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Pagonabarraga J, Bejr-Kasem H, Martinez-Horta S, Kulisevsky J. Parkinson disease psychosis: from phenomenology to neurobiological mechanisms. Nat Rev Neurol 2024; 20:135-150. [PMID: 38225264 DOI: 10.1038/s41582-023-00918-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2023] [Indexed: 01/17/2024]
Abstract
Parkinson disease (PD) psychosis (PDP) is a spectrum of illusions, hallucinations and delusions that are associated with PD throughout its disease course. Psychotic phenomena can manifest from the earliest stages of PD and might follow a continuum from minor hallucinations to structured hallucinations and delusions. Initially, PDP was considered to be a complication associated with dopaminergic drug use. However, subsequent research has provided evidence that PDP arises from the progression of brain alterations caused by PD itself, coupled with the use of dopaminergic drugs. The combined dysfunction of attentional control systems, sensory processing, limbic structures, the default mode network and thalamocortical connections provides a conceptual framework to explain how new incoming stimuli are incorrectly categorized, and how aberrant hierarchical predictive processing can produce false percepts that intrude into the stream of consciousness. The past decade has seen the publication of new data on the phenomenology and neurobiological basis of PDP from the initial stages of the disease, as well as the neurotransmitter systems involved in PDP initiation and progression. In this Review, we discuss the latest clinical, neuroimaging and neurochemical evidence that could aid early identification of psychotic phenomena in PD and inform the discovery of new therapeutic targets and strategies.
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Affiliation(s)
- Javier Pagonabarraga
- Movement Disorder Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
- Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain.
- Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain.
- Centro de Investigación en Red - Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.
| | - Helena Bejr-Kasem
- Movement Disorder Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
- Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
- Centro de Investigación en Red - Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Saul Martinez-Horta
- Movement Disorder Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
- Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
- Centro de Investigación en Red - Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Jaime Kulisevsky
- Movement Disorder Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
- Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
- Centro de Investigación en Red - Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
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Angelopoulou E, Bougea A, Hatzimanolis A, Stefanis L, Scarmeas N, Papageorgiou S. Mild Behavioral Impairment in Parkinson's Disease: An Updated Review on the Clinical, Genetic, Neuroanatomical, and Pathophysiological Aspects. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:115. [PMID: 38256375 PMCID: PMC10820007 DOI: 10.3390/medicina60010115] [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: 12/19/2023] [Revised: 12/30/2023] [Accepted: 01/05/2024] [Indexed: 01/24/2024]
Abstract
Neuropsychiatric symptoms (NPS), including depression, anxiety, apathy, visual hallucinations, and impulse control disorders, are very common during the course of Parkinson's disease (PD), occurring even at the prodromal and premotor stages. Mild behavioral impairment (MBI) represents a recently described neurobehavioral syndrome, characterized by the emergence of persistent and impactful NPS in later life, reflecting arisk of dementia. Accumulating evidence suggests that MBI is highly prevalent in non-demented patients with PD, also being associated with an advanced disease stage, more severe motor deficits, as well as global and multiple-domain cognitive impairment. Neuroimaging studies have revealed that MBI in patients with PD may be related todistinct patterns of brain atrophy, altered neuronal connectivity, and distribution of dopamine transporter (DAT) depletion, shedding more light on its pathophysiological background. Genetic studies in PD patients have also shown that specific single-nucleotide polymorphisms (SNPs) may be associated with MBI, paving the way for future research in this field. In this review, we summarize and critically discuss the emerging evidence on the frequency, associated clinical and genetic factors, as well as neuroanatomical and neurophysiological correlates of MBI in PD, aiming to elucidate the underlying pathophysiology and its potential role as an early "marker" of cognitive decline, particularly in this population. In addition, we aim to identify research gaps, and propose novel relative areas of interest that could aid in our better understanding of the relationship of this newly defined diagnostic entity with PD.
