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Baarbé J, Brown MJN, Saha U, Tran S, Weissbach A, Saravanamuttu J, Cheyne D, Hutchison WD, Chen R. Cortical modulations before lower limb motor blocks are associated with freezing of gait in Parkinson's disease: an EEG source localization study. Neurobiol Dis 2024; 199:106557. [PMID: 38852752 DOI: 10.1016/j.nbd.2024.106557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 05/15/2024] [Accepted: 06/05/2024] [Indexed: 06/11/2024] Open
Abstract
BACKGROUND Freezing of gait (FOG) is a debilitating symptom of Parkinson's disease (PD) characterized by paroxysmal episodes in which patients are unable to step forward. A research priority is identifying cortical changes before freezing in PD-FOG. METHODS We tested 19 patients with PD who had been assessed for FOG (n=14 with FOG and 5 without FOG). While seated, patients stepped bilaterally on pedals to progress forward through a virtual hallway while 64-channel EEG was recorded. We assessed cortical activities before and during lower limb motor blocks (LLMB), defined as a break in rhythmic pedaling, and stops, defined as movement cessation following an auditory stop cue. This task was selected because LLMB correlates with FOG severity in PD and allows recording of high-quality EEG. Patients were tested after overnight withdrawal from dopaminergic medications ("off" state) and in the "on" medications state. EEG source activities were evaluated using individual MRI and standardized low resolution brain electromagnetic tomography (sLORETA). Functional connectivity was evaluated by phase lag index between seeds and pre-defined cortical regions of interest. RESULTS EEG source activities for LLMB vs. cued stops localized to right posterior parietal area (Brodmann area 39), lateral premotor area (Brodmann area 6), and inferior frontal gyrus (Brodmann area 47). In these areas, PD-FOG (n=14) increased alpha rhythms (8-12 Hz) before LLMB vs. typical stepping, whereas PD without FOG (n=5) decreased alpha power. Alpha rhythms were linearly correlated with LLMB severity, and the relationship became an inverted U-shape when assessing alpha rhythms as a function of percent time in LLMB in the "off" medication state. Right inferior frontal gyrus and supplementary motor area connectivity was observed before LLMB in the beta band (13-30 Hz). This same pattern of connectivity was seen before stops. Dopaminergic medication improved FOG and led to less alpha synchronization and increased functional connections between frontal and parietal areas. CONCLUSIONS Right inferior parietofrontal structures are implicated in PD-FOG. The predominant changes were in the alpha rhythm, which increased before LLMB and with LLMB severity. Similar connectivity was observed for LLMB and stops between the right inferior frontal gyrus and supplementary motor area, suggesting that FOG may be a form of "unintended stopping." These findings may inform approaches to neurorehabilitation of PD-FOG.
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Affiliation(s)
- Julianne Baarbé
- Department of Medicine, University of Toronto and Division of Brain, Imaging & Behaviour, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada; Faculty of Health, York University, Toronto, Ontario, Canada.
| | - Matt J N Brown
- Department of Kinesiology, California State University, Sacramento, CA, USA
| | - Utpal Saha
- Department of Medicine, University of Toronto and Division of Brain, Imaging & Behaviour, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Stephanie Tran
- Department of Medicine, University of Toronto and Division of Brain, Imaging & Behaviour, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Anne Weissbach
- Institute of Systems Motor Science, Center of Brain, Behavior and Metabolism, University of Lübeck, Germany
| | - James Saravanamuttu
- Department of Medicine, University of Toronto and Division of Brain, Imaging & Behaviour, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Douglas Cheyne
- Program in Neurosciences and Mental Health, Hospital for Sick Children Research Institute, Toronto, ON, Canada
| | - William D Hutchison
- Department of Medicine, University of Toronto and Division of Brain, Imaging & Behaviour, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada; Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Robert Chen
- Department of Medicine, University of Toronto and Division of Brain, Imaging & Behaviour, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada; Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
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Hanania JU, Reimers E, Bevington CWJ, Sossi V. PET-based brain molecular connectivity in neurodegenerative disease. Curr Opin Neurol 2024:00019052-990000000-00169. [PMID: 38813843 DOI: 10.1097/wco.0000000000001283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Abstract
PURPOSE OF REVIEW Molecular imaging has traditionally been used and interpreted primarily in the context of localized and relatively static neurochemical processes. New understanding of brain function and development of novel molecular imaging protocols and analysis methods highlights the relevance of molecular networks that co-exist and interact with functional and structural networks. Although the concept and evidence of disease-specific metabolic brain patterns has existed for some time, only recently has such an approach been applied in the neurotransmitter domain and in the context of multitracer and multimodal studies. This review briefly summarizes initial findings and highlights emerging applications enabled by this new approach. RECENT FINDINGS Connectivity based approaches applied to molecular and multimodal imaging have uncovered molecular networks with neurodegeneration-related alterations to metabolism and neurotransmission that uniquely relate to clinical findings; better disease stratification paradigms; an improved understanding of the relationships between neurochemical and functional networks and their related alterations, although the directionality of these relationships are still unresolved; and a new understanding of the molecular underpinning of disease-related alteration in resting-state brain activity. SUMMARY Connectivity approaches are poised to greatly enhance the information that can be extracted from molecular imaging. While currently mostly contributing to enhancing understanding of brain function, they are highly likely to contribute to the identification of specific biomarkers that will improve disease management and clinical care.
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Affiliation(s)
| | - Erik Reimers
- Department of Biomedical Engineering, University of British Columbia, Vancouver, British Columbia, Canada
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Tassan Mazzocco M, Serra M, Maspero M, Coliva A, Presotto L, Casu MA, Morelli M, Moresco RM, Belloli S, Pinna A. Positive relation between dopamine neuron degeneration and metabolic connectivity disruption in the MPTP plus probenecid mouse model of Parkinson's disease. Exp Neurol 2024; 374:114704. [PMID: 38281587 DOI: 10.1016/j.expneurol.2024.114704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 01/15/2024] [Accepted: 01/25/2024] [Indexed: 01/30/2024]
Abstract
The clinical manifestation of Parkinson's disease (PD) appears when neurodegeneration is already advanced, compromising the efficacy of disease-modifying treatment approaches. Biomarkers to identify the early stages of PD are therefore of paramount importance for the advancement of the therapy of PD. In the present study, by using a mouse model of PD obtained by subchronic treatment with the neurotoxin 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) and the clearance inhibitor probenecid (MPTPp), we identified prodromal markers of PD by combining in vivo positron emission tomography (PET) imaging and ex vivo immunohistochemistry. Longitudinal PET imaging of the dopamine transporter (DAT) by [18F]-N-(3-fluoropropyl)-2β-carboxymethoxy-3β-(4-iodophenyl) nortropane ([18F]-FP-CIT), and brain glucose metabolism by 2-deoxy-2-[18F]-fluoroglucose ([18F]-FDG) were performed before MPTPp treatment and after 1, 3, and 10 MPTPp administrations, in order to assess relation between dopamine neuron integrity and brain connectivity. The results show that in vivo [18F]-FP-CIT in the dorsal striatum was not modified after the first administration of MPTPp, tended to decrease after 3 administrations, and significantly decreased after 10 MPTPp administrations. Post-mortem immunohistochemical analyses of DAT and tyrosine hydroxylase (TH) in the striatum showed a positive correlation with [18F]-FP-CIT, confirming the validity of repeated MPTPp-treated mice as a model that can reproduce the progressive pathological changes in the early phases of PD. Analysis of [18F]-FDG uptake in several brain areas connected to the striatum showed that metabolic connectivity was progressively disrupted, starting from the first MPTPp administration, and that significant connections between cortical and subcortical regions were lost after 10 MPTPp administrations, suggesting an association between dopamine neuron degeneration and connectivity disruption in this PD model. The results of this study provide a relevant model, where new drugs that can alleviate neurodegeneration in PD could be evaluated preclinically.
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Affiliation(s)
- Margherita Tassan Mazzocco
- PhD Program in Neuroscience, Medicine and Surgery Department, University of Milano-Bicocca, Monza, Italy; Nuclear Medicine Department, San Raffaele Scientific Institute (IRCCS), Milan, Italy
| | - Marcello Serra
- Department of Biomedical Sciences, Section of Neuroscience, University of Cagliari, Cagliari, Italy
| | - Marco Maspero
- Nuclear Medicine Department, San Raffaele Scientific Institute (IRCCS), Milan, Italy; National Research Council of Italy, Institute of Molecular Bioimaging and Physiology, UOS of Segrate, Italy
| | - Angela Coliva
- Nuclear Medicine Department, San Raffaele Scientific Institute (IRCCS), Milan, Italy
| | - Luca Presotto
- Nuclear Medicine Department, San Raffaele Scientific Institute (IRCCS), Milan, Italy; Department of Physics "G. Occhialini", University of Milano - Bicocca, Milan, Italy
| | - Maria Antonietta Casu
- National Research Council of Italy, Institute of Translational Pharmacology, UOS of Cagliari, Scientific and Technological Park of Sardinia POLARIS, Pula, Italy
| | - Micaela Morelli
- Department of Biomedical Sciences, Section of Neuroscience, University of Cagliari, Cagliari, Italy; National Research Council of Italy, Neuroscience Institute, UOS of Cagliari, Italy
| | - Rosa Maria Moresco
- Nuclear Medicine Department, San Raffaele Scientific Institute (IRCCS), Milan, Italy; National Research Council of Italy, Institute of Molecular Bioimaging and Physiology, UOS of Segrate, Italy; School of Medicine and Surgery, University of Milano - Bicocca, Monza, Italy.
| | - Sara Belloli
- Nuclear Medicine Department, San Raffaele Scientific Institute (IRCCS), Milan, Italy; National Research Council of Italy, Institute of Molecular Bioimaging and Physiology, UOS of Segrate, Italy
| | - Annalisa Pinna
- National Research Council of Italy, Neuroscience Institute, UOS of Cagliari, Italy
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Cooper O, Hallett P, Isacson O. Upstream lipid and metabolic systems are potential causes of Alzheimer's disease, Parkinson's disease and dementias. FEBS J 2024; 291:632-645. [PMID: 36165619 PMCID: PMC10040476 DOI: 10.1111/febs.16638] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 09/02/2022] [Accepted: 09/26/2022] [Indexed: 11/28/2022]
Abstract
Brain health requires circuits, cells and molecular pathways to adapt when challenged and to promptly reset once the challenge has resolved. Neurodegeneration occurs when adaptability becomes confined, causing challenges to overwhelm neural circuitry. Studies of rare and common neurodegenerative diseases suggest that the accumulation of lipids can compromise circuit adaptability. Using microglia as an example, we review data that suggest increased lipid concentrations cause dysfunctional inflammatory responses to immune challenges, leading to Alzheimer's disease, Parkinson's disease and dementia. We highlight current approaches to treat lipid metabolic and clearance pathways and identify knowledge gaps towards restoring adaptive homeostasis in individuals who are at-risk of losing cognition.
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Affiliation(s)
- Oliver Cooper
- Neuroregeneration Research Institute, McLean Hospital/Harvard Medical School, 115 Mill Street, Belmont, MA 02478
| | - Penny Hallett
- Neuroregeneration Research Institute, McLean Hospital/Harvard Medical School, 115 Mill Street, Belmont, MA 02478
| | - Ole Isacson
- Neuroregeneration Research Institute, McLean Hospital/Harvard Medical School, 115 Mill Street, Belmont, MA 02478
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Novikov NI, Brazhnik ES, Kitchigina VF. Pathological Correlates of Cognitive Decline in Parkinson's Disease: From Molecules to Neural Networks. BIOCHEMISTRY. BIOKHIMIIA 2023; 88:1890-1904. [PMID: 38105206 DOI: 10.1134/s0006297923110172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 09/22/2023] [Accepted: 09/22/2023] [Indexed: 12/19/2023]
Abstract
Parkinson's disease (PD) is a progressive neurodegenerative disorder caused by the death of dopaminergic neurons in the substantia nigra and appearance of protein aggregates (Lewy bodies) consisting predominantly of α-synuclein in neurons. PD is currently recognized as a multisystem disorder characterized by severe motor impairments and various non-motor symptoms. Cognitive decline is one of the most common and worrisome non-motor symptoms. Moderate cognitive impairments (CI) are diagnosed already at the early stages of PD, usually transform into dementia. The main types of CI in PD include executive dysfunction, attention and memory decline, visuospatial impairments, and verbal deficits. According to the published data, the following mechanisms play an essential role demonstrates a crucial importance in the decline of the motor and cognitive functions in PD: (1) changes in the conformational structure of transsynaptic proteins and protein aggregation in presynapses; (2) synaptic transmission impairment; (3) neuroinflammation (pathological activation of the neuroglia); (4) mitochondrial dysfunction and oxidative stress; (5) metabolic disorders (hypometabolism of glucose, dysfunction of glycolipid metabolism; and (6) functional rearrangement of neuronal networks. These changes can lead to the death of dopaminergic cells in the substantia nigra and affect the functioning of other neurotransmitter systems, thus disturbing neuronal networks involved in the transmission of information related to the regulation of motor activity and cognitive functions. Identification of factors causing detrimental changes in PD and methods for their elimination will help in the development of new approaches to the therapy of PD. The goal of this review was to analyze pathological processes that take place in the brain and underlie the onset of cognitive disorders in PD, as well as to describe the impairments of cognitive functions in this disease.
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Affiliation(s)
- Nikolai I Novikov
- Institute of Theoretical and Experimental Biophysics, Russian Academy of Sciences, Pushchino, Moscow Region, 142290, Russia
| | - Elena S Brazhnik
- Institute of Theoretical and Experimental Biophysics, Russian Academy of Sciences, Pushchino, Moscow Region, 142290, Russia
| | - Valentina F Kitchigina
- Institute of Theoretical and Experimental Biophysics, Russian Academy of Sciences, Pushchino, Moscow Region, 142290, Russia.
