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Bernard K, Mota JA, Wene P, Corenblum MJ, Saez JL, Bartlett MJ, Heien ML, Doyle KP, Polt R, Hay M, Madhavan L, Falk T. The angiotensin (1-7) glycopeptide PNA5 improves cognition in a chronic progressive mouse model of Parkinson's disease through modulation of neuroinflammation. Exp Neurol 2024; 381:114926. [PMID: 39153685 DOI: 10.1016/j.expneurol.2024.114926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 08/05/2024] [Accepted: 08/15/2024] [Indexed: 08/19/2024]
Abstract
Cognitive decline in Parkinson's Disease (PD) is a prevalent and undertreated aspect of disease. Currently, no therapeutics adequately improve this aspect of disease. It has been previously shown that MAS receptor agonism via the glycosylated Angiotensin (1-7) peptide, PNA5, effectively reduces cognitive decline in models of vascular contributions to cognitive impairment and dementia (VCID). PNA5 has a brain/plasma ratio of 0.255 indicating good brain penetration. The goal of the present study was to determine if (1) systemic administration of PNA5 rescued cognitive decline in a mouse model of PD, and (2) if improvements in cognitive status could be correlated with changes to histopathological or blood plasma-based changes. Mice over-expressing human, wild-type α-synuclein (αSyn) under the Thy1 promoter (Thy1-αSyn mice, "line 61") were used as a model of PD with cognitive decline. Thy1-αSyn mice were treated with a systemic dose of PNA5, or saline (1 mg/kg/day) beginning at 4 months of age and underwent behavioral testing at 6 months, compared to WT. Subsequently, mice brains were analyzed for changes to brain pathology, and blood plasma was examined with a Multiplex Immunoassay for peripheral cytokine changes. Treatment with PNA5 reversed cognitive dysfunction measured by Novel Object Recognition and spontaneous alteration in a Y-maze in Thy1-αSyn mice. PNA5 treatment was specific to cognitive deficits, as fine-motor disturbances were unchanged. Enhanced cognition was associated with decreases in hippocampal inflammation and reductions in circulating levels of Macrophage Induced Protein (MIP-1β). Additionally, neuronal loss was blunted within the CA3 hippocampal region of PNA5-treated αsyn mice. These data reveal that PNA5 treatment reduces cognitive dysfunction in a mouse model of PD. These changes are associated with decreased MIP-1β levels in plasma identifying a candidate biomarker for target engagement. Thus, PNA5 treatment could potentially fill the therapeutic gap for cognitive decline in PD.
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Affiliation(s)
- Kelsey Bernard
- Physiological Sciences Graduate Program, University of Arizona, Tucson, AZ, United States
| | - Jesus A Mota
- Department of Neurology, University of Arizona, Tucson, AZ, United States
| | - Paige Wene
- Department of Microbiology, University of Arizona, Tucson, AZ, United States
| | - Mandi J Corenblum
- Department of Neurology, University of Arizona, Tucson, AZ, United States
| | - Juben L Saez
- Department of Neurology, University of Arizona, Tucson, AZ, United States
| | | | - M Leandro Heien
- Department of Chemistry & Biochemistry, Tucson, AZ, United States
| | - Kristian P Doyle
- Department of Neurology, University of Arizona, Tucson, AZ, United States; Department of Immunobiology, University of Arizona, Tucson, AZ, United States
| | - Robin Polt
- Department of Chemistry & Biochemistry, Tucson, AZ, United States; BIO5 Institute, University of Arizona, Tucson, AZ, United States
| | - Meredith Hay
- Department of Physiology, University of Arizona, Tucson, AZ, United States; Evelyn F McKnight Brain Institute, University of Arizona, Tucson, AZ, United States
| | - Lalitha Madhavan
- Physiological Sciences Graduate Program, University of Arizona, Tucson, AZ, United States; Department of Neurology, University of Arizona, Tucson, AZ, United States; BIO5 Institute, University of Arizona, Tucson, AZ, United States; Evelyn F McKnight Brain Institute, University of Arizona, Tucson, AZ, United States.
| | - Torsten Falk
- Physiological Sciences Graduate Program, University of Arizona, Tucson, AZ, United States; Department of Neurology, University of Arizona, Tucson, AZ, United States; Department of Pharmacology, University of Arizona, Tucson, AZ, United States.
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Silva MBBD, Silva ECFD, Bispo MEFDS, Nogueira TDS, Leal JC, Mendes FADS. Association between cognitive performance and manual dexterity in patients with Parkinson's disease. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2024; 29:e2126. [PMID: 39235186 DOI: 10.1002/pri.2126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 08/02/2024] [Accepted: 08/20/2024] [Indexed: 09/06/2024]
Abstract
INTRODUCTION Parkinson's disease (PD) is a progressive neurological condition resulting from the degeneration of dopaminergic neurons in the substantia nigra. Impaired manual dexterity and cognitive impairment are common symptoms and are often associated with recurrent adverse events in this population. OBJECTIVE To verify the association between cognitive performance and manual dexterity in people with PD. METHODS This is a cross-sectional observational study, with 29 participants, who underwent cognitive and manual dexterity assessments, and the following tools were used: Trail Making Test, box and block test (BBT), Learning Test of Rey and Nine Hole Peg Test. Descriptive statistics for clinical and demographic data were performed using mean and standard deviation, and data normality was assessed using the Shapiro-Wilk test. Spearman's nonparametric test was used to determine the correlation between variables. RESULTS Our findings revealed significant associations between cognitive performance and manual dexterity. The nine-hole peg test positively correlated with TMT-Part A and Part B, establishing a relationship between manual dexterity and cognitive functions such as attention and mental flexibility. On the other hand, BBT showed an inverse relationship with TMT-Part B, indicating that longer time on this task was associated with lower manual dexterity. CONCLUSION Fine manual dexterity had a significant correlation with visual search skills and motor speed, while gross motor dexterity had a negative correlation with cognitive skills. No significant results were demonstrated regarding the interaction between manual dexterity and memory.
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Affiliation(s)
| | | | | | | | - Josevan Cerqueira Leal
- Post-graduation Program in Rehabilitation Sciences, University of Brasília, Brasília, Brazil
- Faculty of Ceilândia, Physiotherapy Department, University of Brasilia, Brasilia, Brazil
| | - Felipe Augusto Dos Santos Mendes
- Post-graduation Program in Rehabilitation Sciences, University of Brasília, Brasília, Brazil
- Faculty of Ceilândia, Physiotherapy Department, University of Brasilia, Brasilia, Brazil
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Magnante AT, Ord AS, Holland JA, Sautter SW. Neurocognitive functioning of patients with early-stage Parkinson's disease. APPLIED NEUROPSYCHOLOGY. ADULT 2024; 31:1041-1052. [PMID: 35931087 DOI: 10.1080/23279095.2022.2106865] [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
Parkinson's disease (PD) is a neurological disorder commonly associated with motor deficits. However, cognitive impairment is also common in patients with PD. Cognitive concerns in PD may affect multiple domains of neurocognition and vary across different stages of the disease. Extant research has focused mainly on cognitive deficits in middle to late stages of PD, whereas few studies have examined the unique cognitive profiles of patients with early-stage PD. This study addressed this gap in the published literature and examined neurocognitive functioning and functional capacity of patients with de novo PD, focusing on the unique pattern of cognitive deficits specific to the early stage of the disease. Results indicated that the pattern of cognitive deficits in patients with PD (n = 55; mean age = 72.93) was significantly different from healthy controls (n = 59; mean age = 71.88). Specifically, tasks related to executive functioning, attention, and verbal memory demonstrated the most pronounced deficits in patients with early-stage PD. Clinical implications of these findings are discussed.
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Affiliation(s)
- Anna Theresa Magnante
- College of Health and Behavioral Sciences, Regent University, Virginia Beach, VA, USA
| | - Anna Shirokova Ord
- College of Health and Behavioral Sciences, Regent University, Virginia Beach, VA, USA
| | - Jamie A Holland
- College of Health and Behavioral Sciences, Regent University, Virginia Beach, VA, USA
| | - Scott W Sautter
- College of Health and Behavioral Sciences, Regent University, Virginia Beach, VA, USA
- Hampton Roads Neuropsychology Inc., Virginia Beach, VA, USA
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Hamed SA, Hadad AFE. The effect of anticholinergic drugs on cognition of patients with Parkinson's disease: a cohort study from the Egyptian population. Expert Rev Clin Pharmacol 2024; 17:743-753. [PMID: 38781022 DOI: 10.1080/17512433.2024.2359955] [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: 02/08/2024] [Accepted: 05/22/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Cognitive dysfunction is a non-motor manifestation of Parkinson's disease (PD). We aimed to determine the frequency and patterns of cognitive dysfunction in treated patients with PD and their predictors. RESEARCH DESIGN AND METHODS This study included 80 patients (male = 48; female = 32) and 30 healthy individuals. They underwent neuropsychiatric evaluations. Measurements included Beck's depression inventory - II (BDI-II), mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA). RESULTS Patients had mean age of 55.56 ± 9.06 yrs, duration of PD of 4.86 ± 2.71 yrs and Hoehn and Yahr Scoring of 2.19 ± 0.89. They were on levodopa/carbidopa therapy and adjuvant therapy with benztropine mesylate, an anticholinergic drug, (n = 51) or amantadine sulfate, a dopaminergic drug, (n = 29). Sixteen (20%) had moderate depressive symptoms. Mild and moderate cognitive impairments were reported in 38.8% and 28.8% (by MMSE) and 46.3% and 31.3% (by MoCA). Patients had lower global cognitive scoring (p = 0.0001) and scorings of different cognitive functions (naming, attention, language, abstraction, memory and orientation) than controls. Patients treated with benztropine had lower cognition than with amantadine. Correlation analyses showed that lower cognition was only associated with chronic PD and its treatment (p = 0.0001). CONCLUSIONS Cognitive dysfunction is common with PD (77.5%) particularly with anticholinergic drugs. De-prescription of anticholinergics is recommended for patients with PD.
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Affiliation(s)
- Sherifa Ahmed Hamed
- Department of Neurology and Psychiatry, Assiut University Hospital, Assiut, Egypt
| | - Ali Farrag El Hadad
- Department of Neurology and Psychiatry, Al Azhar University Hospital, Assiut, Egypt
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Aiello EN, Mameli F, Ruggiero F, Zirone E, Zago S, Piacentini S, Poletti B, Reitano MR, Santangelo G, Ticozzi N, Silani V, Priori A, Ferrucci R. Psychometrics and diagnostics of the Italian version of the Alternate Verbal Fluency Battery (AVFB) in non-demented Parkinson's disease patients. Neurol Sci 2024; 45:3767-3774. [PMID: 38467953 PMCID: PMC11255082 DOI: 10.1007/s10072-024-07436-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 02/29/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND Verbal fluency (VF) tasks are known as suitable for detecting cognitive impairment (CI) in Parkinson's disease (PD). This study thus aimed to evaluate the psychometrics and diagnostics of the Alternate Verbal Fluency Battery (AVFB) by Costa et al. (2014) in an Italian cohort of non-demented PD patients, as well as to derive disease-specific cut-offs for it. METHODS N = 192 non-demented PD patients were screened with the Montreal Cognitive Assessment (MoCA) and underwent the AVFB-which includes phonemic, semantic and alternate VF tests (PVF; SVF; AVF), as well as a Composite Shifting Index (CSI) reflecting the "cost" of shifting from a single- to a double-cued VF task. Construct validity and diagnostics were assessed for each AVFB measure against the MoCA. Internal reliability and factorial validity were also tested. RESULTS The MoCA proved to be strongly associated with PVF, SVF and AVF scores, whilst moderately with the CSI. The AVFB was internally consistent and underpinned by a single component; however, an improvement in both internal reliability and fit to its factorial structure was observed when dropping the CSI. Demographically adjusted scores on PVF, SVF and AVF tests were diagnostically sound in detecting MoCA-defined cognitive impairment, whilst this was not true for the CSI. Disease-specific cut-offs for PVF, SVF and AVF tests were derived. DISCUSSION In conclusion, PVF, SVF and AVF tests are reliable, valid and diagnostically sound instruments to detect cognitive impairment in non-demented PD patients and are therefore recommended for use in clinical practice and research.
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Affiliation(s)
- Edoardo Nicolò Aiello
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Francesca Mameli
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Fabiana Ruggiero
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Eleonora Zirone
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefano Zago
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Barbara Poletti
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Oncology and Hemato-Oncology, Università Degli Studi Di Milano, Via Santa Sofia 9, 20122, Milan, Italy
| | | | - Gabriella Santangelo
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Nicola Ticozzi
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Pathophysiology and Transplantation, "Dino Ferrari" Center, Università degli Studi di Milano, Milan, Italy
| | - Vincenzo Silani
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Pathophysiology and Transplantation, "Dino Ferrari" Center, Università degli Studi di Milano, Milan, Italy
| | - Alberto Priori
- ASST Santi Paolo e Carlo, San Paolo University Hospital, Milan, Italy
- "Aldo Ravelli" Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, University of Milan, Milan, Italy
| | - Roberta Ferrucci
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
- Department of Oncology and Hemato-Oncology, Università Degli Studi Di Milano, Via Santa Sofia 9, 20122, Milan, Italy.
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Esfahan SM, Nili MHHK, Hatami J, Sanayei M, Rezayat E. Aging decreases the precision of visual working memory. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2024; 31:762-776. [PMID: 37767882 DOI: 10.1080/13825585.2023.2262105] [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: 05/07/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023]
Abstract
OBJECTIVES As individuals age, cognitive abilities such as working memory (WM), decline. In the current study, we investigated the effect of age on WM, and elucidated sources of errors. METHOD A total of 102 healthy individuals, aged 18 to 71, participated in this research. We designed and administered a face-based visual WM task, collecting responses via a graded scale in a delayed match-to-sample reproduction task. RESULTS The error of participants increased significantly as they aged. Our analysis revealed a significant age-related rise in the standard deviation of error distribution. However, there was no significant change in uniform probability with age. CONCLUSION We found that WM performance declines through the lifespan. Investigating the sources of error, we found that the precision of WM decreased monotonously with age. The results also indicated that the probability of guessing the response as a measure of random response is not affected by age.
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Affiliation(s)
- Shahrzad M Esfahan
- Institute for Cognitive Science Studies (ICSS), Tehran, Iran
- Department of Psychology, Psychology and Educational Science Faculty, University of Tehran, Tehran, Iran
| | - Mohammad-Hossein H K Nili
- School of Electrical & Computer Engineering, College of Engineering, University of Tehran, Tehran, Iran
| | - Javad Hatami
- Institute for Cognitive Science Studies (ICSS), Tehran, Iran
- Department of Psychology, Psychology and Educational Science Faculty, University of Tehran, Tehran, Iran
| | - Mehdi Sanayei
- School of Cognitive Sciences, Institute for Research in Fundamental Sciences (IPM), Tehran, Iran
| | - Ehsan Rezayat
- Department of Psychology, Psychology and Educational Science Faculty, University of Tehran, Tehran, Iran
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Ariesen AMD, Tucha O, Bangma DF, Fuermaier ABM, Jansen JL, De Deyn PP, Koerts J. Financial capability of people living with Parkinson's disease - A case-control study. APPLIED NEUROPSYCHOLOGY. ADULT 2024:1-15. [PMID: 38913538 DOI: 10.1080/23279095.2024.2356658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
Parkinson's disease (PD) is a neurodegenerative disorder affecting 1% of people older than 60 years. One of the abilities that seems vulnerable to the cognitive impairments associated with PD is financial capability. This explorative study aimed to evaluate the extent and type of problems in financial capability of people with PD without a diagnosis of dementia. Participants were 31 people with PD and 62 matched controls. Participants completed an extensive test-battery, including measures for financial capability and cognitive functioning. Compared to controls, the PD-group performed significantly poorer on two financial competence tasks and showed a comparable performance on the other financial capability measures. For 45% of the PD-group, cognitive test performance was indicative of mild cognitive impairment, yet no significant difference was observed in overall cognitive functioning between the PD and control group. In the total sample, only small or medium correlations were found between financial competence and cognition, and between financial capability and the contextual factors of income and financial experience. The findings suggest that in the earlier stages of PD, when cognitive impairments are relatively mild, some problems may be observed in financial competence, yet other domains of financial capability appear less affected. The absence of strong correlations between financial competence and overall cognitive functioning indicates that standard neuropsychological assessments seem inadequate to make financial capability determinations. By offering insight into the financial capability of people in the milder stages of PD, the findings of the present study may aid in the development and provision of tailored support.