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Affiliation(s)
- Efthalia Angelopoulou
- Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (E.A.); (L.S.); (N.S.); (S.P.)
| | - Anastasia Bougea
- Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (E.A.); (L.S.); (N.S.); (S.P.)
| | - Alexandros Hatzimanolis
- Department of Psychiatry, Aiginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece;
| | - Leonidas Stefanis
- Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (E.A.); (L.S.); (N.S.); (S.P.)
| | - Nikolaos Scarmeas
- Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (E.A.); (L.S.); (N.S.); (S.P.)
- Department of Neurology, Columbia University, New York, NY 10032, USA
| | - Sokratis Papageorgiou
- Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (E.A.); (L.S.); (N.S.); (S.P.)
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Nieto-Escamez F, Obrero-Gaitán E, Cortés-Pérez I. Visual Dysfunction in Parkinson's Disease. Brain Sci 2023; 13:1173. [PMID: 37626529 PMCID: PMC10452537 DOI: 10.3390/brainsci13081173] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 07/11/2023] [Accepted: 08/03/2023] [Indexed: 08/27/2023] Open
Abstract
Non-motor symptoms in Parkinson's disease (PD) include ocular, visuoperceptive, and visuospatial impairments, which can occur as a result of the underlying neurodegenerative process. Ocular impairments can affect various aspects of vision and eye movement. Thus, patients can show dry eyes, blepharospasm, reduced blink rate, saccadic eye movement abnormalities, smooth pursuit deficits, and impaired voluntary and reflexive eye movements. Furthermore, visuoperceptive impairments affect the ability to perceive and recognize visual stimuli accurately, including impaired contrast sensitivity and reduced visual acuity, color discrimination, and object recognition. Visuospatial impairments are also remarkable, including difficulties perceiving and interpreting spatial relationships between objects and difficulties judging distances or navigating through the environment. Moreover, PD patients can present visuospatial attention problems, with difficulties attending to visual stimuli in a spatially organized manner. Moreover, PD patients also show perceptual disturbances affecting their ability to interpret and determine meaning from visual stimuli. And, for instance, visual hallucinations are common in PD patients. Nevertheless, the neurobiological bases of visual-related disorders in PD are complex and not fully understood. This review intends to provide a comprehensive description of visual disturbances in PD, from sensory to perceptual alterations, addressing their neuroanatomical, functional, and neurochemical correlates. Structural changes, particularly in posterior cortical regions, are described, as well as functional alterations, both in cortical and subcortical regions, which are shown in relation to specific neuropsychological results. Similarly, although the involvement of different neurotransmitter systems is controversial, data about neurochemical alterations related to visual impairments are presented, especially dopaminergic, cholinergic, and serotoninergic systems.
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Affiliation(s)
- Francisco Nieto-Escamez
- Department of Psychology, University of Almeria, 04120 Almeria, Spain
- Center for Neuropsychological Assessment and Rehabilitation (CERNEP), 04120 Almeria, Spain
| | - Esteban Obrero-Gaitán
- Department of Health Sciences, University of Jaen, Paraje Las Lagunillas s/n, 23071 Jaen, Spain;
| | - Irene Cortés-Pérez
- Department of Health Sciences, University of Jaen, Paraje Las Lagunillas s/n, 23071 Jaen, Spain;
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Diez-Cirarda M, Cabrera-Zubizarreta A, Murueta-Goyena A, Strafella AP, Del Pino R, Acera M, Lucas-Jiménez O, Ibarretxe-Bilbao N, Tijero B, Gómez-Esteban JC, Gabilondo I. Multimodal visual system analysis as a biomarker of visual hallucinations in Parkinson's disease. J Neurol 2023; 270:519-529. [PMID: 36348068 DOI: 10.1007/s00415-022-11427-x] [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: 07/21/2022] [Revised: 10/13/2022] [Accepted: 10/14/2022] [Indexed: 11/09/2022]
