stratified into PD patients, young, middle-aged and elderly healthy controls (age- and sex-matched with PD patients), were analyzed using 3D-T1 magnetization-prepared rapid gradient-echo (MPRAGE) and diffusion weighted images acquired in 3T MRI scanner. Diffusion modeling and probabilistic tractography analysis were applied for generating voxel-based connectivity index maps from each seed voxel. The obtained connectivity matrices were analyzed using graph theoretical tools for characterization of involved network. By network-based statistic (NBS) the interregional connectivity differences between the groups were assessed. Measures evaluating local diffusion properties for anisotropy and diffusivity were computed for characterization of white matter microstructural integrity. The graph theoretical analysis showed a significant decrease in distance measures – eccentricity and characteristic path length – in PD patients in comparison to healthy subjects. Both measures as well were lower in PD patients when compared to young and middle-aged healthy controls. NBS analysis demonstrated lowered structural connectivity in PD patients in comparison to young and middle-aged healthy subject groups, mainly in frontal, cingulate, olfactory, insula, thalamus, and parietal regions. These specific network differences were distinct for PD and were not observed between the healthy subject groups. Microstructural analysis revealed diffusivity alterations within the white matter tracts in PD patients, predominantly in the body, splenium and tapetum of corpus callosum, corticospinal tract, and corona radiata, which were absent in normal aging. The identified alterations of network connectivity presumably caused by neurodegeneration indicate the disruption in global network integration in PD patients. The microstructural changes identified within the white matter could endorse network reconfiguration. This study provides a clear distinction between the network changes occurring during aging and PD. This will facilitate a better understanding of PD pathophysiology and the direct link between white matter changes and their role in the restructured network topology.
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Affiliation(s)
- Nabin Koirala
- Department of Neurology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Abdul Rauf Anwar
- Centre for Biomedical Engineering, University of Engineering and Technology, Lahore, Pakistan
| | - Dumitru Ciolac
- Department of Neurology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.,Department of Neurology, Institute of Emergency Medicine, Chisinau, Moldova.,Laboratory of Neurobiology and Medical Genetics, State University of Medicine and Pharmacy "Nicolae Testemit̨anu", Chisinau, Moldova
| | - Martin Glaser
- Department of Neurosurgery, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Bogdan Pintea
- Department of Neurosurgery, Bergmannsheil Clinic, Ruhr University Bochum, Bochum, Germany
| | - Günther Deuschl
- Department of Neurology, Christian-Albrechts-University, Kiel, Germany
| | - Muthuraman Muthuraman
- Department of Neurology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Sergiu Groppa
- Department of Neurology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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32
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Sobhani S, Rahmani F, Aarabi MH, Sadr AV. Exploring white matter microstructure and olfaction dysfunction in early parkinson disease: diffusion MRI reveals new insight. Brain Imaging Behav 2019; 13:210-219. [PMID: 29134611 DOI: 10.1007/s11682-017-9781-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Olfaction dysfunction is considered as a robust marker of prodromal Parkinson disease (PD). Measurement of olfaction function as a screening test is unsatisfactory due to long lead time interval and low specificity for detection of PD. Use of imaging markers might yield more accurate predictive values and provide bases for combined use of imaging and clinical markers for early PD. Diffusion MRI connectometry was conducted on 85 de novo PD patients in and 36 healthy controls to find: first, white matter tracts with significant difference in quantitative anisotropy between PD groups with various degrees of olfaction dysfunction and second, second fibers with correlation with University of Pennsylvania Smell Identification Test (UPSIT) score in each group using a multiple regression analysis considering age, sex, GDS and MoCA score. Local connectomes were determined in seven of all the possible comparisons, correcting for false discovery rate (FDR). PD patients with anosmia and normal olfaction had the highest number of fibers with decreased connectivity in left inferior longitudinal fasciculus, bilateral fornix, bilateral middle cerebellar peduncle (MCP), bilateral cingulum, bilateral corticospinal tract (CST) and body, genu and splenium of corpus callosum (CC) (FDR = 0.0013). In multiple regression analysis, connectivity in the body, genu and splenium of CC and bilateral fornix had significant negative correlation (FDR between 0.019 and 0.083), and bilateral cingulum and MCP had significant positive correlation (FDR between 0.022 and 0.092) with UPSIT score. White matter connectivity in healthy controls could not be predicted by UPSIT score using the same model. The results of this study provide compelling evidence that microstructural degenerative changes in these areas underlie the clinical phenotype of prodromal olfaction dysfunction in PD and that diffusion parameters of these areas might be able to serve as signature markers for early detection of PD. This is the first report that confirms a discriminative role for UPSIT score in identifying PD specific changes in white matter microstructure. Our results open a window to identify microstructural signatures of prodromal PD in white matter.
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Affiliation(s)
- Soheila Sobhani
- Basir Eye Health Research Center, Tehran, Iran
- Neuroimaging Network (NIN), Universal Scientific Education and Research Network (USERN), Children's Medical Center Hospital, Tehran, 14194, Iran
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzaneh Rahmani
- Neuroimaging Network (NIN), Universal Scientific Education and Research Network (USERN), Children's Medical Center Hospital, Tehran, 14194, Iran.