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6
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Buchert R, Wegner F, Huppertz HJ, Berding G, Brendel M, Apostolova I, Buhmann C, Dierks A, Katzdobler S, Klietz M, Levin J, Mahmoudi N, Rinscheid A, Rogozinski S, Rumpf JJ, Schneider C, Stöcklein S, Spetsieris PG, Eidelberg D, Wattjes MP, Sabri O, Barthel H, Höglinger G. Automatic covariance pattern analysis outperforms visual reading of 18 F-fluorodeoxyglucose-positron emission tomography (FDG-PET) in variant progressive supranuclear palsy. Mov Disord 2023; 38:1901-1913. [PMID: 37655363 DOI: 10.1002/mds.29581] [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: 03/24/2023] [Revised: 07/19/2023] [Accepted: 07/31/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND To date, studies on positron emission tomography (PET) with 18 F-fluorodeoxyglucose (FDG) in progressive supranuclear palsy (PSP) usually included PSP cohorts overrepresenting patients with Richardson's syndrome (PSP-RS). OBJECTIVES To evaluate FDG-PET in a patient sample representing the broad phenotypic PSP spectrum typically encountered in routine clinical practice. METHODS This retrospective, multicenter study included 41 PSP patients, 21 (51%) with RS and 20 (49%) with non-RS variants of PSP (vPSP), and 46 age-matched healthy controls. Two state-of-the art methods for the interpretation of FDG-PET were compared: visual analysis supported by voxel-based statistical testing (five readers) and automatic covariance pattern analysis using a predefined PSP-related pattern. RESULTS Sensitivity and specificity of the majority visual read for the detection of PSP in the whole cohort were 74% and 72%, respectively. The percentage of false-negative cases was 10% in the PSP-RS subsample and 43% in the vPSP subsample. Automatic covariance pattern analysis provided sensitivity and specificity of 93% and 83% in the whole cohort. The percentage of false-negative cases was 0% in the PSP-RS subsample and 15% in the vPSP subsample. CONCLUSIONS Visual interpretation of FDG-PET supported by voxel-based testing provides good accuracy for the detection of PSP-RS, but only fair sensitivity for vPSP. Automatic covariance pattern analysis outperforms visual interpretation in the detection of PSP-RS, provides clinically useful sensitivity for vPSP, and reduces the rate of false-positive findings. Thus, pattern expression analysis is clinically useful to complement visual reading and voxel-based testing of FDG-PET in suspected PSP. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Ralph Buchert
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Florian Wegner
- Department of Neurology, Hannover Medical School, Hannover, Germany
| | | | - Georg Berding
- Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany
| | - Matthias Brendel
- Department of Nuclear Medicine, University Hospital of Munich, LMU, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Ivayla Apostolova
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Carsten Buhmann
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alexander Dierks
- Department of Nuclear Medicine, University Hospital Augsburg, Augsburg, Germany
| | - Sabrina Katzdobler
- German Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- Department of Neurology, University Hospital of Munich, LMU, Munich, Germany
| | - Martin Klietz
- Department of Neurology, Hannover Medical School, Hannover, Germany
| | - Johannes Levin
- German Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- Department of Neurology, University Hospital of Munich, LMU, Munich, Germany
| | - Nima Mahmoudi
- Department of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany
| | - Andreas Rinscheid
- Medical Physics and Radiation Protection, University Hospital Augsburg, Augsburg, Germany
| | | | | | - Christine Schneider
- Department of Neurology and Clinical Neurophysiology, University Hospital Augsburg, Augsburg, Germany
| | - Sophia Stöcklein
- Department of Radiology, University Hospital of Munich, LMU, Munich, Germany
| | - Phoebe G Spetsieris
- The Feinstein Institutes for Medical Research Manhasset, Manhasset, New York, USA
| | - David Eidelberg
- The Feinstein Institutes for Medical Research Manhasset, Manhasset, New York, USA
| | - Mike P Wattjes
- Department of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany
| | - Osama Sabri
- Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - Henryk Barthel
- Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - Günter Höglinger
- Department of Neurology, Hannover Medical School, Hannover, Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany
- Department of Neurology, University Hospital of Munich, LMU, Munich, Germany
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Vij R, Prossin A, Tripathy M, Kim H, Park H, Cheng T, Lotfi D, Chang D. Long-term, repeated doses of intravenous autologous mesenchymal stem cells for a patient with Parkinson's disease: a case report. Front Neurol 2023; 14:1257080. [PMID: 37840944 PMCID: PMC10569690 DOI: 10.3389/fneur.2023.1257080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 09/04/2023] [Indexed: 10/17/2023] Open
Abstract
Parkinson's disease (PD) is a neurodegenerative disease that involves the loss of dopaminergic neurons in the substantia nigra pars compacta of the basal ganglia. Clinically, patient presentation involves a combination of motor and non-motor symptoms characterized by progressive worsening over time and significant decreases in overall quality-of-life. Despite there being no fully restorative cure for PD, Mesenchymal Stem Cell (MSC) therapy offers promising therapeutic potential. Here, we report a case of a 77-year-old female, living with idiopathic Parkinson's Disease for over 17 years. The patient received multiple infusions of autologous Hope Biosciences adipose-derived MSCs (HB-adMSCs). A total of 26 infusion treatments of HB-adMSCs were administered over the course of ~2 years that resulted in marked improvements in her typical Parkinsonian symptoms, as demonstrated by the decreases in her UPDRS (Unified Parkinson's Disease Rating Scale) scores. Changes in clinical scores mirrored concurrent changes in regional brain metabolism as quantified by FDG-PET (Fluorodeoxyglucose-Positron Emission Tomography), compared to baseline. Long-term, multiple infusions of HB-adMSCs were safely tolerated by the patient without any serious adverse events. Further research is needed to evaluate the safety and efficacy of HB-adMSC therapy for the treatment of PD patients.
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Affiliation(s)
- Ridhima Vij
- Hope Biosciences Research Foundation, Sugar Land, TX, United States
| | - Alan Prossin
- McGovern Medical School at UTHealth Houston, TX, United States
| | | | - Hosu Kim
- Hope Biosciences, Sugar Land, TX, United States
| | | | - Thanh Cheng
- Hope Biosciences Research Foundation, Sugar Land, TX, United States
| | - Djamchid Lotfi
- Hope Biosciences Research Foundation, Sugar Land, TX, United States
| | - Donna Chang
- Hope Biosciences Research Foundation, Sugar Land, TX, United States
- Hope Biosciences, Sugar Land, TX, United States
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Spetsieris PG, Eidelberg D. Parkinson's disease progression: Increasing expression of an invariant common core subnetwork. Neuroimage Clin 2023; 39:103488. [PMID: 37660556 PMCID: PMC10491857 DOI: 10.1016/j.nicl.2023.103488] [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: 06/06/2022] [Revised: 07/31/2023] [Accepted: 08/02/2023] [Indexed: 09/05/2023]
Abstract
Notable success has been achieved in the study of neurodegenerative conditions using reduction techniques such as principal component analysis (PCA) and sparse inverse covariance estimation (SICE) in positron emission tomography (PET) data despite their widely differing approach. In a recent study of SICE applied to metabolic scans from Parkinson's disease (PD) patients, we showed that by using PCA to prespecify disease-related partition layers, we were able to optimize maps of functional metabolic connectivity within the relevant networks. Here, we show the potential of SICE, enhanced by disease-specific subnetwork partitions, to identify key regional hubs and their connections, and track their associations in PD patients with increasing disease duration. This approach enabled the identification of a core zone that included elements of the striatum, pons, cerebellar vermis, and parietal cortex and provided a deeper understanding of progressive changes in their connectivity. This subnetwork constituted a robust invariant disease feature that was unrelated to phenotype. Mean expression levels for this subnetwork increased steadily in a group of 70 PD patients spanning a range of symptom durations between 1 and 21 years. The findings were confirmed in a validation sample of 69 patients with up to 32 years of symptoms. The common core elements represent possible targets for disease modification, while their connections to external regions may be better suited for symptomatic treatment.
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Affiliation(s)
- Phoebe G Spetsieris
- Center for Neurosciences, The Feinstein Institutes for Medical Research, Manhasset, NY 11030, United States
| | - David Eidelberg
- Center for Neurosciences, The Feinstein Institutes for Medical Research, Manhasset, NY 11030, United States; Molecular Medicine and Neurology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY 11549, United States.
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Chaib S, Vidal B, Bouillot C, Depoortere R, Newman-Tancredi A, Zimmer L, Levigoureux E. Multimodal imaging study of the 5-HT 1A receptor biased agonist, NLX-112, in a model of L-DOPA-induced dyskinesia. Neuroimage Clin 2023; 39:103497. [PMID: 37632990 PMCID: PMC10474496 DOI: 10.1016/j.nicl.2023.103497] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 07/20/2023] [Accepted: 08/14/2023] [Indexed: 08/28/2023]
Abstract
INTRODUCTION The leading treatment for motor signs of Parkinson's disease is L-DOPA, but, upon extended use, it can lead to levodopa-induced dyskinesia (LID). Serotonergic neurons are involved in LID etiology and previous pre-clinical studies have shown that NLX-112, a 5-HT1A biased agonist, has robust antidyskinetic effects. Here, we investigated its effects in hemiparkinsonian (HPK) rats with a unilateral nigrostriatal 6-OHDA lesion. METHODS We compared HPK rats with LID (i.e., sensitized to the dyskinetic effects of chronic L-DOPA) and without LID (HPK-non-LID), using [18F]FDG PET imaging and fMRI functional connectivity following systemic treatment with saline, L-DOPA, NLX-112 or L-DOPA + NLX-112. RESULTS In HPK-non-LID rats, [18F]FDG PET experiments showed that L-DOPA led to hypermetabolism in motor areas (cerebellum, brainstem, and mesencephalic locomotor region) and to hypometabolism in cortical regions. L-DOPA effects were also observed in HPK-LID rats, with the additional emergence of hypermetabolism in raphe nuclei and hypometabolism in hippocampus and striatum. NLX-112 attenuated L-DOPA-induced raphe hypermetabolism and cingulate cortex hypometabolism in HPK-LID rats. Moreover, in fMRI experiments NLX-112 partially corrected the altered neural circuit connectivity profile in HPK-LID rats, through activity in regions rich in 5-HT1A receptors. CONCLUSION This neuroimaging study sheds light for the first time on the brain activation patterns of HPK-LID rats. The 5-HT1A receptor agonist, NLX-112, prevents occurrence of LID, likely by activating pre-synaptic autoreceptors in the raphe nuclei, resulting in a partial restoration of brain metabolic and connectivity profiles. In addition, NLX-112 also rescues L-DOPA-induced deficits in cortical activation, suggesting potential benefit against non-motor symptoms of Parkinson's disease.
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Affiliation(s)
- Sarah Chaib
- Université Claude Bernard Lyon 1, Lyon Neuroscience Research Center, CNRS, INSERM, Lyon, France; Hospices Civils de Lyon, Lyon, France
| | - Benjamin Vidal
- Université Claude Bernard Lyon 1, Lyon Neuroscience Research Center, CNRS, INSERM, Lyon, France
| | | | | | | | - Luc Zimmer
- Université Claude Bernard Lyon 1, Lyon Neuroscience Research Center, CNRS, INSERM, Lyon, France; Hospices Civils de Lyon, Lyon, France; CERMEP-Imaging Platform, Bron, France.
| | - Elise Levigoureux
- Université Claude Bernard Lyon 1, Lyon Neuroscience Research Center, CNRS, INSERM, Lyon, France; Hospices Civils de Lyon, Lyon, France
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Li W, Tang Y, Peng L, Wang Z, Hu S, Gao X. The reconfiguration pattern of individual brain metabolic connectome for Parkinson's disease identification. MedComm (Beijing) 2023; 4:e305. [PMID: 37388240 PMCID: PMC10300308 DOI: 10.1002/mco2.305] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 05/14/2023] [Accepted: 05/22/2023] [Indexed: 07/01/2023] Open
Abstract
18F-Fluorodeoxyglucose positron emission tomography (18F-FDG PET) is widely employed to reveal metabolic abnormalities linked to Parkinson's disease (PD) at a systemic level. However, the individual metabolic connectome details with PD based on 18F-FDG PET remain largely unknown. To alleviate this issue, we derived a novel brain network estimation method for individual metabolic connectome, that is, Jensen-Shannon Divergence Similarity Estimation (JSSE). Further, intergroup difference between the individual's metabolic brain network and its global/local graph metrics was analyzed to investigate the metabolic connectome's alterations. To further improve the PD diagnosis performance, multiple kernel support vector machine (MKSVM) is conducted for identifying PD from normal control (NC), which combines both topological metrics and connection. Resultantly, PD individuals showed higher nodal topological properties (including assortativity, modularity score, and characteristic path length) than NC individuals, whereas global efficiency and synchronization were lower. Moreover, 45 most significant connections were affected. Further, consensus connections in occipital, parietal, and frontal regions were decrease in PD while increase in subcortical, temporal, and prefrontal regions. The abnormal metabolic network measurements depicted an ideal classification in identifying PD of NC with an accuracy up to 91.84%. The JSSE method identified the individual-level metabolic connectome of 18F-FDG PET, providing more dimensional and systematic mechanism insights for PD.
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Affiliation(s)
- Weikai Li
- College of Mathematics and StatisticsChongqing Jiaotong UniversityChongqingChina
- Department of Nuclear Medicine (PET Center)XiangYa HospitalChangshaHunanChina
- Department of PET/MRShanghai Universal Medical Imaging Diagnostic CenterShanghaiChina
- MIIT Key Laboratory of Pattern Analysis and Machine IntelligenceNanjing University of Aeronautics and AstronauticsNanjingChina
| | - Yongxiang Tang
- Department of Nuclear Medicine (PET Center)XiangYa HospitalChangshaHunanChina
| | - Liling Peng
- Department of PET/MRShanghai Universal Medical Imaging Diagnostic CenterShanghaiChina
| | - Zhengxia Wang
- School of Computer Science and Cyberspace SecurityHainan UniversityHainanChina
| | - Shuo Hu
- Department of Nuclear Medicine (PET Center)XiangYa HospitalChangshaHunanChina
- Key Laboratory of Biological Nanotechnology of National Health CommissionXiangYa HospitalCentral South UniversityChangshaHunanChina
| | - Xin Gao
- Department of PET/MRShanghai Universal Medical Imaging Diagnostic CenterShanghaiChina
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11
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Zheng J, Chen L, Cai G, Wang Y, Huang J, Lin X, Li Y, Yu Q, Chen X, Shi Y, Ye Q. The effect of Parkin gene S/N 167 polymorphism on resting spontaneous brain functional activity in Parkinson's Disease. Parkinsonism Relat Disord 2023; 113:105484. [PMID: 37454429 DOI: 10.1016/j.parkreldis.2023.105484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 05/09/2023] [Accepted: 06/04/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Genetic susceptibility plays a significant role in Parkinson's disease (PD) development. Carriers of the Parkin S/N167 mutation may have an increased risk of PD and altered spontaneous brain activity. OBJECTIVE This study aims to investigate the potential pathogenesis of PD through a comparative analysis of the amplitude of low-frequency fluctuations (ALFF) in resting-state functional magnetic resonance imaging (rs-fMRI) of subjects with Parkin gene S/N 167 polymorphisms, and to examine the association between spontaneous brain activity and clinical scale scores of PD. METHODS A total of 69 PD patients and 84 healthy controls (HC) were included in the study. Each subject was genotyped for the Parkin gene S/N 167 polymorphism and underwent rs-fMRI scans. ALFF analysis was employed to evaluate the relationship among genotypes, interactive brain regions, and clinical symptoms in PD. RESULTS PD patients exhibited decreased ALFF values in the right anterior lobe and vermis of the cerebellum compared to HC. No significant interaction was found between the gene's main effect and the "group × genotype" effect on brain ALFF values. One-factor ANOVA revealed no significant difference in ALFF values between PD subgroups; however, the ALFF values in the right anterior lobe and vermis of the cerebellum were lower in the PD-G and PD-GA groups compared to the HC-G and HC-GA groups. Spearman correlation analysis demonstrated that ALFF values in the PD-GG and PD-GA groups were negatively associated with UPDRS-III scores in the bilateral lingual gyrus (Lingual R/L). CONCLUSION Parkin gene S/N 167 polymorphisms may influence brain functional activity in specific brain regions, and ALFF values are associated with motor symptoms in PD patients.