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Affiliation(s)
- Akke-Marij D Ariesen
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Oliver Tucha
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
- Department of Psychiatry and Psychotherapy, University Medical Center Rostock, Rostock, Germany
- Department of Psychology, Maynooth University, National University of Ireland, Maynooth, Ireland
| | - Dorien F Bangma
- Novicare, Institution for Elderly Care and Disabled Care, Utrecht, The Netherlands
| | - Anselm B M Fuermaier
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Josephien L Jansen
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Peter P De Deyn
- Department of Neurology and Alzheimer Center Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Laboratory of Neurochemistry and Behavior, University of Antwerp, Antwerp, Belgium
- Department of Neurology and Memory Clinic, Middelheim General Hospital (ZNA), Antwerp, Belgium
| | - Janneke Koerts
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
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Saywell I, Foreman L, Child B, Phillips-Hughes AL, Collins-Praino L, Baetu I. Influence of cognitive reserve on cognitive and motor function in α-synucleinopathies: A systematic review and multilevel meta-analysis. Neurosci Biobehav Rev 2024; 161:105672. [PMID: 38608829 DOI: 10.1016/j.neubiorev.2024.105672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 03/26/2024] [Accepted: 04/08/2024] [Indexed: 04/14/2024]
Abstract
Cognitive reserve has shown promise as a justification for neuropathologically unexplainable clinical outcomes in Alzheimer's disease. Recent evidence suggests this effect may be replicated in conditions like Parkinson's disease, dementia with Lewy bodies, and multiple system atrophy. However, the relationships between cognitive reserve and different cognitive abilities, as well as motor outcomes, are still poorly understood in these conditions. Additionally, it is unclear whether the reported effects are confounded by medication. This review analysed studies investigating the relationship between cognitive reserve and clinical outcomes in these α-synucleinopathy cohorts, identified from MEDLINE, Scopus, psycINFO, CINAHL, and Web of Science. 85 records, containing 176 cognition and 31 motor function effect sizes, were pooled using multilevel meta-analysis. There was a significant, positive association between higher cognitive reserve and both better cognition and motor function. Cognition effect sizes differed by disease subtype, cognitive reserve measure, and outcome type; however, no moderators significantly impacted motor function. Review findings highlight the clinical implications of cognitive reserve and importance of engaging in reserve-building behaviours.
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Affiliation(s)
- Isaac Saywell
- School of Psychology, University of Adelaide, Adelaide 5005, Australia.
| | - Lauren Foreman
- School of Psychology, University of Adelaide, Adelaide 5005, Australia
| | - Brittany Child
- School of Psychology, University of Adelaide, Adelaide 5005, Australia
| | | | | | - Irina Baetu
- School of Psychology, University of Adelaide, Adelaide 5005, Australia.
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9
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Ariesen AMD, Tuomainen RE, De Deyn PP, Tucha O, Koerts J. Let Us Talk Money: Subjectively Reported Financial Performance of People Living with Neurodegenerative Diseases-A Systematic Review. Neuropsychol Rev 2024; 34:668-719. [PMID: 37594689 PMCID: PMC11166770 DOI: 10.1007/s11065-023-09597-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 04/28/2023] [Indexed: 08/19/2023]
Abstract
Neurodegenerative diseases (NDDs) form a heterogeneous, widespread group of disorders, generally characterized by progressive cognitive decline and neuropsychiatric disturbances. One of the abilities that seems particularly vulnerable to the impairments in neurodegenerative diseases is the capability to manage one's personal finances. Indeed, people living with neurodegenerative diseases were shown to consistently present with more problems on performance-based financial tasks than healthy individuals. While objective, performance-based tasks provide insight into the financial competence of people living with neurodegenerative diseases in a controlled, standardized setting; relatively little can be said, based on these tasks, about their degree of success in dealing with the financial demands, issues, or questions of everyday life (i.e., financial performance). The aim of this systematic review is to provide an overview of the literature examining self and informant reports of financial performance in people living with neurodegenerative diseases. In total, 22 studies were included that compared the financial performance of people living with mild cognitive impairment (MCI), Alzheimer's disease (AD), Parkinson's disease, or multiple sclerosis to a (cognitively) normal control group. Overall, the results indicate that people living with neurodegenerative diseases are more vulnerable to impairments in financial performance than cognitively normal individuals and that the degree of reported problems seems to be related to the severity of cognitive decline. As the majority of studies however focused on MCI or AD and made use of limited assessment methods, future research should aim to develop and adopt more comprehensive assessments to study strengths and weaknesses in financial performance of people living with different neurodegenerative diseases.
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Affiliation(s)
- Akke-Marij D Ariesen
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Roosa E Tuomainen
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Peter P De Deyn
- Department of Neurology and Alzheimer Center Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Laboratory of Neurochemistry and Behaviour, University of Antwerp, Antwerp, Belgium
- Department of Neurology and Memory Clinic, Middelheim General Hospital (ZNA), Antwerp, Belgium
| | - Oliver Tucha
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
- Department of Psychiatry and Psychotherapy, University Medical Center Rostock, Rostock, Germany
- Department of Psychology, Maynooth University, National University of Ireland, Maynooth, Ireland
| | - Janneke Koerts
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands.
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Castelli MB, Alonso-Recio L, Carvajal F, Serrano JM. Does the Montreal Cognitive Assessment (MoCA) identify cognitive impairment profiles in Parkinson's disease? An exploratory study. APPLIED NEUROPSYCHOLOGY. ADULT 2024; 31:238-247. [PMID: 34894908 DOI: 10.1080/23279095.2021.2011727] [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: 06/14/2023]
Abstract
An important proportion of patients with Parkinson's Disease (PD) present signs of cognitive impairment, although this is heterogeneous. In an attempt to classify this, the dual syndrome hypothesis distinguishes between two profiles: one defined by attentional and executive problems with damage in anterior cerebral regions, and another with mnesic and visuospatial alterations, with damage in posterior cerebral regions. The Montreal Cognitive Assessment (MoCA) is one of the recommended screening tools, and one of the most used, to assess cognitive impairment in PD. However, its ability to specifically identify these two profiles of cognitive impairment has not been studied. The aim of this study was, therefore, to analyze the capacity of the MoCA to detect cognitive impairment, and also to identify anterior and posterior profiles defined by the dual syndrome hypothesis. For this purpose, 59 patients with idiopathic PD were studied with the MoCA and a neuropsychological battery of tests covering all cognitive domains. Results of logistic regression analysis with ROC (Receiver Operating Characteristic) curves showed that MoCA detected cognitive impairment and identified patients with a profile of anterior/attentional and executive deficit, with acceptable sensibility and specificity. However, it did not identify patients with a posterior/mnesic-visuospatial impairment. We discuss the reasons for the lack of sensitivity of MoCA in this profile, and other possible implications of these results with regards the usefulness of this tool to assess cognitive impairment in PD.
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Affiliation(s)
- María Belén Castelli
- Departamento de Psicología Biológica y de la Salud, Facultad de Psicología, Universidad Autónoma de Madrid, Madrid, Spain
| | - Laura Alonso-Recio
- Departamento de Psicología y Salud, Facultad de Ciencias de la Salud y la Educación, Universidad a Distancia de Madrid, Madrid, Spain
| | - Fernando Carvajal
- Departamento de Psicología Biológica y de la Salud, Facultad de Psicología, Universidad Autónoma de Madrid, Madrid, Spain
| | - Juan Manuel Serrano
- Departamento de Psicología Biológica y de la Salud, Facultad de Psicología, Universidad Autónoma de Madrid, Madrid, Spain
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11
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Koch NA, Voss P, Cisneros-Franco JM, Drouin-Picaro A, Tounkara F, Ducharme S, Guitton D, de Villers-Sidani É. Eye movement function captured via an electronic tablet informs on cognition and disease severity in Parkinson's disease. Sci Rep 2024; 14:9082. [PMID: 38643273 PMCID: PMC11032372 DOI: 10.1038/s41598-024-59750-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 04/15/2024] [Indexed: 04/22/2024] Open
Abstract
Studying the oculomotor system provides a unique window to assess brain health and function in various clinical populations. Although the use of detailed oculomotor parameters in clinical research has been limited due to the scalability of the required equipment, the development of novel tablet-based technologies has created opportunities for fast, easy, cost-effective, and reliable eye tracking. Oculomotor measures captured via a mobile tablet-based technology have previously been shown to reliably discriminate between Parkinson's Disease (PD) patients and healthy controls. Here we further investigate the use of oculomotor measures from tablet-based eye-tracking to inform on various cognitive abilities and disease severity in PD patients. When combined using partial least square regression, the extracted oculomotor parameters can explain up to 71% of the variance in cognitive test scores (e.g. Trail Making Test). Moreover, using a receiver operating characteristics (ROC) analysis we show that eye-tracking parameters can be used in a support vector classifier to discriminate between individuals with mild PD from those with moderate PD (based on UPDRS cut-off scores) with an accuracy of 90%. Taken together, our findings highlight the potential usefulness of mobile tablet-based technology to rapidly scale eye-tracking use and usefulness in both research and clinical settings by informing on disease stage and cognitive outcomes.
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Affiliation(s)
- Nils A Koch
- Integrated Program in Neuroscience, McGill University, Montreal, QC, Canada
- Innodem Neurosciences, Montreal, QC, Canada
| | - Patrice Voss
- Montreal Neurological Institute, McGill University, 3801 University Rm 742, Montreal, QC, H3A 2B4, Canada
- Innodem Neurosciences, Montreal, QC, Canada
| | - J Miguel Cisneros-Franco
- Montreal Neurological Institute, McGill University, 3801 University Rm 742, Montreal, QC, H3A 2B4, Canada
| | | | - Fama Tounkara
- Integrated Program in Neuroscience, McGill University, Montreal, QC, Canada
| | - Simon Ducharme
- Montreal Neurological Institute, McGill University, 3801 University Rm 742, Montreal, QC, H3A 2B4, Canada
- Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Daniel Guitton
- Montreal Neurological Institute, McGill University, 3801 University Rm 742, Montreal, QC, H3A 2B4, Canada
| | - Étienne de Villers-Sidani
- Montreal Neurological Institute, McGill University, 3801 University Rm 742, Montreal, QC, H3A 2B4, Canada.
- Innodem Neurosciences, Montreal, QC, Canada.
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Doskas T, Vadikolias K, Ntoskas K, Vavougios GD, Tsiptsios D, Stamati P, Liampas I, Siokas V, Messinis L, Nasios G, Dardiotis E. Neurocognitive Impairment and Social Cognition in Parkinson's Disease Patients. Neurol Int 2024; 16:432-449. [PMID: 38668129 PMCID: PMC11054167 DOI: 10.3390/neurolint16020032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 04/06/2024] [Accepted: 04/11/2024] [Indexed: 04/29/2024] Open
Abstract
In addition to motor symptoms, neurocognitive impairment (NCI) affects patients with prodromal Parkinson's disease (PD). NCI in PD ranges from subjective cognitive complaints to dementia. The purpose of this review is to present the available evidence of NCI in PD and highlight the heterogeneity of NCI phenotypes as well as the range of factors that contribute to NCI onset and progression. A review of publications related to NCI in PD up to March 2023 was performed using PubMed/Medline. There is an interconnection between the neurocognitive and motor symptoms of the disease, suggesting a common underlying pathophysiology as well as an interconnection between NCI and non-motor symptoms, such as mood disorders, which may contribute to confounding NCI. Motor and non-motor symptom evaluation could be used prognostically for NCI onset and progression in combination with imaging, laboratory, and genetic data. Additionally, the implications of NCI on the social cognition of afflicted patients warrant its prompt management. The etiology of NCI onset and its progression in PD is multifactorial and its effects are equally grave as the motor effects. This review highlights the importance of the prompt identification of subjective cognitive complaints in PD patients and NCI management.
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Affiliation(s)
- Triantafyllos Doskas
- Department of Neurology, Athens Naval Hospital, 11521 Athens, Greece;
- Department of Neurology, General University Hospital of Alexandroupoli, 68100 Alexandroupoli, Greece; (K.V.); (D.T.)
| | - Konstantinos Vadikolias
- Department of Neurology, General University Hospital of Alexandroupoli, 68100 Alexandroupoli, Greece; (K.V.); (D.T.)
| | | | - George D. Vavougios
- Department of Neurology, Athens Naval Hospital, 11521 Athens, Greece;
- Department of Neurology, Faculty of Medicine, University of Cyprus, 1678 Lefkosia, Cyprus
- Department of Respiratory Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41500 Larissa, Greece
| | - Dimitrios Tsiptsios
- Department of Neurology, General University Hospital of Alexandroupoli, 68100 Alexandroupoli, Greece; (K.V.); (D.T.)
| | - Polyxeni Stamati
- Department of Neurology, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece; (P.S.); (I.L.); (V.S.); (E.D.)
| | - Ioannis Liampas
- Department of Neurology, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece; (P.S.); (I.L.); (V.S.); (E.D.)
| | - Vasileios Siokas
- Department of Neurology, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece; (P.S.); (I.L.); (V.S.); (E.D.)
| | - Lambros Messinis
- School of Psychology, Laboratory of Neuropsychology and Behavioural Neuroscience, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Grigorios Nasios
- Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, 45500 Ioannina, Greece;
| | - Efthimios Dardiotis
- Department of Neurology, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece; (P.S.); (I.L.); (V.S.); (E.D.)
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Ferguson CE, Foley JA. The influence of working memory and processing speed on other aspects of cognitive functioning in de novo Parkinson's disease: Initial findings from network modelling and graph theory. J Neuropsychol 2024; 18:136-153. [PMID: 37366558 DOI: 10.1111/jnp.12333] [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: 10/14/2022] [Accepted: 06/04/2023] [Indexed: 06/28/2023]
Abstract
Deficits in working memory (WM) and processing speed (PS) are thought to undermine other cognitive functions in de novo Parkinson's disease (dnPD). However, these interrelationships are only partially understood. This study investigated whether there are stronger relationships between verbal WM and verbal episodic memory encoding and retrieval, whether verbal WM and PS have a greater influence on other aspects of cognitive functioning, and whether the overall strength of interrelationships among several cognitive functions differs in dnPD compared to health. Data for 198 healthy controls (HCs) and 293 dnPD patients were analysed. Participants completed a neuropsychological battery probing verbal WM, PS, verbal episodic memory, semantic memory, language and visuospatial functioning. Deficit analysis, network modelling and graph theory were combined to compare the groups. Results suggested that verbal WM performance, while slightly impaired, was more strongly associated with measures of verbal episodic memory encoding and retrieval, as well as other measured cognitive functions in the dnPD network model compared to the HC network model. PS task performance was impaired and more strongly associated with other neuropsychological task scores in the dnPD model. Associations among task scores were stronger overall in the dnPD model. Together, these results provide further evidence that WM and PS are important influences on the other aspects of cognitive functioning measured in this study in dnPD. Moreover, they provide novel evidence that verbal WM and PS might bear greater influence on the other measured cognitive functions and that these functions are more strongly intertwined in dnPD compared to health.