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mohammad Hadi Aarabi
- Basir Eye Health Research Center, Tehran, Iran
- Neuroimaging Network (NIN), Universal Scientific Education and Research Network (USERN), Children's Medical Center Hospital, Tehran, 14194, Iran
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Vafaei Sadr
- Department of Physics, Shahid Beheshti University, G.C., Evin, Tehran, Iran
- Département de Physique Théorique and Center for Astroparticle Physics, Université de Genève, Geneva, Switzerland
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33
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Pelizzari L, Laganà MM, Di Tella S, Rossetto F, Bergsland N, Nemni R, Clerici M, Baglio F. Combined Assessment of Diffusion Parameters and Cerebral Blood Flow Within Basal Ganglia in Early Parkinson's Disease. Front Aging Neurosci 2019; 11:134. [PMID: 31214017 PMCID: PMC6558180 DOI: 10.3389/fnagi.2019.00134] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 05/21/2019] [Indexed: 12/12/2022] Open
Abstract
Diffusion tensor imaging (DTI) is a sensitive tool for detecting brain tissue microstructural alterations in Parkinson’s disease (PD). Abnormal cerebral perfusion patterns have also been reported in PD patients using arterial spin labeling (ASL) MRI. In this study we aimed to perform a combined DTI and ASL assessment in PD patients within the basal ganglia, in order to test the relationship between microstructural and perfusion alterations. Fifty-two subjects participated in this study. Specifically, 26 PD patients [mean age (SD) = 66.7 (8.9) years, 21 males, median (IQR) Modified Hoehn and Yahr = 1.5 (1–1.6)] and twenty-six healthy controls [HC, mean age (SD) = 65.2 (7.5), 15 males] were scanned with 1.5T MRI. Fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), radial diffusivity (RD) maps were derived from diffusion-weighted images, while cerebral blood flow (CBF) maps were computed from ASL data. After registration to Montreal Neurological Institute standard space, FA, MD, AD, RD and CBF median values were extracted within specific regions of interest: substantia nigra, caudate, putamen, globus pallidus, thalamus, red nucleus and subthalamic nucleus. DTI measures and CBF were compared between the two groups. The relationship between diffusion parameters and CBF was tested with Spearman’s correlations. False discovery rate (FDR)-corrected p-values lower than 0.05 were considered significant, while uncorrected p-values <0.05 were considered a trend. No significant FA, MD and RD differences were observed. AD was significantly increased in PD patients compared with HC in the putamen (p = 0.005, pFDR = 0.035). No significant CBF differences were found between PD patients and HC. Diffusion parameters were not significantly correlated with CBF in the HC group, while a significant correlation emerged for PD patients in the caudate nucleus, for all DTI measures (with FA: r = 0.543, pFDR = 0.028; with MD: r = −0.661, pFDR = 0.002; with AD: r = −0.628, pFDR = 0.007; with RD: r = −0.635, pFDR = 0.003). This study showed that DTI is a more sensitive technique than ASL to detect alterations in the basal ganglia in the early phase of PD. Our results suggest that, although DTI and ASL convey different information, a relationship between microstructural integrity and perfusion changes in the caudate may be present.
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Affiliation(s)
| | | | | | | | - Niels Bergsland
- IRCCS, Fondazione Don Carlo Gnocchi, Milan, Italy.,Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, United States
| | - Raffaello Nemni
- IRCCS, Fondazione Don Carlo Gnocchi, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Mario Clerici
- IRCCS, Fondazione Don Carlo Gnocchi, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
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34
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Ashraf-Ganjouei A, Kheiri G, Masoudi M, Mohajer B, Mojtahed Zadeh M, Saberi P, Shirin Shandiz M, Aarabi MH. White Matter Tract Alterations in Drug-Naïve Parkinson's Disease Patients With Excessive Daytime Sleepiness. Front Neurol 2019; 10:378. [PMID: 31057475 PMCID: PMC6477886 DOI: 10.3389/fneur.2019.00378] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 03/27/2019] [Indexed: 01/05/2023] Open
Abstract
Excessive daytime sleepiness (EDS) is relatively frequent in patients with Parkinson's disease (PD), having a prominent burden on patients' quality of life and causing dangerous events such as motor-vehicle accidents. Previous studies have indicated the role of certain neural tracts in the pathophysiology of sleep disturbances, especially in PD patients. We hypothesized that white matter integrity and connectivity might be altered in patients with PD and EDS. Therefore, this study investigated brain white matter microstructure alterations in patients with Parkinson's disease with EDS (PD-EDS) compared to healthy controls and PD patients without EDS (PD-nEDS). Diffusion MRI connectometry was used to carry out group analysis between PD patients with and without EDS and healthy individuals. EDS in PD patients is associated with decreased connectivity in the left and right fornix, left and right inferior longitudinal fasciculus (ILF), left inferior and middle cerebellar peduncles in comparison to PD-nEDS group. These differences between PD-EDS and PD-nEDS patients reflects microstructural changes with respect to sleep-related circuits, which can pave the way for future investigations considering EDS pathogenesis in Parkinson's disease.
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Affiliation(s)
- Amir Ashraf-Ganjouei
- Students' Scientific Research Center, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ghazaleh Kheiri
- Students' Scientific Research Center, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Masoudi
- Students' Scientific Research Center, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahram Mohajer
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahtab Mojtahed Zadeh
- Students' Scientific Research Center, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Pejman Saberi
- Department of Radiology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Shirin Shandiz
- Department of Medical Physics, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Mohammad Hadi Aarabi
- Students' Scientific Research Center, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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35
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Ji G, Ren C, Li Y, Sun J, Liu T, Gao Y, Xue D, Shen L, Cheng W, Zhu C, Tian Y, Hu P, Chen X, Wang K. Regional and network properties of white matter function in Parkinson's disease. Hum Brain Mapp 2019; 40:1253-1263. [PMID: 30414340 PMCID: PMC6865582 DOI: 10.1002/hbm.24444] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 10/05/2018] [Accepted: 10/16/2018] [Indexed: 02/01/2023] Open
Abstract
Parkinson's disease (PD) is a neurodegenerative disorder with dysfunction in cortices as well as white matter (WM) tracts. While the changes to WM structure have been extensively investigated in PD, the nature of the functional changes to WM remains unknown. In this study, the regional activity and functional connectivity of WM were compared between PD patients (n = 57) and matched healthy controls (n = 52), based on multimodel magnetic resonance imaging data sets. By tract-based spatial statistical analyses of regional activity, patients showed decreased structural-functional coupling in the left corticospinal tract compared to controls. This tract also displayed abnormally increased functional connectivity within the left post-central gyrus and left putamen in PD patients. At the network level, the WM functional network showed small-worldness in both controls and PD patients, yet it was abnormally increased in the latter group. Based on the features of the WM functional connectome, previously un-evaluated individuals could be classified with fair accuracy (73%) and area under the curve of the receiver operating characteristics (75%). These neuroimaging findings provide direct evidence for WM functional changes in PD, which is crucial to understand the functional role of fiber tracts in the pathology of neural circuits.