Abstract
Visual hallucinations (VH) are present in up to 75% of Parkinson's disease (PD) patients. However, their neural bases and participation of the visual system in VH are not well-understood in PD. Seventy-four participants, 12 PD with VH (PDVH), 35 PD without VH (PDnoVH) and 27 controls underwent a battery of primary visual function and visual cognition tests, retinal optical coherence tomography and structural and resting-state functional brain MRI. We quantified cortical thickness with Freesurfer and functional connectivity (FC) of Visual (VIS), Fronto-Parietal (FP), Ventral Attention (VAN) and Dorsal Attention (DAN) networks with CONN toolbox. Group comparisons were performed with MANCOVA. Area Under the Curve (AUC) was computed to assess the ability of visual variables to differentiate PDVH and PDnoVH. There were no significant PDVH vs PDnoVH differences in disease duration, motor manifestations, general cognition or dopamine agonist therapy (DA) use. Compared to PDnoVH and HC, and regardless of DA use, PDVH showed significantly reduced contrast sensitivity, visuoperceptive and visuospatial abilities, increased retina photoreceptor layer thickness, reduced cortical thickness mostly in right visual associative areas, decreased between-network VIS-VAN and VAN-DAN connectivity and increased within-network DAN connectivity. The combination of clinical and imaging variables that best discriminated PDVH and PDnoVH (highest AUC), where within-network DAN FC, photoreceptor layer thickness and cube analysis test from Visual Object and Space Perception Battery (accuracy of 81.8%). Compared to PDnoVH, PDVH have specific functional and structural abnormalities within the visual system, which can be quantified non-invasively and could potentially constitute biomarkers for VH in PD.
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Affiliation(s)
- Maria Diez-Cirarda
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Cruces Plaza S/N, 48903, Barakaldo, Vizcaya, Spain.
| | | | - Ane Murueta-Goyena
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Cruces Plaza S/N, 48903, Barakaldo, Vizcaya, Spain
- Department of Neurosciences, Faculty of Medicine and Nursery, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Antonio P Strafella
- Krembil Brain Institute, UHN & Brain Health Imaging Centre, Campbell Family Mental Health Research Institute, CAMH, University of Toronto, Toronto, Canada
| | - Rocio Del Pino
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Cruces Plaza S/N, 48903, Barakaldo, Vizcaya, Spain
| | - Marian Acera
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Cruces Plaza S/N, 48903, Barakaldo, Vizcaya, Spain
| | - Olaia Lucas-Jiménez
- Department of Psychology, Faculty of Health Sciences, Univesity of Deusto, Bilbao, Spain
| | - Naroa Ibarretxe-Bilbao
- Department of Psychology, Faculty of Health Sciences, Univesity of Deusto, Bilbao, Spain
| | - Beatriz Tijero
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Cruces Plaza S/N, 48903, Barakaldo, Vizcaya, Spain
- Department of Neurology, Cruces University Hospital, Barakaldo, Spain
| | - Juan Carlos Gómez-Esteban
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Cruces Plaza S/N, 48903, Barakaldo, Vizcaya, Spain
- Department of Neurosciences, Faculty of Medicine and Nursery, University of the Basque Country (UPV/EHU), Leioa, Spain
- Department of Neurology, Cruces University Hospital, Barakaldo, Spain
| | - Iñigo Gabilondo
- Neurodegenerative Diseases Group, Biocruces Bizkaia Health Research Institute, Cruces Plaza S/N, 48903, Barakaldo, Vizcaya, Spain.
- Department of Neurology, Cruces University Hospital, Barakaldo, Spain.
- IKERBASQUE: The Basque Foundation for Science, Bilbao, Spain.