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Affiliation(s)
- Cameron E Ferguson
- School of Psychological Science, University of Bristol, Bristol, UK
- Community Neurological Rehabilitation Service, Aneurin Bevan University Health Board, Newport, UK
| | - Jennifer A Foley
- Queen Square Institute of Neurology, University College London, London, UK
- Department of Neuropsychology, National Hospital for Neurology and Neurosurgery, London, UK
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Van Criekinge T, Sahu U, Bhatt T. Effect of Explicit Prioritization on Dual Tasks During Standing and Walking in People With Neurologic and Neurocognitive Disorders: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil 2024:S0003-9993(24)00824-4. [PMID: 38401769 DOI: 10.1016/j.apmr.2024.02.714] [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: 10/05/2023] [Revised: 02/05/2024] [Accepted: 02/10/2024] [Indexed: 02/26/2024]
Abstract
OBJECTIVES To examine the effectiveness of explicit task (ie, equal, motor or cognitive) prioritization during dual tasking (DT) in adults with neurologic and neurocognitive disorders (stroke, Parkinson disease [PD], multiple sclerosis, dementia, Alzheimer disease, and mild cognitive impairment). DATA SOURCE A systematic search in 4 databases (PubMed, Web of Science, Embase, and Cochrane Central) yielded 1138 unique studies published up to 2023. STUDY SELECTION Forty-one experimental studies were selected that assessed the effect of explicit prioritization instructions on both motor and cognitive performance during dual-tasks related to standing and walking in selected populations. Primary outcome measures were walking speed and response accuracy. Availability of data allowed us to perform a meta-analysis on 27 of the 41 articles by using inverse variance with a random effects model. DATA EXTRACTION The data including design, subject characteristics, motor and cognitive tasks, prioritization, motor and cognitive outcomes, instructions, and key findings were extracted. Two assessors rated the selected studies for risk of bias and quality using the Quality Assessment Tools of the National Institutes of Health. DATA SYNTHESIS This study examined 1535 adults who were asked to perform motor-cognitive DT in standing or walking, including 381 adults with stroke, 526 with PD, 617 with multiple sclerosis, 10 with dementia, 9 with Alzheimer disease, and 8 with mild cognitive impairment. During all prioritization instructions, participants slowed down during DT (standardized mean difference (SMD)equal=0.43; SMDmotor=0.78; SMDcognitive=0.69, P<.03) while maintaining similar response accuracy (SMDequal=0.12; SMDmotor=0.23; SMDcognitive=-.01, P>.05). However, considerable between-group heterogeneity was observed resulting in different motor and cognitive responses between pathologies. CONCLUSION Motor prioritization was achieved in adults with PD and stroke, unlike adults with neurocognitive disorders who were negatively affected by any type DT prioritizing. The reported within-group heterogeneity revealed that effects of explicit task prioritization are dependent on motor and cognitive task complexity, and the type of instructions. Recommendations are provided to ensure accurate use of instructions during DT paradigms.
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Affiliation(s)
| | - Upasana Sahu
- Department of Physical Therapy, College of Applied Health and Sciences, University of Illinois at Chicago, Chicago, IL
| | - Tanvi Bhatt
- Department of Physical Therapy, College of Applied Health and Sciences, University of Illinois at Chicago, Chicago, IL.
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Reilly S, Dhaliwal S, Arshad U, Macerollo A, Husain N, Costa AD. The effects of rivastigmine on neuropsychiatric symptoms in the early stages of Parkinson's disease: A systematic review. Eur J Neurol 2024; 31:e16142. [PMID: 37975761 PMCID: PMC11236000 DOI: 10.1111/ene.16142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 10/14/2023] [Accepted: 10/26/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND AND PURPOSE Neuropsychiatric symptoms including depression, apathy and psychosis occur frequently in patients with Parkinson's disease. A subgroup of patients develop cognitive impairment, which may increase the risk of falls due to reduced attention. The acetylcholinesterase inhibitor rivastigmine is beneficial in Parkinson's disease dementia, but whether the use of rivastigmine is effective earlier in the disease course is unclear. The aim of this systematic review was to assess the evidence for rivastigmine in the treatment of neuropsychiatric symptoms in Parkinson's disease without dementia. METHODS Embase, Medline, PsychINFO, Cochrane CENTRAL, NGLC, National Institute for Health and Care Excellence Evidence and medRxiv.org were searched for studies with terms relating to population (Parkinson's disease) and intervention (rivastigmine). Of 1922 references identified, 358 were duplications. Following title and abstract review, 1331 articles were excluded. After full-text review, nine articles remained. RESULTS Outcomes were heterogenous, therefore, the results are presented in narrative form. The articles included six randomized controlled trials, two open-label trials and one case series. Outcome measures included: time to develop psychosis; frequency of rapid eye movement sleep behaviour disorder (RBD) episodes; apathy; gait variability; falls; cognitive ability; Neuropsychiatric Inventory score; and regional spontaneous brain activity. CONCLUSIONS There is evidence that rivastigmine is beneficial for RBD and apathy in Parkinson's disease patients without dementia. There is high level evidence that rivastigmine reduces falls, which may be due to improved attention. The impact of rivastigmine on psychotic symptoms is less clear, but is supported by current theoretical models which involve acetylcholine dysfunction in the generation of visual hallucinations in Parkinson's disease.
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Affiliation(s)
- Siobhan Reilly
- Greater Manchester Mental Health NHS Foundation TrustManchesterUK
| | | | - Usman Arshad
- Pakistan Institute of Living and LearningKarachiPakistan
- The University of ManchesterManchesterUK
| | - Antonella Macerollo
- The Walton Centre NHS Foundation Trust for Neurology and NeurosurgeryLiverpoolUK
- Institute of Systems, Molecular and Integrative BiologyUniversity of LiverpoolLiverpoolUK
| | - Nusrat Husain
- The University of ManchesterManchesterUK
- Mersey Care NHS Foundation TrustLiverpoolUK
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Citro S, Lazzaro GD, Cimmino AT, Giuffrè GM, Marra C, Calabresi P. A multiple hits hypothesis for memory dysfunction in Parkinson disease. Nat Rev Neurol 2024; 20:50-61. [PMID: 38052985 DOI: 10.1038/s41582-023-00905-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2023] [Indexed: 12/07/2023]
Abstract
Cognitive disorders are increasingly recognized in Parkinson disease (PD), even in early disease stages, and memory is one of the most affected cognitive domains. Classically, hippocampal cholinergic system dysfunction was associated with memory disorders, whereas nigrostriatal dopaminergic system impairment was considered responsible for executive deficits. Evidence from PD studies now supports involvement of the amygdala, which modulates emotional attribution to experiences. Here, we propose a tripartite model including the hippocampus, striatum and amygdala as key structures for cognitive disorders in PD. First, the anatomo-functional relationships of these structures are explored and experimental evidence supporting their role in cognitive dysfunction in PD is summarized. We then discuss the potential role of α-synuclein, a pathological hallmark of PD, in the tripartite memory system as a key mechanism in the pathogenesis of memory disorders in the disease.
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Affiliation(s)
- Salvatore Citro
- Neurology Section, Department of Neuroscience, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giulia Di Lazzaro
- Neurology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Angelo Tiziano Cimmino
- Neurology Section, Department of Neuroscience, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Guido Maria Giuffrè
- Neurology Section, Department of Neuroscience, Università Cattolica del Sacro Cuore, Rome, Italy
- Neurology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Camillo Marra
- Neurology Section, Department of Neuroscience, Università Cattolica del Sacro Cuore, Rome, Italy
- Neurology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Paolo Calabresi
- Neurology Section, Department of Neuroscience, Università Cattolica del Sacro Cuore, Rome, Italy.
- Neurology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
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Kobak Tur E, Ari BC. Mild cognitive impairment in patients with Parkinson´s disease and the analysis of associated factors. Neurol Res 2023; 45:1161-1168. [PMID: 37743634 DOI: 10.1080/01616412.2023.2258038] [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: 05/20/2023] [Accepted: 09/04/2023] [Indexed: 09/26/2023]
Abstract
OBJECTIVES This research targeted to understand the impact of clinical findings, non-motor symptoms, white matter hyperintensities (WMHs), and metabolic features on cognition in Parkinson's disease patients with mild cognitive impairment (PD-MCI). METHODS Sixty-one PD patients sundered into two groups: PD-MCI and normal cognition (PD-NC). We assessed cognition using Montreal Cognitive Assessment-TR (MoCA-TR) and Frontal Assessment Battery (FAB). We used the modified Hoehn&Yahr staging scale (mH&Y), Unified Parkinson's Disease Rating Scale (UPDRS), Freezing of Gait questionnaire, Beck Depression Inventory, Parkinson's disease sleep scale-2, Pittsburgh sleep quality index, Epworth sleepiness scale, and Non-motor symptoms questionnaire to evaluate all patients. We used the Fazekas scale to evaluate the WMHs and also investigated all laboratory parameters affecting cognitive functions. RESULTS Duration of disease, UPDRS-Motor part, age, disease stage, and daytime sleepiness were dramatically higher in the PD-MCI group than in PD-NC (p < 0.05). WMHs and homocysteine were higher in the PD-MCI group than in the controls (p = 0.016 and p < 0.001, respectively). There was a negative correlation between cognition and duration of disease, age, disease stage, UPDRS-Motor scale, daytime drowsiness, WMHs and homocysteine levels. Homocysteine was negatively related to visuospatial/executive functions (r=-0.303, p = 0.021). WMHs were correlated with global cognition (p =.000 r = .-542), language (p = .001, r = -.434), and delayed recall (p = .011, r = -.332). DISCUSSION Mild cognitive impairment is a widespread clinical situation of PD patients and often presents before the motor symptoms. Revealing curable causes that affect cognition before the development of PD-related dementia is crucial in controlling motor findings and reducing the burden of the caretakers.
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Affiliation(s)
- Esma Kobak Tur
- Department of Neurology, University of Health Sciences, Istanbul, Turkey
| | - Buse Cagla Ari
- Department of Neurology, Bahcesehir University Medical Faculty, Istanbul, Turkey
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18
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Torres K, Singleton M. Analyses of correct responses and errors on measures of verbal fluency among Parkinson's disease and essential tremor patients. Clin Neuropsychol 2023; 37:1479-1497. [PMID: 36550679 DOI: 10.1080/13854046.2022.2157885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 12/07/2022] [Indexed: 12/24/2022]
Abstract
Objective: Parkinson's disease (PD) and essential tremor (ET) involve neuroanatomical circuitry that impact frontal lobe functioning, via the striatum and cerebellum, respectively. The aim of this exploratory study was to investigate quantitative and qualitative performance between and within these groups on measures of verbal fluency. Method: Sixty-three PD and 53 ET patients completed neuropsychological testing. Linear regression models with robust variance estimation compared verbal fluency performance between groups related to correct responses and errors. Paired t-tests investigated within group error rates. Results: PD patients gave more correct responses for phonological (β ̂ =5.3, p=.01) and category fluency (β ̂ =4.1, p=.01) than ET patients; however, when processing speed was added as a covariate, this attenuated performance on both measures and only phonological fluency remained significant (β ̂ =4.0, p=.04). There were no statistical differences in error scores between groups. Error rates within groups suggested that PD patients had higher error rates in total errors and perseveration errors on phonological fluency (M = 2.6, p=.00; M = 1.6, p=.00) and higher total errors and set-loss error rates on category switching (M = 5.1, p<.001; M = 4.1, p<.001). ET patients had higher error rate with relation to total errors and set-loss errors on phonological fluency (M = 2.5, p=.00; M = 1.5, p=.02) and category switching (M = 3.9, p=,00; M = 3.9, p<.001). Conclusions: PD patients performed better than ET patients on phonological fluency. PD patients appear to make more perseveration errors on phonological fluency, while ET patients made more set-loss errors. Implications for frontal lobe dysfunction and clinical impact are discussed.
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Affiliation(s)
- Karen Torres
- Department of Neurology, University of Washington, Seattle, WA, USA
| | - Michael Singleton
- Institute of Translational Health Sciences, University of Washington, Seattle, WA, USA
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19
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Page AD, Schroeder JR, Knowles T, Jog M, Adams SG. A Comparison of Voice Amplifiers and Personal Communication Systems for Hypophonia: An Exploration of Communicative Participation. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:1850-1865. [PMID: 36958017 DOI: 10.1044/2023_ajslp-22-00161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
PURPOSE The primary purpose of this study was to evaluate how individuals with hypophonia (HP; also referred to as HP participants) and their primary communication partners (PCPs; also referred to as PCP participants) rate communicative participation before and after experience with a speech amplification device. A secondary purpose was to evaluate pre- and post-device effects on self-rated communicative participation for each of the three speech amplification devices trialed outside of the laboratory. METHOD Seventeen individuals with HP and their PCPs participated in a crossover design study that compared three different amplification devices: a wired belt-pack amplifier, a wireless stationary amplifier, and a personal frequency modulation (FM) system. Both the individuals with HP and their PCPs self-rated communicative participation at baseline and after trialing each device following 1-week device trial periods at home. Patient-reported outcome measures included the Communicative Effectiveness Survey (CES) and the Voice Activity and Participation Profile (VAPP). Following study completion, participants indicated whether they would like to select a specific device to continue using. RESULTS Overall, HP participants rated communicative participation following device use higher than that in the pre-device condition, with the FM system resulting in the overall highest VAPP ratings and second highest CES ratings. Furthermore, HP and PCP participants rated these measures similarly. Finally, HP participants who selected a device to continue using self-reported lower total communicative effectiveness scores and greater voice activity limitations and participation restrictions at baseline in comparison to the nonselectors. CONCLUSIONS This study contributes to an increased understanding of how communicative participation is experienced within this clinical population resulting from speech amplification. It is suggested that the inclusion of participation-based outcome measurement is essential to ensure a multidimensional and comprehensive approach to device prescription for individuals with HP.