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Affiliation(s)
- Gong‐Jun Ji
- Department of Medical Psychology, Chaohu Clinical Medical CollegeAnhui Medical UniversityHefeiChina
| | - Cuiping Ren
- Department of Neurology, The First Affiliated Hospital of Anhui Medical UniversityHefeiChina
- Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental HealthHefeiChina
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric DisordersHefeiChina
| | - Ying Li
- Department of Neurology, The First Affiliated Hospital of Anhui Medical UniversityHefeiChina
- Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental HealthHefeiChina
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric DisordersHefeiChina
| | - Jinmei Sun
- Department of Neurology, The First Affiliated Hospital of Anhui Medical UniversityHefeiChina
- Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental HealthHefeiChina
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric DisordersHefeiChina
| | - Tingting Liu
- Department of Neurology, The First Affiliated Hospital of Anhui Medical UniversityHefeiChina
- Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental HealthHefeiChina
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric DisordersHefeiChina
| | - Yaxiang Gao
- Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental HealthHefeiChina
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric DisordersHefeiChina
| | - Dongzhang Xue
- Department of NeurologyThe 123 Hospital of People's Liberation ArmyBengbuChina
| | - Longshan Shen
- Department of ImagingThe Second Affiliated Hospital of Bengbu Medical CollegeBengbuChina
| | - Wen Cheng
- College of Literature and EducationBengbu CollegeBengbuChina
| | - Chunyan Zhu
- Department of Medical Psychology, Chaohu Clinical Medical CollegeAnhui Medical UniversityHefeiChina
- Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental HealthHefeiChina
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric DisordersHefeiChina
| | - Yanghua Tian
- Department of Neurology, The First Affiliated Hospital of Anhui Medical UniversityHefeiChina
- Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental HealthHefeiChina
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric DisordersHefeiChina
| | - Panpan Hu
- Department of Neurology, The First Affiliated Hospital of Anhui Medical UniversityHefeiChina
- Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental HealthHefeiChina
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric DisordersHefeiChina
| | - Xianwen Chen
- Department of Neurology, The First Affiliated Hospital of Anhui Medical UniversityHefeiChina
- Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental HealthHefeiChina
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric DisordersHefeiChina
| | - Kai Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical UniversityHefeiChina
- Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental HealthHefeiChina
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric DisordersHefeiChina
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36
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Ghazi Sherbaf F, Mojtahed Zadeh M, Haghshomar M, Aarabi MH. Posterior limb of the internal capsule predicts poor quality of life in patients with Parkinson's disease: connectometry approach. Acta Neurol Belg 2019. [PMID: 29542093 DOI: 10.1007/s13760-018-0910-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Psychiatric symptoms and motor impairment are major contributions to the poor quality of life in patients with Parkinson's disease (PD). Here, we applied a novel diffusion-weighted imaging approach, diffusion MRI connectometry, to investigate the correlation of quality of life, evaluated by Parkinson's Disease Questionnaire (PDQ39) with the white matter structural connectivity in 27 non-demented PD patients (disease duration of 5.3 ± 2.9 years, H and Y stage = 1.5 ± 0.6, UPDRS-III = 13.7 ± 6.5, indicating unilateral and mild motor involvement). The connectometry analysis demonstrated bilateral posterior limbs of the internal capsule (PLIC) with increased connectivity related to the higher quality of life (FDR = 0.027) in a multiple regression model. The present study suggests for the first time a neural basis of the quality of life in PD in the light of major determinants of poor quality of life in these patients: anxiety, depression, apathy and motor impairment. Results in our sample of non-demented PD patients with relatively mild motor impairment and no apparent sign of depression/anxiety also identify a unique and inexplicable association of the PLIC to the quality of life in PD patients.
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Affiliation(s)
- Farzaneh Ghazi Sherbaf
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Department of Radiology, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahtab Mojtahed Zadeh
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Department of Radiology, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Haghshomar
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hadi Aarabi
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
- Department of Radiology, Tehran University of Medical Sciences, Tehran, Iran.
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Pathophysiology of levodopa-induced dyskinesia: Insights from multimodal imaging and immunohistochemistry in non-human primates. Neuroimage 2018; 183:132-141. [DOI: 10.1016/j.neuroimage.2018.08.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 07/21/2018] [Accepted: 08/09/2018] [Indexed: 12/12/2022] Open
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38
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Ghazi Sherbaf F, Same K, Aarabi MH. High angular resolution diffusion imaging correlates of depression in Parkinson's disease: a connectometry study. Acta Neurol Belg 2018; 118:573-579. [PMID: 29728904 DOI: 10.1007/s13760-018-0937-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 04/26/2018] [Indexed: 11/30/2022]
Abstract
Depression is a significant disabling feature in Parkinson's disease (PD). However, the neuropathology of this comorbidity is still unclear. In fact, few studies have tried to elucidate the neural correlates of depression in PD and have mostly examined specific regions of interest. In this study, we applied diffusion MRI connectometry, a powerful complementary approach to investigate alterations in whole white matter pathways regarding the severity of depressive symptoms. Using a multiple regression model, the correlation of severity of depressive symptoms assessed by the Hospital Anxiety and Depression Scale (HADS) with white matter connectivity was surveyed in 27 non-demented PD patients related to 26 age, sex, and educational level-matched healthy subjects. Results revealed areas, where white matter quantitative anisotropy (QA) was correlated with depression score in PD patients, without any significant association in healthy controls. The analysis showed a significant negative association (false discovery rate < 0.05) between scores on depression subscale of HADS in PD patients and QA of left Cingulum, Genu, and Splenium of the Corpus Callosum, and anterior and posterior limbs of the right internal capsule. This finding might improve our understanding of the neural basis of depression and its severity in PD.
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Affiliation(s)
- Farzaneh Ghazi Sherbaf
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Kaveh Same
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hadi Aarabi
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.
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Juttukonda MR, Franco G, Englot DJ, Lin YC, Petersen KJ, Trujillo P, Hedera P, Landman BA, Kang H, Donahue MJ, Konrad PE, Dawant BM, Claassen DO. White matter differences between essential tremor and Parkinson disease. Neurology 2018; 92:e30-e39. [PMID: 30504432 DOI: 10.1212/wnl.0000000000006694] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 09/05/2018] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To assess white matter integrity in patients with essential tremor (ET) and Parkinson disease (PD) with moderate to severe motor impairment. METHODS Sedated participants with ET (n = 57) or PD (n = 99) underwent diffusion tensor imaging (DTI) and fractional anisotropy, mean diffusivity, axial diffusivity, and radial diffusivity values were computed. White matter tracts were defined using 3 well-described atlases. To determine candidate white matter regions that differ between ET and PD groups, a bootstrapping analysis was applied using the least absolute shrinkage and selection operator. Linear regression was applied to assess magnitude and direction of differences in DTI metrics between ET and PD populations in the candidate regions. RESULTS Fractional anisotropy values that differentiate ET from PD localize primarily to thalamic and visual-related pathways, while diffusivity differences localized to the cerebellar peduncles. Patients with ET exhibited lower fractional anisotropy values than patients with PD in the lateral geniculate body (p < 0.01), sagittal stratum (p = 0.01), forceps major (p = 0.02), pontine crossing tract (p = 0.03), and retrolenticular internal capsule (p = 0.04). Patients with ET exhibited greater radial diffusivity values than patients with PD in the superior cerebellar peduncle (p < 0.01), middle cerebellar peduncle (p = 0.05), and inferior cerebellar peduncle (p = 0.05). CONCLUSIONS Regionally, distinctive white matter microstructural values in patients with ET localize to the cerebellar peduncles and thalamo-cortical visual pathways. These findings complement recent functional imaging studies in ET but also extend our understanding of putative physiologic features that account for distinctions between ET and PD.