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Xu H, Zhang M, Wang Z, Yang Y, Chang Y, Liu L. Abnormal brain activities in multiple frequency bands in Parkinson’s disease with apathy. Front Neurosci 2022; 16:975189. [PMID: 36300172 PMCID: PMC9589053 DOI: 10.3389/fnins.2022.975189] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 09/23/2022] [Indexed: 11/13/2022] Open
Abstract
Background Apathy is among the most prevalent and incapacitating non-motor symptoms of Parkinson’s disease (PD). PD patients with apathy (PD-A) have been reported to have abnormal spontaneous brain activity mainly in 0.01–0.08 Hz. However, the frequency-dependence of brain activity in PD-A remains unclear. Therefore, this study aimed to examine whether abnormalities in PD-A are associated with specific frequency bands. Materials and methods Overall, 28 patients with PD-A, 19 PD patients without apathy (PD-NA), and 32 gender-, age-matched healthy controls (HCs) were enrolled. We collected resting-state functional magnetic resonance imaging (rs-fMRI) data, demographic information, and neuropsychological assessments, including apathy, depression, anxiety and cognitive function for every participant. The amplitude of low-frequency fluctuation (ALFF), fractional amplitude of low-frequency fluctuation (fALFF), percent amplitude of fluctuation (PerAF), regional homogeneity (ReHo), and degree centrality (DC) were calculated in the conventional (0.01–0.08 Hz), slow-4 (0.027–0.073 Hz), and slow-5 (0.01–0.027 Hz) frequency bands based on statistical parametric mapping (SPM12) and RESTplus V1.25. Two-sample t-tests were performed to compare the differences among the three groups. Results PD-A reduced ALFF in the right anterior cingulate gyri in the slow-5 band and decreased fALFF in the right middle frontal gyrus in the conventional band, compared to patients with PD-NA. However, PerAF, ReHo, and DC could not distinguish PD-A from PD-NA in the three bands. PD-A had higher ALFF and fALFF in the left middle occipital gyrus and lower fALFF in the bilateral insula in the slow-5 band compared to the HCs. Furthermore, abnormal DC value in hippocampus and parahippocampus was observed separately in the conventional band and in the slow-4 band between PD-A and HCs. Moreover, PD-A and PD-NA showed lower ReHo in cerebellum in the three bands compared to the HCs. Conclusion Our study revealed that PD-A and PD-NA might have different neurophysiological mechanisms. Concurrently, the ALFF in the slow-5 band and fALFF in the conventional band were sensitive in differentiating PD-A from PD-NA. The influence of apathy on the disease can be considered in the future research on PD, with the effects of frequency band taken into account when analyzing spontaneous brain activities in PD-A.
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Affiliation(s)
- Haikun Xu
- Department of Radiology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Mengchao Zhang
- Department of Radiology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Ziju Wang
- Department of Pediatrics, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Yanyan Yang
- Department of Radiology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Ying Chang
- Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, China
- Ying Chang,
| | - Lin Liu
- Department of Radiology, China-Japan Union Hospital of Jilin University, Changchun, China
- *Correspondence: Lin Liu,
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Sanda N, Escribano Paredes JB, Ferastraoaru V. Visual hallucinosis during hypoperfusion of the right occipito-temporal cortex. J Neurol 2022; 269:6627-6633. [PMID: 36001140 PMCID: PMC9618476 DOI: 10.1007/s00415-022-11346-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: 04/18/2022] [Revised: 08/16/2022] [Accepted: 08/17/2022] [Indexed: 11/25/2022]
Abstract
Objectives Positive visual phenomena, although reported in lesions of visual cortex, are often overlooked in patients with acute neurological conditions. Yet, their occurrence without structural abnormalities or other underlying neurological disorders represents a unique observation. This report aims to raise awareness of these phenomena, their implications for understanding visual consciousness and to propose a practical, structured algorithm for the clinical assessment of visual hallucinations related to neurological conditions. Methods We describe the clinical presentation and imaging findings in two patients with isolated visual hallucinosis secondary to transitory hypoperfusion. Results One patient presented with subocclusion of the right posterior cerebral artery and the other with multifocal arterial abnormalities suggestive of reversible cerebral vasoconstriction syndrome (RCVS). Both presented isolated visual hallucinations and hypoperfusion of the right mesial occipito-temporal cortex. Hallucinated images exhibited peculiarities of certain attributes that were recognized only through guided perceptual analysis performed during their occurrence. Discussion Dysfunctions in the visual and attentional networks due to the uneven impact of hypoperfusion on the regions of the mesial occipito-temporal cortex likely contributed to the occurrence of visual hallucinations. The initial impaired awareness of certain image attributes obscured an altered, non-realistic rendering of the hallucinated images. Enhancement of awareness through clinical guidance indicates improved attentional deployment, modulation of visual information processing and hallucination–background integration. These features of the hallucinatory phenomena highlight the critical role of semiological analysis during their occurrence and question the validity of post hoc inquiries.