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Affiliation(s)
- Allyson D Page
- School of Communication Sciences and Disorders, Western University, London, Ontario, Canada
| | - Jessi-Rae Schroeder
- Health & Rehabilitation Sciences, Western University, London, Ontario, Canada
| | - Thea Knowles
- Department of Communicative Disorders and Sciences, The State University of New York at Buffalo
| | - Mandar Jog
- Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
| | - Scott G Adams
- School of Communication Sciences and Disorders, Western University, London, Ontario, Canada
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Hacker ML, Tramontana MG, Pazira K, Meystedt JC, Turchan M, Harper KA, Fan R, Ye F, Davis TL, Konrad PE, Charles D. Long-term neuropsychological outcomes of deep brain stimulation in early-stage Parkinson's disease. Parkinsonism Relat Disord 2023; 113:105479. [PMID: 37380539 PMCID: PMC11232874 DOI: 10.1016/j.parkreldis.2023.105479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 05/30/2023] [Accepted: 05/31/2023] [Indexed: 06/30/2023]
Abstract
INTRODUCTION The pilot trial of deep brain stimulation (DBS) in early-stage Parkinson's disease (PD) randomized 30 patients (medication duration 0.5-4 years; without dyskinesia or motor fluctuations) to receive optimal drug therapy alone (early ODT) or subthalamic nucleus (STN) DBS plus ODT (early DBS + ODT). This study reports long-term neuropsychological outcomes from the early DBS pilot trial. METHODS This is an extension of an earlier study that examined two-year neuropsychological outcomes in the pilot trial. The primary analysis was conducted on the five-year cohort (n = 28), and a secondary analysis was conducted on the 11-year cohort (n = 12). Linear mixed effects models for each analysis compared overall trend in outcomes for randomization groups. All subjects who completed the 11-year assessment were also pooled to evaluate long-term change from baseline. RESULTS There were no significant differences between groups in either the five- or 11-year analyses. Across all PD patients who completed the 11-year visit, there was significant decline in Stroop Color and Color-Word and Purdue Pegboard from baseline to 11 years. CONCLUSIONS Previous significant differences between the groups in phonemic verbal fluency and cognitive processing speed showing more decline for early DBS + ODT subjects one year after baseline diminished as PD progressed. No cognitive domains were worse for early DBS + ODT subjects compared to standard of care subjects. There were shared declines across all subjects on cognitive processing speed and motor control, likely reflecting disease progression. More study is needed to understand the long-term neuropsychological outcomes associated with early DBS in PD.
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Affiliation(s)
- Mallory L Hacker
- Department of Neurology, Vanderbilt University Medical Center, United States.
| | | | - Kian Pazira
- Department of Neurology, Vanderbilt University Medical Center, United States
| | | | - Maxim Turchan
- Department of Neurology, Vanderbilt University Medical Center, United States
| | - Kelly A Harper
- Department of Neurology, Vanderbilt University Medical Center, United States
| | - Run Fan
- Department of Biostatistics, Vanderbilt University Medical Center, United States
| | - Fei Ye
- Department of Biostatistics, Vanderbilt University Medical Center, United States
| | - Thomas L Davis
- Department of Neurology, Vanderbilt University Medical Center, United States
| | - Peter E Konrad
- Department of Neurosurgery, West Virginia University, United States
| | - David Charles
- Department of Neurology, Vanderbilt University Medical Center, United States
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Botta R, Keshav KJ, Kutty B, Mahadevan A, Pal PK, Yadav R. NIMHANS Neuropsychological Battery for Elderly in Parkinson's Disease Patients: Validation and Diagnosis using MDS PD-MCI Task Force Criteria in Indian Population. Ann Indian Acad Neurol 2023; 26:247-255. [PMID: 37538425 PMCID: PMC10394447 DOI: 10.4103/aian.aian_903_22] [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: 11/10/2022] [Revised: 02/26/2023] [Accepted: 02/28/2023] [Indexed: 08/05/2023] Open
Abstract
Introduction Cognitive impairment is a common non-motor feature of Parkinson's Disease (PD). Diagnosis of mild cognitive impairment is challenging and routinely missed in clinical practice. Our study aimed to study the efficacy of NIMHANS Neuropsychological Battery for Elderly (NNB-E) in diagnosing subtle cognitive deficits in PD patients. Objective The aim of this study is to validate NNB-E and evaluate cognitive impairment in PD patients in comparison with healthy controls. Methods We recruited 31 PD patients and 31 healthy controls in the current study. We validated NNB-E using receiver operating characteristic (ROC) curve analysis, Crohnbach's alpha, principal component analysis, and Pearson product-moment correlation, and studied the cognitive impairments using NNB-E in the non-demented PD patients and controls who scored ≥24 on HMSE. Results Cognitive performance of PD patients was poor compared to controls. NNB-E showed good internal consistency and construct validity with Crohnbach's alpha of 0.861 and area under the curve (AUC) of 0.878. The battery was able to detect mild cognitive impairment in 74.1% of patients and 6.4% of controls. The ROC curve showed that the overall sensitivity of the battery was 73.2% and specificity was 92.6% at an optimal cutoff score. Different cutoff values set for defining PD-MCI as per MDS task force criteria resulted in varying frequencies of MCI ranging from 25.8% to 71%. Conclusion Our study established the validity of NNB-E in PD patients, and this tool was suitable for diagnosing PD-MCI and discriminating PD patients from normal controls in the Indian population. This study also showed PD-MCI at various cutoff scores with greater impairment in executive and attention domains.
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Affiliation(s)
- Ragasudha Botta
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
- Department of Clinical Neurosciences, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Kumar J Keshav
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Bindu Kutty
- Department of Neurophysiology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Anita Mahadevan
- Department of Neuropathology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Pramod Kumar Pal
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Ravi Yadav
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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Aveni K, Ahmed J, Borovsky A, McRae K, Jenkins ME, Sprengel K, Fraser JA, Orange JB, Knowles T, Roberts AC. Predictive language comprehension in Parkinson's disease. PLoS One 2023; 18:e0262504. [PMID: 36753529 PMCID: PMC9907838 DOI: 10.1371/journal.pone.0262504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 12/27/2021] [Indexed: 02/09/2023] Open
Abstract
Verb and action knowledge deficits are reported in persons with Parkinson's disease (PD), even in the absence of dementia or mild cognitive impairment. However, the impact of these deficits on combinatorial semantic processing is less well understood. Following on previous verb and action knowledge findings, we tested the hypothesis that PD impairs the ability to integrate event-based thematic fit information during online sentence processing. Specifically, we anticipated persons with PD with age-typical cognitive abilities would perform more poorly than healthy controls during a visual world paradigm task requiring participants to predict a target object constrained by the thematic fit of the agent-verb combination. Twenty-four PD and 24 healthy age-matched participants completed comprehensive neuropsychological assessments. We recorded participants' eye movements as they heard predictive sentences (The fisherman rocks the boat) alongside target, agent-related, verb-related, and unrelated images. We tested effects of group (PD/control) on gaze using growth curve models. There were no significant differences between PD and control participants, suggesting that PD participants successfully and rapidly use combinatory thematic fit information to predict upcoming language. Baseline sentences with no predictive information (e.g., Look at the drum) confirmed that groups showed equivalent sentence processing and eye movement patterns. Additionally, we conducted an exploratory analysis contrasting PD and controls' performance on low-motion-content versus high-motion-content verbs. This analysis revealed fewer predictive fixations in high-motion sentences only for healthy older adults. PD participants may adapt to their disease by relying on spared, non-action-simulation-based language processing mechanisms, although this conclusion is speculative, as the analyses of high- vs. low-motion items was highly limited by the study design. These findings provide novel evidence that individuals with PD match healthy adults in their ability to use verb meaning to predict upcoming nouns despite previous findings of verb semantic impairment in PD across a variety of tasks.
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Affiliation(s)
- Katharine Aveni
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, United States of America
| | - Juweiriya Ahmed
- Department of Psychology, Western University, London, ON, Canada
| | - Arielle Borovsky
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN, United States of America
| | - Ken McRae
- Department of Psychology, Western University, London, ON, Canada
| | - Mary E. Jenkins
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Katherine Sprengel
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, United States of America
| | - J. Alexander Fraser
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Department of Ophthalmology, Western University, St. Jo122seph’s Health Care, London, ON, Canada
| | - Joseph B. Orange
- School of Communication Sciences and Disorders, Western University, London, ON, Canada
- Canadian Centre for Activity and Aging, Western University, London, ON, Canada
| | - Thea Knowles
- Department of Psychology, Western University, London, ON, Canada
| | - Angela C. Roberts
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, United States of America
- School of Communication Sciences and Disorders, Western University, London, ON, Canada
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Richter F, Stanojlovic M, Käufer C, Gericke B, Feja M. A Mouse Model to Test Novel Therapeutics for Parkinson's Disease: an Update on the Thy1-aSyn ("line 61") Mice. Neurotherapeutics 2023; 20:97-116. [PMID: 36715870 PMCID: PMC10119371 DOI: 10.1007/s13311-022-01338-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2022] [Indexed: 01/31/2023] Open
Abstract
Development of neuroprotective therapeutics for Parkinson's disease (PD) is facing a lack of translation from pre-clinical to clinical trials. One strategy for improvement is to increase predictive validity of pre-clinical studies by using extensively characterized animal models with a comprehensive set of validated pharmacodynamic readouts. Mice over-expressing full-length, human, wild-type alpha-synuclein under the Thy-1 promoter (Thy1-aSyn line 61) reproduce key features of sporadic PD, such as progressive loss of striatal dopamine, alpha-synuclein pathology, deficits in motor and non-motor functions, and elevation of inflammatory markers. Extensive work with this model by multiple laboratories over the past decade further increased confidence in its robustness and validity, especially for analyzing pathomechanisms of alpha-synuclein pathology and down-stream pathways, and for pre-clinical drug testing. Interestingly, while postnatal transgene expression is widespread in central and peripheral neurons, the extent and progression of down-stream pathology differs between brain regions, thereby replicating the characteristic selective vulnerability of neurodegenerative diseases. In-depth characterization of these readouts in conjunction with behavioral deficits has led to more informative endpoints for pre-clinical trials. Each drug tested in Thy1-aSyn line 61 enhances knowledge on how molecular targets, pathology, and functional behavioral readouts are interconnected, thereby further optimizing the platform towards predictive validity for clinical trials. Here, we present the current state of the art using Thy1-aSyn line 61 for drug target discovery, validation, and pre-clinical testing.
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Affiliation(s)
- Franziska Richter
- Department of Pharmacology, Toxicology and Pharmacy, University of Veterinary Medicine Hannover, Foundation, Bünteweg 17, 30559, Hannover, Germany.
- Center for Systems Neuroscience Hannover, Hannover, Germany.
| | - Milos Stanojlovic
- Department of Pharmacology, Toxicology and Pharmacy, University of Veterinary Medicine Hannover, Foundation, Bünteweg 17, 30559, Hannover, Germany
| | - Christopher Käufer
- Department of Pharmacology, Toxicology and Pharmacy, University of Veterinary Medicine Hannover, Foundation, Bünteweg 17, 30559, Hannover, Germany
| | - Birthe Gericke
- Department of Pharmacology, Toxicology and Pharmacy, University of Veterinary Medicine Hannover, Foundation, Bünteweg 17, 30559, Hannover, Germany
- Center for Systems Neuroscience Hannover, Hannover, Germany
| | - Malte Feja
- Department of Pharmacology, Toxicology and Pharmacy, University of Veterinary Medicine Hannover, Foundation, Bünteweg 17, 30559, Hannover, Germany
- Center for Systems Neuroscience Hannover, Hannover, Germany
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miRNAs as the important regulators of myasthenia gravis: involvement of major cytokines and immune cells. Immunol Res 2022; 71:153-163. [PMID: 36396903 DOI: 10.1007/s12026-022-09342-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 11/09/2022] [Indexed: 11/18/2022]
Abstract
Myasthenia gravis (MG) is a type of muscle paralysis created by immune responses against acetylcholine receptor proteins in neuromuscular synapses. This disease is characterized by muscle weakness, especially ocular weakness symptoms that could be ptosis (fall of the upper eyelid) or diplopia (double vision of a single object). Some patients also identified with speech and swallowing problems. The main goals of MG therapeutic approaches are to achieve remission, reduce symptoms, and improve life quality. Recently, other studies have revealed the potential role of various microRNAs (miRNAs) in the development of MG through different mechanisms and have proposed these molecules as effective biomarkers for the treatment of MG. This review was aimed at providing an overview of the critical regulatory roles of various miRNAs in the pathogenesis of this autoimmune disease focusing on human MG studies and the interaction between different miRNAs with important cytokines and immune cells during the development of this autoimmune disease.
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Marner L, Korsholm K, Anderberg L, Lonsdale MN, Jensen MR, Brødsgaard E, Denholt CL, Gillings N, Law I, Friberg L. [ 18F]FE-PE2I PET is a feasible alternative to [ 123I]FP-CIT SPECT for dopamine transporter imaging in clinically uncertain parkinsonism. EJNMMI Res 2022; 12:56. [PMID: 36070114 PMCID: PMC9452620 DOI: 10.1186/s13550-022-00930-x] [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: 03/01/2022] [Accepted: 08/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dopamine transporter (DAT) imaging of striatum is clinically used in Parkinson's disease (PD) and neurodegenerative parkinsonian syndromes (PS) especially in the early disease stages. The aim of the present study was to evaluate the diagnostic performance of the recently developed tracer for DAT imaging [18F]FE-PE2I PET/CT to the reference standard [123I]FP-CIT SPECT. METHODS Ninety-eight unselected patients referred for DAT imaging were included prospectively and consecutively and evaluated with [18F]FE-PE2I PET/CT and [123I]FP-CIT SPECT on two separate days. PET and SPECT scans were categorized independently by two blinded expert readers as either normal, vascular changes, or mixed. Semiquantitative values were obtained for each modality and compared regarding effect size using Glass' delta. RESULTS Fifty-six of the [123I]FP-CIT SPECT scans were considered abnormal (52 caused by PS, 4 by infarctions). Using [18F]FE-PE2I PET/CT, 95 of the 98 patients were categorized identically to SPECT as PS or non-PS with a sensitivity of 0.94 [0.84-0.99] and a specificity of 1.00 [0.92-1.00]. Inter-reader agreement for [18F]FE-PE2I PET with a kappa of 0.97 [0.89-1.00] was comparable to the agreement for [123I]FP-CIT SPECT of 0.96 [0.76-1.00]. Semiquantitative values for short 10-min reconstructions of [18F]FE-PE2I PET/CT were comparable to longer reconstructions. The effect size for putamen/caudate nucleus ratio was significantly increased using PET compared to SPECT. CONCLUSIONS The high correspondence of [18F]FE-PE2I PET compared to reference standard [123I]FP-CIT SPECT establishes [18F]FE-PE2I PET as a feasible PET tracer for clinical use with favourable scan logistics.