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Affiliation(s)
- Meher R Juttukonda
- From the Departments of Radiology and Radiological Sciences (M.R.J., M.J.D.), Neurological Surgery (D.J.E., P.E.K.), Biostatistics (Y.-C.L., H.K.), Neurology (P.T., P.H., M.J.D.), and Psychiatry (M.J.D.), Vanderbilt University Medical Center, Nashville, TN; Department of Pathophysiology and Transplantation (G.F.) University of Milan, Italy; and Chemical and Physical Biology Program (K.J.P.) and Departments of Electrical Engineering (B.A.L., B.M.D.), Computer Engineering (B.A.L., B.M.D.), Computer Science and Biomedical Engineering (B.A.L., B.M.D.), and Neurology (D.O.C.), Vanderbilt University, Nashville, TN
| | - Giulia Franco
- From the Departments of Radiology and Radiological Sciences (M.R.J., M.J.D.), Neurological Surgery (D.J.E., P.E.K.), Biostatistics (Y.-C.L., H.K.), Neurology (P.T., P.H., M.J.D.), and Psychiatry (M.J.D.), Vanderbilt University Medical Center, Nashville, TN; Department of Pathophysiology and Transplantation (G.F.) University of Milan, Italy; and Chemical and Physical Biology Program (K.J.P.) and Departments of Electrical Engineering (B.A.L., B.M.D.), Computer Engineering (B.A.L., B.M.D.), Computer Science and Biomedical Engineering (B.A.L., B.M.D.), and Neurology (D.O.C.), Vanderbilt University, Nashville, TN
| | - Dario J Englot
- From the Departments of Radiology and Radiological Sciences (M.R.J., M.J.D.), Neurological Surgery (D.J.E., P.E.K.), Biostatistics (Y.-C.L., H.K.), Neurology (P.T., P.H., M.J.D.), and Psychiatry (M.J.D.), Vanderbilt University Medical Center, Nashville, TN; Department of Pathophysiology and Transplantation (G.F.) University of Milan, Italy; and Chemical and Physical Biology Program (K.J.P.) and Departments of Electrical Engineering (B.A.L., B.M.D.), Computer Engineering (B.A.L., B.M.D.), Computer Science and Biomedical Engineering (B.A.L., B.M.D.), and Neurology (D.O.C.), Vanderbilt University, Nashville, TN
| | - Ya-Chen Lin
- From the Departments of Radiology and Radiological Sciences (M.R.J., M.J.D.), Neurological Surgery (D.J.E., P.E.K.), Biostatistics (Y.-C.L., H.K.), Neurology (P.T., P.H., M.J.D.), and Psychiatry (M.J.D.), Vanderbilt University Medical Center, Nashville, TN; Department of Pathophysiology and Transplantation (G.F.) University of Milan, Italy; and Chemical and Physical Biology Program (K.J.P.) and Departments of Electrical Engineering (B.A.L., B.M.D.), Computer Engineering (B.A.L., B.M.D.), Computer Science and Biomedical Engineering (B.A.L., B.M.D.), and Neurology (D.O.C.), Vanderbilt University, Nashville, TN
| | - Kalen J Petersen
- From the Departments of Radiology and Radiological Sciences (M.R.J., M.J.D.), Neurological Surgery (D.J.E., P.E.K.), Biostatistics (Y.-C.L., H.K.), Neurology (P.T., P.H., M.J.D.), and Psychiatry (M.J.D.), Vanderbilt University Medical Center, Nashville, TN; Department of Pathophysiology and Transplantation (G.F.) University of Milan, Italy; and Chemical and Physical Biology Program (K.J.P.) and Departments of Electrical Engineering (B.A.L., B.M.D.), Computer Engineering (B.A.L., B.M.D.), Computer Science and Biomedical Engineering (B.A.L., B.M.D.), and Neurology (D.O.C.), Vanderbilt University, Nashville, TN
| | - Paula Trujillo
- From the Departments of Radiology and Radiological Sciences (M.R.J., M.J.D.), Neurological Surgery (D.J.E., P.E.K.), Biostatistics (Y.-C.L., H.K.), Neurology (P.T., P.H., M.J.D.), and Psychiatry (M.J.D.), Vanderbilt University Medical Center, Nashville, TN; Department of Pathophysiology and Transplantation (G.F.) University of Milan, Italy; and Chemical and Physical Biology Program (K.J.P.) and Departments of Electrical Engineering (B.A.L., B.M.D.), Computer Engineering (B.A.L., B.M.D.), Computer Science and Biomedical Engineering (B.A.L., B.M.D.), and Neurology (D.O.C.), Vanderbilt University, Nashville, TN
| | - Peter Hedera
- From the Departments of Radiology and Radiological Sciences (M.R.J., M.J.D.), Neurological Surgery (D.J.E., P.E.K.), Biostatistics (Y.-C.L., H.K.), Neurology (P.T., P.H., M.J.D.), and Psychiatry (M.J.D.), Vanderbilt University Medical Center, Nashville, TN; Department of Pathophysiology and Transplantation (G.F.) University of Milan, Italy; and Chemical and Physical Biology Program (K.J.P.) and Departments of Electrical Engineering (B.A.L., B.M.D.), Computer Engineering (B.A.L., B.M.D.), Computer Science and Biomedical Engineering (B.A.L., B.M.D.), and Neurology (D.O.C.), Vanderbilt University, Nashville, TN
| | - Bennett A Landman
- From the Departments of Radiology and Radiological Sciences (M.R.J., M.J.D.), Neurological Surgery (D.J.E., P.E.K.), Biostatistics (Y.-C.L., H.K.), Neurology (P.T., P.H., M.J.D.), and Psychiatry (M.J.D.), Vanderbilt University Medical Center, Nashville, TN; Department of Pathophysiology and Transplantation (G.F.) University of Milan, Italy; and Chemical and Physical Biology Program (K.J.P.) and Departments of Electrical Engineering (B.A.L., B.M.D.), Computer Engineering (B.A.L., B.M.D.), Computer Science and Biomedical Engineering (B.A.L., B.M.D.), and Neurology (D.O.C.), Vanderbilt University, Nashville, TN
| | - Hakmook Kang
- From the Departments of Radiology and Radiological Sciences (M.R.J., M.J.D.), Neurological Surgery (D.J.E., P.E.K.), Biostatistics (Y.-C.L., H.K.), Neurology (P.T., P.H., M.J.D.), and Psychiatry (M.J.D.), Vanderbilt University Medical Center, Nashville, TN; Department of Pathophysiology and Transplantation (G.F.) University of Milan, Italy; and Chemical and Physical Biology Program (K.J.P.) and Departments of Electrical Engineering (B.A.L., B.M.D.), Computer Engineering (B.A.L., B.M.D.), Computer Science and Biomedical Engineering (B.A.L., B.M.D.), and Neurology (D.O.C.), Vanderbilt University, Nashville, TN
