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Campo-Prieto P, Cancela-Carral JM, Rodríguez-Fuentes G. Immersive Virtual Reality Reaction Time Test and Relationship with the Risk of Falling in Parkinson's Disease. SENSORS (BASEL, SWITZERLAND) 2023; 23:s23094529. [PMID: 37177733 PMCID: PMC10181617 DOI: 10.3390/s23094529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/02/2023] [Accepted: 05/04/2023] [Indexed: 05/15/2023]
Abstract
Immersive virtual reality (IVR) uses customized and advanced software and hardware to create a digital 3D reality in which all of the user's senses are stimulated with computer-generated sensations and feedback. This technology is a promising tool that has already proven useful in Parkinson's disease (PD). The risk of falls is very high in people with PD, and reaction times and processing speed may be markers of postural instability and functionality, cognitive impairment and disease progression. An exploratory study was conducted to explore the feasibility of reaction time tests performed in IVR as predictors of falls. A total of 26 volunteers (79.2% male; 69.73 ± 6.32 years) diagnosed with PD (1.54 ± 0.90 H&Y stage; 26.92 ± 2.64 MMSE) took part in the study. IVR intervention was feasible, with no adverse effects (no Simulator Sickness Questionnaire symptoms). IVR reaction times were related (Spearman's rho) to functionality (timed up and go test (TUG) (rho = 0.537, p = 0.005); TUG-Cognitive (rho = 0.576, p = 0.020); cognitive impairment mini mental state exam (MMSE) (rho = -0.576, p = 0.002)) and the years of the patients (rho = 0.399, p = 0.043) but not with the first PD symptom or disease stage. IVR test is a complementary assessment tool that may contribute to preventing falls in the proposed sample. Additionally, based on the relationship between TUG and reaction times, a cut-off time is suggested that would be effective at predicting the risk of suffering a fall in PD patients using a simple and quick IVR test.
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Affiliation(s)
- Pablo Campo-Prieto
- Faculty of Physiotherapy, Department of Functional Biology and Health Sciences, University of Vigo, HealthyFit Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, E-36005 Pontevedra, Spain
| | - José Mª Cancela-Carral
- Faculty of Education and Sports Science, Department of Special Didactics, University of Vigo, HealthyFit Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, E-36005 Pontevedra, Spain
| | - Gustavo Rodríguez-Fuentes
- Faculty of Physiotherapy, Department of Functional Biology and Health Sciences, University of Vigo, HealthyFit Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, E-36005 Pontevedra, Spain
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Reif AE, Summers DK, A Whitfield J, Goberman AM. Prolonged Processing Time for Manual and Vocal Responses in Parkinson Disease: A Psychological Refractory Period Paradigm Study. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:461-474. [PMID: 36634237 DOI: 10.1044/2022_jslhr-22-00435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
PURPOSE The purpose of this study was to examine a potential increased cognitive processing bottleneck within Parkinson disease (PD) by extending a previous overlapping task methodology. Additionally, this study extends previous overlapping task methodology in PD to examine the influence of modality (vocal vs. manual) on response delays in overlapping tasks in PD. METHOD This study used the psychological refractory period (PRP) paradigm (overlapping-task paradigm) to study processing limitations as participants complete two tasks that increasingly overlap in time. Three levels of temporal overlap of tasks were utilized to vary cognitive demands on manual and vocal response time tasks. Ten participants with PD (PwPD) and 12 participants without PD were included in this study. RESULTS Participants with PD demonstrated response time delays across temporal overlap conditions (likely indicating motor deficits) along with a larger increase in response delays in the most overlapped, cognitively taxing condition (likely indicating longer central processing bottleneck). Additionally, modality did not influence response times differently in overlapping task conditions or within participant groups. CONCLUSION An extension of previous overlapping task methodologies within a complex task was successful in demonstrating an increased central processing deficit across manual and vocal response delays in PD, regardless of modality of response.
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Affiliation(s)
- Angela E Reif
- School of Speech-Language Pathology and Audiology, The University of Akron, OH
| | - Dale K Summers
- Department of Speech & Hearing Sciences, University of Washington, Seattle
| | - Jason A Whitfield
- Department of Communication Sciences and Disorders, Bowling Green State University, OH
| | - Alexander M Goberman
- Department of Communication Sciences and Disorders, Bowling Green State University, OH
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Olfactory Impairment Correlates with Executive Functions Disorders and Other Specific Cognitive Dysfunctions in Parkinson's Disease. BIOLOGY 2023; 12:biology12010112. [PMID: 36671804 PMCID: PMC9855400 DOI: 10.3390/biology12010112] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/21/2022] [Accepted: 01/09/2023] [Indexed: 01/13/2023]
Abstract
INTRODUCTION Olfactory and cognitive disorders represent important non-motor symptoms in Parkinson's disease (PD). No clear evidence was reported about association of specific cognitive domains and olfactory impairment. OBJECTIVE The aim of this study was to evaluate the association between olfactory dysfunction and specific cognitive domains in PD patients compared to controls. METHODS 178 PD patients and 98 controls were enrolled and evaluated for odor threshold (OT), discrimination (OD), identification (OI), and TDI score using the Sniffin' Sticks test. Cognitive function was evaluated using the Montreal Cognitive Assessment scale with six sub-scores: Orientation (OIS), Attention (AIS), Language (LIS), Visuospatial (VIS), Memory (MIS), and Executive index scores (EIS). RESULTS Statistically significant correlations were observed between OT versus, LIS, and between TDI score versus EIS. Multivariate linear regression analysis, including age and sex which are well-known predictors of olfactory dysfunction, showed that, among specific cognitive domains, only LIS was significant predictor for OT, VIS was a significant predictor for OD, while both EIS and AIS were significant predictors for OI, and finally only EIS was significant predictor for TDI score. CONCLUSIONS Olfactory disorders in PD patients appear commonly related to dysfunction of specific cognitive domains, with strict association between global olfactory impairment and executive function deficits.