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Affiliation(s)
- Lisbeth Marner
- Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital Bispebjerg, Bispebjerg Bakke 23, Copenhagen, Denmark. .,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
| | - Kirsten Korsholm
- grid.411702.10000 0000 9350 8874Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital Bispebjerg, Bispebjerg Bakke 23, Copenhagen, Denmark ,grid.475435.4Department of Clinical Physiology, Nuclear Medicine and PET, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Lasse Anderberg
- grid.475435.4Department of Clinical Physiology, Nuclear Medicine and PET, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Markus N. Lonsdale
- grid.411702.10000 0000 9350 8874Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital Bispebjerg, Bispebjerg Bakke 23, Copenhagen, Denmark
| | - Mads Radmer Jensen
- grid.411702.10000 0000 9350 8874Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital Bispebjerg, Bispebjerg Bakke 23, Copenhagen, Denmark
| | - Eva Brødsgaard
- grid.411702.10000 0000 9350 8874Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital Bispebjerg, Bispebjerg Bakke 23, Copenhagen, Denmark
| | - Charlotte L. Denholt
- grid.475435.4Department of Clinical Physiology, Nuclear Medicine and PET, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Nic Gillings
- grid.475435.4Department of Clinical Physiology, Nuclear Medicine and PET, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Ian Law
- grid.5254.60000 0001 0674 042XDepartment of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark ,grid.475435.4Department of Clinical Physiology, Nuclear Medicine and PET, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Lars Friberg
- grid.411702.10000 0000 9350 8874Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital Bispebjerg, Bispebjerg Bakke 23, Copenhagen, Denmark
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Yogev-Seligmann G, Krasovsky T, Kafri M. Compensatory movement strategies differentially affect attention allocation and gait parameters in persons with Parkinson’s disease. Front Hum Neurosci 2022; 16:943047. [PMID: 36061510 PMCID: PMC9433535 DOI: 10.3389/fnhum.2022.943047] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 08/03/2022] [Indexed: 11/29/2022] Open
Abstract
Persons with Parkinson’s disease (PwP) are advised to use compensatory strategies such as external cues or cognitive movement strategies to overcome gait disturbances. It is suggested that external cues involve the processing of sensory stimulation, while cognitive-movement strategies use attention allocation. This study aimed to compare over time changes in attention allocation in PwP between prolonged walking with cognitive movement strategy and external cues; to compare the effect of cognitive movement strategies and external cues on gait parameters; and evaluate whether these changes depend on cognitive function. Eleven PwP participated in a single-group pilot study. Participants walked for 10 min under each of three conditions: natural walking, using external cuing, using a cognitive movement strategy. Attention and gait variables were extracted from a single-channel electroencephalogram and accelerometers recordings, respectively. Attention allocation was assessed by the% of Brain Engagement Index (BEI) signals within an attentive engagement range. Cognitive function was assessed using a neuropsychological battery. The walk was divided into 2-min time segments, and the results from each 2-min segment were used to determine the effects of time and condition. Associations between cognitive function and BEI signals were tested. Findings show that in the cognitive movement strategy condition, there was a reduction in the % of BEI signals within the attentive engagement range after the first 2 min of walking. Despite this reduction the BEI did not consistently differ from natural and metronome walking. Spatiotemporal gait variables were better in the cognitive movement strategy condition relative to the other conditions. Global cognitive and information processing scores were significantly associated with the BEI only when the cognitive movement strategy was applied. In conclusion, the study shows that a cognitive movement strategy has positive effects on gait variables but may impose a higher attentional load. Furthermore, when walking using a cognitive movement strategy, persons with higher cognitive function showed elevated attentive engagement. The findings support the idea that cognitive and attentional resources are required for cognitive movement strategies in PwP. Additionally, this study provides support for using single-channel EEG to explore mechanistic aspects of clinical interventions.
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Affiliation(s)
- Galit Yogev-Seligmann
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Mount Carmel, Israel
- *Correspondence: Galit Yogev-Seligmann,
| | - Tal Krasovsky
- Department of Physical Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Mount Carmel, Israel
- Department of Pediatric Rehabilitation, Sheba Medical Center, Edmond and Lily Safra Children’s Hospital, Ramat Gan, Israel
| | - Michal Kafri
- Department of Physical Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Mount Carmel, Israel
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Xu H, Gu L, Zhang S, Wu Y, Wei X, Wang C, Xu Y, Guo Y. N200 and P300 component changes in Parkinson’s disease: a meta-analysis. Neurol Sci 2022; 43:6719-6730. [DOI: 10.1007/s10072-022-06348-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 08/11/2022] [Indexed: 11/28/2022]
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Hou M, Hou X, Qiu Y, Wang J, Zhang M, Mao X, Wu X. Characteristics of Cognitive Impairment and Their Relationship With Total Cerebral Small Vascular Disease Score in Parkinson's Disease. Front Aging Neurosci 2022; 14:884506. [PMID: 35875803 PMCID: PMC9301002 DOI: 10.3389/fnagi.2022.884506] [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: 02/26/2022] [Accepted: 06/16/2022] [Indexed: 11/21/2022] Open
Abstract
Background This study aimed to investigate the characteristics of cognitive dysfunctions and their relationship with total cerebral small vascular disease (CSVD) in Parkinson’s disease (PD). Methods A total of 174 idiopathic PD patients who underwent brain magnetic resonance imaging (MRI) were recruited. Demographic information, vascular disease risk factors, motor function (MDS-UPDRS III score), and cognitive level (MoCA, MMSE) were collected for these patients. The total CSVD burden was scored based on lacunes, enlarged perivascular spaces (EPVS), high-grade white matter hyperintensities (WMH), and cerebral microbleeds (CMBs) for each subject. Results Cognitive scores on MoCA for language, delayed recall, and orientation were significantly reduced in PD patients with CSVD burden ≥ 1 than in those with CSVD burden = 0. Educational level, PDQ 39, and CSVD burden were significantly associated with MoCA scores in individuals with PD. For the whole group, the full model accounted for 33.6% variation in total MoCA scores. In which, CSVD burden explained 2.7% of the results, and the detection of lacunes, WMH, EPVS, and strictly lobar CMBs were significantly correlated with MoCA scores. The stability of the outcomes was confirmed by sensitivity analysis. Conclusion CSVD can independently contribute to cognitive decline in PD and cause damage in specific cognitive domains. Promoting neurovascular health may help preserve cognitive functions in PD.
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Affiliation(s)
- Miaomiao Hou
- Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaojun Hou
- Department of Neurology, The First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Yiqing Qiu
- Department of Neurosurgery, The First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Jiali Wang
- Department of Neurosurgery, The First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Mingyang Zhang
- Department of Chemistry, University of Utah, Salt Lake City, UT, United States
| | - Xiaowei Mao
- Department of Neurology, The First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Xi Wu
- Department of Neurosurgery, The First Affiliated Hospital of Naval Medical University, Shanghai, China
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Svaerke K, Faerk AK, Riis A, Stiegnitz von Ehrenfels SEM, Mogensen J, Lokkegaard A. Effects of Computer-Based Cognitive Rehabilitation on Attention, Executive Functions, and Quality of Life in Patients with Parkinson's Disease: A Randomized, Controlled, Single-Blinded Pilot Study. Dement Geriatr Cogn Disord 2022; 50:519-528. [PMID: 34986487 DOI: 10.1159/000520591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 10/25/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Cognitive decline in Parkinson's disease (PD) has become increasingly recognized in recent years, and there is a need to identify methods for cognitive rehabilitation in PD patients. OBJECTIVE The aim of this study was to explore the feasibility and effects of 2 different computer-based cognitive rehabilitation (CBCR) interventions on attention, executive functions, and quality of life (QoL) in PD patients. METHODS Thirty nondemented PD patients were randomly assigned to one of 3 groups: one passive control group and 2 intervention groups with 2 different CBCR programmes. The intervention period was 8 weeks with follow-up visits in clinic every second week. Before and after the intervention period, patients were tested with a neuropsychological battery of attention, executive functions, and QoL. RESULTS Twenty-four patients completed the study. Patients in one of the CBCR groups experienced a significant within-group increase on the primary measures of attention, executive functions, and QoL. However, this effect was not significant between groups. No significant differences were observed for the other CBCR group or the control group. CONCLUSIONS CBCR is a feasible intervention for cognitive rehabilitation in nondemented PD patients. The effects of training were modest and should be further explored in larger clinical trials. Some CBCR programmes might be more effective than others for PD patients. The protocol for this study was published prospectively at ClinicalTrials.gov on September 18, 2017 with ID: NCT03285347.
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Affiliation(s)
- Katrine Svaerke
- Department of Neurology, Bispebjerg Hospital, Copenhagen, Denmark
| | | | - Asta Riis
- Unit for Cognitive Neuroscience, University of Copenhagen, Copenhagen, Denmark
| | | | - Jesper Mogensen
- Unit for Cognitive Neuroscience, University of Copenhagen, Copenhagen, Denmark
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El-Kattan MM, Rashed LA, Shazly SR, Ismail RS. Relation of serum level of tumor necrosis factor-alpha to cognitive functions in patients with Parkinson’s disease. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2022. [DOI: 10.1186/s41983-022-00460-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Inflammation is suggested to play a role in the development of non-motor Parkinson’s disease (PD) symptoms. We aimed to investigate the association between serum tumor necrosis factor-alpha (TNF-α) levels and cognition in PD patients. Thirty patients with PD and 30 healthy controls were included. Evaluation and staging of PD were done using Unified PD Rating Scale. Cognitive assessment was done using Addenbrooke’s Cognitive Examination (ACE-III) and trail making B tests. Measurement of serum levels of TNF-α was done.
Results
Patients had significantly worser cognitive scores than controls except for language subclass of ACE score. Mean serum TNF-α level was significantly greater in PD patients as compared to controls. TNF-α serum level was significantly negatively correlated with ACE visuospatial function. Sensitivity and specificity of TNF-α to detect cognitive dysfunction in PD using ACE III and trail making B tests were (73.1, 75%), (57.1, 56.2%), respectively, whereas sensitivity and specificity of TNF-α to detect severity of PD using H&Y staging in PD were 50%.
Conclusion
Patients with PD frequently have cognitive impairment. Elevated serum TNF-α levels in patients with PD, and association of this cytokine to visuospatial impairment, implicate this pro-inflammatory cytokine in the neurobiology of cognitive impairment in PD.
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Zeng W, Fan W, Kong X, Liu X, Liu L, Cao Z, Zhang X, Yang X, Cheng C, Wu Y, Xu Y, Cao X, Xu Y. Altered Intra- and Inter-Network Connectivity in Drug-Naïve Patients With Early Parkinson’s Disease. Front Aging Neurosci 2022; 14:783634. [PMID: 35237144 PMCID: PMC8884479 DOI: 10.3389/fnagi.2022.783634] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 01/17/2022] [Indexed: 12/22/2022] Open
Abstract
The aim of our study was to investigate differences in whole brain connectivity at different levels between drug-naïve individuals with early Parkinson’s disease (PD) and healthy controls (HCs). Resting-state functional magnetic resonance imaging data were collected from 47 patients with early-stage, drug-naïve PD and 50 HCs. Functional brain connectivity was analyzed at the integrity, network, and edge levels; UPDRS-III, MMSE, MOCA, HAMA, and HAMD scores, reflecting the symptoms of PD, were collected for further regression analysis. Compared with age-matched HCs, reduced functional connectivity were mainly observed in the visual (VSN), somatomotor (SMN), limbic (LBN), and deep gray matter networks (DGN) at integrity level [p < 0.05, false discovery rate (FDR) corrected]. Intra-network analysis indicated decreased functional connectivity in DGN, SMN, LBN, and ventral attention networks (VAN). Inter-network analysis indicated reduced functional connectivity in nine pairs of resting-state networks. At the edge level, the LBN was the center of abnormal functional connectivity (p < 0.05, FDR corrected). MOCA score was associated with the intra-network functional connectivity strength (FC) of the DGN, and inter-network FC of the DGN-VAN. HAMA and HAMD scores were associated with the FC of the SMN and DGN, and either the LBN or VAN, respectively. We demonstrated variations in whole brain connections of drug-naïve patients with early PD. Major changes involved the SMN, DGN, LBN, and VSN, which may be relevant to symptoms of early PD. Additionally, our results support PD as a disconnection syndrome.
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Affiliation(s)
- Weiqi Zeng
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenliang Fan
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Xiangchuang Kong
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Xiaoming Liu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Ling Liu
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ziqin Cao
- Department of Chemistry, Emory University, Atlanta, GA, United States
| | - Xiaoqian Zhang
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoman Yang
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chi Cheng
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yi Wu
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yu Xu
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xuebing Cao
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Xuebing Cao,
| | - Yan Xu
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Yan Xu,
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Kumar S, Bansal A, Shri N, Nath NJ, Dosaya D. Effect of food insecurity on the cognitive problems among elderly in India. BMC Geriatr 2021; 21:725. [PMID: 34922495 PMCID: PMC8684220 DOI: 10.1186/s12877-021-02689-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 11/29/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Food Insecurity (FI) is a crucial social determinant of health, independent of other socioeconomic factors, as inadequate food resources create a threat to physical and mental health especially among older person. The present study explores the associations between FI and cognitive ability among the aged population in India. METHODS To measure the cognitive functioning we have used two proxies, word recall and computational problem. Descriptive analysis and multivariable logistic regression was used to understand the prevalence of word recall and computational problem by food security and some selected sociodemographic parameters. All the results were reported at 95% confidence interval. RESULTS We have used the data from the first wave of longitudinal ageing study of India (LASI), with a sample of 31,464 older persons 60 years and above. The study identified that 17 and 5% of the older population in India experiencing computational and word recall problem, respectively. It was found that respondents from food secure households were 14% less likely to have word recall problems [AOR:0.86, 95% CI:0.31-0.98], and 55% likely to have computational problems [AOR:0.45, 95% CI:0.29-0.70]. We also found poor cognitive functioning among those experiencing disability, severe ADL, and IADL. Further, factors such as age, education, marital status, working status, health related factors were the major contributors to the cognitive functioning in older adults. CONCLUSION This study suggest that food insecurity is associated with a lower level of cognition among the elderly in India, which highlight the need of food policy and interventional strategies to address food insecurity, especially among the individuals belonging to lower wealth quintiles. Furthermore, increasing the coverage of food distribution may also help to decrease the burden of disease for the at most risk population. Also, there is a need for specific programs and policies that improve the availability of nutritious food among elderly.
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Affiliation(s)
- Shubham Kumar
- International Institute for Population Sciences, Govandi East, Mumbai, 400088 India
| | - Anjali Bansal
- International Institute for Population Sciences, Govandi East, Mumbai, 400088 India
| | - Neha Shri
- International Institute for Population Sciences, Govandi East, Mumbai, 400088 India
| | - Nayan Jyoti Nath
- CHRIST (Deemed-to-be-University), Central Campus, Bengaluru, India
| | - Divya Dosaya
- Birla Institute of Technology and Science, Pilani, India
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Nejtek VA, James RN, Salvatore MF, Alphonso HM, Boehm GW. Premature cognitive decline in specific domains found in young veterans with mTBI coincide with elder normative scores and advanced-age subjects with early-stage Parkinson's disease. PLoS One 2021; 16:e0258851. [PMID: 34788310 PMCID: PMC8598036 DOI: 10.1371/journal.pone.0258851] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 10/06/2021] [Indexed: 12/02/2022] Open
Abstract
Importance Epidemiologists report a 56% increased risk of veterans with (+) mild traumatic brain injury (mTBI) developing Parkinson’s disease (PD) within 12-years post-injury. The most relevant contributors to this high risk of PD in veterans (+) mTBI is unknown. As cognitive problems often precede PD diagnosis, identifying specific domains most involved with mTBI-related PD onset is critical. Objectives To discern which cognitive domains underlie the mTBI-PD risk relationship proposed in epidemiology studies. Design and setting This exploratory match-controlled, cross-sectional study was conducted in a medical school laboratory from 2017–2020. Participants Age- and IQ-matched veterans with (+) and without mTBI, non-veteran healthy controls, and IQ-matched non-demented early-stage PD were compared. Chronic neurological, unremitted/debilitating diseases, disorders, dementia, and substance use among others were excluded. Exposure Veterans were or were not exposed to non-penetrating combat-related mTBI occurring within the past 7-years. No other groups had recent military service or mTBI. Main outcomes / measures Cognitive flexibility, attention, memory, visuospatial ability, and verbal fluency were examined with well-known standardized neuropsychological assessments. Results Out of 200 volunteers, 114 provided evaluable data. Groups significantly differed on cognitive tests [F (21,299) = 3.09, p<0.0001]. Post hoc tests showed veterans (+) mTBI performed significantly worse than matched-control groups on four out of eight cognitive tests (range: p = .009 to .049), and more often than not performed comparably to early-stage PD (range: p = .749 to .140). Conclusions and relevance We found subtle, premature cognitive decline occurring in very specific cognitive domains in veterans (+) mTBI that would typically be overlooked in a clinic setting, This result potentially puts them at-risk for continual cognitive decline that may portend to the eventual onset of PD or some other neurodegenerative disease.