| | - Manus J Donahue
- From the Departments of Radiology and Radiological Sciences (M.R.J., M.J.D.), Neurological Surgery (D.J.E., P.E.K.), Biostatistics (Y.-C.L., H.K.), Neurology (P.T., P.H., M.J.D.), and Psychiatry (M.J.D.), Vanderbilt University Medical Center, Nashville, TN; Department of Pathophysiology and Transplantation (G.F.) University of Milan, Italy; and Chemical and Physical Biology Program (K.J.P.) and Departments of Electrical Engineering (B.A.L., B.M.D.), Computer Engineering (B.A.L., B.M.D.), Computer Science and Biomedical Engineering (B.A.L., B.M.D.), and Neurology (D.O.C.), Vanderbilt University, Nashville, TN
| | - Peter E Konrad
- From the Departments of Radiology and Radiological Sciences (M.R.J., M.J.D.), Neurological Surgery (D.J.E., P.E.K.), Biostatistics (Y.-C.L., H.K.), Neurology (P.T., P.H., M.J.D.), and Psychiatry (M.J.D.), Vanderbilt University Medical Center, Nashville, TN; Department of Pathophysiology and Transplantation (G.F.) University of Milan, Italy; and Chemical and Physical Biology Program (K.J.P.) and Departments of Electrical Engineering (B.A.L., B.M.D.), Computer Engineering (B.A.L., B.M.D.), Computer Science and Biomedical Engineering (B.A.L., B.M.D.), and Neurology (D.O.C.), Vanderbilt University, Nashville, TN
| | - Benoit M Dawant
- From the Departments of Radiology and Radiological Sciences (M.R.J., M.J.D.), Neurological Surgery (D.J.E., P.E.K.), Biostatistics (Y.-C.L., H.K.), Neurology (P.T., P.H., M.J.D.), and Psychiatry (M.J.D.), Vanderbilt University Medical Center, Nashville, TN; Department of Pathophysiology and Transplantation (G.F.) University of Milan, Italy; and Chemical and Physical Biology Program (K.J.P.) and Departments of Electrical Engineering (B.A.L., B.M.D.), Computer Engineering (B.A.L., B.M.D.), Computer Science and Biomedical Engineering (B.A.L., B.M.D.), and Neurology (D.O.C.), Vanderbilt University, Nashville, TN
| | - Daniel O Claassen
- From the Departments of Radiology and Radiological Sciences (M.R.J., M.J.D.), Neurological Surgery (D.J.E., P.E.K.), Biostatistics (Y.-C.L., H.K.), Neurology (P.T., P.H., M.J.D.), and Psychiatry (M.J.D.), Vanderbilt University Medical Center, Nashville, TN; Department of Pathophysiology and Transplantation (G.F.) University of Milan, Italy; and Chemical and Physical Biology Program (K.J.P.) and Departments of Electrical Engineering (B.A.L., B.M.D.), Computer Engineering (B.A.L., B.M.D.), Computer Science and Biomedical Engineering (B.A.L., B.M.D.), and Neurology (D.O.C.), Vanderbilt University, Nashville, TN.
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Sanjari Moghaddam H, Dolatshahi M, Salardini E, Aarabi MH. Association of olfaction dysfunction with brain microstructure in prodromal Parkinson disease. Neurol Sci 2018; 40:283-291. [DOI: 10.1007/s10072-018-3629-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 10/26/2018] [Indexed: 01/07/2023]
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Taylor KI, Sambataro F, Boess F, Bertolino A, Dukart J. Progressive Decline in Gray and White Matter Integrity in de novo Parkinson's Disease: An Analysis of Longitudinal Parkinson Progression Markers Initiative Diffusion Tensor Imaging Data. Front Aging Neurosci 2018; 10:318. [PMID: 30349475 PMCID: PMC6186956 DOI: 10.3389/fnagi.2018.00318] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 09/21/2018] [Indexed: 12/01/2022] Open
Abstract
Background: Progressive neuronal loss in neurodegenerative diseases such as Parkinson's disease (PD) is associated with progressive degeneration of associated white matter tracts as measured by diffusion tensor imaging (DTI). These findings may have diagnostic and functional implications but their value in de novo PD remains unknown. Here we analyzed longitudinal DTI data from Parkinson's Progression Markers Initiative de novo PD patients for changes over time relative to healthy control (HC) participants. Methods: Baseline and 1-year follow-up DTI MRI data from 71 PD patients and 45 HC PPMI participants were included in the analyses. Whole-brain fractional anisotropy (FA) and mean diffusivity (MD) images were compared for baseline group differences and group-by-time interactions. Baseline and 1-year changes in DTI values were correlated with changes in DTI measures and symptom severity, respectively. Results: At baseline, PD patients showed significantly increased FA in brainstem, cerebellar, anterior corpus callosal, inferior frontal and inferior fronto-occipital white matter and increased MD in primary sensorimotor and supplementary motor regions. Over 1 year PD patients showed a significantly stronger decline in FA compared to HC in the optic radiation and corpus callosum and parietal, occipital, posterior temporal, posterior thalamic, and vermis gray matter. Significant increases in MD were observed in white matter of the midbrain, optic radiation and corpus callosum, while gray matter of prefrontal, insular and posterior thalamic regions. Baseline brainstem FA white matter (WM) values predicted 1-year changes in FA white matter and MD gray matter values. White but not gray matter changes in both FA and MD were significantly associated with changes in symptom severity. Conclusion: Significant gray and white matter DTI alterations are observable at the time of PD diagnosis and expand in the first year of de novo PD to other cortical and white matter regions. This pattern of DTI changes is in line with preclinical and neuroanatomical studies suggesting that the increased spatial spread of alpha-synuclein neuropathology is the key mechanism of PD progression. Taken together, these findings suggest that DTI may serve as a sensitive biomarker of disease progression in early-stage PD.