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Fründt O, Fadhel M, Heesen C, Seddiq Zai S, Gerloff C, Vettorazzi E, Pöttgen J, Buhmann C. Do Impulse Control Disorders Impair Car Driving Performance in Patients with Parkinson's Disease? JOURNAL OF PARKINSON'S DISEASE 2022; 12:2261-2275. [PMID: 36120790 DOI: 10.3233/jpd-223420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Based on data regarding the prevalence of Parkinson's disease (PD), the prevalence of impulsive control disorders (ICD) in PD, and the percentage of PD patients driving a car, it has to be assumed that at least 50,000 PD patients with ICD in Germany actively drive a car. However, these patients might be at risk for unsafe driving due to ICD-related dysfunctions such as failure to resist an impulse or temptation, to control an act or other altered neurobehavioral processes. OBJECTIVE This study determines the influence of ICD on driving ability in PD. METHODS We prospectively compared driving simulator performance of 23 PD patients with and 23 matched patients without ICD. ICD had to be socially compensated and presence was defined clinically for primary and questionnaire-based (QUIP-RS) for post-hoc analyses. Furthermore, between-group comparisons of driving-relevant neuropsychological tests were executed. RESULTS Except from a lower blinking frequency when changing lanes, overall driving safety of patients with ICD did not differ significantly from those without-regardless of the clinical or QUIP-RS-based ICD definition. ICD severity did not correlate with driving performance, but the latter correlated significantly with mean reaction times and certain neuropsychiatric tests (MoCA, TMT-A, TAP-M "flexibility" and DBQ "error"). CONCLUSION Clinically compensated ICD does not seem to impair driving safety in PD patients. Rather, cognitive and attentional deficits appear to be clinical markers for driving uncertainty.
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Affiliation(s)
- Odette Fründt
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Neurology, Klinikum Ernst von Bergmann, Potsdam, Germany
| | - Mazen Fadhel
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christoph Heesen
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Institute of Neuroimmunology and Multiple Sclerosis (INIMS), Center for Molecular Neurobiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Susan Seddiq Zai
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Institute of Neuroimmunology and Multiple Sclerosis (INIMS), Center for Molecular Neurobiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Gerloff
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Eik Vettorazzi
- Center for Experimental Medicine & Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jana Pöttgen
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Institute of Neuroimmunology and Multiple Sclerosis (INIMS), Center for Molecular Neurobiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Carsten Buhmann
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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McCusker MC, Wiesman AI, Spooner RK, Santamaria PM, McKune J, Heinrichs-Graham E, Wilson TW. Altered neural oscillations during complex sequential movements in patients with Parkinson's disease. Neuroimage Clin 2021; 32:102892. [PMID: 34911196 PMCID: PMC8645515 DOI: 10.1016/j.nicl.2021.102892] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 11/01/2021] [Accepted: 11/19/2021] [Indexed: 11/20/2022]
Abstract
The sequelae of Parkinson's disease (PD) includes both motor- and cognitive-related symptoms. Although traditionally considered a subcortical disease, there is increasing evidence that PD has a major impact on cortical function as well. Prior studies have reported alterations in cortical neural function in patients with PD during movement, but to date such studies have not examined whether the complexity of multicomponent movements modulate these alterations. In this study, 23 patients with PD (medication "off" state) and 27 matched healthy controls performed simple and complex finger tapping sequences during magnetoencephalography (MEG), and the resulting MEG data were imaged to identify the cortical oscillatory dynamics serving motor performance. The patients with PD were significantly slower than controls at executing the sequences overall, and both groups took longer to complete the complex sequences than the simple. In terms of neural differences, patients also exhibited weaker beta complexity-related effects in the right medial frontal gyrus and weaker complexity-related alpha activity in the right posterior and inferior parietal lobules, suggesting impaired motor sequence execution. Characterizing the cortical pathophysiology of PD could inform current and future therapeutic interventions that address both motor and cognitive symptoms.
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Affiliation(s)
- Marie C McCusker
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA; Interdepartmental Neuroscience Program, Yale University School of Medicine, New Haven, CT, USA
| | - Alex I Wiesman
- College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA; The Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Rachel K Spooner
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA; College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA; Institute of Clinical Neuroscience and Medical Psychology, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | | | - Jennifer McKune
- Department of Physical Therapy, Nebraska Medicine, Omaha, NE, USA
| | - Elizabeth Heinrichs-Graham
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA; College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA.
| | - Tony W Wilson
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA; College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
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Cosgrove J, Hinder MR, St George RJ, Picardi C, Smith SL, Lones MA, Jamieson S, Alty JE. Significant cognitive decline in Parkinson's disease exacerbates the reliance on visual feedback during upper limb reaches. Neuropsychologia 2021; 157:107885. [PMID: 33965420 DOI: 10.1016/j.neuropsychologia.2021.107885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/28/2021] [Accepted: 05/04/2021] [Indexed: 11/27/2022]
Abstract
While upper limb reaches are often made in a feed-forward manner, visual feedback during the movement can be used to guide the reaching hand towards a target. In Parkinson's disease (PD), there is evidence that the utilisation of this visual feedback is increased. However, it is unclear if this is due solely to the characteristic slowness of movements in PD providing more opportunity for incorporating visual feedback to modify reach trajectories, or whether it is due to cognitive decline impacting (feed-forward) movement planning ability. To investigate this, we compared reaction times and movement times of reaches to a target in groups of PD patients with normal cognition (PD-NC), mild cognitive impairment (PD-MCI) or dementia (PD-D), to that of controls with normal cognition (CON-NC) or mild cognitive impairment (CON-MCI). Reaches were undertaken with full visual feedback (at a 'natural' and 'fast-as-possible' pace); with reduced visual feedback of the reaching limb to an illuminated target; and without any visual feedback to a remembered target with eyes closed. The PD-D group exhibited slower reaction times than all other groups across conditions, indicative of less efficient movement planning. When reaching to a remembered target with eyes closed, all PD groups exhibited slower movement times relative to their natural pace with full visual feedback. Crucially, this relative slowing was most pronounced for the PD-D group, compared to the PD-MCI and PD-NC groups, suggesting that substantial cognitive decline in PD exacerbates dependence on visual feedback during upper limb reaches.
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Affiliation(s)
- Jeremy Cosgrove
- Department of Neurology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Mark R Hinder
- Sensorimotor Neuroscience and Ageing Research Lab, School of Psychological Sciences, University of Tasmania, Hobart, Australia
| | - Rebecca J St George
- Sensorimotor Neuroscience and Ageing Research Lab, School of Psychological Sciences, University of Tasmania, Hobart, Australia
| | | | | | - Michael A Lones
- School of Mathematical and Computer Sciences, Heriot-Watt University, Edinburgh, UK
| | - Stuart Jamieson
- Department of Neurology, Leeds Teaching Hospitals NHS Trust, Leeds, UK; Hull York Medical School, University of York, UK
| | - Jane E Alty
- Department of Neurology, Leeds Teaching Hospitals NHS Trust, Leeds, UK; Hull York Medical School, University of York, UK; Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Australia.