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Affiliation(s)
- Vicki A Nejtek
- University of North Texas Health Science Center, Fort Worth, Texas, United States of America
| | - Rachael N James
- University of North Texas Health Science Center, Fort Worth, Texas, United States of America
| | - Michael F Salvatore
- University of North Texas Health Science Center, Fort Worth, Texas, United States of America
| | - Helene M Alphonso
- University of North Texas Health Science Center, Fort Worth, Texas, United States of America.,John Peter Smith Health Network, Fort Worth, Texas, United States of America
| | - Gary W Boehm
- Texas Christian University, Fort Worth, Texas, United States of America
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Herrera ML, Deza-Ponzio R, Ghersi MS, de la Villarmois EA, Virgolini MB, Pérez MF, Molina VA, Bellini MJ, Hereñú CB. Early Cognitive Impairment Behind Nigrostriatal Circuit Neurotoxicity: Are Astrocytes Involved? ASN Neuro 2021; 12:1759091420925977. [PMID: 32466659 PMCID: PMC7263115 DOI: 10.1177/1759091420925977] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Cognitive dysfunction is one of the most severe nonmotor symptoms of nigrostriatal impairment. This occurs as a result of profound functional and morphological changes of different neuronal circuits, including modifications in the plasticity and architecture of hippocampal synapses. Such alterations can be implicated in the genesis and progression of dementia associated with neurodegenerative diseases including Parkinson-like symptoms. There are few studies regarding cognitive changes in nigrostriatal animal models. The aim of this study was to characterize the onset of memory deficit after induction of neurotoxicity with 6-hydroxydopamine (6-OHDA) and its correlation with hippocampal dysfunction. For this, we bilaterally microinjected 6-OHDA in dorsolateral Caudate-Putamen unit (CPu) and then, animals were tested weekly for working memory, spatial short-term memory, and motor performance. We evaluated tyrosine hydroxylase (TH) as a dopamine marker, aldehyde dehydrogenase 2 (ALDH2), a mitochondria detoxification enzyme and astrocyte glial fibrillar acid protein (GFAP) an immunoreactivity marker involved in different areas: CPu, substantia nigra, prefrontal cortex, and hippocampus. We observed a specific prefrontal cortex and nigrostriatal pathway TH reduction while ALDH2 showed a decrease-positive area in all the studied regions. Moreover, GFAP showed a specific CPu decrease and hippocampus increase of positively stained area on the third week after toxicity. We also evaluated the threshold to induce long-term potentiation in hippocampal excitability. Our findings showed that reduced hippocampal synaptic transmission was accompanied by deficits in memory processes, without affecting motor performance on the third-week post 6-OHDA administration. Our results suggest that 3 weeks after neurotoxic administration, astrocytes and ALDH2 mitochondrial enzyme modifications participate in altering the properties that negatively affect hippocampal function and consequently cognitive behavior.
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Affiliation(s)
- Macarena L Herrera
- Instituto de Farmacología Experimental de Córdoba (IFEC-CONICET), Departamento de Farmacología, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba.,Instituto de Investigaciones Bioquímicas de La Plata (INIBIOLP-CONICET), Facultad de Ciencias Médicas, Universidad Nacional de La Plata, Buenos Aires, Argentina
| | - Romina Deza-Ponzio
- Instituto de Farmacología Experimental de Córdoba (IFEC-CONICET), Departamento de Farmacología, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba
| | - Marisa S Ghersi
- Instituto de Farmacología Experimental de Córdoba (IFEC-CONICET), Departamento de Farmacología, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba
| | - Emilce A de la Villarmois
- Instituto de Farmacología Experimental de Córdoba (IFEC-CONICET), Departamento de Farmacología, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba
| | - Miriam B Virgolini
- Instituto de Farmacología Experimental de Córdoba (IFEC-CONICET), Departamento de Farmacología, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba
| | - Mariela F Pérez
- Instituto de Farmacología Experimental de Córdoba (IFEC-CONICET), Departamento de Farmacología, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba
| | - Victor A Molina
- Instituto de Farmacología Experimental de Córdoba (IFEC-CONICET), Departamento de Farmacología, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba
| | - María J Bellini
- Instituto de Investigaciones Bioquímicas de La Plata (INIBIOLP-CONICET), Facultad de Ciencias Médicas, Universidad Nacional de La Plata, Buenos Aires, Argentina
| | - Claudia B Hereñú
- Instituto de Farmacología Experimental de Córdoba (IFEC-CONICET), Departamento de Farmacología, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba
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Parkin BL, Daws RE, Das-Neves I, Violante IR, Soreq E, Faisal AA, Sandrone S, Lao-Kaim NP, Martin-Bastida A, Roussakis AA, Piccini P, Hampshire A. Dissociable effects of age and Parkinson's disease on instruction-based learning. Brain Commun 2021; 3:fcab175. [PMID: 34485905 PMCID: PMC8410985 DOI: 10.1093/braincomms/fcab175] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 04/06/2021] [Accepted: 05/10/2021] [Indexed: 12/02/2022] Open
Abstract
The cognitive deficits associated with Parkinson's disease vary across individuals and change across time, with implications for prognosis and treatment. Key outstanding challenges are to define the distinct behavioural characteristics of this disorder and develop diagnostic paradigms that can assess these sensitively in individuals. In a previous study, we measured different aspects of attentional control in Parkinson's disease using an established fMRI switching paradigm. We observed no deficits for the aspects of attention the task was designed to examine; instead those with Parkinson's disease learnt the operational requirements of the task more slowly. We hypothesized that a subset of people with early-to-mid stage Parkinson's might be impaired when encoding rules for performing new tasks. Here, we directly test this hypothesis and investigate whether deficits in instruction-based learning represent a characteristic of Parkinson's Disease. Seventeen participants with Parkinson's disease (8 male; mean age: 61.2 years), 18 older adults (8 male; mean age: 61.3 years) and 20 younger adults (10 males; mean age: 26.7 years) undertook a simple instruction-based learning paradigm in the MRI scanner. They sorted sequences of coloured shapes according to binary discrimination rules that were updated at two-minute intervals. Unlike common reinforcement learning tasks, the rules were unambiguous, being explicitly presented; consequently, there was no requirement to monitor feedback or estimate contingencies. Despite its simplicity, a third of the Parkinson's group, but only one older adult, showed marked increases in errors, 4 SD greater than the worst performing young adult. The pattern of errors was consistent, reflecting a tendency to misbind discrimination rules. The misbinding behaviour was coupled with reduced frontal, parietal and anterior caudate activity when rules were being encoded, but not when attention was initially oriented to the instruction slides or when discrimination trials were performed. Concomitantly, Magnetic Resonance Spectroscopy showed reduced gamma-Aminobutyric acid levels within the mid-dorsolateral prefrontal cortices of individuals who made misbinding errors. These results demonstrate, for the first time, that a subset of early-to-mid stage people with Parkinson's show substantial deficits when binding new task rules in working memory. Given the ubiquity of instruction-based learning, these deficits are likely to impede daily living. They will also confound clinical assessment of other cognitive processes. Future work should determine the value of instruction-based learning as a sensitive early marker of cognitive decline and as a measure of responsiveness to therapy in Parkinson's disease.
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Affiliation(s)
- Beth L Parkin
- Department of Psychology, School of Social Science, University of Westminster, 115 New Cavendish Street, London, W1W 6UW, UK
| | - Richard E Daws
- The Cognitive, Computational and Clinical Neuroscience Laboratory, Department of Medicine, Imperial College London, London W120NN, UK
| | - Ines Das-Neves
- The Cognitive, Computational and Clinical Neuroscience Laboratory, Department of Medicine, Imperial College London, London W120NN, UK
| | - Ines R Violante
- The Cognitive, Computational and Clinical Neuroscience Laboratory, Department of Medicine, Imperial College London, London W120NN, UK
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK
| | - Eyal Soreq
- The Cognitive, Computational and Clinical Neuroscience Laboratory, Department of Medicine, Imperial College London, London W120NN, UK
| | - A Aldo Faisal
- Brain and Behaviour Laboratory, Department of Bioengineering, Imperial College London, London W12 0NN, UK
- Brain and Behaviour Laboratory, Department of Computing, Imperial College London, London W12 0NN, UK
- Behaviour Analytics Lab, Data Science Institute, Imperial College London, London W12 0NN, UK
- MRC London Institute of Medical Sciences, London W12 0NN, UK
| | - Stefano Sandrone
- The Cognitive, Computational and Clinical Neuroscience Laboratory, Department of Medicine, Imperial College London, London W120NN, UK
| | - Nicholas P Lao-Kaim
- Neurology Imaging Unit, Division of Neurology, Imperial College London, London W12 0NN, UK
| | - Antonio Martin-Bastida
- Neurology Imaging Unit, Division of Neurology, Imperial College London, London W12 0NN, UK
- Department of Neurology and Neurosciences, Clinica Universidad de Navarra, Pamplona-Madrid 28027, Spain
| | | | - Paola Piccini
- Neurology Imaging Unit, Division of Neurology, Imperial College London, London W12 0NN, UK
| | - Adam Hampshire
- The Cognitive, Computational and Clinical Neuroscience Laboratory, Department of Medicine, Imperial College London, London W120NN, UK
- UK DRI Care Research & Technology Centre, Imperial College London, London W12 0NN, UK
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36
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Dan X, Hu Y, Sun J, Gao L, Zhou Y, Ma J, Doyon J, Wu T, Chan P. Altered Cerebellar Resting-State Functional Connectivity in Early-Stage Parkinson's Disease Patients With Cognitive Impairment. Front Neurol 2021; 12:678013. [PMID: 34512503 PMCID: PMC8425347 DOI: 10.3389/fneur.2021.678013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 07/30/2021] [Indexed: 01/01/2023] Open
Abstract
Background: Cognitive impairment is one of the most prominent non-motor symptoms in Parkinson's disease (PD), due in part to known cerebellar dysfunctions. Furthermore, previous studies have reported altered cerebellar functional connectivity (FC) in PD patients. Yet whether these changes are also due to the cognitive deficits in PD remain unclear. Methods: A total of 122 non-dementia participants, including 64 patients with early PD and 58 age- and gender-matched elderly controls were stratified into four groups based on their cognitive status (normal cognition vs. cognitive impairment). Cerebellar volumetry and FC were investigated by analyzing, respectively, structural and resting-state functional MRI data among groups using quality control and quantitative measures. Correlation analysis between MRI metrics and clinical features (motor and cognitive scores) were performed. Results: Compared to healthy control subjects with no cognitive deficits, altered cerebellar FC were observed in early PD participants with both motor and cognitive deficits, but not in PD patients with normal cognition, nor elderly subjects showing signs of a cognitive impairment. Moreover, connectivity between the "motor" cerebellum and SMA was positively correlated with motor scores, while intracerebellar connectivity was positively correlated with cognitive scores in PD patients with cognitive impairment. No cerebellar volumetric difference was observed between groups. Conclusions: These findings show that altered cerebellar FC during resting state in early PD patients may be driven not solely by the motor deficits, but by cognitive deficits as well, hence highlighting the interplay between motor and cognitive functioning, and possibly reflecting compensatory mechanisms, in the early PD.
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Affiliation(s)
- Xiaojuan Dan
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
- Key Laboratory on Neurodegenerative Disorders of Ministry of Education, Key Laboratory on Parkinson's Disease of Beijing, Beijing, China
| | - Yang Hu
- Laboratory of Psychological Health and Imaging, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Junyan Sun
- Department of Neurobiology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Linlin Gao
- Department of Neurobiology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Yongtao Zhou
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Jinghong Ma
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Julien Doyon
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Tao Wu
- Department of Neurobiology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Piu Chan
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
- Key Laboratory on Neurodegenerative Disorders of Ministry of Education, Key Laboratory on Parkinson's Disease of Beijing, Beijing, China
- National Clinical Research Center for Geriatric Disorders, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Beijing Institute for Brain Disorders Parkinson's Disease Center, Capital Medical University, Beijing, China
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The Anterior Attentional-Intentional System in Patients with Parkinson's Disease-A Pilot and Feasibility Study. Brain Sci 2021; 11:brainsci11081013. [PMID: 34439632 PMCID: PMC8392698 DOI: 10.3390/brainsci11081013] [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: 06/29/2021] [Revised: 07/22/2021] [Accepted: 07/27/2021] [Indexed: 11/16/2022] Open
Abstract
(1) Background: This study compared anterior attentional–intentional system performance between three groups: Parkinson’s disease (PD) patients with normal cognition (PD-NC), with mild cognitive impairment (PD-MCI), and a comparison group (CG). It also evaluated the feasibility of the recruitment and study procedures; (2) Methods: From 45 participants recruited, 39 were allocated (mean age 65.31; 43.59% men) to PD-NC, PD-MCI and CG (13 per group). To assess attention, we used three tasks from the ROtman–Baycrest Battery for Investigating Attention: Simple Reaction time (RT), Choice RT, and Prepare RT. We conducted a mixed-model analysis of variance with a 3 (groups) × 4 (tasks) design to compare reaction times; (3) Results: PD-MCI had slower reaction times than PD-NC (p = 0.028) and the CG (p = 0.052); there was no difference between PD-NC and CG. PD-MCI might perform worse on monitoring tasks than PD-NC, Z = −1.68, p = 0.092. Nearly half the volunteers from the CG and 87% of all eligible patients were enrolled in the study and completed all neuropsychological procedures; (4) Conclusions: General cognitive decline appears related to partial deficits in energization and tends to impair attentional monitoring. Furthermore, PD-NC exhibited similar reaction times to the CG. Results from the feasibility study contributed to the definitive study.