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Affiliation(s)
- Jingxue Zheng
- Department of Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, Fujian, China; Fudan University Shanghai Cancer Center(Xiamen Branch), Xiamen, Fujian, China
| | - Lina Chen
- Department of Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
| | - Guoen Cai
- Department of Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
| | - Yingqing Wang
- Department of Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
| | - Jieming Huang
- Department of Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
| | - Xiaoling Lin
- Department of Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
| | - Yueping Li
- Department of Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
| | - Qianwen Yu
- Department of Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
| | - Xiaochun Chen
- Department of Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, Fujian, China; Institute of Neuroscience, Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China
| | - Yanchuan Shi
- Department of Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, Fujian, China; Department of Neurology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China.
| | - Qinyong Ye
- Department of Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, Fujian, China; Institute of Neuroscience, Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China.
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12
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Mancini M, Natoli S, Gardoni F, Di Luca M, Pisani A. Dopamine Transmission Imbalance in Neuroinflammation: Perspectives on Long-Term COVID-19. Int J Mol Sci 2023; 24:ijms24065618. [PMID: 36982693 PMCID: PMC10056044 DOI: 10.3390/ijms24065618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/09/2023] [Accepted: 03/13/2023] [Indexed: 03/17/2023] Open
Abstract
Dopamine (DA) is a key neurotransmitter in the basal ganglia, implicated in the control of movement and motivation. Alteration of DA levels is central in Parkinson’s disease (PD), a common neurodegenerative disorder characterized by motor and non-motor manifestations and deposition of alpha-synuclein (α-syn) aggregates. Previous studies have hypothesized a link between PD and viral infections. Indeed, different cases of parkinsonism have been reported following COVID-19. However, whether SARS-CoV-2 may trigger a neurodegenerative process is still a matter of debate. Interestingly, evidence of brain inflammation has been described in postmortem samples of patients infected by SARS-CoV-2, which suggests immune-mediated mechanisms triggering the neurological sequelae. In this review, we discuss the role of proinflammatory molecules such as cytokines, chemokines, and oxygen reactive species in modulating DA homeostasis. Moreover, we review the existing literature on the possible mechanistic interplay between SARS-CoV-2-mediated neuroinflammation and nigrostriatal DAergic impairment, and the cross-talk with aberrant α-syn metabolism.
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Affiliation(s)
- Maria Mancini
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy;
- IRCCS Mondino Foundation, 27100 Pavia, Italy
| | - Silvia Natoli
- Department of Clinical Science and Translational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy;
- IRCCS Maugeri Pavia, 27100 Pavia, Italy
| | - Fabrizio Gardoni
- Department of Pharmacological and Biomolecular Sciences “Rodolfo Paoletti”, University of Milan, 20133 Milan, Italy; (F.G.); (M.D.L.)
| | - Monica Di Luca
- Department of Pharmacological and Biomolecular Sciences “Rodolfo Paoletti”, University of Milan, 20133 Milan, Italy; (F.G.); (M.D.L.)
| | - Antonio Pisani
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy;
- IRCCS Mondino Foundation, 27100 Pavia, Italy
- Correspondence: ; Tel.: +39-0382-380-247
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13
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Parkinson's Disease-Related Brain Metabolic Pattern Is Expressed in Schizophrenia Patients during Neuroleptic Drug-Induced Parkinsonism. Diagnostics (Basel) 2022; 13:diagnostics13010074. [PMID: 36611366 PMCID: PMC9818349 DOI: 10.3390/diagnostics13010074] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/18/2022] [Accepted: 12/20/2022] [Indexed: 12/29/2022] Open
Abstract
Drug-induced parkinsonism (DIP) is a frequent parkinsonian syndrome that appears as a result of pharmacotherapy for the management of psychosis. It could substantially hamper treatment and therefore its diagnosis has a direct influence on treatment effectiveness. Although of such high importance, there is a lack of systematic research for developing neuroimaging-based criteria for DIP diagnostics for such patients. Therefore, the current study was aimed at applying a metabolic brain imaging approach using the 18F-FDG positron emission tomography and spatial covariance analysis to reveal possible candidates for DIP markers. As a result, we demonstrated, to our knowledge, the first attempt at the application of the Parkinson's Disease-Related Pattern (PDRP) as a metabolic signature of parkinsonism for the assessment of PDRP expression for schizophrenia patients with DIP. As a result, we observed significant differences in PDRP expression between the control group and the groups with PD and DIP patients. Similar differences in PDRP expression were also found when the non-DIP schizophrenia patients were compared with the PD group. Therefore, our findings made it possible to conclude that PDRP is a promising tool for the development of clinically relevant criteria for the estimation of the risk of developing DIP.
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14
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Seiffert AP, Gómez-Grande A, Alonso-Gómez L, Méndez-Guerrero A, Villarejo-Galende A, Gómez EJ, Sánchez-González P. Differences in Striatal Metabolism in [ 18F]FDG PET in Parkinson's Disease and Atypical Parkinsonism. Diagnostics (Basel) 2022; 13:diagnostics13010006. [PMID: 36611298 PMCID: PMC9818161 DOI: 10.3390/diagnostics13010006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 12/12/2022] [Accepted: 12/18/2022] [Indexed: 12/24/2022] Open
Abstract
Neurodegenerative parkinsonisms affect mainly cognitive and motor functions and are syndromes of overlapping symptoms and clinical manifestations such as tremor, rigidness, and bradykinesia. These include idiopathic Parkinson's disease (PD) and the atypical parkinsonisms, namely progressive supranuclear palsy (PSP), corticobasal degeneration (CBD), multiple system atrophy (MSA) and dementia with Lewy body (DLB). Differences in the striatal metabolism among these syndromes are evaluated using [18F]FDG PET, caused by alterations to the dopaminergic activity and neuronal loss. A study cohort of three patients with PD, 29 with atypical parkinsonism (10 PSP, 6 CBD, 2 MSA, 7 DLB, and 4 non-classifiable), and a control group of 25 patients with normal striatal metabolism is available. Standardized uptake value ratios (SUVR) are extracted from the striatum, and the caudate and the putamen separately. SUVRs are compared among the study groups. In addition, hemispherical and caudate-putamen differences are evaluated in atypical parkinsonisms. Striatal hypermetabolism is detected in patients with PD, while atypical parkinsonisms show hypometabolism, compared to the control group. Hemispherical differences are observed in CBD, MSA and DLB, with the latter also showing statistically significant caudate-putamen asymmetry (p = 0.018). These results indicate disease-specific metabolic uptake patterns in the striatum that can support the differential diagnosis.
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Affiliation(s)
- Alexander P. Seiffert
- Biomedical Engineering and Telemedicine Centre, ETSI Telecomunicación, Center for Biomedical Technology, Universidad Politécnica de Madrid, 28040 Madrid, Spain
- Correspondence: (A.P.S.); (P.S.-G.)
| | - Adolfo Gómez-Grande
- Department of Nuclear Medicine, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
- Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Laura Alonso-Gómez
- Biomedical Engineering and Telemedicine Centre, ETSI Telecomunicación, Center for Biomedical Technology, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | | | - Alberto Villarejo-Galende
- Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Department of Neurology, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
- Group of Neurodegenerative Diseases, Hospital 12 de Octubre Research Institute (imas12), 28041 Madrid, Spain
- Biomedical Research Networking Center in Neurodegenerative Diseases (CIBERNED), 28029 Madrid, Spain
| | - Enrique J. Gómez
- Biomedical Engineering and Telemedicine Centre, ETSI Telecomunicación, Center for Biomedical Technology, Universidad Politécnica de Madrid, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Patricia Sánchez-González
- Biomedical Engineering and Telemedicine Centre, ETSI Telecomunicación, Center for Biomedical Technology, Universidad Politécnica de Madrid, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Correspondence: (A.P.S.); (P.S.-G.)
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15
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Zang Z, Song T, Li J, Nie B, Mei S, Zhang C, Wu T, Zhang Y, Lu J. Simultaneous PET/fMRI revealed increased motor area input to subthalamic nucleus in Parkinson's disease. Cereb Cortex 2022; 33:167-175. [PMID: 35196709 DOI: 10.1093/cercor/bhac059] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 01/23/2022] [Accepted: 01/25/2022] [Indexed: 11/12/2022] Open
Abstract
Invasive electrophysiological recordings in patients with Parkinson's disease (PD) are extremely difficult for cross-sectional comparisons with healthy controls. Noninvasive approaches for identifying information flow between the motor area and the subthalamic nucleus (STN) are critical for evaluation of treatment strategy. We aimed to investigate the direction of the cortical-STN hyperdirect pathway using simultaneous 18F-FDG-PET/functional magnetic resonance imaging (fMRI). Data were acquired during resting state on 34 PD patients and 25 controls. The ratio of standard uptake value for PET images and the STN functional connectivity (FC) maps for fMRI data were generated. The metabolic connectivity mapping (MCM) approach that combines PET and fMRI data was used to evaluate the direction of the connectivity. Results showed that PD patients exhibited both increased FDG uptake and STN-FC in the sensorimotor area (PFDR < 0.05). MCM analysis showed higher cortical-STN MCM value in the PD group (F = 6.63, P = 0.013) in the left precentral gyrus. There was a high spatial overlap between the increased glucose metabolism and increased STN-FC in the sensorimotor area in PD. The MCM approach further revealed an exaggerated cortical input to the STN in PD, supporting the precentral gyrus as a target for treatment such as the repetitive transcranial magnetic stimulation.
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Affiliation(s)
- Zhenxiang Zang
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Changchun Rd. 45, Xicheng district, Beijing 100053, China.,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Changchun Rd. 45, Xicheng district, Beijing 100053, China
| | - Tianbin Song
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Changchun Rd. 45, Xicheng district, Beijing 100053, China.,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Changchun Rd. 45, Xicheng district, Beijing 100053, China
| | - Jiping Li
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Changchun Rd. 45, Xicheng district, Beijing 100053, China
| | - Binbin Nie
- Beijing Engineering Research Center of Radiographic Techniques and Equipment, Institute of High Energy Physics, Chinese Academy of Sciences, Yuquan Rd. 19, Shijingshan district, Beijing 100049, China
| | - Shanshan Mei
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Changchun Rd. 45, Xicheng district, Beijing 100053, China
| | - Chun Zhang
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Changchun Rd. 45, Xicheng district, Beijing 100053, China.,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Changchun Rd. 45, Xicheng district, Beijing 100053, China
| | - Tao Wu
- Department of Neurobiology, Neurology and Geriatrics, Xuanwu Hospital of Capital Medical University, National Clinical Research Center for Geriatric Disorders, Changchun Rd. 45, Xicheng district, Beijing 100053, China
| | - Yuqing Zhang
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Changchun Rd. 45, Xicheng district, Beijing 100053, China
| | - Jie Lu
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Changchun Rd. 45, Xicheng district, Beijing 100053, China.,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Changchun Rd. 45, Xicheng district, Beijing 100053, China
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16
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Chen H, Xu Y, Chen L, Shang S, Luo X, Wang X, Xia W, Zhang H. The convergent and divergent patterns in brain perfusion between Alzheimer's disease and Parkinson's disease with dementia: An ASL MRI study. Front Neurosci 2022; 16:892374. [PMID: 36408395 PMCID: PMC9669427 DOI: 10.3389/fnins.2022.892374] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 08/11/2022] [Indexed: 11/06/2022] Open
Abstract
Background Aberrant brain blood perfusion changes have been found to play an important role in the progress of Alzheimer's disease (AD) and Parkinson's disease with dementia (PDD). However, the convergent and divergent patterns in brain perfusion between two dementias remain poorly documented. Objective To explore the impaired brain perfusion pattern and investigate their overlaps and differences between AD and PDD using normalized cerebral blood flow (CBF). Methods The regional perfusion in patients with AD and PDD as well as healthy control (HC) subjects were explored using the three-dimensional arterial spin labeling. The normalized CBF values were compared across the three groups and further explored the potential linkages to clinical assessments. Results In total, 24 patients with AD, 26 patients with PDD, and 35 HC subjects were enrolled. Relative to the HC group, both the AD group and the PDD group showed reduced normalized CBF mainly in regions of the temporal and frontal gyrus, whereas preserved perfusion presented in the sensorimotor cortex and basal ganglia area. Compared with the AD group, the PDD group showed decreased perfusion in the right putamen and right supplementary motor area (SMA), while preserved perfusion in the right inferior parietal lobule (IPL) and right precuneus. In the AD group, significant correlations were observed between the normalized CBF values in the right IPL and scores of global cognitive function (P = 0.033, ρ = 0.442), between the normalized CBF values in the right precuneus and the scores of memory function (P = 0.049,ρ = 0.406). The normalized CBF in the right putamen was significantly linked to cores of motor symptoms (P = 0.017, ρ = 0.214) in the PDD group. Conclusion Our findings suggested convergent and divergent patterns of brain hemodynamic dysregulation between AD and PDD and contributed to a better understanding of the pathophysiological mechanisms.