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Arroyo A, Periáñez JA, Ríos-Lago M, Lubrini G, Andreo J, Benito-León J, Louis ED, Romero JP. Components determining the slowness of information processing in parkinson's disease. Brain Behav 2021; 11:e02031. [PMID: 33452724 PMCID: PMC7994698 DOI: 10.1002/brb3.2031] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/16/2020] [Accepted: 12/25/2020] [Indexed: 01/19/2023] Open
Abstract
INTRODUCTION Bradyphrenia is a key cognitive feature in Parkinson's disease (PD). There is no consensus on whether information processing speed is impaired or not beyond motor performance. OBJECTIVE This study aims to explore which perceptual, motor, or cognitive components of information processing are involved in the slowdown affecting cognitive performance. METHODS The study included 48 patients with PD (age: 63, 3 ± 8, 18; HY I-III; UPDRS 15,46 ± 7,76) and 53 healthy controls (age: 60,09 ± 12,83). Five reaction time (RT) tasks were administered to all participants. The average RT in each of the tasks and the percentage of correct answers were measured. Patients with PD were in "ON state" at the time of the evaluation. Perceptual, motor, and cognitive components were isolated by means of a series of ANCOVAs. RESULTS As expected, the motor component was slowed down in patients with PD. Moreover, while patients with PD showed slower RT than controls in all tasks, differences between groups did not exponentially increase with the increasing task complexity. ANCOVA analyses also revealed that the perceptual and sustained alert component resulted to be slowed down, with no differences being found in any of the remaining isolated cognitive components (i.e., response strategy-inhibition, decisional, visual search, or interference control). CONCLUSIONS The results revealed that slowness of information processing in PD was mainly associated with an impaired processing speed of the motor and perceptual-alertness components analyzed. The results may help designing new neurorehabilitation strategies, focusing on the improvement of perceptual and alertness mechanisms.
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Affiliation(s)
- Aida Arroyo
- Facultad de Ciencias Experimentales, Universidad Francisco de Vitoria, Madrid, Spain
| | - José A Periáñez
- Experimental Psychology Department, Universidad Complutense de Madrid, Madrid, Spain
| | - Marcos Ríos-Lago
- Basic Psychology II Department, UNED, Madrid 28040, Spain; Brain Damage Unit, Hospital Beata María Ana, Madrid, Spain
| | - Genny Lubrini
- Experimental Psychology Department, Universidad Complutense de Madrid, Madrid, Spain
| | - Jorge Andreo
- Facultad de Ciencias Experimentales, Universidad Francisco de Vitoria, Madrid, Spain
| | - Julián Benito-León
- Department of Neurology, University Hospital "12 de Octubre", Madrid, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain; Department of Medicine, Complutense University, Madrid, Spain
| | - Elan D Louis
- Department of Neurology and Neurotherapeutics at UT Southwestern Medical Center
| | - Juan Pablo Romero
- Facultad de Ciencias Experimentales, Universidad Francisco de Vitoria, Madrid 28223, Spain; Brain Damage Unit, Hospital Beata María Ana, Madrid, Spain
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Spatial attention and spatial short term memory in PSP and Parkinson's disease. Cortex 2021; 137:49-60. [PMID: 33588132 DOI: 10.1016/j.cortex.2020.12.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 11/27/2020] [Accepted: 12/03/2020] [Indexed: 11/20/2022]
Abstract
Progressive Supranuclear Palsy (PSP) is a neurodegenerative disorder characterised by deterioration in motor, oculomotor and cognitive function. A key clinical feature of PSP is the progressive paralysis of eye movements, most notably for vertical saccades. These oculomotor signs can be subtle, however, and PSP is often misdiagnosed as Parkinson's disease (PD), in its early stages. Although some of the clinical features of PD and PSP overlap, they are distinct disorders with differing underlying pathological processes, responses to treatment and prognoses. One key difference lies in the effects the diseases have on cognition. The oculomotor system is tightly linked to cognitive processes such as spatial attention and spatial short-term memory (sSTM), and previous studies have suggested that PSP and PD experience different deficits in these domains. We therefore hypothesised that people with PSP (N = 15) would experience problems with attention (assessed with feature and conjunction visual search tasks) and sSTM (assessed with the Corsi blocks task) compared to people with PD (N = 16) and Age Matched Controls (N = 15). As predicted, feature and conjunction search were sgnificantly slower in the PSP group compared to the other groups, and this deficit was significantly worse for feature compared to conjunction search. The PD group did not differ from AMC on feature search but were significantly impaired on the conjunction search. The PSP group also had a pronounced vertical sSTM impairment that was not present in PD or AMC groups. It is argued that PSP is associated with specific impairment of visuospatial cognition which is caused by degeneration of the oculomotor structures that support exogenous spatial attention, consistent with oculomotor theories of spatial attention and memory.
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Douglass A, Walterfang M, Velakoulis D, Abel L. Visual Search in Behavioral Variant Frontotemporal Dementia. J Alzheimers Dis 2019; 72:1303-1312. [PMID: 31707370 DOI: 10.3233/jad-190981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Changes to visual search have shown specific patterns in a number of dementia subtypes. The cortical regions involved in the control of visual search overlap with the regions affected in behavioral variant frontotemporal dementia (bvFTD). Previous literature has examined visual search in bvFTD with smaller array sizes. OBJECTIVE To examine the pattern of behavior shown by bvFTD patients while undertaking visual search in the presence of larger numbers of distractors to model increased cognitive load. METHODS 15 bvFTD and 17 control participants undertook three visual search tasks: color, orientation, and conjunction searches. A wide range of array sizes was used, from 16 to 100 items arranged as a square. Behavior was quantified using accuracy, response time, and eye movements. RESULTS BvFTD participants displayed a reduction in accuracy and an increased response time across all task types. BvFTD participants displayed an increase in number of objects examined and number of fixations made for color and conjunction tasks. Fixation duration was increased for orientation and conjunction (the more difficult tasks) but not color search. Results indicated the increase in time to response to be due to an increased intercept, with no significant difference in slope for the different tasks. CONCLUSION BvFTD participants display a pattern of visual search behavior consisting of a decrease in accuracy, an increase in response time, and a corresponding increase in the number and length of eye movements made during visual search. The pattern seen corresponds to studies of frontal lobe damage, while differing in pattern from that seen in a range of other cognitive conditions.