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Affiliation(s)
- Nicolae Sanda
- Department of Neurology, Geneva University Hospital, Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland.
| | | | - Victor Ferastraoaru
- Department of Neurology, Montefiore Medical Center/Albert Einstein College of Medicine, New York, USA
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Sinclair L, Brenton J, Liu AKL, MacLachlan R, Gentleman SM, Love S. Possible Contribution of Altered Cholinergic Activity in the Visual Cortex in Visual Hallucinations in Parkinson's Disease. J Neuropsychiatry Clin Neurosci 2022; 34:168-176. [PMID: 34961331 DOI: 10.1176/appi.neuropsych.21040103] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Up to one-third of patients with Parkinson's disease (PD) experience visual hallucinations (VHs). Lewy bodies are sparse in the visual cortices and seem unlikely to explain the hallucinations. Some neuroimaging studies have found that perfusion is reduced in the occipital lobe in individuals with VHs. Recent work has suggested that decreased cholinergic input may directly lead to the decreased perfusion. The investigators hypothesized that individuals with PD and VHs would have biochemical evidence of reduced microvascular perfusion and reduced cholinergic activity in areas of the brain that process visual images. METHODS Tissue from Brodmann's area (BA) 18 and BA 19 was obtained from a well-characterized cohort matched for age, gender, and postmortem interval in 69 individuals (PD without VHs, N=11; PD without dementia plus VHs N=10, N=10; PD with dementia plus VHs, N=16; and control subjects, N=32). Von Willebrand factor, vascular endothelial growth factor A, and myelin-associated glycoprotein:proteolipid protein-1 (MAG:PLP1) ratio-a measure of tissue oxygenation relative to metabolic demand, acetylcholinesterase (AChE), butyrylcholinesterase (BChE), choline acetyltransferase, and α-synuclein-were quantified by enzyme-linked immunosorbent assay. The primary outcome was the MAG:PLP1 ratio. RESULTS There was no biochemical evidence of chronic hypoperfusion in PD, although microvessel density was decreased in ventral BA 18 and BA 19. There was no between-group difference in BChE in either dorsal BA 18 or BA 19. AChE concentration was reduced in individuals with PD compared with control subjects in dorsal and ventral BA 18 and dorsal BA 19, and it was increased in ventral BA 19. These changes were most marked in the PD plus VHs group. CONCLUSIONS These results suggest that changes in cholinergic activity rather than chronic hypoperfusion may underlie VHs in PD.
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Affiliation(s)
- Lindsey Sinclair
- Dementia Research Group, University of Bristol, United Kingdom (Sinclair, Brenton, MacLachlan, Love); Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, United Kingdom (Liu); and Neuropathology Unit, Department of Brain Sciences, Imperial College London (Liu, Gentleman)
| | - Jake Brenton
- Dementia Research Group, University of Bristol, United Kingdom (Sinclair, Brenton, MacLachlan, Love); Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, United Kingdom (Liu); and Neuropathology Unit, Department of Brain Sciences, Imperial College London (Liu, Gentleman)
| | - Alan King Lun Liu
- Dementia Research Group, University of Bristol, United Kingdom (Sinclair, Brenton, MacLachlan, Love); Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, United Kingdom (Liu); and Neuropathology Unit, Department of Brain Sciences, Imperial College London (Liu, Gentleman)
| | - Rob MacLachlan
- Dementia Research Group, University of Bristol, United Kingdom (Sinclair, Brenton, MacLachlan, Love); Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, United Kingdom (Liu); and Neuropathology Unit, Department of Brain Sciences, Imperial College London (Liu, Gentleman)
| | - Steve M Gentleman
- Dementia Research Group, University of Bristol, United Kingdom (Sinclair, Brenton, MacLachlan, Love); Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, United Kingdom (Liu); and Neuropathology Unit, Department of Brain Sciences, Imperial College London (Liu, Gentleman)
| | - Seth Love