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Affiliation(s)
- Kirsten I. Taylor
- Neuroscience, Ophthalmology, and Rare Diseases, Pharma Research and Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., Basel, Switzerland
| | - Fabio Sambataro
- Neuroscience, Ophthalmology, and Rare Diseases, Pharma Research and Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., Basel, Switzerland
- Department of Experimental and Clinical Medical Sciences (DISM), University of Udine, Udine, Italy
| | - Frank Boess
- Neuroscience, Ophthalmology, and Rare Diseases, Pharma Research and Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., Basel, Switzerland
| | - Alessandro Bertolino
- Neuroscience, Ophthalmology, and Rare Diseases, Pharma Research and Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., Basel, Switzerland
- Department of Basic Medical Science, Neuroscience, and Sense Organs, University of Bari, Bari, Italy
- Psychiatry Unit, Bari University Hospital, Bari, Italy
| | - Juergen Dukart
- Neuroscience, Ophthalmology, and Rare Diseases, Pharma Research and Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., Basel, Switzerland
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Ashraf-Ganjouei A, Majd A, Javinani A, Aarabi MH. Autonomic dysfunction and white matter microstructural changes in drug-naïve patients with Parkinson's disease. PeerJ 2018; 6:e5539. [PMID: 30225168 PMCID: PMC6139241 DOI: 10.7717/peerj.5539] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 08/08/2018] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Autonomic dysfunction (AD) is one of the non-motor features of Parkinson's disease (PD). Some symptoms tend to occur in the early stages of PD. AD also has a great impact on patient's quality of life. In this study, we aimed to discover the association between AD (Scales for Outcomes in Parkinson's disease-Autonomic, SCOPA-AUT) and microstructural changes in white matter tracts in drug-naïve early PD patients to elucidate the central effects of autonomic nervous system impairments. METHOD In total, this study included 85 subjects with PD recruited from the Parkinson's Progression Markers Initiative (PPMI) database. Among the 85 PD patients, 38 were in Hoehn & Yahr stage 1 (HY1PD) and 47 were in stage 2 (HY2PD). Diffusion magnetic resonance imaging (DMRI) data were reconstructed in the MNI space using q-space diffeomorphic reconstruction to obtain the spin distribution function. The spin distribution function (SDF) values were used in DMRI connectometry analysis. We investigated through diffusion MRI connectometry the structural correlates of white matter tracts with SCOPA-AUT subscores and total score. RESULTS Connectometry analysis also revealed positive association with white matter density in bilateral corticospinal tract in HY1PD patients and negative association in genu of corpus callosum (CC) and, bilateral cingulum in both groups. In addition, there were associations between gastrointestinal, sexual, thermoregulatory and urinary items and structural brain connectivity in PD. CONCLUSION Our study reveals positive correlation, suggesting neural compensations in early PD. Cingulum and CC tracts have well-known roles in PD pathology, compatible with our findings that bring new insights to specific areas of AD and its role in central nervous system (CNS) neurodegeneration, paving the way for using prodromal makers in the diagnosis and treatment of PD.
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Affiliation(s)
| | - Alireza Majd
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Javinani
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Microstructural changes in patients with Parkinson disease and REM sleep behavior disorder: depressive symptoms versus non-depressed. Acta Neurol Belg 2018; 118:415-421. [PMID: 29442234 DOI: 10.1007/s13760-018-0896-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 02/08/2018] [Indexed: 10/18/2022]
Abstract
Search for Parkinson's disease (PD) progression biomarkers has led to the identification of both motor and non-motor symptoms relevant of prodromal PD that could be eye-opening to the spreading underlying Lewy body pathogenesis. One most robust predictor of PD is the REM sleep behavior disorder (RBD), and one most common early non-motor symptom of PD is depression. With RBD, frequently coexisting with clinical depression and both predicting dopamine transmission dysfunction, we aimed to survey structural associates of depressive symptoms in early PD patients with comorbid RBD. Through diffusion MRI connectometry, we tracked fiber differences comparing DWI images obtained from 14 patients with depressive symptoms and 18 without depression from a group with comorbid RBD and PD. DWI images and patients were recruited from the Parkinson's Progression Markers Initiative database. PD-RBD patients with depressive symptoms showed pathways with significantly reduced connectivity in the right cingulum, left and right fornix, left inferior longitudinal fasciculus, right corticospinal tract, left middle cerebellar peduncle and genu of corpus callosum (FDR = 0.0228). Diffusivity alteration of the mentioned fibers in depressed, early PD patients with RBD might reflect underlying PD pathology and serve as common structural DWI signatures for early PD diagnosis.
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Haghshomar M, Dolatshahi M, Ghazi Sherbaf F, Sanjari Moghaddam H, Shirin Shandiz M, Aarabi MH. Disruption of Inferior Longitudinal Fasciculus Microstructure in Parkinson's Disease: A Systematic Review of Diffusion Tensor Imaging Studies. Front Neurol 2018; 9:598. [PMID: 30093877 PMCID: PMC6070770 DOI: 10.3389/fneur.2018.00598] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 07/05/2018] [Indexed: 12/19/2022] Open
Abstract
Parkinson's disease (PD) is a neurodegenerative disorder accompanied by a series of pathological mechanisms which contribute to a variety of motor and non-motor symptoms. Recently, there has been an increasing interest in structural diffusion tensor imaging (DTI) in PD which has shed light on our understanding of structural abnormalities underlying PD symptoms or its associations with pathological mechanisms. One of the white matter tracts shown to be disrupted in PD with a possible contribution to some PD symptoms is the inferior longitudinal fasciculus (ILF). On the whole, lower ILF integrity contributes to thought disorders, impaired visual emotions, cognitive impairments such as semantic fluency deficits, and mood disorders. This review outlines the microstructural changes in ILF associated with systemic inflammation and various PD symptoms like cognitive decline, facial emotion recognition deficit, depression, color discrimination deficit, olfactory dysfunction, and tremor genesis. However, few studies have investigated DTI correlates of each symptom and larger studies with standardized imaging protocols are required to extend these preliminary findings and lead to more promising results.