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Affiliation(s)
- Hongri Chen
- Department of Radiology, Clinical Medical College, Yangzhou University, Yangzhou, China
- Department of Radiology, Weihai Maternal and Child Health Care Hospital, Weihai, China
| | - Yao Xu
- Department of Neurology, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Lanlan Chen
- Department of Neurology, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Songan Shang
- Department of Radiology, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Xianfu Luo
- Department of Radiology, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Xin Wang
- Department of Rehabilitation, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Wei Xia
- Department of Radiology, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Hongying Zhang
- Department of Radiology, Clinical Medical College, Yangzhou University, Yangzhou, China
- *Correspondence: Hongying Zhang
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17
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Deery HA, Di Paolo R, Moran C, Egan GF, Jamadar SD. Lower brain glucose metabolism in normal ageing is predominantly frontal and temporal: A systematic review and pooled effect size and activation likelihood estimates meta-analyses. Hum Brain Mapp 2022; 44:1251-1277. [PMID: 36269148 PMCID: PMC9875940 DOI: 10.1002/hbm.26119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 09/29/2022] [Accepted: 10/05/2022] [Indexed: 01/31/2023] Open
Abstract
This review provides a qualitative and quantitative analysis of cerebral glucose metabolism in ageing. We undertook a systematic literature review followed by pooled effect size and activation likelihood estimates (ALE) meta-analyses. Studies were retrieved from PubMed following the PRISMA guidelines. After reviewing 635 records, 21 studies with 22 independent samples (n = 911 participants) were included in the pooled effect size analyses. Eight studies with eleven separate samples (n = 713 participants) were included in the ALE analyses. Pooled effect sizes showed significantly lower cerebral metabolic rates of glucose for older versus younger adults for the whole brain, as well as for the frontal, temporal, parietal, and occipital lobes. Among the sub-cortical structures, the caudate showed a lower metabolic rate among older adults. In sub-group analyses controlling for changes in brain volume or partial volume effects, the lower glucose metabolism among older adults in the frontal lobe remained significant, whereas confidence intervals crossed zero for the other lobes and structures. The ALE identified nine clusters of lower glucose metabolism among older adults, ranging from 200 to 2640 mm3 . The two largest clusters were in the left and right inferior frontal and superior temporal gyri and the insula. Clusters were also found in the inferior temporal junction, the anterior cingulate and caudate. Taken together, the results are consistent with research showing less efficient glucose metabolism in the ageing brain. The findings are discussed in the context of theories of cognitive ageing and are compared to those found in neurodegenerative disease.
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Affiliation(s)
- Hamish A. Deery
- Turner Institute for Brain and Mental HealthMonash UniversityMelbourneAustralia,Monash Biomedical ImagingMonash UniversityMelbourneAustralia
| | - Robert Di Paolo
- Turner Institute for Brain and Mental HealthMonash UniversityMelbourneAustralia,Monash Biomedical ImagingMonash UniversityMelbourneAustralia
| | - Chris Moran
- Peninsula Clinical School, Central Clinical SchoolMonash UniversityFrankstonVictoriaAustralia,Department of Geriatric MedicinePeninsula HealthFrankstonVictoriaAustralia
| | - Gary F. Egan
- Turner Institute for Brain and Mental HealthMonash UniversityMelbourneAustralia,Monash Biomedical ImagingMonash UniversityMelbourneAustralia,Australian Research Council Centre of Excellence for Integrative Brain FunctionMelbourneAustralia
| | - Sharna D. Jamadar
- Turner Institute for Brain and Mental HealthMonash UniversityMelbourneAustralia,Monash Biomedical ImagingMonash UniversityMelbourneAustralia,Australian Research Council Centre of Excellence for Integrative Brain FunctionMelbourneAustralia
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18
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Zang Z, Song T, Li J, Yan S, Nie B, Mei S, Ma J, Yang Y, Shan B, Zhang Y, Lu J. Modulation effect of substantia nigra iron deposition and functional connectivity on putamen glucose metabolism in Parkinson's disease. Hum Brain Mapp 2022; 43:3735-3744. [PMID: 35471638 PMCID: PMC9294292 DOI: 10.1002/hbm.25880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 03/04/2022] [Accepted: 04/05/2022] [Indexed: 11/30/2022] Open
Abstract
Neurodegeneration of the substantia nigra affects putamen activity in Parkinson's disease (PD), yet in vivo evidence of how the substantia nigra modulates putamen glucose metabolism in humans is missing. We aimed to investigate how substantia nigra modulates the putamen glucose metabolism using a cross‐sectional design. Resting‐state fMRI, susceptibility‐weighted imaging, and [18F]‐fluorodeoxyglucose‐PET (FDG‐PET) data were acquired. Forty‐two PD patients and 25 healthy controls (HCs) were recruited for simultaneous PET/MRI scanning. The main measurements of the current study were R2* images representing iron deposition (28 PD and 25 HCs), standardized uptake value ratio (SUVr) images representing FDG‐uptake (33 PD and 25 HCs), and resting state functional connectivity maps from resting state fMRI (34 PD and 25 HCs). An interaction term based on the general linear model was used to investigate the joint modulation effect of nigral iron deposition and nigral‐putamen functional connectivity on putamen FDG‐uptake. Compared with HCs, we found increased iron deposition in the substantia nigra (p = .007), increased FDG‐uptake in the putamen (left: PFWE < 0.001; right: PFWE < 0.001), and decreased functional connectivity between the substantia nigra and the anterior putamen (left PFWE < 0.001, right: PFWE = 0.007). We then identified significant interaction effect of nigral iron deposition and nigral‐putamen connectivity on FDG‐uptake in the putamen (p = .004). The current study demonstrated joint modulation effect of the substantia nigra iron deposition and nigral‐putamen functional connectivity on putamen glucose metabolic distribution, thereby revealing in vivo pathological mechanism of nigrostriatal neurodegeneration of PD.
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Affiliation(s)
- Zhenxiang Zang
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China
| | - Tianbin Song
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China
| | - Jiping Li
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Shaozhen Yan
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China
| | - Binbin Nie
- Beijing Engineering Research Center of Radiographic Techniques and Equipment, Institute of High Energy Physics, Chinese Academy of Sciences, China
| | - Shanshan Mei
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jie Ma
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China
| | - Yu Yang
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China
| | - Baoci Shan
- Beijing Engineering Research Center of Radiographic Techniques and Equipment, Institute of High Energy Physics, Chinese Academy of Sciences, China
| | - Yuqing Zhang
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jie Lu
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China
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19
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Yoon EJ, Lee JY, Kim H, Yoo D, Shin JH, Nam H, Jeon B, Kim YK. Brain Metabolism Related to Mild Cognitive Impairment and Phenoconversion in Patients With Isolated REM Sleep Behavior Disorder. Neurology 2022; 98:e2413-e2424. [PMID: 35437260 PMCID: PMC9231839 DOI: 10.1212/wnl.0000000000200326] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 02/17/2022] [Indexed: 11/15/2022] Open
Abstract
Background and Objectives Mild cognitive impairment (MCI) in isolated REM sleep behavior disorder (iRBD) is a risk factor for subsequent neurodegeneration. We aimed to identify brain metabolism and functional connectivity changes related to MCI in patients with iRBD and the neuroimaging markers' predictive value for phenoconversion. Methods This is a prospective cohort study of patients with iRBD with a mean follow-up of 4.2 ± 2.6 years. At baseline, patients with iRBD and age- and sex-matched healthy controls (HCs) underwent 18F-fluorodeoxyglucose (FDG)–PET and resting-state fMRI scans and a comprehensive neuropsychological test battery. Voxel-wise group comparisons for FDG-PET data were performed using a general linear model. Seed-based connectivity maps were computed using brain regions showing significant hypometabolism associated with MCI in patients with iRBD and compared between groups. A Cox regression analysis was applied to investigate the association between brain metabolism and risk of phenoconversion. Results Forty patients with iRBD, including 21 with MCI (iRBD-MCI) and 19 with normal cognition (iRBD-NC), and 24 HCs were included in the study. The iRBD-MCI group revealed relative hypometabolism in the inferior parietal lobule, lateral and medial occipital, and middle and inferior temporal cortex bilaterally compared with HC and the iRBD-NC group. In seed-based connectivity analyses, the iRBD-MCI group exhibited decreased functional connectivity of the left angular gyrus with the occipital cortex. Of 40 patients with iRBD, 12 patients converted to Parkinson disease (PD) or dementia with Lewy bodies (DLB). Hypometabolism of the occipital pole (hazard ratio [95% CI] 6.652 [1.387–31.987]), medial occipital (4.450 [1.143–17.327]), and precuneus (3.635 [1.009–13.093]) was associated with higher phenoconversion rate to PD/DLB. Discussion MCI in iRBD is related to functional and metabolic changes in broad brain areas, particularly the occipital and parietal areas. Moreover, hypometabolism in these brain regions was a predictor of phenoconversion to PD or DLB. Evaluation of cognitive function and neuroimaging characteristics could be useful for risk stratification in patients with iRBD.
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Affiliation(s)
- Eun Jin Yoon
- Memory Network Medical Research Center, Seoul National University, Seoul, Korea, Republic of.,Department of Nuclear Medicine, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea, Republic of
| | - Jee-Young Lee
- Department of Neurology, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea, Republic of
| | - Heejung Kim
- Department of Nuclear Medicine, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea, Republic of.,Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul, Korea, Republic of
| | - Dallah Yoo
- Department of Neurology, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea, Republic of.,Department of Neurology, Kyung Hee University Hospital, Seoul, Korea, Republic of
| | - Jung Hwan Shin
- Department of Neurology, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea, Republic of
| | - Hyunwoo Nam
- Department of Neurology, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea, Republic of
| | - Beomseok Jeon
- Department of Neurology, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Korea, Republic of
| | - Yu Kyeong Kim
- Department of Nuclear Medicine, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea, Republic of
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20
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Sigurdsson HP, Yarnall AJ, Galna B, Lord S, Alcock L, Lawson RA, Colloby SJ, Firbank MJ, Taylor J, Pavese N, Brooks DJ, O'Brien JT, Burn DJ, Rochester L. Gait‐Related Metabolic Covariance Networks at Rest in Parkinson's Disease. Mov Disord 2022; 37:1222-1234. [PMID: 35285068 PMCID: PMC9314598 DOI: 10.1002/mds.28977] [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: 06/18/2021] [Revised: 02/08/2022] [Accepted: 02/10/2022] [Indexed: 11/09/2022] Open
Abstract
Background Gait impairments are characteristic motor manifestations and significant predictors of poor quality of life in Parkinson's disease (PD). Neuroimaging biomarkers for gait impairments in PD could facilitate effective interventions to improve these symptoms and are highly warranted. Objective The aim of this study was to identify neural networks of discrete gait impairments in PD. Methods Fifty‐five participants with early‐stage PD and 20 age‐matched healthy volunteers underwent quantitative gait assessment deriving 12 discrete spatiotemporal gait characteristics and [18F]‐2‐fluoro‐2‐deoxyglucose‐positron emission tomography measuring resting cerebral glucose metabolism. A multivariate spatial covariance approach was used to identify metabolic brain networks that were related to discrete gait characteristics in PD. Results In PD, we identified two metabolic gait‐related covariance networks. The first correlated with mean step velocity and mean step length (pace gait network), which involved relatively increased and decreased metabolism in frontal cortices, including the dorsolateral prefrontal and orbital frontal, insula, supplementary motor area, ventrolateral thalamus, cerebellum, and cuneus. The second correlated with swing time variability and step time variability (temporal variability gait network), which included relatively increased and decreased metabolism in sensorimotor, superior parietal cortex, basal ganglia, insula, hippocampus, red nucleus, and mediodorsal thalamus. Expression of both networks was significantly elevated in participants with PD relative to healthy volunteers and were not related to levodopa dosage or motor severity. Conclusions We have identified two novel gait‐related brain networks of altered glucose metabolism at rest. These gait networks could serve as a potential neuroimaging biomarker of gait impairments in PD and facilitate development of therapeutic strategies for these disabling symptoms. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society
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Affiliation(s)
- Hilmar P. Sigurdsson
- Translational and Clinical Research Institute, Faculty of Medical Sciences Newcastle University Newcastle upon Tyne United Kingdom
| | - Alison J. Yarnall
- Translational and Clinical Research Institute, Faculty of Medical Sciences Newcastle University Newcastle upon Tyne United Kingdom
- Newcastle upon Tyne Hospitals NHS Foundation Trust Newcastle upon Tyne United Kingdom
| | - Brook Galna
- Translational and Clinical Research Institute, Faculty of Medical Sciences Newcastle University Newcastle upon Tyne United Kingdom
- Health Futures Institute Murdoch University Perth Australia
| | - Sue Lord
- Auckland University of Technology Auckland New Zealand
| | - Lisa Alcock
- Translational and Clinical Research Institute, Faculty of Medical Sciences Newcastle University Newcastle upon Tyne United Kingdom
| | - Rachael A. Lawson
- Translational and Clinical Research Institute, Faculty of Medical Sciences Newcastle University Newcastle upon Tyne United Kingdom
| | - Sean J. Colloby
- Translational and Clinical Research Institute, Faculty of Medical Sciences Newcastle University Newcastle upon Tyne United Kingdom
| | - Michael J. Firbank
- Translational and Clinical Research Institute, Faculty of Medical Sciences Newcastle University Newcastle upon Tyne United Kingdom
| | - John‐Paul Taylor
- Translational and Clinical Research Institute, Faculty of Medical Sciences Newcastle University Newcastle upon Tyne United Kingdom
| | - Nicola Pavese
- Translational and Clinical Research Institute, Faculty of Medical Sciences Newcastle University Newcastle upon Tyne United Kingdom
- Department of Nuclear Medicine and PET Aarhus University Hospital Aarhus Denmark
| | - David J. Brooks
- Translational and Clinical Research Institute, Faculty of Medical Sciences Newcastle University Newcastle upon Tyne United Kingdom
- Department of Nuclear Medicine and PET Aarhus University Hospital Aarhus Denmark
| | - John T. O'Brien
- Department of Psychiatry University of Cambridge Cambridge United Kingdom
| | - David J. Burn
- Faculty of Medical Sciences Newcastle University Newcastle upon Tyne United Kingdom
| | - Lynn Rochester
- Translational and Clinical Research Institute, Faculty of Medical Sciences Newcastle University Newcastle upon Tyne United Kingdom
- Newcastle upon Tyne Hospitals NHS Foundation Trust Newcastle upon Tyne United Kingdom
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21
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Amod FH, Bhigjee AI, Nyakale N. Utility of 18F FDG-PET in Parkinsonism in an African population. eNeurologicalSci 2022; 27:100399. [PMID: 35434388 PMCID: PMC9011012 DOI: 10.1016/j.ensci.2022.100399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/21/2022] [Accepted: 03/28/2022] [Indexed: 11/18/2022] Open
Affiliation(s)
- Ferzana Hassan Amod
- Department of Neurology, Inkosi Albert Luthuli Central Hospital, Cato Manor, Durban, South Africa
- Department of Neurology, University of KwaZulu-Natal, Durban, South Africa
- Corresponding author at: Department of Neurology, Inkosi Albert Luthuli Central Hospital, Cato Manor, Durban, South Africa.
| | - Ahmed Iqbal Bhigjee
- Department of Neurology, Inkosi Albert Luthuli Central Hospital, Cato Manor, Durban, South Africa
- Department of Neurology, University of KwaZulu-Natal, Durban, South Africa
| | - Nozipho Nyakale
- Department of Nuclear Medicine, Inkosi Albert Luthuli Central Hospital, Cato Manor, Durban, South Africa, Head of Nuclear Medicine Department, Sefako Makgatho Health Sciences University, Ga-Rankuwa, South Africa
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22
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Abstract
Positron emission tomography greatly advanced our understanding on the underlying neural mechanisms of movement disorders. PET with flurodeoxyglucose (FDG) is especially useful as it depicts regional metabolic activity level that can predict patients' symptoms. Multivariate pattern analysis has been used to determine and quantify the co-varying brain networks associated with specific clinical traits of neurodegenerative disease. The result is a biomarker, useful for diagnosis, treatments, and follow up studies. Parkinsonian traits and parkinsonisms are associated with specific spatial pattern of metabolic abnormality useful for differential diagnosis. This approach has also been used for monitoring disease progression and novel treatment responses mostly in Parkinson's disease. In this book chapter, we, illustrate and discuss the significance of the brain networks associated with disease and their modification with neuroplastic changes.