- Dementia Research Group, University of Bristol, United Kingdom (Sinclair, Brenton, MacLachlan, Love); Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, United Kingdom (Liu); and Neuropathology Unit, Department of Brain Sciences, Imperial College London (Liu, Gentleman)
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Fry A, Singh D, Manganas L, Gordon ML, Christodoulou C, Leung HC, Schwartz GJ. Parkinson's Disease With Visual Hallucinations Is Associated With Epileptiform Activity on EEG. Front Neurol 2022; 12:788632. [PMID: 35087470 PMCID: PMC8787040 DOI: 10.3389/fneur.2021.788632] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 12/16/2021] [Indexed: 11/30/2022] Open
Abstract
Background: Visual hallucinations (VHs) in Parkinson's disease (PD) are the cardinal symptoms which declare the onset of PD psychosis (PDP). The anthropomorphic and zoomorphic VHs of PD resemble those of Charles Bonnet syndrome and temporal lobe epilepsy. In both of these disorders electroencephalography (EEG) abnormalities have been described. We therefore sought to examine whether VHs in PD were associated with similar EEG abnormalities. Methods: This retrospective observational study searched the medical records of 300 PD patients and filtered for those containing clinical 20-min scalp EEGs. Remaining records were separated into two groups: patients with reported VHs and those without. The prevalence of epileptiform discharges in the EEGs of both groups was identified. Results: Epileptiform discharges were present in 5 of 13 (38.5%) PD patients with VHs; all localized to the temporal lobe. No epileptiform discharges were observed in the EEGs of the 31 PD patients without VHs. Conclusion: The significantly high incidence of temporal lobe epileptiform discharges in PD patients with VHs as compared to those without VHs lends to the possibility of an association visual cortex epileptogenic focus. Accordingly, for treatment-refractory patients, antiepileptic drugs might be considered, as in the case of Charles Bonnet syndrome, temporal lobe epilepsy and migraine with visual aura. Future prospective studies involving larger samples and multi-center cohorts are required to validate these observational findings.
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Affiliation(s)
- Adam Fry
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Dharampreet Singh
- Department of Neurology, Renaissance School of Medicine at Stony Brook University, New York, NY, United States.,Department of Neurology, Joan C. Edwards School of Medicine at Marshall University, Huntington, WV, United States
| | - Louis Manganas
- Department of Neurology, Renaissance School of Medicine at Stony Brook University, New York, NY, United States
| | - Marc L Gordon
- The Litwin-Zucker Research Center, The Feinstein Institutes for Medical Research, Northwell Health, New York, NY, United States.,Departments of Neurology and Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY, United States
| | - Christopher Christodoulou
- Department of Neuropsychology, Renaissance School of Medicine at Stony Brook University, New York, NY, United States
| | - Hoi-Chung Leung
- Department of Psychology, Stony Brook University, Stony Brook, NY, United States
| | - Guy J Schwartz
- Department of Neurology, Renaissance School of Medicine at Stony Brook University, New York, NY, United States
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Nakata T, Shimada K, Iba A, Oda H, Terashima A, Koide Y, Kawasaki R, Yamada T, Ishii K. Correlation between noise pareidolia test scores for visual hallucinations and regional cerebral blood flow in dementia with Lewy bodies. Ann Nucl Med 2022; 36:384-392. [DOI: 10.1007/s12149-022-01717-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 01/10/2022] [Indexed: 01/08/2023]
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10