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Affiliation(s)
- Amanda Douglass
- Optometry, School of Medicine, Deakin University, Waurn Ponds, Australia.,Department of Optometry and Vision Sciences, The University of Melbourne, Melbourne, Australia
| | - Mark Walterfang
- Department of Psychiatry, The University of Melbourne, Melbourne, Australia.,Neuropsychiatry Unit, Royal Melbourne Hospital, Melbourne, Australia.,Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
| | - Dennis Velakoulis
- Department of Psychiatry, The University of Melbourne, Melbourne, Australia.,Neuropsychiatry Unit, Royal Melbourne Hospital, Melbourne, Australia
| | - Larry Abel
- Department of Optometry and Vision Sciences, The University of Melbourne, Melbourne, Australia
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Özdokur KV, Engin E, Yengin Ç, Ertaş H, Ertaş FN. Determination of Carbidopa, Levodopa, and Droxidopa by High-Performance Liquid Chromatography–Tandem Mass Spectrometry. ANAL LETT 2017. [DOI: 10.1080/00032719.2017.1316283] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Kemal Volkan Özdokur
- Department of Chemistry, Faculty of Science, Ege University, Izmir, Turkey
- Department of Chemistry, Faculty of Science and Letter, Erzincan University, Izmir, Turkey
- Centre for Drug Research & Development and Pharmacokinetic Applications, Ege University, Izmir, Turkey
| | - Esra Engin
- Department of Chemistry, Faculty of Science, Ege University, Izmir, Turkey
- Centre for Drug Research & Development and Pharmacokinetic Applications, Ege University, Izmir, Turkey
| | - Çiğdem Yengin
- Faculty of Pharmacy, Centre for Pharmaceutical Science and Research, Ege University, Izmir, Turkey
| | - Hasan Ertaş
- Department of Chemistry, Faculty of Science, Ege University, Izmir, Turkey
| | - F. Nil Ertaş
- Department of Chemistry, Faculty of Science, Ege University, Izmir, Turkey
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Ferrazzoli D, Ortelli P, Maestri R, Bera R, Gargantini R, Palamara G, Zarucchi M, Giladi N, Frazzitta G. Focused and Sustained Attention Is Modified by a Goal-Based Rehabilitation in Parkinsonian Patients. Front Behav Neurosci 2017; 11:56. [PMID: 28408871 PMCID: PMC5374341 DOI: 10.3389/fnbeh.2017.00056] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 03/16/2017] [Indexed: 11/23/2022] Open
Abstract
Rehabilitation for patients with Parkinson’s disease (PD) is based on cognitive strategies that exploit attention. Parkinsonians exhibit impairments in divided attention and interference control. Nevertheless, the effectiveness of specific rehabilitation treatments based on attention suggests that other attentional functions are preserved. Data about attention are conflicting in PD, and it is not clear whether rehabilitative treatments that entail attentional strategies affect attention itself. Reaction times (RTs) represent an instrument to explore attention and investigate whether changes in attentional performances parallel rehabilitation induced-gains. RTs of 103 parkinsonian patients in “on” state, without cognitive deficits, were compared with those of a population of 34 healthy controls. We studied those attentional networks that subtend the use of cognitive strategies in motor rehabilitation: alertness and focused and sustained attention, which is a component of the executive system. We used visual and auditory RTs to evaluate alertness and multiple choices RTs (MC RTs) to explore focused and sustained attention. Parkinsonian patients underwent these tasks before and after a 4-week multidisciplinary, intensive and goal-based rehabilitation treatment (MIRT). Unified Parkinson’s Disease Rating Scale (UPDRS) III and Timed Up and Go test (TUG) were assessed at the enrollment and at the end of MIRT to evaluate the motor-functional effectiveness of treatment. We did not find differences in RTs between parkinsonian patients and controls. Further, we found that improvements in motor-functional outcome measures after MIRT (p < 0.0001) paralleled a reduction in MC RTs (p = 0.014). No changes were found for visual and auditory RTs. Correlation analysis revealed no association between changes in MC RTs and improvements in UPDRS-III and TUG. These findings indicate that alertness, as well as focused and sustained attention, are preserved in “on” state. This explains why Parkinsonians benefit from a goal-based rehabilitation that entails the use of attention. The reduction in MC RTs suggests a positive effect of MIRT on the executive component of attention and indicates that this type of rehabilitation provides benefits by exploiting executive functions. This ensues from different training approaches aimed at bypassing the dysfunctional basal ganglia circuit, allowing the voluntary execution of the defective movements. These data suggest that the effectiveness of a motor rehabilitation tailored for PD lies on cognitive engagement.
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Affiliation(s)
- Davide Ferrazzoli
- Department of Parkinson's disease, Movement Disorders and Brain Injury Rehabilitation, Moriggia Pelascini HospitalComo, Italy
| | - Paola Ortelli
- Department of Parkinson's disease, Movement Disorders and Brain Injury Rehabilitation, Moriggia Pelascini HospitalComo, Italy
| | - Roberto Maestri
- Department of Biomedical Engineering, Istituti Clinici Scientifici Maugeri Spa Società Benefit, IRCCS MontescanoPavia, Italy
| | - Rossana Bera
- Department of Parkinson's disease, Movement Disorders and Brain Injury Rehabilitation, Moriggia Pelascini HospitalComo, Italy
| | - Roberto Gargantini
- Department of Parkinson's disease, Movement Disorders and Brain Injury Rehabilitation, Moriggia Pelascini HospitalComo, Italy
| | - Grazia Palamara
- Department of Parkinson's disease, Movement Disorders and Brain Injury Rehabilitation, Moriggia Pelascini HospitalComo, Italy
| | - Marianna Zarucchi
- Department of Parkinson's disease, Movement Disorders and Brain Injury Rehabilitation, Moriggia Pelascini HospitalComo, Italy
| | - Nir Giladi
- Movement Disorders Unit, Neurological Institute, Tel-Aviv Medical Centre, Sagol School for Neuroscience, Sackler School of Medicine, Tel-Aviv UniversityTel-Aviv, Israel
| | - Giuseppe Frazzitta
- Department of Parkinson's disease, Movement Disorders and Brain Injury Rehabilitation, Moriggia Pelascini HospitalComo, Italy
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Holroyd CB, Umemoto A. The research domain criteria framework: The case for anterior cingulate cortex. Neurosci Biobehav Rev 2016; 71:418-443. [DOI: 10.1016/j.neubiorev.2016.09.021] [Citation(s) in RCA: 126] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 09/23/2016] [Accepted: 09/23/2016] [Indexed: 01/07/2023]
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Vlagsma TT, Koerts J, Tucha O, Dijkstra HT, Duits AA, van Laar T, Spikman JM. Mental slowness in patients with Parkinson’s disease: Associations with cognitive functions? J Clin Exp Neuropsychol 2016; 38:844-52. [DOI: 10.1080/13803395.2016.1167840] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Chagdes JR, Huber JE, Saletta M, Darling-White M, Raman A, Rietdyk S, Zelaznik HN, Haddad JM. The relationship between intermittent limit cycles and postural instability associated with Parkinson's disease. JOURNAL OF SPORT AND HEALTH SCIENCE 2016; 5:14-24. [PMID: 30356531 PMCID: PMC6188581 DOI: 10.1016/j.jshs.2016.01.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Revised: 06/06/2015] [Accepted: 11/20/2015] [Indexed: 05/20/2023]
Abstract
BACKGROUND Many disease-specific factors such as muscular weakness, increased muscle stiffness, varying postural strategies, and changes in postural reflexes have been shown to lead to postural instability and fall risk in people with Parkinson's disease (PD). Recently, analytical techniques, inspired by the dynamical systems perspective on movement control and coordination, have been used to examine the mechanisms underlying the dynamics of postural declines and the emergence of postural instabilities in people with PD. METHODS A wavelet-based technique was used to identify limit cycle oscillations (LCOs) in the anterior-posterior (AP) postural sway of people with mild PD (n = 10) compared to age-matched controls (n = 10). Participants stood on a foam and on a rigid surface while completing a dual task (speaking). RESULTS There was no significant difference in the root mean square of center of pressure between groups. Three out of 10 participants with PD demonstrated LCOs on the foam surface, while none in the control group demonstrated LCOs. An inverted pendulum model of bipedal stance was used to demonstrate that LCOs occur due to disease-specific changes associated with PD: time-delay and neuromuscular feedback gain. CONCLUSION Overall, the LCO analysis and mathematical model appear to capture the subtle postural instabilities associated with mild PD. In addition, these findings provide insights into the mechanisms that lead to the emergence of unstable posture in patients with PD.