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23
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Horsager J, Knudsen K, Sommerauer M. Clinical and imaging evidence of brain-first and body-first Parkinson's disease. Neurobiol Dis 2022; 164:105626. [PMID: 35031485 DOI: 10.1016/j.nbd.2022.105626] [Citation(s) in RCA: 50] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 01/04/2022] [Accepted: 01/07/2022] [Indexed: 12/17/2022] Open
Abstract
Braak's hypothesis has been extremely influential over the last two decades. However, neuropathological and clinical evidence suggest that the model does not conform to all patients with Parkinson's disease (PD). To resolve this controversy, a new model was recently proposed; in brain-first PD, the initial α-synuclein pathology arise inside the central nervous system, likely rostral to the substantia nigra pars compacta, and spread via interconnected structures - eventually affecting the autonomic nervous system; in body-first PD, the initial pathological α-synuclein originates in the enteric nervous system with subsequent caudo-rostral propagation to the autonomic and central nervous system. By using REM-sleep behavior disorder (RBD) as a clinical identifier to distinguish between body-first PD (RBD-positive at motor symptom onset) and brain-first PD (RBD-negative at motor symptom onset), we explored the literature to evaluate clinical and imaging differences between these proposed subtypes. Body-first PD patients display: 1) a larger burden of autonomic symptoms - in particular orthostatic hypotension and constipation, 2) more frequent pathological α-synuclein in peripheral tissues, 3) more brainstem and autonomic nervous system involvement in imaging studies, 4) more symmetric striatal dopaminergic loss and motor symptoms, and 5) slightly more olfactory dysfunction. In contrast, only minor cortical metabolic alterations emerge before motor symptoms in body-first. Brain-first PD is characterized by the opposite clinical and imaging patterns. Patients with pathological LRRK2 genetic variants mostly resemble a brain-first PD profile whereas patients with GBA variants typically conform to a body-first profile. SNCA-variant carriers are equally distributed between both subtypes. Overall, the literature indicates that body-first and brain-first PD might be two distinguishable entities on some clinical and imaging markers.
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Affiliation(s)
- Jacob Horsager
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Department of Nuclear Medicine and PET, Aarhus University Hospital, Aarhus, Denmark.
| | - Karoline Knudsen
- Department of Nuclear Medicine and PET, Aarhus University Hospital, Aarhus, Denmark
| | - Michael Sommerauer
- Department of Nuclear Medicine and PET, Aarhus University Hospital, Aarhus, Denmark; Department of Neurology, University Hospital Cologne, Faculty of Medicine, University of Cologne, Köln, Germany; Institute of Neuroscience and Medicine (INM-3), Forschungszentrum Jülich, Jülich, Germany
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24
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Orso B, Arnaldi D, Peira E, Famá F, Giorgetti L, Girtler N, Brugnolo A, Mattioli P, Biassoni E, Donniaquio A, Massa F, Bauckneht M, Miceli A, Morbelli S, Nobili F, Pardini M. The Role of Monoaminergic Tones and Brain Metabolism in Cognition in De Novo Parkinson's Disease. JOURNAL OF PARKINSON'S DISEASE 2022; 12:1945-1955. [PMID: 35811536 DOI: 10.3233/jpd-223308] [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 Cognitive impairment is frequent in Parkinson's disease (PD) and several neurotransmitter changes have been reported since the time of diagnosis, although seldom investigated altogether in the same patient cohort. OBJECTIVE Our aim was to evaluate the association between neurotransmitter impairment, brain metabolism, and cognition in a cohort of de novo, drug-naïve PD patients. METHODS We retrospectively selected 95 consecutive drug-naïve PD patients (mean age 71.89±7.53) undergoing at the time of diagnosis a brain [18F]FDG-PET as a marker of brain glucose metabolism and proxy measure of neurodegeneration, [123I]FP-CIT-SPECT as a marker and dopaminergic deafferentation in the striatum and frontal cortex, as well as a marker of serotonergic deafferentation in the thalamus, and quantitative electroencephalography (qEEG) as an indirect measure of cholinergic deafferentation. Patients also underwent a complete neuropsychological battery. RESULTS Positive correlations were observed between (i) executive functions and left cerebellar cortex metabolism, (ii) prefrontal dopaminergic tone and working memory (r = 0.304, p = 0.003), (iii) qEEG slowing in the posterior leads and both memory (r = 0.299, p = 0.004) and visuo-spatial functions (r = 0.357, p < 0.001). CONCLUSIONS In subjects with PD, the impact of regional metabolism and diffuse projection systems degeneration differs across cognitive domains. These findings suggest possible tailored approaches to the treatment of cognitive deficits in PD.
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Affiliation(s)
- Beatrice Orso
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - Dario Arnaldi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico S. Martino, Genoa, Italy
| | - Enrico Peira
- Istituto nazionale di Fisica Nucleare (IN FN), Genoa section, Genoa, Italy
| | - Francesco Famá
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico S. Martino, Genoa, Italy
| | | | - Nicola Girtler
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico S. Martino, Genoa, Italy
| | - Andrea Brugnolo
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico S. Martino, Genoa, Italy
| | - Pietro Mattioli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - Erica Biassoni
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - Andrea Donniaquio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - Federico Massa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - Matteo Bauckneht
- IRCCS Ospedale Policlinico S. Martino, Genoa, Italy
- Department of Health Science (DISSAL), University of Genoa, Genoa, Italy
| | - Alberto Miceli
- IRCCS Ospedale Policlinico S. Martino, Genoa, Italy
- Department of Health Science (DISSAL), University of Genoa, Genoa, Italy
| | - Silvia Morbelli
- IRCCS Ospedale Policlinico S. Martino, Genoa, Italy
- Department of Health Science (DISSAL), University of Genoa, Genoa, Italy
| | - Flavio Nobili
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico S. Martino, Genoa, Italy
| | - Matteo Pardini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico S. Martino, Genoa, Italy
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25
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Gamma camera imaging in movement disorders. Nucl Med Mol Imaging 2022. [DOI: 10.1016/b978-0-12-822960-6.00193-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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26
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Exploring brain glucose metabolic patterns in cognitively normal adults at risk of Alzheimer's disease: A cross-validation study with Chinese and ADNI cohorts. Neuroimage Clin 2021; 33:102900. [PMID: 34864286 PMCID: PMC8648808 DOI: 10.1016/j.nicl.2021.102900] [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: 06/17/2021] [Revised: 11/17/2021] [Accepted: 11/24/2021] [Indexed: 12/13/2022]
Abstract
At-risk AD-related metabolic covariance patterns were proposed for cognitively NCs. Patterns were cross-validated in two independent cohorts of Chinese and Americans. Pattern expression scores were significantly higher in Aβ+ NCs than in Aβ- NCs. Pattern expression scores were stable over time based on follow-up data. Pattern expression scores correlated with CSF tau biomarkers, but not with brain Aβ deposition.
Objective Disease-related metabolic brain patterns have been verified for a variety of neurodegenerative diseases including Alzheimer’s disease (AD). This study aimed to explore and validate the pattern derived from cognitively normal controls (NCs) in the Alzheimer’s continuum. Methods This study was based on two cohorts; one from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) and the other from the Sino Longitudinal Study on Cognitive Decline (SILCODE). Each subject underwent [18F]fluoro-2-deoxyglucose positron emission tomography (PET) and [18F]florbetapir-PET imaging. Participants were binary-grouped based on β-amyloid (Aβ) status, and the positivity was defined as Aβ+. Voxel-based scaled subprofile model/principal component analysis (SSM/PCA) was used to generate the “at-risk AD-related metabolic pattern (ARADRP)” for NCs. The pattern expression score was obtained and compared between the groups, and receiver operating characteristic curves were drawn. Notably, we conducted cross-validation to verify the robustness and correlation analyses to explore the relationships between the score and AD-related pathological biomarkers. Results Forty-eight Aβ+ NCs and 48 Aβ- NCs were included in the ADNI cohort, and 25 Aβ+ NCs and 30 Aβ- NCs were included in the SILCODE cohort. The ARADRPs were identified from the combined cohorts and the two separate cohorts, characterized by relatively lower regional loadings in the posterior parts of the precuneus, posterior cingulate, and regions of the temporal gyrus, as well as relatively higher values in the superior/middle frontal gyrus and other areas. Patterns identified from the two separate cohorts showed some regional differences, including the temporal gyrus, basal ganglia regions, anterior parts of the precuneus, and middle cingulate. Cross-validation suggested that the pattern expression score was significantly higher in the Aβ+ group of both cohorts (p < 0.01), and contributed to the diagnosis of Aβ+ NCs (with area under the curve values of 0.696–0.815). The correlation analysis revealed that the score was related to tau pathology measured in cerebrospinal fluid (p-tau: p < 0.02; t-tau: p < 0.03), but not Aβ pathology assessed with [18F]florbetapir-PET (p > 0.23). Conclusions ARADRP exists for NCs, and the acquired pattern expression score shows a certain ability to discriminate Aβ+ NCs from Aβ- NCs. The SSM/PCA method is expected to be helpful in the ultra-early diagnosis of AD in clinical practice.
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27
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Pasquini J, Ceravolo R. The Molecular Neuroimaging of Tremor. Curr Neurol Neurosci Rep 2021; 21:74. [PMID: 34817737 PMCID: PMC8613162 DOI: 10.1007/s11910-021-01157-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2021] [Indexed: 11/28/2022]
Abstract
Purpose of Review Tremor is a hyperkinetic movement disorder most commonly encountered in essential tremor (ET) and Parkinson’s disease (PD). The purpose of this review is to summarize molecular neuroimaging studies with major implications on pathophysiological and clinical features of tremor. Recent Findings Oscillatory brain activity responsible for tremor manifestation is thought to originate in a cerebello-thalamo-cortical network. Molecular neuroimaging has helped clarify metabolic aspects and neurotransmitter influences on the main tremor network. In ET, recent positron emission tomography (PET) studies are built on previous knowledge and highlighted the possibility of investigating metabolic brain changes after treatments, in the attempt to establish therapeutic biomarkers. In PD, molecular neuroimaging has advanced the knowledge of non-dopaminergic determinants of tremor, providing insights into serotonergic and noradrenergic contributions. Summary Recent advances have greatly extended the knowledge of tremor pathophysiology and it is now necessary to translate such knowledge in more efficacious treatments for this symptom.
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Affiliation(s)
- Jacopo Pasquini
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy. .,Clinical Ageing Research Unit, Newcastle University, Campus for Ageing & Vitality, Westgate Road, Newcastle upon Tyne, NE4 5PL, UK.
| | - Roberto Ceravolo
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.,Neurodegenerative Diseases Center, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
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28
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Cognitive and Behavior Deficits in Parkinson's Disease with Alteration of FDG-PET Irrespective of Age. Geriatrics (Basel) 2021; 6:geriatrics6040110. [PMID: 34842741 PMCID: PMC8628799 DOI: 10.3390/geriatrics6040110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/07/2021] [Accepted: 11/08/2021] [Indexed: 11/16/2022] Open
Abstract
Significant progress has been made in our understanding of the neurobiology of Parkinson’s disease (PD). Post-mortem studies are an important step and could help to comprehend not only the progression of motor symptoms, but also the involvement of other clinical domains, including cognition, behavior and impulse control disorders (ICDs). The correlation of neuropathological extension of the disease with the clinical stages remains challenging. Molecular imaging, including positron emission tomography (PET) and single photon computed tomography (SPECT), could allow for bridging the gap by providing in vivo evidence of disease extension. In the last decade, we have observed a plethora of reports describing improvements in the sensitivity of neuroimaging techniques. These data contribute to increasing the accuracy of PD diagnosis, differentiating PD from other causes of parkinsonism and also obtaining a surrogate marker of disease progression. FDG-PET has been used to measure cerebral metabolic rates of glucose, a proxy for neuronal activity, in PD. Many studies have shown that this technique could be used in early PD, where reduced metabolic activity correlates with disease progression and could predict histopathological diagnosis. The aim of this work is to report two particular cases of PD in which the assessment of brain metabolic activity (from FDG-PET) has been combined with clinical aspects of non-motor symptoms. Integration of information on neuropsychological and metabolic imaging allows us to improve the treatment of PD patients irrespective of age.
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29
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Radmard S, Ortega RA, Ford B, Vanegas-Arroyave N, McKhann GM, Sheth SA, Winfield L, Luciano MS, Saunders-Pullman R, Pullman SL. Using computerized spiral analysis to evaluate deep brain stimulation outcomes in Parkinson disease. Clin Neurol Neurosurg 2021; 208:106878. [PMID: 34418700 DOI: 10.1016/j.clineuro.2021.106878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 08/02/2021] [Accepted: 08/04/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine whether spiral analysis can monitor the effects of deep brain stimulation (DBS) in Parkinson disease (PD) and provide a window on clinical features that change post-operatively. Clinical evaluation after DBS is subjective and insensitive to small changes. Spiral analysis is a computerized test that quantifies kinematic, dynamic, and spatial aspects of spiral drawing. Validated computational indices are generated and correlate with a range of clinically relevant motor findings. These include measures of overall clinical severity (Severity), bradykinesia and rigidity (Smoothness), amount of tremor (Tremor), irregularity of drawing movements (Variability), and micrographia (Tightness). METHODS We retrospectively evaluated the effect of subthalamic nucleus (STN) (n = 66) and ventral intermediate thalamus (Vim) (n = 10) DBS on spiral drawing in PD subjects using spiral analysis. Subjects freely drew ten spirals on plain paper with an inking pen on a graphics tablet. Five spiral indices (Severity, Smoothness, Tremor, Variability, Tightness) were calculated and compared pre- and post-operatively using Wilcoxon-rank sum tests, adjusting for multiple comparisons. RESULTS Severity improved after STN and Vim DBS (p < 0.005). Smoothness (p < 0.01) and Tremor (p < 0.02) both improved after STN and Vim DBS. Variability improved only with Vim DBS. Neither STN nor Vim DBS significantly changed Tightness. CONCLUSIONS All major spiral indices, except Tightness, improved after DBS. This suggests spiral analysis monitors DBS effects in PD and provides an objective window on relevant clinical features that change post-operatively. It may thus have utilization in clinical trials or investigations into the neural pathways altered by DBS. The lack of change in Tightness supports the notion that DBS does not improve micrographia.