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Li J, Liao H, Wang T, Zi Y, Zhang L, Wang M, Mao Z, Song C, Zhou F, Shen Q, Cai S, Tan C. Alterations of Regional Homogeneity in the Mild and Moderate Stages of Parkinson's Disease. Front Aging Neurosci 2021; 13:676899. [PMID: 34366823 PMCID: PMC8336937 DOI: 10.3389/fnagi.2021.676899] [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: 03/06/2021] [Accepted: 06/23/2021] [Indexed: 01/26/2023] Open
Abstract
Objectives: This study aimed to investigate alterations in regional homogeneity (ReHo) in early Parkinson's disease (PD) at different Hoehn and Yahr (HY) stages and to demonstrate the relationships between altered brain regions and clinical scale scores. Methods: We recruited 75 PD patients, including 43 with mild PD (PD-mild; HY stage: 1.0-1.5) and 32 with moderate PD (PD-moderate; HY stage: 2.0-2.5). We also recruited 37 age- and sex-matched healthy subjects as healthy controls (HC). All subjects underwent neuropsychological assessments and a 3.0 Tesla magnetic resonance scanning. Regional homogeneity of blood oxygen level-dependent (BOLD) signals was used to characterize regional cerebral function. Correlative relationships between mean ReHo values and clinical data were then explored. Results: Compared to the HC group, the PD-mild group exhibited increased ReHo values in the right cerebellum, while the PD-moderate group exhibited increased ReHo values in the bilateral cerebellum, and decreased ReHo values in the right superior temporal gyrus, the right Rolandic operculum, the right postcentral gyrus, and the right precentral gyrus. Reho value of right Pre/Postcentral was negatively correlated with HY stage. Compared to the PD-moderate group, the PD-mild group showed reduced ReHo values in the right superior orbital gyrus and the right rectus, in which the ReHo value was negatively correlated with cognition. Conclusion: The right superior orbital gyrus and right rectus may serve as a differential indicator for mild and moderate PD. Subjects with moderate PD had a greater scope for ReHo alterations in the cortex and compensation in the cerebellum than those with mild PD. PD at HY stages of 2.0-2.5 may already be classified as Braak stages 5 and 6 in terms of pathology. Our study revealed the different patterns of brain function in a resting state in PD at different HY stages and may help to elucidate the neural function and early diagnosis of patients with PD.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Changlian Tan
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, China
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Combs HL, Wyman-Chick KA, Erickson LO, York MK. Development of standardized regression-based formulas to assess meaningful cognitive change in early Parkinson's disease. Arch Clin Neuropsychol 2021; 36:734-745. [PMID: 33103727 DOI: 10.1093/arclin/acaa104] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 07/29/2020] [Accepted: 10/01/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Longitudinal assessment of cognitive and emotional functioning in patients with Parkinson's disease (PD) is helpful in tracking progression of the disease, developing treatment plans, evaluating outcomes, and educating patients and families. Determining whether change over time is meaningful in neurodegenerative conditions, such as PD, can be difficult as repeat assessment of neuropsychological functioning is impacted by factors outside of cognitive change. Regression-based prediction formulas are one method by which clinicians and researchers can determine whether an observed change is meaningful. The purpose of the current study was to develop and validate regression-based prediction models of cognitive and emotional test scores for participants with early-stage idiopathic PD and healthy controls (HC) enrolled in the Parkinson's Progression Markers Initiative (PPMI). METHODS Participants with de novo PD and HC were identified retrospectively from the PPMI archival database. Data from baseline testing and 12-month follow-up were utilized in this study. In total, 688 total participants were included in the present study (NPD = 508; NHC = 185). Subjects from both groups were randomly divided into development (70%) and validation (30%) subsets. RESULTS Early-stage idiopathic PD patients and healthy controls were similar at baseline. Regression-based models were developed for all cognitive and self-report mood measures within both populations. Within the validation subset, the predicted and observed cognitive test scores did not significantly differ, except for semantic fluency. CONCLUSIONS The prediction models can serve as useful tools for researchers and clinicians to study clinically meaningful cognitive and mood change over time in PD.
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Theodoros D. Telerehabilitation for Communication and Swallowing Disorders in Parkinson's Disease. JOURNAL OF PARKINSONS DISEASE 2021; 11:S65-S70. [PMID: 33896848 PMCID: PMC8385517 DOI: 10.3233/jpd-202414] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Communication and swallowing disorders are highly prevalent in people with Parkinson's disease (PD). The negative impact of these disorders on the quality of life of the person with PD and their families cannot be underestimated. Despite a demand for speech-language pathology services to support people with PD, many barriers to services exist. Telerehabilitation provides an alternate and complementary approach to in-person therapy that is patient-centered, enables timely assessment and intervention, and facilitates continuity of care throughout the course of the disease. This review explores the telerehabilitation applications designed for the management of the communication and swallowing disorders in PD, addresses the benefits and challenges of telerehabilitation, identifies future research directions, and highlights the potential of new technologies to enhance the management of communication and swallowing disorders and quality of life for people with PD.
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Affiliation(s)
- Deborah Theodoros
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
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Murueta-Goyena A, Barrenechea M, Erramuzpe A, Teijeira-Portas S, Pengo M, Ayala U, Romero-Bascones D, Acera M, Del Pino R, Gómez-Esteban JC, Gabilondo I. Foveal Remodeling of Retinal Microvasculature in Parkinson's Disease. Front Neurosci 2021; 15:708700. [PMID: 34321998 PMCID: PMC8311167 DOI: 10.3389/fnins.2021.708700] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 06/11/2021] [Indexed: 11/26/2022] Open
Abstract
Background Retinal microvascular alterations have been previously described in Parkinson’s disease (PD) patients using optical coherence tomography angiography (OCT-A). However, an extensive description of retinal vascular morphological features, their association with PD-related clinical variables and their potential use as diagnostic biomarkers has not been explored. Methods We performed a cross-sectional study including 49 PD patients (87 eyes) and 40 controls (73 eyes). Retinal microvasculature was evaluated with Spectralis OCT-A and cognitive status with Montreal Cognitive Assessment. Unified PD Rating Scale and disease duration were recorded in patients. We extracted microvascular parameters from superficial and deep vascular plexuses of the macula, including the area and circularity of foveal avascular zone (FAZ), skeleton density, perfusion density, vessel perimeter index, vessel mean diameter, fractal dimension (FD) and lacunarity using Python and MATLAB. We compared the microvascular parameters between groups and explored their association with thickness of macular layers and clinical outcomes. Data were analyzed with General Estimating Equations (GEE) and adjusted for age, sex, and hypertension. Logistic regression GEE models were fitted to predict diagnosis of PD versus controls from microvascular, demographic, and clinical data. The discrimination ability of models was tested with receiver operating characteristic curves. Results FAZ area was significantly smaller in patients compared to controls in superficial and deep plexuses, whereas perfusion density, skeleton density, FD and lacunarity of capillaries were increased in the foveal zone of PD. In the parafovea, microvascular parameters of superficial plexus were associated with ganglion cell-inner plexiform layer thickness, but this was mainly driven by PD with mild cognitive impairment. No such associations were observed in controls. FAZ area was negatively associated with cognition in PD (non-adjusted models). Foveal lacunarity, combined with demographic and clinical confounding factors, yielded an outstanding diagnostic accuracy for discriminating PD patients from controls. Conclusion Parkinson’s disease patients displayed foveal microvascular alterations causing an enlargement of the vascular bed surrounding FAZ. Parafoveal microvascular alterations were less pronounced but were related to inner retinal layer thinning. Retinal microvascular abnormalities helped discriminating PD from controls. All this supports OCT-A as a potential non-invasive biomarker to reveal vascular pathophysiology and improve diagnostic accuracy in PD.
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Affiliation(s)
- Ane Murueta-Goyena
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.,Department of Preventive Medicine and Public Health, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Maitane Barrenechea
- Biomedical Engineering Department, Faculty of Engineering, Mondragon Unibertsitatea (MU-ENG), Mondragon, Spain
| | - Asier Erramuzpe
- Biomedical Engineering Department, Faculty of Engineering, Mondragon Unibertsitatea (MU-ENG), Mondragon, Spain
| | - Sara Teijeira-Portas
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
| | - Marta Pengo
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Unai Ayala
- Biomedical Engineering Department, Faculty of Engineering, Mondragon Unibertsitatea (MU-ENG), Mondragon, Spain
| | - David Romero-Bascones
- Biomedical Engineering Department, Faculty of Engineering, Mondragon Unibertsitatea (MU-ENG), Mondragon, Spain
| | - Marian Acera
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
| | - Rocío Del Pino
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
| | - Juan Carlos Gómez-Esteban
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.,Neurology Department, Cruces University Hospital, Barakaldo, Spain.,Department of Neurosciences, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Iñigo Gabilondo
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.,Neurology Department, Cruces University Hospital, Barakaldo, Spain.,Ikerbasque: The Basque Foundation for Science, Bilbao, Spain
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Sherstnev VV, Solov’eva OA, Gruden’ MA, Ratmirov AM, Konovalova EV. Hippocampal Neurogenesis, Dopaminergic Neurons of the Substantia Nigra, and Behavior after Intranasal Administration of Native α-Synuclein Protein to Ageing Mice. NEUROCHEM J+ 2021. [DOI: 10.1134/s181971242101013x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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43
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Ramezani M, Mouches P, Yoon E, Rajashekar D, Ruskey JA, Leveille E, Martens K, Kibreab M, Hammer T, Kathol I, Maarouf N, Sarna J, Martino D, Pfeffer G, Gan-Or Z, Forkert ND, Monchi O. Investigating the relationship between the SNCA gene and cognitive abilities in idiopathic Parkinson's disease using machine learning. Sci Rep 2021; 11:4917. [PMID: 33649398 PMCID: PMC7921412 DOI: 10.1038/s41598-021-84316-4] [Citation(s) in RCA: 4] [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] [Received: 10/31/2020] [Accepted: 02/10/2021] [Indexed: 01/16/2023] Open
Abstract
Cognitive impairments are prevalent in Parkinson's disease (PD), but the underlying mechanisms of their development are unknown. In this study, we aimed to predict global cognition (GC) in PD with machine learning (ML) using structural neuroimaging, genetics and clinical and demographic characteristics. As a post-hoc analysis, we aimed to explore the connection between novel selected features and GC more precisely and to investigate whether this relationship is specific to GC or is driven by specific cognitive domains. 101 idiopathic PD patients had a cognitive assessment, structural MRI and blood draw. ML was performed on 102 input features including demographics, cortical thickness and subcortical measures, and several genetic variants (APOE, MAPT, SNCA, etc.). Using the combination of RRELIEFF and Support Vector Regression, 11 features were found to be predictive of GC including sex, rs894280, Edinburgh Handedness Inventory, UPDRS-III, education, five cortical thickness measures (R-parahippocampal, L-entorhinal, R-rostral anterior cingulate, L-middle temporal, and R-transverse temporal), and R-caudate volume. The rs894280 of SNCA gene was selected as the most novel finding of ML. Post-hoc analysis revealed a robust association between rs894280 and GC, attention, and visuospatial abilities. This variant indicates a potential role for the SNCA gene in cognitive impairments of idiopathic PD.
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Affiliation(s)
- Mehrafarin Ramezani
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute (HBI), Cummings School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Pauline Mouches
- Hotchkiss Brain Institute (HBI), Cummings School of Medicine, University of Calgary, Calgary, AB, Canada
- Biomedical Engineering Graduate Program, University of Calgary, Calgary, Canada
- Department of Radiology, University of Calgary, Calgary, AB, Canada
| | - Eunjin Yoon
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute (HBI), Cummings School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Deepthi Rajashekar
- Hotchkiss Brain Institute (HBI), Cummings School of Medicine, University of Calgary, Calgary, AB, Canada
- Biomedical Engineering Graduate Program, University of Calgary, Calgary, Canada
- Department of Radiology, University of Calgary, Calgary, AB, Canada
| | - Jennifer A Ruskey
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada
- Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
| | - Etienne Leveille
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Kristina Martens
- Hotchkiss Brain Institute (HBI), Cummings School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Mekale Kibreab
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute (HBI), Cummings School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Tracy Hammer
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute (HBI), Cummings School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Iris Kathol
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute (HBI), Cummings School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Nadia Maarouf
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute (HBI), Cummings School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Justyna Sarna
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute (HBI), Cummings School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Davide Martino
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute (HBI), Cummings School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Gerald Pfeffer
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute (HBI), Cummings School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Medical Genetics, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Ziv Gan-Or
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada
- Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
- Department of Human Genetics, McGill University, Montreal, QC, Canada
| | - Nils D Forkert
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute (HBI), Cummings School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Radiology, University of Calgary, Calgary, AB, Canada
| | - Oury Monchi
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
- Hotchkiss Brain Institute (HBI), Cummings School of Medicine, University of Calgary, Calgary, AB, Canada.
- Department of Radiology, University of Calgary, Calgary, AB, Canada.
- Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada.
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Crowley SJ, Banan G, Amin M, Tanner JJ, Hizel L, Nguyen P, Brumback B, Rodriguez K, McFarland N, Bowers D, Ding M, Mareci TA, Price CC. Statistically Defined Parkinson's Disease Executive and Memory Cognitive Phenotypes: Demographic, Behavioral, and Structural Neuroimaging Comparisons. JOURNAL OF PARKINSONS DISEASE 2021; 11:283-297. [PMID: 33216042 DOI: 10.3233/jpd-202166] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Some individuals with Parkinson's disease (PD) experience working memory and inhibitory difficulties, others learning and memory difficulties, while some only minimal to no cognitive deficits for many years. OBJECTIVE To statistically derive PD executive and memory phenotypes, and compare PD phenotypes on disease and demographic variables, vascular risk factors, and specific neuroimaging variables with known associations to executive and memory function relative to non-PD peers. METHODS Non-demented individuals with PD (n = 116) and non-PD peers (n = 62) were recruited to complete neuropsychology measures, blood draw, and structural magnetic resonance imaging. Tests representing the cognitive domains of interest (4 executive function, 3 memory) were included in a k-means cluster analysis comprised of the PD participants. Resulting clusters were compared demographic and disease-related variables, vascular risk markers, gray/white regions of interest, and white matter connectivity between known regions involved in executive and memory functions (dorsolateral prefrontal cortices to caudate nuclei; entorhinal cortices to hippocampi). RESULTS Clusters showed: 1) PD Executive, n = 25; 2) PD Memory, n = 35; 3) PD Cognitively Well; n = 56. Even after disease variable corrections, PD Executive had less subcortical gray matter, white matter, and fewer bilateral dorsolateral-prefrontal cortex to caudate nucleus connections; PD Memory showed bilaterally reduced entorhinal-hippocampal connections. PD Cognitively Well showed only reduced putamen volume and right entorhinal cortex to hippocampi connections relative to non-PD peers. Groups did not statistically differ on cortical integrity measures or cerebrovascular disease markers. CONCLUSION PD cognitive phenotypes showed different structural gray and white matter patterns. We discuss data relative to phenotype demographics, cognitive patterns, and structural brain profiles.
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Affiliation(s)
- Samuel J Crowley
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Guita Banan
- Department of Biochemistry and Molecular Biology, Gainesville, FL, USA.,McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Manish Amin
- Department of Biochemistry and Molecular Biology, Gainesville, FL, USA.,McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Jared J Tanner
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.,McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Loren Hizel
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Peter Nguyen
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Babette Brumback
- Department of Biostatistics, University of Florida, Gainesville, FL, USA
| | - Katie Rodriguez
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Nikolaus McFarland
- Department of Neurology, Gainesville, FL, USA.,Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA
| | - Dawn Bowers
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.,Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA
| | - Mingzhou Ding
- McKnight Brain Institute, University of Florida, Gainesville, FL, USA.,Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
| | - Thomas A Mareci
- Department of Biochemistry and Molecular Biology, Gainesville, FL, USA.,McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Catherine C Price
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.,Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA
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CSF Biomarkers Reflecting Protein Pathology and Axonal Degeneration Are Associated with Memory, Attentional, and Executive Functioning in Early-Stage Parkinson's Disease. Int J Mol Sci 2020; 21:ijms21228519. [PMID: 33198266 PMCID: PMC7697681 DOI: 10.3390/ijms21228519] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/09/2020] [Accepted: 11/10/2020] [Indexed: 01/21/2023] Open
Abstract
In early-stage Parkinson′s disease (PD), cognitive impairment is common, and a variety of cognitive domains including memory, attention, and executive functioning may be affected. Cerebrospinal fluid (CSF) biomarkers are potential markers of cognitive functioning. We aimed to explore whether CSF α-synuclein species, neurofilament light chain, amyloid-β42, and tau are associated with cognitive performance in early-stage PD patients. CSF levels of total-α-synuclein and phosphorylated-α-synuclein, neurofilament light chain, amyloid-β42, and total-tau and phosphorylated-tau were measured in 26 PD patients (disease duration ≤5 years and Hoehn and Yahr stage 1–2.5). Multivariable linear regression models, adjusted for age, gender, and educational level, were used to assess the relationship between CSF biomarker levels and memory, attention, executive and visuospatial function, and language performance scores. In 26 early-stage PD patients, attention and memory were the most commonly affected domains. A higher CSF phosphorylated-α-synuclein/total-α-synuclein ratio was associated with better executive functioning (sβ = 0.40). Higher CSF neurofilament light was associated with worse memory (sβ = −0.59), attentional (sβ = −0.32), and executive functioning (sβ = −0.35). Reduced CSF amyloid-β42 levels were associated with poorer attentional functioning (sβ = 0.35). Higher CSF phosphorylated-tau was associated with worse language functioning (sβ = −0.33). Thus, CSF biomarker levels, in particular neurofilament light, were related to the most commonly affected cognitive domains in early-stage PD. This indicates that CSF biomarker levels may identify early-stage PD patients who are at an increased risk of developing cognitive impairment.