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Affiliation(s)
- James R. Chagdes
- Department of Mechanical and Manufacturing Engineering, Miami University, Oxford, OH 45056, USA
| | - Jessica E. Huber
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN 47907, USA
| | - Meredith Saletta
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City, IA 52242, USA
| | - Meghan Darling-White
- Department of Speech, Language, and Hearing Sciences, University of Arizona, Tucson, AZ 85721, USA
| | - Arvind Raman
- School of Mechanical Engineering, Purdue University, West Lafayette, IN 47907, USA
| | - Shirley Rietdyk
- Department of Health and Kinesiology, Purdue University, West Lafayette, IN 47907, USA
| | - Howard N. Zelaznik
- Department of Health and Kinesiology, Purdue University, West Lafayette, IN 47907, USA
| | - Jeffrey M. Haddad
- Department of Health and Kinesiology, Purdue University, West Lafayette, IN 47907, USA
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Buhmann C, Kraft S, Hinkelmann K, Krause S, Gerloff C, Zangemeister WH. Visual Attention and Saccadic Oculomotor Control in Parkinson's Disease. Eur Neurol 2015; 73:283-93. [PMID: 25925289 DOI: 10.1159/000381335] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 02/22/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND In patients with Parkinson's disease (PD) we aimed at differentiating the relation between selective visual attention, deficits of programming and dynamics of saccadic eye movements while searching for a target and hand-reaction time as well as hand-movement time. Visual attention is crucial for concentrating selectively on one aspect of the visual field while ignoring other aspects. Eye movements are anatomically and functionally related to mechanisms of visual attention. Saccadic dysfunction might confound selective visual attention in PD. METHODS We studied visual selective attention in 22 medicated PD patients (clinical ON status, mild to moderate disease severity) and 22 age matched controls. We looked for possible interferences through oculomotor deficits. Two tasks were compared: free viewing of photographs and time optimal visual search of a hidden target. Visual search times (VST), task related dynamics of saccades, and hand-reaction and hand-movement times were analyzed. RESULTS In the free viewing task mild to moderately affected PD patients did not differ statistically from healthy subjects with respect to saccade dynamics. However, patients differed significantly from healthy subjects in the time optimal visual search task with 25% lower rates of successful searches. Hand movement reaction time did not differ in both groups, whereas hand movement execution time was significantly prolonged in PD patients. CONCLUSION Saccadic oculomotor control and hand movement reaction times were intact, whereas in our less severely affected treated PD patients, visual selective attention was not. The highly reduced successful search rate might be related to disturbed programming and delayed execution of saccades during time optimal visual search due to decreased execution of serial-order sequential generation of saccades.
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Affiliation(s)
- Carsten Buhmann
- Department of Neurology, University Clinic Hamburg-Eppendorf, Hamburg, Germany
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Quantitative electromyographic analysis of reaction time to external auditory stimuli in drug-naïve Parkinson's disease. PARKINSONS DISEASE 2014; 2014:848035. [PMID: 24724037 PMCID: PMC3958792 DOI: 10.1155/2014/848035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 01/09/2014] [Indexed: 11/21/2022]
Abstract
Evaluation of motor symptoms in Parkinson's disease (PD) is still based on clinical rating scales by clinicians. Reaction time (RT) is the time interval between a specific stimulus and the start of muscle response. The aim of this study was to identify the characteristics of RT responses in PD patients using electromyography (EMG) and to elucidate the relationship between RT and clinical features of PD. The EMG activity of 31 PD patients was recorded during isometric muscle contraction. RT was defined as the time latency between an auditory beep and responsive EMG activity. PD patients demonstrated significant delays in both initiation and termination of muscle contraction compared with controls. Cardinal motor symptoms of PD were closely correlated with RT. RT was longer in more-affected side and in more-advanced PD stages. Frontal cognitive function, which is indicative of motor programming and movement regulation and perseveration, was also closely related with RT. In conclusion, greater RT is the characteristic motor features of PD and it could be used as a sensitive tool for motor function assessment in PD patients. Further investigations are required to clarify the clinical impact of the RT on the activity of daily living of patients with PD.
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Higginson CI, Lanni K, Sigvardt KA, Disbrow EA. The contribution of trail making to the prediction of performance-based instrumental activities of daily living in Parkinson's disease without dementia. J Clin Exp Neuropsychol 2013; 35:530-9. [PMID: 23663116 DOI: 10.1080/13803395.2013.798397] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Performance on Part B of the Trail Making Test (TMT) contributes to the prediction of ability to complete instrumental activities of daily living (IADLs) in Parkinson's disease (PD). Although this suggests that cognitive flexibility is important in the everyday functioning of individuals with PD, this may not be the case as the TMT is multifactorial, involving motor speed, visual scanning, sequencing, and cognitive flexibility. The purpose of the current study was to determine which elements of the task contribute to the prediction of IADLs in a sample of 30 nondemented individuals with PD. Correlational analyses indicated strong relationships between a performance-based measure of IADLs and measures involving scanning, sequencing, and cognitive flexibility from the Delis-Kaplan Executive Function System (D-KEFS) TMT. Results from standard regressions indicated that measures of sequencing and level of depression but not scanning, cognitive flexibility, or demographic variables made a significant, independent contribution to the prediction of IADLs. These results suggest that the sequencing element of the TMT is paramount in the prediction of IADLs in PD.