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Affiliation(s)
- Sara Radmard
- Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA.
| | | | - Blair Ford
- Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Nora Vanegas-Arroyave
- Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Guy M McKhann
- Department of Neurological Surgery, Columbia University Irving Medical Center, New York, NY, USA
| | - Sameer A Sheth
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA
| | - Linda Winfield
- Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Marta San Luciano
- Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | | | - Seth L Pullman
- Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
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30
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Mild cognitive impairment and abnormal brain metabolic expression in idiopathic REM sleep behavior disorder. Parkinsonism Relat Disord 2021; 90:1-7. [PMID: 34314988 DOI: 10.1016/j.parkreldis.2021.07.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 06/09/2021] [Accepted: 07/20/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Mild cognitive impairment (MCI) is a common feature of isolated rapid-eye-movement sleep behavior disorder (iRBD). Here, we assessed cognitive functions and MCI in a prospective iRBD cohort and investigated their association with disease-specific brain metabolic patterns. METHODS Forty-four patients with polysomnography-confirmed iRBD performed a standardized battery of neuropsychological examinations every two years. We used previously established spatial covariance patterns from de novo drug-naïve Parkinson's disease with concomitant RBD (denovoPDRBD-RP) and iRBD (iRBD-RP) using 18F-fluorodeoxyglucose PET scan. We compared those expressions between iRBD with normal cognition (iRBD-NC) and with mild cognitive impairment (iRBD-MCI), and evaluated whether they predict progressive cognitive deterioration. RESULTS Twenty iRBD patients (45 %) had MCI at baseline and 12 patients (27 %, about 7 % per year) had clinically significant cognitive deterioration after 4 years. The iRBD-MCI and iRBD-NC groups showed similar rates of cognitive change, but iRBD-MCI consistently performed worse in the domains of verbal memory and executive function. Elevated denovoPDRBD-RP expression predicted cognitive deterioration (hazard ratio = 5.98 [1.70-21.06]), whereas iRBD-RP did not. CONCLUSIONS Increased disease-specific brain metabolic patterns are associated with iRBD-MCI and impending cognitive deterioration with the risk of progression to Lewy body dementia.
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31
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Sidtis JJ, Sidtis DVL, Dhawan V, Tagliati M, Eidelberg D. Stimulation of the Subthalamic Nucleus Changes Cortical-Subcortical Blood Flow Patterns During Speech: A Positron Emission Tomography Study. Front Neurol 2021; 12:684596. [PMID: 34122323 PMCID: PMC8187801 DOI: 10.3389/fneur.2021.684596] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 05/05/2021] [Indexed: 12/18/2022] Open
Abstract
Background: Deep brain stimulation of the subthalamic nucleus (STN-DBS) is an effective treatment for Parkinson's disease (PD) but can have an adverse effect on speech. In normal speakers and in those with spinocerebellar ataxia, an inverse relationship between regional cerebral blood flow (rCBF) in the left inferior frontal (IFG) region and the right caudate (CAU) is associated with speech rate. This pattern was examined to determine if it was present in PD, and if so, whether it was altered by STN-DBS. Methods: Positron Emission Tomography (PET) measured rCBF during speech in individuals with PD not treated with STN-DBS (n = 7), and those treated with bilateral STN-DBS (n = 7). Previously reported results from non-PD control subjects (n = 16) were reported for comparison. The possible relationships between speech rate during scanning and data from the left and right IFG and CAU head regions were investigated using a step-wise multiple linear regression to identify brain regions that interacted to predict speech rate. Results: The multiple linear regression analysis replicated previously reported predictive coefficients for speech rate involving the left IFG and right CAU regions. However, the relationships between these predictive coefficients and speech rates were abnormal in both PD groups. In PD who had not received STN-DBS, the right CAU coefficient decreased normally with increasing speech rate but the left IFG coefficient abnormally decreased. With STN-DBS, this pattern was partially normalized with the addition of a left IFG coefficient that increased with speech rate, as in normal controls, but the abnormal left IFG decreasing coefficient observed in PD remained. The magnitudes of both cortical predictive coefficients but not the CAU coefficient were exaggerated with STN-DBS. Conclusions: STN-DBS partially corrects the abnormal relationships between rCBF and speech rate found in PD by introducing a left IFG subregion that increases with speech rate, but the conflicting left IFG subregion response remained. Conflicting IFG responses may account for some of the speech problems observed after STN-DBS. Cortical and subcortical regions may be differentially affected by STN-DBS.
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Affiliation(s)
- John J Sidtis
- Brain and Behavior Laboratory, Geriatrics Department, Nathan Kline Institute, Orangeburg, NY, United States.,Department of Psychiatry, School of Medicine, New York University Langone, New York, NY, United States
| | - Diana Van Lancker Sidtis
- Brain and Behavior Laboratory, Geriatrics Department, Nathan Kline Institute, Orangeburg, NY, United States.,Department of Communicative Disorders and Sciences, New York University Steinhardt School, New York, NY, United States
| | - Vijay Dhawan
- Center for Neurosciences, The Feinstein Institute for Medical Research, Manhasset, NY, United States
| | - Michele Tagliati
- Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - David Eidelberg
- Center for Neurosciences, The Feinstein Institute for Medical Research, Manhasset, NY, United States
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Máñez-Miró JU, Rodríguez-Rojas R, Del Álamo M, Martínez-Fernández R, Obeso JA. Present and future of subthalamotomy in the management of Parkinson´s disease: a systematic review. Expert Rev Neurother 2021; 21:533-545. [PMID: 33788645 DOI: 10.1080/14737175.2021.1911649] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Introduction: The subthalamic nucleus (STN) is known to be involved in the pathophysiology of Parkinson´s disease and by reducing its abnormal activity, normal output of basal ganglia can be restored along with improvement in PD cardinal motor features. Deep brain stimulation of the STN is currently the main surgical procedure for PD with motor complications, but lesioning can be an alternative.Areas covered: Here, the authors systematically review the current evidence regarding subthalamotomy both with radiofrequency and, more recently, with focused ultrasound (FUS) for the treatment of PD.Expert opinion: Unilateral subthalamotomy for the treatment of PD motor features can be considered a viable option in asymmetric patients, particularly with FUS which allows a minimally invasive safe and effective ablation of the STN. Risk of inducing dyskinesia (i.e., hemichorea/ballism) may be strikingly reduced when lesions enlarge dorsally to impinge on pallidothalamic fibers.
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Affiliation(s)
- Jorge U Máñez-Miró
- HM CINAC (Centro Integral De Neurociencias Abarca Campal), Hospital Universitario HM Puerta Del Sur, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto De Salud Carlos III, Madrid, Spain
| | - Rafael Rodríguez-Rojas
- HM CINAC (Centro Integral De Neurociencias Abarca Campal), Hospital Universitario HM Puerta Del Sur, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto De Salud Carlos III, Madrid, Spain
| | - Marta Del Álamo
- HM CINAC (Centro Integral De Neurociencias Abarca Campal), Hospital Universitario HM Puerta Del Sur, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto De Salud Carlos III, Madrid, Spain
| | - R Martínez-Fernández
- HM CINAC (Centro Integral De Neurociencias Abarca Campal), Hospital Universitario HM Puerta Del Sur, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto De Salud Carlos III, Madrid, Spain
| | - José A Obeso
- HM CINAC (Centro Integral De Neurociencias Abarca Campal), Hospital Universitario HM Puerta Del Sur, Madrid, Spain.,Network Center for Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto De Salud Carlos III, Madrid, Spain.,CEU-San Pablo University, Móstoles, Madrid, Spain
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Beheshti I, Ko JH. Modulating brain networks associated with cognitive deficits in Parkinson's disease. Mol Med 2021; 27:24. [PMID: 33691622 PMCID: PMC7945662 DOI: 10.1186/s10020-021-00284-5] [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: 12/22/2020] [Accepted: 03/02/2021] [Indexed: 12/12/2022] Open
Abstract
Parkinson’s disease (PD) is a relatively well characterised neurological disorder that primarily affects motor and cognitive functions. This paper reviews on how transcranial direct current stimulation (tDCS) can be used to modulate brain networks associated with cognitive deficits in PD. We first provide an overview of brain network abnormalities in PD, by introducing the brain network modulation approaches such as pharmacological interventions and brain stimulation techniques. We then present the potential underlying mechanisms of tDCS technique, and specifically highlight how tDCS can be applied to modulate brain network abnormality associated with cognitive dysfunction among PD patients. More importantly, we address the limitations of existing studies and suggest possible future directions, with the aim of helping researchers to further develop the use of tDCS technique in clinical settings.
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Affiliation(s)
- Iman Beheshti
- Department of Human Anatomy and Cell Science, University of Manitoba, 130-745 Bannatyne Ave., Winnipeg, MB, R3E 0J9, Canada.,Kleysen Institute for Advanced Medicine, Health Science Centre, Winnipeg, MB, Canada
| | - Ji Hyun Ko
- Department of Human Anatomy and Cell Science, University of Manitoba, 130-745 Bannatyne Ave., Winnipeg, MB, R3E 0J9, Canada. .,Kleysen Institute for Advanced Medicine, Health Science Centre, Winnipeg, MB, Canada. .,Graduate Program in Biomedical Engineering, University of Manitoba, Winnipeg, MB, Canada.
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Frey KA. Molecular Imaging of Extrapyramidal Movement Disorders With Dementia: The 4R Tauopathies. Semin Nucl Med 2021; 51:275-285. [PMID: 33431202 DOI: 10.1053/j.semnuclmed.2020.12.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Two pathologically distinct neurodegenerative conditions, progressive supranuclear palsy and corticobasal degeneration, share in common deposits of tau proteins that differ both molecularly and ultrastructurally from the common tau deposits diagnostic of Alzheimer disease. The proteinopathy in these disorders is characterized by fibrillary aggregates of 4R tau proteins. The clinical presentations of progressive supranuclear palsy and of corticobasal degeneration are often confused with more common disorders such as Parkinson disease or subtypes of frontotemporal lobar degeneration. Neither of these 4R tau disorders has effective therapy, and while there are emerging molecular imaging approaches to identify patients earlier in the course of disease, there are as yet no reliably sensitive and specific approaches to diagnoses in life. In this review, aspects of the clinical syndromes, neuropathology, and molecular biomarker imaging studies applicable to progressive supranuclear palsy and to corticobasal degeneration will be presented. Future development of more accurate molecular imaging approaches is proposed.
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Affiliation(s)
- Kirk A Frey
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, The University of Michigan Health System, Ann Arbor, MI.
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Watanabe H, Hattori T, Kume A, Misu K, Ito T, Koike Y, Johnson TA, Kamitsuji S, Kamatani N, Sobue G. Improved Parkinsons disease motor score in a single-arm open-label trial of febuxostat and inosine. Medicine (Baltimore) 2020; 99:e21576. [PMID: 32871874 PMCID: PMC7458241 DOI: 10.1097/md.0000000000021576] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Cellular energetics play an important role in Parkinsons disease etiology, but no treatments directly address this deficiency. Our past research showed that treatment with febuxostat and inosine increased blood hypoxanthine and ATP in healthy adults, and a preliminary trial in 3 Parkinson's disease patients suggested some symptomatic improvements with no adverse effects. METHODS To examine the efficacy on symptoms and safety in a larger group of Parkinsons disease patients, we conducted a single-arm, open-label trial at 5 Japanese neurology clinics and enrolled thirty patients (nmales = 11; nfemales = 19); 26 patients completed the study (nmales = 10; nfemales = 16). Each patient was administered febuxostat 20 mg and inosine 500 mg twice-per-day (after breakfast and dinner) for 8 weeks. The primary endpoint was the difference of MDS-UPDRS Part III score immediately before and after 57 days of treatment. RESULTS Serum hypoxanthine concentrations were raised significantly after treatment (Pre = 11.4 μM; Post = 38.1 μM; P < .0001). MDS-UPDRS Part III score was significantly lower after treatment (Pre = 28.1 ± 9.3; Post = 24.7 ± 10.8; mean ± SD; P = .0146). Sixteen adverse events occurred in 13/29 (44.8%) patients, including 1 serious adverse event (fracture of the second lumbar vertebra) that was considered not related to the treatment. CONCLUSIONS The results of this study suggest that co-administration of febuxostat and inosine is relatively safe and effective for improving symptoms of Parkinsons disease patients. Further controlled trials need to be performed to confirm the symptomatic improvement and to examine the disease-modifying effect in long-term trials.
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Affiliation(s)
- Hirohisa Watanabe
- Nagoya University Graduate School of Medicine, Brain and Mind Research Center, Nagoya
- Fujita Health University School of Medicine, Department of Neurology, Toyoake
| | | | | | | | | | | | | | | | | | - Gen Sobue
- Nagoya University Graduate School of Medicine, Brain and Mind Research Center, Nagoya
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Xing Y, Tench C, Wongwandee M, Schwarz ST, Bajaj N, Auer DP. Coordinate based meta-analysis of motor functional imaging in Parkinson's: disease-specific patterns and modulation by dopamine replacement and deep brain stimulation. Brain Imaging Behav 2020; 14:1263-1280. [PMID: 30809759 PMCID: PMC7381438 DOI: 10.1007/s11682-019-00061-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To investigate factors affecting the pattern of motor brain activation reported in people with Parkinson's (PwP), aiming to differentiate disease-specific features from treatment effects. METHODS A co-ordinate-based-meta-analysis (CBMA) of functional motor neuroimaging studies involving patients with Parkinson's (PwP), and healthy controls (HC) identified 126 suitable articles. The experiments were grouped based on subject feature, medication status (onMed/offMed), deep brain stimulation (DBS) status (DBSon/DBSoff) and type of motor initiation. RESULTS HC and PwP shared similar neural networks during upper extremity motor tasks but with differences of reported frequency in mainly bilateral putamen, insula and ipsilateral inferior parietal and precentral gyri. The activation height was significantly reduced in the bilateral putamen, left SMA, left subthalamus nucleus, right thalamus and right midial global pallidum in PwPoffMed (vs. HC), and pre-SMA hypoactivation correlated with disease severity. These changes were not found in patients on dopamine replacement therapy (PwPonMed vs. HC) in line with a restorative function. By contrast, left SMA and primary motor cortex showed hyperactivation in the medicated state (vs. HC) suggesting dopaminergic overcompensation. Deep-brain stimulation (PwP during the high frequency subthalamus nucleus (STN) DBS vs. no stimulation) induced a decrease in left SMA activity and the expected increase in the left subthalamic/thalamic region regardless of hand movement. We further demonstrated a disease related effect of motor intention with only PwPoffMed showing increased activation in the medial frontal lobe in self-initiated studies. CONCLUSION We describe a consistent disease-specific pattern of putaminal hypoactivation during motor tasks that appears reversed by dopamine replacement. Inconsistent reports of altered SMA/pre-SMA activation can be explained by task- and medication-specific variation in intention. Moreover, SMA activity was reduced during STN-DBS, while dopamine-induced hyperactivation of SMA which might underpin hyperdynamic L-dopa related overcompensation.