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Conner MR, Jang D, Anderson BJ, Kritzer MF. Biological Sex and Sex Hormone Impacts on Deficits in Episodic-Like Memory in a Rat Model of Early, Pre-motor Stages of Parkinson's Disease. Front Neurol 2020; 11:942. [PMID: 33041964 PMCID: PMC7527538 DOI: 10.3389/fneur.2020.00942] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 07/21/2020] [Indexed: 01/30/2023] Open
Abstract
Episodic memory deficits are among the earliest appearing and most commonly occurring examples of cognitive impairment in Parkinson's disease (PD). These enduring features can also predict a clinical course of rapid motor decline, significant cognitive deterioration, and the development of PD-related dementia. The lack of effective means to treat these deficits underscores the need to better understand their neurobiological bases. The prominent sex differences that characterize episodic memory in health, aging and in schizophrenia and Alzheimer's disease suggest that neuroendocrine factors may also influence episodic memory dysfunction in PD. However, while sex differences have been well-documented for many facets of PD, sex differences in, and sex hormone influences on associated episodic memory impairments have been less extensively studied and have never been examined in preclinical PD models. Accordingly, we paired bilateral neostriatal 6-hydroxydopamine (6-OHDA) lesions with behavioral testing using the What-Where-When Episodic-Like Memory (ELM) Task in adult rats to first determine whether episodic-like memory is impaired in this model. We further compared outcomes in gonadally intact female and male subjects, and in male rats that had undergone gonadectomy—with and without hormone replacement, to determine whether biological sex and/or sex hormones influenced the expression of dopamine lesioned-induced memory deficits. These studies showed that 6-OHDA lesions profoundly impaired recall for all memory domains in male and female rats. They also showed that in males, circulating gonadal hormones powerfully modulated the negative impacts of 6-OHDA lesions on What, Where, and When discriminations in domain-specific ways. Specifically, the absence of androgens was shown to fully attenuate 6-OHDA lesion-induced deficits in ELM for “Where” and to partially protect against lesion-induced deficits in ELM for “What.” In sum, these findings show that 6-OHDA lesions in rats recapitulate the vulnerability of episodic memory seen in early PD. Together with similar evidence recently obtained for spatial working memory, the present findings also showed that diminished androgen levels provide powerful, highly selective protections against the harmful effects that 6-OHDA lesions have on memory functions in male rats.
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Affiliation(s)
- Meagan R Conner
- Graduate Program in Neuroscience, Stony Brook University, Stony Brook, NY, United States.,Department of Neurobiology and Behavior, Stony Brook University, Stony Brook, NY, United States
| | - Doyeon Jang
- Department of Neurobiology and Behavior, Stony Brook University, Stony Brook, NY, United States
| | - Brenda J Anderson
- Department of Psychology, Stony Brook University, Stony Brook, NY, United States
| | - Mary F Kritzer
- Department of Neurobiology and Behavior, Stony Brook University, Stony Brook, NY, United States
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47
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Júlio F, Ribeiro MJ, Morgadinho A, Sousa M, van Asselen M, Simões MR, Castelo-Branco M, Januário C. Cognition, function and awareness of disease impact in early Parkinson's and Huntington's disease. Disabil Rehabil 2020; 44:921-939. [PMID: 32620060 DOI: 10.1080/09638288.2020.1783001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Purpose: Patients with Parkinson's and Huntington's Disease (PD and HD) present impairments in cognitively challenging everyday activities. This study contrasts these two basal ganglia disorders on the ability to perform daily life- like tasks and their level of awareness regarding the disease impact on function.Methods: 19 controls, 10 early-onset PD, 20 early stage PD, and 15 early manifest HD patients were compared in the "EcoKitchen," a virtual reality task with increasing executive load, the "Behavioural Assessment of Dysexecutive Syndrome battery - BADS," and "The Adults and Older Adults Functional Assessment Inventory - IAFAI," a self-report functional questionnaire. The EcoKitchen clinical correlates were investigated.Results: All clinical groups presented slower EcoKitchen performance than controls, however, only HD patients showed decreased accuracy. HD and PD patients exhibited reduced BADS scores compared to the other study participants. Importantly, on the IAFAI, PD patients signalled more physically related incapacities and HD patients indicated more cognitively related incapacities. Accordingly, the EcoKitchen performance was significantly associated with PD motor symptom severity.Conclusions: Our findings suggest differential disease impact on cognition and function across PD and HD patients, with preserved awareness regarding disease- related functional sequelae. These observations have important implications for clinical management, research and rehabilitation.Implications for rehabilitationPatients with early stage Parkinson's and Huntington's disease have diagnosis-specific impairments in the performance of executively demanding everyday activities and, yet, show preserved awareness about the disease impact on their daily life.An active involvement of patients in the rehabilitation process should be encouraged, as their appraisal of the disease effects can help on practical decisions about meaningful targets for intervention, vocational choices, quality-of-life issues and/or specific everyday skills to boost.The EcoKitchen, a non-immersive virtual reality task, can detect and quantify early deficits in everyday-like tasks and is therefore a valuable tool for assessing the effects of rehabilitation strategies on the functional cognition of these patients.Rehabilitation efforts in the mild stages of Parkinson's and Huntington's disease should be aware of greater time needs from the patients in the performance of daily life tasks, target executive skills, and give a more prominent role to patients in symptoms report and management.
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Affiliation(s)
- Filipa Júlio
- University of Coimbra, Faculty of Psychology and Education Sciences, Coimbra, Portugal.,University of Coimbra, Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Coimbra, Portugal
| | - Maria J Ribeiro
- University of Coimbra, Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Coimbra, Portugal
| | | | - Mário Sousa
- Coimbra University Hospital, Coimbra, Portugal
| | - Marieke van Asselen
- University of Coimbra, Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Coimbra, Portugal
| | - Mário R Simões
- University of Coimbra, Faculty of Psychology and Education Sciences, Coimbra, Portugal.,University of Coimbra, Faculty of Psychology and Education Sciences, Center for Research in Neuropsychology and Cognitive Behavioural Intervention (CINEICC), Coimbra, Portugal
| | - Miguel Castelo-Branco
- University of Coimbra, Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Coimbra, Portugal.,University of Coimbra, Institute of Nuclear Sciences Applied to Health (ICNAS), Coimbra, Portugal.,University of Coimbra, Faculty of Medicine, Coimbra, Portugal
| | - Cristina Januário
- University of Coimbra, Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Coimbra, Portugal.,Coimbra University Hospital, Coimbra, Portugal.,University of Coimbra, Faculty of Medicine, Coimbra, Portugal
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Qu S, Meng X, Liu Y, Zhang X, Zhang Y. Ginsenoside Rb1 prevents MPTP-induced changes in hippocampal memory via regulation of the α-synuclein/PSD-95 pathway. Aging (Albany NY) 2020; 11:1934-1964. [PMID: 30958793 PMCID: PMC6503885 DOI: 10.18632/aging.101884] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 03/20/2019] [Indexed: 12/12/2022]
Abstract
Memory deficiency is a common non-motor symptom of Parkinson’s disease (PD), and conventionally, α-synuclein is considered to be an important biomarker for both motor and cognitive characteristics attributed to PD. However, the role of physiological α-synuclein in cognitive impairment remains undetermined. Ginsenoside Rb1 has been shown to protect dopaminergic neurons (DA) from death and inhibit α-synuclein fibrillation and toxicity in vitro. Our recent study also revealed that ginsenoside Rb1 ameliorates motor deficits and prevents DA neuron death via upregulating glutamate transporter GLT-1 in the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) mouse model of PD. Whether Rb1 can improve memory deficiency and the underlying mechanism is still unknown. In this study, we found that Rb1 can prevent the spatial learning and memory deficits, increase long-term potentiation (LTP) and hippocampal glutamatergic transmission in the MPTP mouse model. The underlying neuroprotective mechanism of Rb1-improved synaptic plasticity involves Rb1 promoting hippocampal CA3 α-synuclein expression, restoring the glutamate in the CA3-schaffer collateral-CA1 pathway, and sequentially increasing postsynaptic density-95 (PSD-95) expression. Thus, we provide evidence that Rb1 modulates memory function, synaptic plasticity, and excitatory transmission via the trans-synaptic α-synuclein/PSD-95 pathway. Our findings suggest that Rb1 may serve as a functional drug in treating the memory deficiency in PD.
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Affiliation(s)
- Shaogang Qu
- Central Laboratory and Department of Neurology, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde Foshan), Foshan, China
| | - Xingjun Meng
- Central Laboratory and Department of Neurology, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde Foshan), Foshan, China
| | - Yan Liu
- Department of Traditional Chinese Medicine, Medical College, Xiamen University, Xiamen, China
| | - Xiuping Zhang
- Teaching Center of Experimental Medicine, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Yunlong Zhang
- Key Laboratory of Neuroscience, School of Basic Medical Sciences, Guangzhou Medical University, Guangzhou, China.,Shenzhen Research Institute of Xiamen University, Shenzhen, China
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49
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Güntekin B, Aktürk T, Yıldırım E, Yılmaz NH, Hanoğlu L, Yener G. Abnormalities in auditory and visual cognitive processes are differentiated with theta responses in patients with Parkinson's disease with and without dementia. Int J Psychophysiol 2020; 153:65-79. [PMID: 32339563 DOI: 10.1016/j.ijpsycho.2020.04.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 04/08/2020] [Accepted: 04/14/2020] [Indexed: 11/25/2022]
Abstract
The research on the abnormalities of event-related oscillations in Parkinson's disease (PD) was mostly studied with cognitively normal patients. The present study aims to show the adverse effects of cognitive decline in PD patients via the EEG-Brain Oscillations approach by comparing the electrophysiological responses in two modalities, i.e. auditory, and visual in which PD group show deficit. We conducted a study in which we analyzed event-related theta power and phase-locking during auditory and visual oddball paradigm. Cognitively normal PD (PDCN) patients (N = 15), PD with mild cognitive impairment (PDMCI) patients (N = 22), PD dementia (PDD) patients (N = 11) and healthy controls (HC) (N = 17) were included in the study. Neuropsychological assessments were applied to all participants. There was a gradual decrease in scores of neuropsychological tests (HC, PDCN, PDMCI, PDD, respectively). Most of the neuropsychological test scores of the participants were highly correlated with the theta power and theta phase locking values, especially over frontal-central areas. HC had higher theta phase-locking and power in comparison to PDMCI and PDD. The differentiation between HC and PDCN was specific to frontal-central areas. Theta power and theta phase-locking were decreased overall locations in PDMCI and PDD both during visual and auditory oddball paradigms compared with PDCN. The results indicate that theta responses in PD patients decreased gradually as the cognitive decline increased. We can conclude that complex abnormalities in their neurotransmitter and neuronal signal systems that occur with the progression of the disease could be responsible for these results.
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Affiliation(s)
- Bahar Güntekin
- Istanbul Medipol University, School of Medicine, Department of Biophysics, Istanbul, Turkey; REMER, Clinical Electrophysiology, Neuroimaging and Neuromodulation Lab., Istanbul Medipol University, Istanbul, Turkey.
| | - Tuba Aktürk
- Istanbul Medipol University, Vocational School, Program of Electroneurophysiology, Istanbul, Turkey; Istanbul Medipol University, Graduate School of Health Sciences, Department of Neuroscience, Istanbul, Turkey
| | - Ebru Yıldırım
- Istanbul Medipol University, Vocational School, Program of Electroneurophysiology, Istanbul, Turkey; Istanbul Medipol University, Graduate School of Health Sciences, Department of Neuroscience, Istanbul, Turkey
| | - Nesrin Helvacı Yılmaz
- Istanbul Medipol University, School of Medicine, Department of Neurology, Istanbul, Turkey
| | - Lütfü Hanoğlu
- REMER, Clinical Electrophysiology, Neuroimaging and Neuromodulation Lab., Istanbul Medipol University, Istanbul, Turkey; Istanbul Medipol University, School of Medicine, Department of Neurology, Istanbul, Turkey
| | - Görsev Yener
- Dokuz Eylül University Medical School, Department of Neurology, Izmir, Turkey; Dokuz Eylül University, Brain Dynamics Multidisciplinary Research Center, Izmir, Turkey
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50
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Cognition Deficits in Parkinson's Disease: Mechanisms and Treatment. PARKINSONS DISEASE 2020; 2020:2076942. [PMID: 32269747 PMCID: PMC7128056 DOI: 10.1155/2020/2076942] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 02/08/2020] [Accepted: 02/26/2020] [Indexed: 12/22/2022]
Abstract
Parkinson's disease (PD) is the second most common progressive neurodegenerative disorder mainly in middle-elderly population, which represents diverse nonmotor symptoms (NMS) besides such well-documented motor symptoms as bradykinesia, resting tremor, rigidity, and postural instability. With the advancement of aging trend worldwide, the global prevalence of PD is mounting up year after year. Nowadays, accumulating lines of studies have given a comprehensive and thorough coverage of motor symptoms in PD. Yet much less attention as compared has been paid to the nonmotor symptoms of PD, such as cognition deficits. Of note, a patient with PD who suffers from cognitive impairment may harbour a statistically significantly higher risk of progressing toward dementia, which negatively affects their life expectancy and daily functioning and overall lowers the global quality of life. Furthermore, it is a widely held view that cognitive dysfunction does not just occur in the late stage of PD. On the basis of numerous studies, mild cognitive impairment (MCI) is a harbinger of dementia in PD, which is observed as an intermediate state with considerable variability; some patients remain stable and some even revert to normal cognition. Considered that the timing, profile, and rate of cognitive impairment vary greatly among PD individuals, it is extremely urgent for researchers and clinicians alike to identify and predict future cognitive decline in this population. Simultaneously, early screening and canonical management of PD with cognitive deficits are very imperative to postpone the disease progression and improve the prognosis of patients. In our review, we focus on a description of cognitive decline in PD, expound emphatically the pathological mechanisms underlying cognition deficits in PD, then give a comprehensive overview of specific therapeutic strategies, and finally dissect what fresh insights may bring new exciting prospect for the subfield.
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