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18
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Martin A, Mills J. Parkinson's Disease Nurse Specialists and the King's College Hospital model of care. ACTA ACUST UNITED AC 2013. [DOI: 10.12968/bjnn.2013.9.1.22] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Anne Martin
- King's College Hospital, Denmark Hill, London, SE5 9RS, England
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Bermejo-Pareja F, Puertas-Martín V. Cognitive features of essential tremor: a review of the clinical aspects and possible mechanistic underpinnings. TREMOR AND OTHER HYPERKINETIC MOVEMENTS (NEW YORK, N.Y.) 2012; 2. [PMID: 23440004 PMCID: PMC3572680 DOI: 10.7916/d89w0d7w] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/18/2011] [Accepted: 05/08/2012] [Indexed: 01/10/2023]
Abstract
The classical concept of essential tremor (ET) as a monosymptomatic tremorogenic disorder has been questioned in the last decade as new evidence has been described. Clinical, neuroimaging, and pathological studies have described a probable structural basis (mainly in cerebellum) and evidence that ET is associated with subtle clinical cerebellar deficits and several non-motor clinical manifestations, such as cognitive and mood disorders. We performed literature searches in Medline, ISI Web of Knowledge, and PsycInfo databases. The aim of this review is to describe cognitive deficits associated with ET. First, we present a brief history of ET cognitive disorders presented. Second, we describe several clinical cross-sectional series demonstrating that ET is associated with mild cognitive deficits of attention, executive functions, several types of memory (working memory, immediate, short term, delayed, and possibly others) and, mood disorders (depression). Recent neuroimaging studies favor a cerebellar basis for these cognitive deficits. Population-based surveys confirm that mild cognitive dysfunction is not limited to severe ET cases, the entire ET group, including mild and undiagnosed cases, can be affected. Cohort studies indicated that ET cognitive deficits could be progressive and that ET patients had an increased risk of dementia. The mood and cognitive deficits in ET are in agreement with cognitive affective cerebellar syndrome described in patients with cerebellar disorders. New evidence, mainly from functional (neuroimaging) and prospective clinical studies would further bolster recent descriptions of ET clinical manifestations.
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Affiliation(s)
- Félix Bermejo-Pareja
- Head of the Neurology Department, University Hospital "12 de Octubre", Madrid, Spain ; Biomedical Research Network on Neurodegenerative Disorders (CIBERNED), Carlos III National Research Institute, Madrid, Spain ; Department of Biomedical Sciences (ANECA), Complutense University of Madrid, Spain
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Adam JJ, van Houdt H, Scholtissen B, Visser-Vandewalle V, Winogrodzka A, Duits A. Executive control in Parkinson's disease: Effects of dopaminergic medication and deep brain stimulation on anti-cue keypress performance. Neurosci Lett 2011; 500:113-7. [DOI: 10.1016/j.neulet.2011.06.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2011] [Revised: 05/30/2011] [Accepted: 06/08/2011] [Indexed: 11/27/2022]
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McKinlay A, Dalrymple-Alford JC, Grace RC, Roger D. The effect of attentional set-shifting, working memory, and processing speed on pragmatic language functioning in Parkinson's disease. ACTA ACUST UNITED AC 2009. [DOI: 10.1080/09541440802281266] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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22
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Turle-Lorenzo N, Maurin B, Puma C, Chezaubernard C, Morain P, Baunez C, Nieoullon A, Amalric M. The dopamine agonist piribedil with L-DOPA improves attentional dysfunction: relevance for Parkinson's disease. J Pharmacol Exp Ther 2006; 319:914-23. [PMID: 16920993 DOI: 10.1124/jpet.106.109207] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Cognitive deficits are often associated with motor symptoms in Parkinson's disease. This study investigates the ability of piribedil ([(methylenedioxy-3,4 benzyl)-4 pyperazinyl-1]-2 pyrimidine), a D(2)/D(3) dopamine (DA) receptor agonist with antagonist activity at alpha(2A)-adrenoceptors, to restore motor and attentional deficits in nigrostriatal 6-hydroxydopamine-lesioned rats. Subjects were trained to depress a lever, detect a stimulus occurring after variable foreperiods, and release the lever quickly afterward. Striatal DA depletions produce deficits in the timing of foreperiods and prolong reaction times. Although a subchronic treatment with piribedil (0.1-2 mg/kg) is not effective, a dose of 0.3 mg/kg administered for 3 weeks significantly reverses the akinetic deficits produced by the striatal dopamine depletion and progressively improves attentional deficits. When coadministered with the dopamine prodrug l-3,4-dihydroxyphenylalanine (l-DOPA) (3 mg/kg), piribedil (0.3 mg/kg) promotes a rapid and full recovery of preoperative performance. These results suggest that administration of l-DOPA in combination with piribedil in a chronic treatment as either initial or supplemental therapy for Parkinson's disease might improve cognitive functions while reducing the risk for motor complications.
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Affiliation(s)
- Nathalie Turle-Lorenzo
- Laboratoire de Neurobiologie de la Cognition, UMR 6155 Centre National de la Recherche Scientifique-Université de Provence, Case C, 3 Place Victor Hugo, 13331 Marseille cedex 3, France
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Ito J, Kitagawa J. Performance monitoring and error processing during a lexical decision task in patients with Parkinson's disease. J Geriatr Psychiatry Neurol 2006; 19:46-54. [PMID: 16449761 DOI: 10.1177/0891988705284716] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
To evaluate performance monitoring and error processing during lexical decision tasks, event-related potentials (ERPs) obtained by time-locked to correct and error responses were studied in 17 Parkinson's disease (PD) patients without dementia and 15 healthy elderly participants. The amplitude of error negativity (Ne) obtained by averages time-locked to error response was significantly reduced in the PD patients, whereas there were no significant differences in the negative component for the correct response (Nc) between the two participant groups. The amplitude of the error positivity (Pe) and correct positivity (Pc) after the Ne and Nc components was also significantly reduced in the PD patients. The PD patients showed significantly slower reaction times and higher error rates. The reduced amplitude of the Ne, Pe, and Pc components in the PD patients suggested impaired performance and conflict monitoring as well as abnormal response strategy adjustments and deviant in later error monitoring processes associated with emotional, conscious evaluation of the error.