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Affiliation(s)
- Maryam Haghshomar
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahsa Dolatshahi
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Mehdi Shirin Shandiz
- Department of Medical Physics, Zahedan University of Medical Sciences, Zahedan, Iran
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Firbank MJ, Parikh J, Murphy N, Killen A, Allan CL, Collerton D, Blamire AM, Taylor JP. Reduced occipital GABA in Parkinson disease with visual hallucinations. Neurology 2018; 91:e675-e685. [PMID: 30021920 PMCID: PMC6105043 DOI: 10.1212/wnl.0000000000006007] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 05/23/2018] [Indexed: 02/06/2023] Open
Abstract
Objective To investigate the relationship between visual hallucinations in Parkinson disease (PD) and levels of γ-aminobutyric acid (GABA) in the primary visual cortex. Methods We utilized magnetic resonance spectroscopy to investigate occipital GABA levels in 36 participants with PD, 19 with and 17 without complex visual hallucinations, together with 20 healthy controls without hallucinations. In addition, we acquired T1-weighted MRI, whole-brain fMRI during a visual task, and diffusion tensor imaging. Results We found lower GABA+/creatine in PD with visual hallucinations (0.091 ± 0.010) vs those without (0.101 ± 0.010) and controls (0.099 ± 0.010) (F2,49 = 4.5; p = 0.016). Reduced gray matter in the hallucinations group was also observed in the anterior temporal lobe. Although there were widespread reductions in white matter integrity in the visual hallucinations group, this was no longer significant after controlling for cognitive function. Conclusions The data suggest that reduced levels of GABA are associated with visual hallucinations in PD and implicate changes to the ventral visual stream in the genesis of visual hallucinations. Modulation of visual cortical excitability through, for example, pharmacologic intervention, may be a promising treatment avenue to explore.
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Affiliation(s)
- Michael J Firbank
- From the Institute of Neuroscience (M.J.F., A.K., C.L.A., D.C., J.-P.T.), Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne; and Newcastle Magnetic Resonance Centre (J.P., A.M.B.), Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK; and Baylor College of Medicine (N.M.), Houston, TX.
| | - Jehill Parikh
- From the Institute of Neuroscience (M.J.F., A.K., C.L.A., D.C., J.-P.T.), Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne; and Newcastle Magnetic Resonance Centre (J.P., A.M.B.), Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK; and Baylor College of Medicine (N.M.), Houston, TX
| | - Nicholas Murphy
- From the Institute of Neuroscience (M.J.F., A.K., C.L.A., D.C., J.-P.T.), Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne; and Newcastle Magnetic Resonance Centre (J.P., A.M.B.), Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK; and Baylor College of Medicine (N.M.), Houston, TX
| | - Alison Killen
- From the Institute of Neuroscience (M.J.F., A.K., C.L.A., D.C., J.-P.T.), Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne; and Newcastle Magnetic Resonance Centre (J.P., A.M.B.), Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK; and Baylor College of Medicine (N.M.), Houston, TX
| | - Charlotte L Allan
- From the Institute of Neuroscience (M.J.F., A.K., C.L.A., D.C., J.-P.T.), Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne; and Newcastle Magnetic Resonance Centre (J.P., A.M.B.), Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK; and Baylor College of Medicine (N.M.), Houston, TX
| | - Daniel Collerton
- From the Institute of Neuroscience (M.J.F., A.K., C.L.A., D.C., J.-P.T.), Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne; and Newcastle Magnetic Resonance Centre (J.P., A.M.B.), Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK; and Baylor College of Medicine (N.M.), Houston, TX
| | - Andrew M Blamire
- From the Institute of Neuroscience (M.J.F., A.K., C.L.A., D.C., J.-P.T.), Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne; and Newcastle Magnetic Resonance Centre (J.P., A.M.B.), Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK; and Baylor College of Medicine (N.M.), Houston, TX
| | - John-Paul Taylor
- From the Institute of Neuroscience (M.J.F., A.K., C.L.A., D.C., J.-P.T.), Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne; and Newcastle Magnetic Resonance Centre (J.P., A.M.B.), Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK; and Baylor College of Medicine (N.M.), Houston, TX
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Lucas‐Jiménez O, Ojeda N, Peña J, Cabrera‐Zubizarreta A, Díez‐Cirarda M, Gómez‐Esteban JC, Gómez‐Beldarrain MÁ, Ibarretxe‐Bilbao N. Apathy and brain alterations in Parkinson's disease: a multimodal imaging study. Ann Clin Transl Neurol 2018; 5:803-814. [PMID: 30009198 PMCID: PMC6043767 DOI: 10.1002/acn3.578] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 03/27/2018] [Accepted: 04/13/2018] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Apathy is a common nonmotor symptom in Parkinson's disease (PD) affecting 40% of patients. The aim of the study was to investigate brain changes and correlates of frontal, striatal, and limbic pathways related to subclinical symptoms of apathy in PD patients. METHODS Thirty-two PD patients divided into low-subclinical symptoms of apathy (LSA) (n = 18) and high-subclinical symptoms of apathy (HSA) (n = 14) and 25 healthy controls (HC) underwent a T1-weighted, diffusion-weighted, and resting-state functional MRI. Apathy was evaluated with the Lille Apathy Rating Scale. Voxel-based morphometry, tract-based spatial statistics, and resting-state functional connectivity (FC) analyses were performed with a region-of-interest approach. RESULTS HSA-PD showed increased white matter axial and mean diffusivity compared with HC and increased white matter axial diffusivity compared with LSA-PD. HSA-PD showed decreased fronto-striatal and fronto-limbic FC compared with HC and decreased fronto-striatal FC compared with LSA-PD. LSA-PD showed decreased fronto-limbic but increased fronto-striatal FC (hyperconnectivity) compared with HC. No significant differences in grey matter were found. Fronto-striatal FC and white matter axial and mean diffusivity were associated with symptoms of apathy in HSA-PD. The fronto-striatal hyperconnectivity was associated with lower symptoms of apathy in LSA-PD. INTERPRETATION Findings suggest distinct brain alterations in PD groups with subclinical symptoms of apathy. The increased pattern of activation in LSA-PD, accompanied with lower apathetic symptomatology, might be the initial manifestation of compensatory mechanisms for dysfunctional limbic pathway. The same pattern of hyperconnectivity has been found in other pathologies and the implication of these abnormalities as a cross-disease model for initial apathy symptomatology is further discussed.