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Affiliation(s)
- Yue Xing
- Radiological Sciences, Division of Clinical Neuroscience, University of Nottingham, Nottingham, NG7 2UH, UK.
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, NG7 2UH, UK.
- NIHR Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, NG7 2UH, UK.
- Radiological Sciences, Sir Peter Mansfield Imaging Centre, NIHR Nottingham BRC, University of Nottingham, Nottingham, NG7 2UH, UK.
| | - Christopher Tench
- Division of Clinical Neurology, Queen's Medical Centre, University of Nottingham, Nottingham, UK
| | - Monton Wongwandee
- Department of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand
| | - Stefan T Schwarz
- Radiological Sciences, Division of Clinical Neuroscience, University of Nottingham, Nottingham, NG7 2UH, UK
- Department of Radiology, Cardiff and Vale University Health Board, Cardiff, Wales
| | - Nin Bajaj
- Department of Neurology, Nottingham University Hospitals, Nottingham, NG7 2UH, UK
| | - Dorothee P Auer
- Radiological Sciences, Division of Clinical Neuroscience, University of Nottingham, Nottingham, NG7 2UH, UK.
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, NG7 2UH, UK.
- NIHR Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, NG7 2UH, UK.
- Radiological Sciences, Sir Peter Mansfield Imaging Centre, NIHR Nottingham BRC, University of Nottingham, Nottingham, NG7 2UH, UK.
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Borghammer P, Van Den Berge N. Brain-First versus Gut-First Parkinson's Disease: A Hypothesis. JOURNAL OF PARKINSONS DISEASE 2020; 9:S281-S295. [PMID: 31498132 PMCID: PMC6839496 DOI: 10.3233/jpd-191721] [Citation(s) in RCA: 179] [Impact Index Per Article: 44.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Parkinson’s disease (PD) is a highly heterogeneous disorder, which probably consists of multiple subtypes. Aggregation of misfolded alpha-synuclein and propagation of these proteinacious aggregates through interconnected neural networks is believed to be a crucial pathogenetic factor. It has been hypothesized that the initial pathological alpha-synuclein aggregates originate in the enteric or peripheral nervous system (PNS) and invade the central nervous system (CNS) via retrograde vagal transport. However, evidence from neuropathological studies suggests that not all PD patients can be reconciled with this hypothesis. Importantly, a small fraction of patients do not show pathology in the dorsal motor nucleus of the vagus. Here, it is hypothesized that PD can be divided into a PNS-first and a CNS-first subtype. The former is tightly associated with REM sleep behavior disorder (RBD) during the prodromal phase and is characterized by marked autonomic damage before involvement of the dopaminergic system. In contrast, the CNS-first phenotype is most often RBD-negative during the prodromal phase and characterized by nigrostriatal dopaminergic dysfunction prior to involvement of the autonomic PNS. The existence of these subtypes is supported by in vivo imaging studies of RBD-positive and RBD-negative patient groups and by histological evidence— reviewed herein. The present proposal provides a fresh hypothesis-generating framework for future studies into the etiopathogenesis of PD and seems capable of explaining a number of discrepant findings in the neuropathological literature.
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Affiliation(s)
- Per Borghammer
- Nuclear Medicine and PET, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Dysautonomia Is Linked to Striatal Dopamine Deficits and Regional Cerebral Perfusion in Early Parkinson Disease. Clin Nucl Med 2020; 45:e342-e348. [PMID: 32520498 DOI: 10.1097/rlu.0000000000003107] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE The aim of this study was to investigate the association between autonomic dysfunction and striatal dopamine depletion or metabolic changes in de novo Parkinson disease (PD). METHODS Based on the Composite Autonomic Severity Score (CASS), patients with de novo PD were classified into PD with (PD-AUT+) and without autonomic dysfunction (PD-AUT-) groups. We compared the dopamine transporter (DAT) availability in the striatum by quantitatively measuring F-FP-CIT PET between both groups. We also assessed the association between DAT availability and the CASS. In addition, we compared regional uptake in early-phase images of F-FP-CIT PET as well as cortical thickness between the PD-AUT+ and PD-AUT- groups. RESULTS The PD-AUT+ group had significantly lower DAT availability in all striatal subregions than did the PD-AUT- group. The total CASS was significantly correlated with DAT availability in all striatal subregions. In addition, the subscores of the adrenergic component were correlated with DAT availability in all striatal subregions. The subscores of the cardiovagal component were negatively correlated with DAT availability in the caudate and ventral striatum. In early-phase F-FP-CIT PET, the PD-AUT+ group exhibited decreased regional perfusion in the parieto-occipital areas and increased regional perfusion in the pallidothalamic, pontocerebellar, inferior frontal, and primary motor areas compared with the PD-AUT- group. There were no regions of different cortical thickness between the PD groups. CONCLUSIONS The present study revealed that autonomic dysfunction is closely linked to striatal dopamine depletion and prominent PD-related perfusion patterns in de novo PD, suggesting a greater pathological burden in patients with dysautonomia.
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Menardy F, Varani AP, Combes A, Léna C, Popa D. Functional Alteration of Cerebello-Cerebral Coupling in an Experimental Mouse Model of Parkinson's Disease. Cereb Cortex 2020; 29:1752-1766. [PMID: 30715237 PMCID: PMC6418382 DOI: 10.1093/cercor/bhy346] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 11/13/2018] [Indexed: 12/21/2022] Open
Abstract
In Parkinson's disease, the degeneration of the midbrain dopaminergic neurons is consistently associated with modified metabolic activity in the cerebellum. Here we examined the functional reorganization taking place in the cerebello-cerebral circuit in a murine model of Parkinson's disease with 6-OHDA lesion of midbrain dopaminergic neurons. Cerebellar optogenetic stimulations evoked similar movements in control and lesioned mice, suggesting a normal coupling of cerebellum to the motor effectors after the lesion. In freely moving animals, the firing rate in the primary motor cortex was decreased after the lesion, while cerebellar nuclei neurons showed an increased firing rate. This increase may result from reduced inhibitory Purkinje cells inputs, since a population of slow and irregular Purkinje cells was observed in the cerebellar hemispheres of lesioned animals. Moreover, cerebellar stimulations generated smaller electrocortical responses in the motor cortex of lesioned animals suggesting a weaker cerebello-cerebral coupling. Overall these results indicate the presence of functional changes in the cerebello-cerebral circuit, but their ability to correct cortical dysfunction may be limited due to functional uncoupling between the cerebellum and cerebral cortex.
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Affiliation(s)
- Fabien Menardy
- Neurophysiology of Brain Circuits Team, Institut de Biologie de l'Ecole Normale Supérieure (IBENS), Ecole Normale Supérieure, CNRS, INSERM, PSL Research University, Paris, France
| | - Andrés Pablo Varani
- Neurophysiology of Brain Circuits Team, Institut de Biologie de l'Ecole Normale Supérieure (IBENS), Ecole Normale Supérieure, CNRS, INSERM, PSL Research University, Paris, France
| | - Adèle Combes
- Neurophysiology of Brain Circuits Team, Institut de Biologie de l'Ecole Normale Supérieure (IBENS), Ecole Normale Supérieure, CNRS, INSERM, PSL Research University, Paris, France
| | - Clément Léna
- Neurophysiology of Brain Circuits Team, Institut de Biologie de l'Ecole Normale Supérieure (IBENS), Ecole Normale Supérieure, CNRS, INSERM, PSL Research University, Paris, France
| | - Daniela Popa
- Neurophysiology of Brain Circuits Team, Institut de Biologie de l'Ecole Normale Supérieure (IBENS), Ecole Normale Supérieure, CNRS, INSERM, PSL Research University, Paris, France
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Khomenko I, Pronina M, Kataeva G, Kropotov J, Irishina Y, Susin D. Combined 18F-fluorodeoxyglucose positron emission tomography and event-related potentials study of the cognitive impairment mechanisms in Parkinson’s disease. J Clin Neurosci 2020; 72:335-341. [DOI: 10.1016/j.jocn.2019.11.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 11/30/2019] [Indexed: 10/25/2022]
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Abnormal pattern of brain glucose metabolism in Parkinson's disease: replication in three European cohorts. Eur J Nucl Med Mol Imaging 2019; 47:437-450. [PMID: 31768600 PMCID: PMC6974499 DOI: 10.1007/s00259-019-04570-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 10/03/2019] [Indexed: 12/15/2022]
Abstract
Rationale In Parkinson’s disease (PD), spatial covariance analysis of 18F-FDG PET data has consistently revealed a characteristic PD-related brain pattern (PDRP). By quantifying PDRP expression on a scan-by-scan basis, this technique allows objective assessment of disease activity in individual subjects. We provide a further validation of the PDRP by applying spatial covariance analysis to PD cohorts from the Netherlands (NL), Italy (IT), and Spain (SP). Methods The PDRPNL was previously identified (17 controls, 19 PD) and its expression was determined in 19 healthy controls and 20 PD patients from the Netherlands. The PDRPIT was identified in 20 controls and 20 “de-novo” PD patients from an Italian cohort. A further 24 controls and 18 “de-novo” Italian patients were used for validation. The PDRPSP was identified in 19 controls and 19 PD patients from a Spanish cohort with late-stage PD. Thirty Spanish PD patients were used for validation. Patterns of the three centers were visually compared and then cross-validated. Furthermore, PDRP expression was determined in 8 patients with multiple system atrophy. Results A PDRP could be identified in each cohort. Each PDRP was characterized by relative hypermetabolism in the thalamus, putamen/pallidum, pons, cerebellum, and motor cortex. These changes co-varied with variable degrees of hypometabolism in posterior parietal, occipital, and frontal cortices. Frontal hypometabolism was less pronounced in “de-novo” PD subjects (Italian cohort). Occipital hypometabolism was more pronounced in late-stage PD subjects (Spanish cohort). PDRPIT, PDRPNL, and PDRPSP were significantly expressed in PD patients compared with controls in validation cohorts from the same center (P < 0.0001), and maintained significance on cross-validation (P < 0.005). PDRP expression was absent in MSA. Conclusion The PDRP is a reproducible disease characteristic across PD populations and scanning platforms globally. Further study is needed to identify the topography of specific PD subtypes, and to identify and correct for center-specific effects. Electronic supplementary material The online version of this article (10.1007/s00259-019-04570-7) contains supplementary material, which is available to authorized users.
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Guan X, Guo T, Zeng Q, Wang J, Zhou C, Liu C, Wei H, Zhang Y, Xuan M, Gu Q, Xu X, Huang P, Pu J, Zhang B, Zhang MM. Oscillation-specific nodal alterations in early to middle stages Parkinson's disease. Transl Neurodegener 2019; 8:36. [PMID: 31807287 PMCID: PMC6857322 DOI: 10.1186/s40035-019-0177-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 11/07/2019] [Indexed: 02/26/2023] Open
Abstract
BACKGROUND Different oscillations of brain networks could carry different dimensions of brain integration. We aimed to investigate oscillation-specific nodal alterations in patients with Parkinson's disease (PD) across early stage to middle stage by using graph theory-based analysis. METHODS Eighty-eight PD patients including 39 PD patients in the early stage (EPD) and 49 patients in the middle stage (MPD) and 36 controls were recruited in the present study. Graph theory-based network analyses from three oscillation frequencies (slow-5: 0.01-0.027 Hz; slow-4: 0.027-0.073 Hz; slow-3: 0.073-0.198 Hz) were analyzed. Nodal metrics (e.g. nodal degree centrality, betweenness centrality and nodal efficiency) were calculated. RESULTS Our results showed that (1) a divergent effect of oscillation frequencies on nodal metrics, especially on nodal degree centrality and nodal efficiency, that the anteroventral neocortex and subcortex had high nodal metrics within low oscillation frequencies while the posterolateral neocortex had high values within the relative high oscillation frequency was observed, which visually showed that network was perturbed in PD; (2) PD patients in early stage relatively preserved nodal properties while MPD patients showed widespread abnormalities, which was consistently detected within all three oscillation frequencies; (3) the involvement of basal ganglia could be specifically observed within slow-5 oscillation frequency in MPD patients; (4) logistic regression and receiver operating characteristic curve analyses demonstrated that some of those oscillation-specific nodal alterations had the ability to well discriminate PD patients from controls or MPD from EPD patients at the individual level; (5) occipital disruption within high frequency (slow-3) made a significant influence on motor impairment which was dominated by akinesia and rigidity. CONCLUSIONS Coupling various oscillations could provide potentially useful information for large-scale network and progressive oscillation-specific nodal alterations were observed in PD patients across early to middle stages.
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Affiliation(s)
- Xiaojun Guan
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No.88 Jiefang Road, Shangcheng District, Hangzhou, 310009 China
| | - Tao Guo
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No.88 Jiefang Road, Shangcheng District, Hangzhou, 310009 China
| | - Qiaoling Zeng
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No.88 Jiefang Road, Shangcheng District, Hangzhou, 310009 China
| | - Jiaqiu Wang
- Department of Neurology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Cheng Zhou
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No.88 Jiefang Road, Shangcheng District, Hangzhou, 310009 China
| | - Chunlei Liu
- Helen Wills Neuroscience Institute, University of California, Berkeley, CA USA
- Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, CA USA
| | - Hongjiang Wei
- Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, CA USA
| | - Yuyao Zhang
- Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, CA USA
| | - Min Xuan
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No.88 Jiefang Road, Shangcheng District, Hangzhou, 310009 China
| | - Quanquan Gu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No.88 Jiefang Road, Shangcheng District, Hangzhou, 310009 China
| | - Xiaojun Xu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No.88 Jiefang Road, Shangcheng District, Hangzhou, 310009 China
| | - Peiyu Huang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No.88 Jiefang Road, Shangcheng District, Hangzhou, 310009 China
| | - Jiali Pu
- Department of Neurology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Baorong Zhang
- Department of Neurology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Min-Ming Zhang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No.88 Jiefang Road, Shangcheng District, Hangzhou, 310009 China
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Li X, Xiong Y, Liu S, Zhou R, Hu Z, Tong Y, He L, Niu Z, Ma Y, Guo H. Predicting the Post-therapy Severity Level (UPDRS-III) of Patients With Parkinson's Disease After Drug Therapy by Using the Dynamic Connectivity Efficiency of fMRI. Front Neurol 2019; 10:668. [PMID: 31354605 PMCID: PMC6636605 DOI: 10.3389/fneur.2019.00668] [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: 02/01/2019] [Accepted: 06/06/2019] [Indexed: 11/13/2022] Open
Abstract
Parkinson's disease (PD) is a multi-systemic disease in the brain arising from the dysfunction of several neural networks. The diagnosis and treatment of PD have gained more attention for clinical researchers. While there have been many fMRI studies about functional topological changes of PD patients, whether the dynamic changes of functional connectivity can predict the drug therapy effect is still unclear. The primary objective of this study was to assess whether large-scale functional efficiency changes of topological network are detectable in PD patients, and to explore whether the severity level (UPDRS-III) after drug treatment can be predicted by the pre-treatment resting-state fMRI (rs-fMRI). Here, we recruited 62 Parkinson's disease patients and calculated the dynamic nodal efficiency networks based on rs-fMRI. With connectome-based predictive models using the least absolute shrinkage and selection operator, we demonstrated that the dynamic nodal efficiency properties predict drug therapy effect well. The contributed regions for the prediction include hippocampus, post-central gyrus, cingulate gyrus, and orbital gyrus. Specifically, the connections between hippocampus and cingulate gyrus, hippocampus and insular gyrus, insular gyrus, and orbital gyrus are positively related to the recovery (post-therapy severity level) after drug therapy. The analysis of these connection features may provide important information for clinical treatment of PD patients.