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Affiliation(s)
- Junko Ito
- Central Clinical Laboratory, Division of Neurophysiology, Kyoto University Hospital, Kyoto, Japan.
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Horowitz TS, Choi WY, Horvitz JC, Côté LJ, Mangels JA. Visual search deficits in Parkinson's disease are attenuated by bottom-up target salience and top-down information. Neuropsychologia 2006; 44:1962-77. [PMID: 16580700 DOI: 10.1016/j.neuropsychologia.2006.01.037] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2005] [Indexed: 11/21/2022]
Abstract
Patients with Parkinson's disease (PD), a degenerative disorder primarily affecting the nigrostriatal dopamine system, exhibit deficits in selecting task-relevant stimuli in the presence of irrelevant stimuli, such as in visual search tasks. However, results from previous studies suggest that these deficits may vary as a function of whether selection must rely primarily on the "bottom-up" salience of the target relative to background stimuli, or whether "top-down" information about the identity of the target is available to bias selection. In the present study, moderate-to-severe medicated PD patients and age-matched controls were tested on six visual search tasks that systematically varied the relationship between bottom-up target salience (feature search, noisy feature search, conjunction search) and top-down target knowledge (Target Known versus Target Unknown). Comparison of slope and intercepts of the RT x set size function provided information about the efficiency of search and non-search (e.g., decision, response) components, respectively. Patients exhibited higher intercepts than controls as bottom-up target salience decreased, however these deficits were disproportionately larger under Target Unknown compared to Target Known conditions. Slope differences between PD and controls were limited to the Target Unknown Conjunction condition, where patients exhibited a shallower slope in the target absent condition, indicating that they terminated search earlier. These results suggest that under conditions of high background noise, medicated PD patients were primarily impaired in decision and/or response processes downstream from the target search itself, and that the deficit was attenuated when top-down information was available to guide selection of the target signal.
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Affiliation(s)
- Todd S Horowitz
- Brigham & Women's Hospital and Harvard Medical School, MA, USA
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25
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Crevits L, Vandierendonck A, Stuyven E, Verschaete S, Wildenbeest J. Effect of intention and visual fixation disengagement on prosaccades in Parkinson's disease patients. Neuropsychologia 2004; 42:624-32. [PMID: 14725800 DOI: 10.1016/j.neuropsychologia.2003.10.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
In a previous study, we postulated a divergence in reflexive versus voluntary saccade behavior in Parkinson's disease (PD) patients and hypothesized a fronto-striatal dysfunction. The voluntary saccade tasks included antisaccades (AS) and remembered saccades (RemS). However, multiple cognitive processes are involved in AS and RemS and the procedures lack a visual target. The present study had two main objectives. Firstly, we wanted to extend our previous findings of disturbed AS and RemS to other intentional (endogenous, "voluntary") saccades but now with a visible target. Therefore, an intentional prosaccade (IpS) task was used. Secondly, we investigated whether there is a different saccade behavior in PD patients and controls in conditions where the central fixation stimulus is extinguished shortly before the onset of the peripheral target (the so called gap condition) to assess the role of disengagement of visual fixation. With respect to the first objective, the present study found a clear dissociation between the performances of PD patients on reflexive saccade (RS) versus IpS tasks. Patients did not differ from controls in latency or error rate of RS. However, in the IpS task, latency was longer and error rate was higher in PD patients. Thus, the present study provides evidence that PD patients are deficient in intentional saccade tasks independent from the fact whether a target is visible or not. As to the second objective, saccades of PD patients did show a shorter latency in the gap than in the no gap condition. This suggests that the gap effect is not dominantly dependent on nigro-collicular neuronal circuits that are affected in PD. In the patients, the gap effect was reliable in the RS task, but not in the IpS condition. These discordant gap findings might suggest modulation of selected neuronal circuits involved in early sensorimotor processing. The present findings do not to support the hypothesis that impaired saccade behavior in PD patients is merely dependent on the presence or the absence of visual fixation and suggests a higher order psychomotor dysfunction, presumably of intentional nature. The dorsolateral prefrontal cortex might correspond to the premotor cognitive dysfunction site. However, an additional involvement of the frontal eye field can not be excluded from the present study.
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Affiliation(s)
- Luc Crevits
- Neuro-ophthalmology Unit, Department of Neurology, Ghent University Hospital, De Pintelaan 185, B-9000, Ghent, Belgium.
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Gauggel S, Rieger M, Feghoff TA. Inhibition of ongoing responses in patients with Parkinson's disease. J Neurol Neurosurg Psychiatry 2004; 75:539-44. [PMID: 15026491 PMCID: PMC1739013 DOI: 10.1136/jnnp.2003.016469] [Citation(s) in RCA: 222] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We investigated the involvement of the basal ganglia in inhibiting ongoing responses in patients with Parkinson's disease (PD). METHODS Thirty two patients with PD and 31 orthopaedic controls performed the stop signal task, which allows an estimation of the time it takes to inhibit an ongoing reaction (stop signal reaction time, SSRT). RESULTS Patients with PD showed significantly longer SSRTs than the controls. This effect seemed to be independent of global cognitive impairment and severity of PD. Furthermore, in the PD patients, there was no significant relation between general slowing and inhibitory efficiency. CONCLUSIONS Our results provide evidence for involvement of the basal ganglia in the inhibition of ongoing responses.
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Affiliation(s)
- S Gauggel
- Department of Psychology, University of Technology-Chemnitz, Wilhelm-Raabe-Strasse 43, D-09120 Chemnitz, Germany.
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Ketcham CJ, Hodgson TL, Kennard C, Stelmach GE. Memory-motor transformations are impaired in Parkinson's disease. Exp Brain Res 2003; 149:30-9. [PMID: 12592501 DOI: 10.1007/s00221-002-1332-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2002] [Accepted: 10/19/2002] [Indexed: 10/20/2022]
Abstract
Parkinson's disease patients are known to suffer loss of dopaminergic input to the rostral caudate nucleus. Recent functional magnetic resonance imaging (fMRI) studies have implicated this structure in the transformation of spatial information in memory to guide action, suggesting that memory to motor transformations may be selectively impaired in Parkinson's disease. In order to investigate this possibility we tested a group of Parkinson's disease patients (PDs) using a memory-guided pointing task. Of interest was whether patients showed reduced accuracy in the task as a function of memory load. Twelve PD patients and 13 elderly controls were asked to recall single or four step target sequences with 2 time delays (500 and 3,500 ms). In all memory-guided conditions PD patients showed increased variability in memory-guided movement end-points. This effect was not affected by delay, number of items, or the sequence familiarity. The results are consistent with increased variability in memory-motor transformations in early PD, due to dopamine depletion within the rostral caudate nucleus.