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Affiliation(s)
- Olaia Lucas‐Jiménez
- Department of Methods and Experimental PsychologyFaculty of Psychology and EducationUniversity of DeustoBilbaoSpain
| | - Natalia Ojeda
- Department of Methods and Experimental PsychologyFaculty of Psychology and EducationUniversity of DeustoBilbaoSpain
| | - Javier Peña
- Department of Methods and Experimental PsychologyFaculty of Psychology and EducationUniversity of DeustoBilbaoSpain
| | | | - María Díez‐Cirarda
- Department of Methods and Experimental PsychologyFaculty of Psychology and EducationUniversity of DeustoBilbaoSpain
| | - Juan Carlos Gómez‐Esteban
- Neurodegenerative Diseases GroupBiocruces Health Research InstituteUniversity of Basque CountryBarakaldoSpain
| | | | - Naroa Ibarretxe‐Bilbao
- Department of Methods and Experimental PsychologyFaculty of Psychology and EducationUniversity of DeustoBilbaoSpain
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Ghazi Sherbaf F, Rostam Abadi Y, Mojtahed Zadeh M, Ashraf-Ganjouei A, Sanjari Moghaddam H, Aarabi MH. Microstructural Changes in Patients With Parkinson's Disease Comorbid With REM Sleep Behaviour Disorder and Depressive Symptoms. Front Neurol 2018; 9:441. [PMID: 29997561 PMCID: PMC6028696 DOI: 10.3389/fneur.2018.00441] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 05/25/2018] [Indexed: 12/14/2022] Open
Abstract
The diagnosis of Parkinson's disease (PD) is currently anchored on clinical motor symptoms, which appear more than 20 years after initiation of the neurotoxicity. Extra-nigral involvement in the onset of PD with probable nonmotor manifestations before the development of motor signs, lead us to the preclinical (asymptomatic) or prodromal stages of the disease (various nonmotor or subtle motor signs). REM sleep behavior disorder (RBD) and depression are established prodromal clinical markers of PD and predict worse motor and cognitive outcomes. Nevertheless, taken by themselves, these markers are not yet claimed to be practical in identifying high-risk individuals. Combining promising markers may be helpful in a reliable diagnosis of early PD. Therefore, we aimed to detect neural correlates of RBD and depression in 93 treatment-naïve and non-demented early PD by means of diffusion MRI connectometry. Comparing four groups of PD patients with or without comorbid RBD and/or depressive symptoms with each other and with 31 healthy controls, we found that these two non-motor symptoms are associated with lower connectivity in several white matter tracts including the cerebellar peduncles, corpus callosum and long association fibers such as cingulum, fornix, and inferior longitudinal fasciculus. For the first time, we were able to detect the involvement of short association fibers (U-fibers) in PD neurodegenerative process. Longitudinal studies on larger sample groups are needed to further investigate the reported associations.
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Yoo HS, Jeon S, Chung SJ, Yun M, Lee PH, Sohn YH, Evans AC, Ye BS. Olfactory dysfunction in Alzheimer's disease- and Lewy body-related cognitive impairment. Alzheimers Dement 2018; 14:1243-1252. [PMID: 29936148 DOI: 10.1016/j.jalz.2018.05.010] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Revised: 05/02/2018] [Accepted: 05/14/2018] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Olfactory dysfunction is common in Alzheimer's disease- and Lewy body-related disorders, but its neural correlates have not been clearly elucidated. METHODS We retrospectively recruited 237 patients with Alzheimer's disease-related cognitive impairment (ADCI) and 217 with Lewy body-related cognitive impairment (LBCI). They were identically evaluated using the Cross-Cultural Smell Identification Test, neuropsychological tests, and brain magnetic resonance imaging. RESULTS LBCI had more severe olfactory dysfunction than ADCI. Patients with more severe cognitive dysfunction had worse olfactory function in both groups. In ADCI, lower Cross-Cultural Smell Identification Test scores correlated with a lower cortical thickness in brain regions typically affected in Alzheimer's disease, most prominently in the right parahippocampal cortex, whereas in LBCI, the scores correlated with white matter abnormalities in regions vulnerable to Lewy body, including subcortical regions of the orbitofrontal and frontoparietal cortices. DISCUSSION Our results suggest that cortical atrophy in ADCI and white matter abnormalities in LBCI play important roles in olfactory dysfunction.
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Affiliation(s)
- Han Soo Yoo
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Seun Jeon
- McGill Center for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Seok Jong Chung
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Mijin Yun
- Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Young Ho Sohn
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Alan C Evans
- McGill Center for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Byoung Seok Ye
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
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Longitudinal diffusion tensor imaging changes in early Parkinson’s disease: ICICLE-PD study. J Neurol 2018; 265:1528-1539. [DOI: 10.1007/s00415-018-8873-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 04/13/2018] [Accepted: 04/16/2018] [Indexed: 02/03/2023]
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Fling BW, Curtze C, Horak FB. Gait Asymmetry in People With Parkinson's Disease Is Linked to Reduced Integrity of Callosal Sensorimotor Regions. Front Neurol 2018; 9:215. [PMID: 29670573 PMCID: PMC5893803 DOI: 10.3389/fneur.2018.00215] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 03/20/2018] [Indexed: 11/13/2022] Open
Abstract
Background Individuals with Parkinson’s disease (PD) often manifest significant temporal and spatial asymmetries of the lower extremities during gait, which significantly contribute to mobility impairments. While the neural mechanisms underlying mobility asymmetries within this population remain poorly understood, recent evidence points to altered microstructural integrity of white matter fiber tracts within the corpus callosum as potentially playing a substantial role. Objectives The purpose of this study was to quantify spatial and temporal gait asymmetries as well as transcallosal microstructural integrity of white matter fiber tracts connecting the primary and secondary sensorimotor cortices in people with PD and age-matched control participants. Methods Spatial and temporal gait asymmetry in the levodopa off state was assessed using an instrumented walkway. On the next day, diffusion-weighted images were collected to assess white matter microstructural integrity in transcallosal fibers connecting the homologous sensorimotor cortical regions. Results People with PD exhibited significantly more temporal and spatial gait asymmetry than healthy control subjects. Furthermore, people with PD had significantly reduced white matter microstructural integrity of transcallosal fibers connecting homologous regions of the pre-supplementary motor and supplementary motor areas (SMAs), but not the primary motor or somatosensory cortices. Finally, reduced transcallosal fiber tract integrity of the pre-SMA and S1 was associated with greater step length asymmetry in people with PD. Conclusion People with PD showed increased step length asymmetries and decreased microstructural integrity of callosal white matter tracts connecting the higher-order sensorimotor cortices (pre-SMA and SMA). The strong association between gait asymmetries and corpus collosum integrity, supports the hypothesis that reduced transcallosal structural connectivity is a significant mechanism underlying gait asymmetries in people with PD.
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Affiliation(s)
- Brett W Fling
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, United States.,Molecular, Cellular and Integrative Neuroscience Program, Colorado State University, Fort Collins, CO, United States
| | - Carolin Curtze
- Department of Neurology, Oregon Health & Science University, Portland, OR, United States
| | - Fay B Horak
- Department of Neurology, Oregon Health & Science University, Portland, OR, United States.,Veterans Affairs Portland Health Care System, Portland, OR, United States
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