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Affiliation(s)
- Xuesong Li
- School of Computer Science and Technology, Beijing Institute of Technology, Beijing, China
| | - Yuhui Xiong
- Department of Biomedical Engineering, Center for Biomedical Imaging Research, School of Medicine, Tsinghua University, Beijing, China
| | - Simin Liu
- Department of Biomedical Engineering, Center for Biomedical Imaging Research, School of Medicine, Tsinghua University, Beijing, China
| | - Rongsong Zhou
- Department of Neurosurgery, Tsinghua University Yuquan Hospital, Beijing, China
| | - Zhangxuan Hu
- Department of Biomedical Engineering, Center for Biomedical Imaging Research, School of Medicine, Tsinghua University, Beijing, China
| | - Yan Tong
- Nuffield Department of Clinical Neurosciences, Wellcome Centre for Integrative Neuroimaging, FMRIB, University of Oxford, Oxford, United Kingdom
| | - Le He
- Department of Biomedical Engineering, Center for Biomedical Imaging Research, School of Medicine, Tsinghua University, Beijing, China
| | - Zhendong Niu
- School of Computer Science and Technology, Beijing Institute of Technology, Beijing, China
| | - Yu Ma
- Department of Neurosurgery, Tsinghua University Yuquan Hospital, Beijing, China
| | - Hua Guo
- Department of Biomedical Engineering, Center for Biomedical Imaging Research, School of Medicine, Tsinghua University, Beijing, China
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Peralta C, Biafore F, Depetris TS, Bastianello M. Recent Advancement and Clinical Implications of 18FDG-PET in Parkinson's Disease, Atypical Parkinsonisms, and Other Movement Disorders. Curr Neurol Neurosci Rep 2019; 19:56. [PMID: 31256288 DOI: 10.1007/s11910-019-0966-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
PURPOSE OF REVIEW The molecular imaging field has been very instrumental in identifying the multiple network interactions that compose the human brain. The cerebral glucose metabolism is associated with neural function. 18F-fluoro-deoxyglucose-PET (FDG-PET) studies reflect brain metabolism in a pattern-specific manner. This article reviews FDG-PET studies in Parkinson's disease (PD), atypical parkinsonism (AP), Huntington's disease (HD), and dystonia. RECENT FINDINGS The metabolic pattern of PD, disease progression, non-motor symptoms such as fatigue, depression, apathy, impulse control disorders, and cognitive impairment, and the risk of progression to dementia have been identified with FDG-PET studies. In prodromal PD, the REM sleep behavior disorder-related covariance pattern has been described. In AP, FDG-PET studies have demonstrated to be superior to D2/D3 SPECT in differentiating PD from AP. The metabolic patterns of HD and dystonia have also been described. FDG-PET studies are an excellent tool to identify patterns of brain metabolism.
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Affiliation(s)
- Cecilia Peralta
- Department of Neurology, CEMIC University Hospital, Elias Galván 4102, C1431FWO, Buenos Aires, Argentina.
| | - Federico Biafore
- Department of Biostatistics, School of Science and Technology, National University of San Martín, Campus Miguelete, 25 de Mayo y Francia, Buenos Aires, Argentina
| | - Tamara Soto Depetris
- Department of Neurology, CEMIC University Hospital, Elias Galván 4102, C1431FWO, Buenos Aires, Argentina
| | - Maria Bastianello
- Department of Molecular and Metabolic Imaging, CEMIC University Hospital, Elias Galván, 4102, Buenos Aires, Argentina
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Krishna V, Sammartino F, Rabbani Q, Changizi B, Agrawal P, Deogaonkar M, Knopp M, Young N, Rezai A. Connectivity-based selection of optimal deep brain stimulation contacts: A feasibility study. Ann Clin Transl Neurol 2019; 6:1142-1150. [PMID: 31353863 PMCID: PMC6649384 DOI: 10.1002/acn3.784] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 02/19/2019] [Accepted: 03/26/2019] [Indexed: 01/25/2023] Open
Abstract
Background The selection of optimal deep brain stimulation (DBS) parameters is time‐consuming, experience‐dependent, and best suited when acute effects of stimulation can be observed (e.g., tremor reduction). Objectives To test the hypothesis that optimal stimulation location can be estimated based on the cortical connections of DBS contacts. Methods We analyzed a cohort of 38 patients with Parkinson's disease (24 training, and 14 test cohort). Using whole‐brain probabilistic tractography, we first mapped the cortical regions associated with stimulation‐induced efficacy (rigidity, bradykinesia, and tremor improvement) and side effects (paresthesia, motor contractions, and visual disturbances). We then trained a support vector machine classifier to categorize DBS contacts into efficacious, defined by a therapeutic window ≥2 V (threshold for side effect minus threshold for efficacy), based on their connections with cortical regions associated with efficacy versus side effects. The connectivity‐based classifications were then compared with actual stimulation contacts using receiver‐operating characteristics (ROC) curves. Results Unique cortical clusters were associated with stimulation‐induced efficacy and side effects. In the training dataset, 42 of the 47 stimulation contacts were accurately classified as efficacious, with a therapeutic window of ≥3 V in 31 (66%) and between 2 and 2.9 V in 11 (24%) electrodes. This connectivity‐based estimation was successfully replicated in the test cohort with similar accuracy (area under ROC = 0.83). Conclusions Cortical connections can predict the efficacy of DBS contacts and potentially facilitate DBS programming. The clinical utility of this paradigm in optimizing DBS outcomes should be prospectively tested, especially for directional electrodes.
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Affiliation(s)
- Vibhor Krishna
- Center for NeuromodulationThe Ohio State UniversityColumbusOhio
| | | | - Qinwan Rabbani
- Center for NeuromodulationThe Ohio State UniversityColumbusOhio
| | | | - Punit Agrawal
- Center for NeuromodulationThe Ohio State UniversityColumbusOhio
| | | | - Michael Knopp
- Wright Center of Innovation in Biomedical ImagingThe Ohio State UniversityColumbusOhio
| | - Nicole Young
- Center for NeuromodulationThe Ohio State UniversityColumbusOhio
| | - Ali Rezai
- Center for NeuromodulationThe Ohio State UniversityColumbusOhio
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Esmaeeli S, Murphy K, Swords GM, Ibrahim BA, Brown JW, Llano DA. Visual hallucinations, thalamocortical physiology and Lewy body disease: A review. Neurosci Biobehav Rev 2019; 103:337-351. [PMID: 31195000 DOI: 10.1016/j.neubiorev.2019.06.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Revised: 06/03/2019] [Accepted: 06/08/2019] [Indexed: 12/22/2022]
Abstract
One of the core diagnostic criteria for Dementia with Lewy Bodies (DLB) is the presence of visual hallucinations. The presence of hallucinations, along with fluctuations in the level of arousal and sleep disturbance, point to potential pathological mechanisms at the level of the thalamus. However, the potential role of thalamic dysfunction in DLB, particularly as it relates to the presence of formed visual hallucinations is not known. Here, we review the literature on the pathophysiology of DLB with respect to modern theories of thalamocortical function and attempt to derive an understanding of how such hallucinations arise. Based on the available literature, we propose that combined thalamic-thalamic reticular nucleus and thalamocortical pathology may explain the phenomenology of visual hallucinations in DLB. In particular, diminished α7 cholinergic activity in the thalamic reticular nucleus may critically disinhibit thalamocortical activity. Further, concentrated pathological changes within the posterior regions of the thalamus may explain the predilection for the hallucinations to be visual in nature.
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Affiliation(s)
- Shooka Esmaeeli
- Department of Molecular and Integrative Physiology, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Kathleen Murphy
- Department of Molecular and Integrative Physiology, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Gabriel M Swords
- University of Illinois at Chicago College of Medicine, Chicago, IL, United States
| | - Baher A Ibrahim
- Department of Molecular and Integrative Physiology, University of Illinois at Urbana-Champaign, Urbana, IL, United States; Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Jeffrey W Brown
- University of Illinois at Chicago College of Medicine, Chicago, IL, United States
| | - Daniel A Llano
- Department of Molecular and Integrative Physiology, University of Illinois at Urbana-Champaign, Urbana, IL, United States; Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, United States; Carle Neuroscience Institute, Urbana, IL, United States.
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Greene RK, Walsh E, Mosner MG, Dichter GS. A potential mechanistic role for neuroinflammation in reward processing impairments in autism spectrum disorder. Biol Psychol 2019; 142:1-12. [PMID: 30552950 PMCID: PMC6401269 DOI: 10.1016/j.biopsycho.2018.12.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 12/11/2018] [Accepted: 12/11/2018] [Indexed: 01/18/2023]
Abstract
Accumulating evidence suggests that autism spectrum disorder (ASD) may be conceptualized within a framework of reward processing impairments. The Social Motivation Theory of Autism posits that reduced motivation to interact with people and decreased pleasure derived from social interactions may derail typical social development and contribute to the emergence of core social communication deficits in ASD. Neuroinflammation may disrupt the development of mesolimbic dopaminergic systems that are critical for optimal functioning of social reward processing systems. This neuroinflammation-induced disturbance of mesolimbic dopaminergic functioning has been substantiated using maternal immune activation rodent models whose offspring show aberrant dopaminergic corticostriatal function, as well as behavioral characteristics of ASD model systems. Preclinical findings are in turn supported by clinical evidence of increased mesolimbic neuroinflammatory responses in individuals with ASD. This review summarizes evidence for reward processing deficits and neuroinflammatory impairments in ASD and examines how immune inflammatory dysregulation may impair the development of dopaminergic mesolimbic circuitry in ASD. Finally, future research directions examining neuroinflammatory effects on reward processing in ASD are proposed.
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Affiliation(s)
- Rachel K Greene
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA.
| | - Erin Walsh
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC 27514, USA.
| | - Maya G Mosner
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA.
| | - Gabriel S Dichter
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA; Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC 27514, USA; Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC 27514, USA.
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Niethammer M, Eidelberg D. Network Imaging in Parkinsonian and Other Movement Disorders: Network Dysfunction and Clinical Correlates. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2019; 144:143-184. [DOI: 10.1016/bs.irn.2018.10.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Abstract
Approximately one third of depressed patients fail to respond to currently available antidepressant therapies. Therefore, new conceptual frameworks are needed to identify pathophysiologic pathways and neurobiological targets for the development of novel treatment strategies. In this regard, recent evidence suggests that inflammation may contribute to symptoms relevant to a number of psychiatric disorders and particularly depression. Numerous studies (including meta-analyses) have found elevated peripheral and central inflammatory cytokines and acute phase proteins in depression. Chronic exposure to increased inflammation is thought to drive changes in neurotransmitters and neurocircuits that lead to depressive symptoms and that may also interfere with or circumvent the efficacy of antidepressants. Indeed, patients with high inflammation have been shown to exhibit poor response to conventional antidepressant therapies. Recent developments in our ability to understand and measure the effects of inflammation on the brain in patients have opened new doors for the testing of novel treatment strategies that target the immune system or its consequences on neurotransmitter systems. Such recent developments in the field of behavioral immunology and their translational implications for the treatment of depression are discussed herein.
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Abstract
Even before the success of combined positron emission tomography and computed tomography (PET/CT), the neuroimaging community was conceiving the idea to integrate the positron emission tomography (PET), with very high molecular quantitative data but low spatial resolution, and magnetic resonance imaging (MRI), with high spatial resolution. Several technical limitations have delayed the use of a hybrid scanner in neuroimaging studies, including the full integration of the PET detector ring within the MRI system, the optimization of data acquisition, and the implementation of reliable methods for PET attenuation, motion correction, and joint image reconstruction. To be valid and useful in clinical and research settings, this instrument should be able to simultaneously acquire PET and MRI, and generate quantitative parametric PET images comparable to PET-CT. While post hoc co-registration of combined PET and MRI data acquired separately became the most reliable technique for the generation of "fused" PET-MRI images, only hybrid PET-MRI approach allows merging these measurements naturally and correlating them in a temporal manner. Furthermore, hybrid PET-MRI represents the most accurate tool to investigate in vivo the interplay between molecular and functional aspects of brain pathophysiology. Hybrid PET-MRI technology is still in the early stages in the movement disorders field, due to the limited availability of scanners with integrated optimized methodological models. This technology is ideally suited to investigate interactions between resting-state functional/arterial spin labeling MRI and [18F]FDG PET glucose metabolism in the evaluation of the brain "hubs" particularly vulnerable to neurodegeneration, areas with a high degree of connectivity and associated with an efficient synaptic neurotransmission. In Parkinson's disease, hybrid PET-MRI is also the ideal instrument to deeper explore the relationship between resting-state functional MRI and dopamine release at [11C]raclopride PET challenge, in the identification of early drug-naïve Parkinson's disease patients at higher risk of motor complications and in the evaluation of the efficacy of novel neuroprotective treatment able to restore at the same time the altered resting state and the release of dopamine. In this chapter, we discuss the key methodological aspects of hybrid PET-MRI; the evidence in movement disorders of the key resting-state functional and perfusion MRI; [18F]FDG PET and [11C]raclopride PET challenge studies; the potential advantages of using hybrid PET-MRI to investigate the pathophysiology of movement disorders and neurodegenerative diseases. Future directions of hybrid PET-MRI will be discussed alongside with up-to-date technological innovations on hybrid systems.
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