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Affiliation(s)
- Caroline J Ketcham
- Motor Control Laboratory, Arizona State University, PO Box 870404, Tempe, AZ 85287-0404, USA
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Crawford TJ, Bennett D, Lekwuwa G, Shaunak S, Deakin JFW. Cognition and the inhibitory control of saccades in schizophrenia and Parkinson's disease. PROGRESS IN BRAIN RESEARCH 2003; 140:449-66. [PMID: 12508608 DOI: 10.1016/s0079-6123(02)40068-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
Historically, various lines of evidence have converged on the view that the brain expends much of its neural resources on inhibiting its own activity in a critical step towards the cognitive control of behaviour. The loss of inhibitory control is widely reported in neurological and psychiatric disorders; however, the consequences of reduced inhibition in terms of wider cognitive effects on cognitive control operations such as planning, abstract thought, working memory and the ability to appreciate the perspective of others ('theory of mind') has been widely overlooked. The antisaccade paradigm examines the conflict between a prepotent stimulus that produces a powerful urge to fixate the target, and the overriding goal to 'look' in the opposite direction. In this chapter we illustrate how this paradigm is increasingly used to explore the relationship of inhibitory control and cognition in Parkinson's disease, schizophrenia and healthy participants. Evidence is presented that is consistent with the theory of cognitive inhibition as a distinct process that can be dissociated from working memory. We conclude that the inhibitory control of saccadic eye movement should be studied in the wider context of cognitive operations.
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Affiliation(s)
- T J Crawford
- Mental Health and Neural Systems Research Unit, Department of Psychology, Lancaster University, Lancaster, LA1 4YF, UK.
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Geng JJ, Behrmann M. Selective Visual Attention and Visual Search: Behavioral and Neural Mechanisms. PSYCHOLOGY OF LEARNING AND MOTIVATION 2003. [DOI: 10.1016/s0079-7421(03)01005-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Chapter 15 Reaction time as an index of motor preparation/programming and speed of response initiation. HANDBOOK OF CLINICAL NEUROPHYSIOLOGY 2003. [DOI: 10.1016/s1567-4231(09)70163-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
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Nagaratnam N, Gayagay G. Hypersexuality in nursing care facilities—a descriptive study. Arch Gerontol Geriatr 2002; 35:195-203. [PMID: 14764358 DOI: 10.1016/s0167-4943(02)00026-2] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2001] [Revised: 02/04/2002] [Accepted: 02/08/2002] [Indexed: 11/15/2022]
Abstract
The continuance of sexual expression in the elderly as age advances is well recognized. Sexual disinhibition, however, in a restricted environment such as in nursing care facilities has received scant attention. We wish to describe eight patients residing in nursing care facilities who were seen because of their problematic sexually related behaviors. These behaviors include cuddling, touching of the genitals, sexual remarks propositioning, grabbing and groping, use of obscene language and masturbating without shame. In all instances concern emanated from members of the nursing staff. Other associated behaviors included aggression, agitation, and irritability amongst others. The computed tomography (CT) scan of the brain showed infarction in the frontal lobe (4), parietal lobe (1), and the caudate (1). One had severe Parkinson's Disease and one had severe dementia of the Alzheimer's disease. All ten patients had an organic basis for their symptoms. Sexually inappropriate behaviors remain highly controversial and labeling them as 'diseased' or an 'illness' may have enormous individual, cultural and medico-legal implications. The clinico-anatomical correlation are discussed.
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Affiliation(s)
- Nages Nagaratnam
- Department of Medicine, Aged Care and Rehabilitation Services, Blacktown-Mount Druitt Health, Blacktown, NSW 2148, Australia.
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Abstract
Parkinson's disease (PD) is attributable primarily to depletion of dopamine in the basal ganglia, but the full effects of this depletion are unknown. It is well known that PD involves motor slowing, and although it is not easy to distinguish between the motor and cognitive components of behavior, clinical observations suggest that cognitive processing may also be compromised. However, it remains unclear whether such cognitive involvement exists, and if so, to what extent. Previous studies of cognitive slowing in PD have yielded conflicting results. This may be attributable to variations in experimental procedures, because most of the experiments used reaction-time tasks, which are inevitably confounded by motor components. In the present study, we evaluated the speed of cognitive processing in patients with PD without bradykinesia as a variable. We developed a mental-operation task that required serial updating of mental representations in response to a series of visual stimuli. By changing the speed of visual presentation and evaluating performance accuracy, the speed of cognitive processing was assessed independently of motor slowing. Cognitive impairment in PD became evident when higher speeds of cognitive processing (verbal more so than spatial) were required. In addition, cognitive slowing and motor slowing were significantly correlated. The results of the present study suggest that slowing in PD is not restricted to the motor domain but can be generally observed in other domains of behavior, including cognitive mental operations.
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Pääsuke M, Mõttus K, Ereline J, Gapeyeva H, Taba P. Lower limb performance in older female patients with Parkinson's disease. Aging Clin Exp Res 2002; 14:185-91. [PMID: 12387525 DOI: 10.1007/bf03324434] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS This study examined lower limb performance in older sedentary patients with Parkinson's disease (PD). METHODS Fourteen female patients with mild to moderate PD and 12 age-matched controls were included in this study. The force preparation and production of the knee extensor muscles during maximal isometric contraction were measured by dynamometric chair. Two force plates were used to measure the chair rising performance. RESULTS PD patients had longer visual reaction time during performing maximal isometric contraction, and lower maximal isometric force (MF) and rate of force development of the knee extensor muscles compared with controls. However, MF relative to body weight (BW) did not differ significantly in PD patients and controls. A longer chair rising time and lower maximal rate of vertical ground reaction force (VGRF) development while rising from a chair were found in PD patients compared with controls. No significant differences in maximal VGRF, and the sum of maximal VGRF of the right and left legs relative to the BW while rising from a chair were observed between the groups. In PD patients, chair rising time correlated negatively with MF of the knee extensor muscles. PD subjects also showed a positive correlation between the BW-related maximal VGRF while rising from a chair and MF of the knee extensor muscles relative to BW. CONCLUSIONS These data suggest that subjects with PD are more deficient in the regulation of force-time parameters, rather than simply in force production of the knee extensor muscles.
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Affiliation(s)
- Mati Pääsuke
- lnstitute of Exercise Biology, University of Tartu, Estonia.
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