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Xiong Y, Ji L, He L, Chen L, Zhang X, Chen Z, Li X, Zhao H, Shirakawa M, Yuan C, Ma Y, Guo H. Effects of Levodopa Therapy on Cerebral Arteries and Perfusion in Parkinson's Disease Patients. J Magn Reson Imaging 2021; 55:943-953. [PMID: 34477268 DOI: 10.1002/jmri.27903] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 08/12/2021] [Accepted: 08/13/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Levodopa is the most-commonly used therapy for Parkinson's Disease (PD). Imaging findings show increased cerebral blood flow (CBF) response to levodopa, but the artery morphological change is less studied. PURPOSE To investigate the effect of levodopa on cerebral arteries and CBF. STUDY TYPE Prospective. POPULATION 57 PD patients (56 ± 10 years, 26 males) and 17 age-matched healthy controls (AMC, 57 ± 9 years, 9 males) were scanned at baseline (OFF). Patients were rescanned 50 minutes after taking levodopa (ON). FIELD STRENGTH AND SEQUENCE 3 T; Simultaneous noncontrast angiography intraplaque imaging (SNAP) based on turbo field echo; Pseudo-continuous arterial spin labeling (PCASL) based on echo-planner imaging. ASSESSMENT The Unified Parkinson's Disease Rating Scale (UPDRS-III) was used to assess the disease severity. Length and radius of arteries were measured from SNAP images. CBF was calculated from PCASL images globally and regionally. STATISTICAL TESTS Mann Whitney U tests were conducted in comparing PD vs. AMC. Wilcoxon matched-pairs signed rank tests were used in comparing OFF vs. ON, and the more-affected vs. the less-affected hemisphere in PD. Linear regressions were performed to test the correlations of neuroimaging findings with behavioral changes. Significance threshold was P < 0.05 with Bonferroni correction. RESULTS PD patients were identified with significantly lower CBF (PD OFF Mean = 40.15 ± 5.99, AMC Mean = 43.48 ± 6.21 mL/100 g/min) and shortened total artery length (PD OFF Mean = 5851.07 ± 1393.45, AMC Mean = 7479.16 ± 1335.93 mm). Levodopa elevated CBF of PD brains (PD ON Mean = 41.48 ± 6.32 mL/100 g/min) and expanded radius of proximal arteries. Artery radius change significantly correlated with CBF change in corresponding territories (r = 0.559 for Internal Carotid Arteries, r = 0.448 for Basilar Artery, and r = 0.464 for Middle Cerebral Artery M1). Global CBF significantly related to UPDRS-III (r = -0.391) post-levodopa. DATA CONCLUSION Levodopa can increase CBF by dilating proximal arteries. LEVEL OF EVIDENCE 1 TECHNICAL EFFICACY STAGE: 4.
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Affiliation(s)
- Yuhui Xiong
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
| | - Lanxin Ji
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
| | - Le He
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
| | - Li Chen
- Vascular Imaging Laboratory, Department of Radiology, University of Washington, Seattle, WA, USA
| | - Xue Zhang
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
| | - Zhensen Chen
- Vascular Imaging Laboratory, Department of Radiology, University of Washington, Seattle, WA, USA
| | - Xuesong Li
- School of Computer Science and Technology, Beijing Institute of Technology, Beijing, China
| | - Huilin Zhao
- Vascular Imaging Laboratory, Department of Radiology, University of Washington, Seattle, WA, USA
| | - Manabu Shirakawa
- Vascular Imaging Laboratory, Department of Radiology, University of Washington, Seattle, WA, USA
| | - Chun Yuan
- Vascular Imaging Laboratory, Department of Radiology, University of Washington, Seattle, WA, USA
| | - Yu Ma
- Department of Neurosurgery, Tsinghua University Yuquan Hospital, Beijing, China
| | - Hua Guo
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
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11
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Zhou M, Zhuo L, Ji R, Gao Y, Yao H, Feng R, Zhang L, Huang G, Huang X. Alterations in functional network centrality in first-episode drug-naïve adolescent-onset schizophrenia. Brain Imaging Behav 2021; 16:316-323. [PMID: 34410608 DOI: 10.1007/s11682-021-00505-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2021] [Indexed: 02/05/2023]
Abstract
Schizophrenia is a disorder resulting from aberrant brain networks and circuits. In the current study, we aimed to investigate specific network alterations in adolescent-onset schizophrenia (AOS) and to help identify the neurophysiological mechanisms of this adolescent disorder. We recruited forty-one subjects, including 20 AOS patients and 21 matched healthy controls (HCs), and we acquired brain images to examine the specific changes in functional network patterns using degree centrality (DC), which quantifies the strength of the local functional connectivity hubs. Whole-brain correlation analysis was applied to assess the relationships between clinical characteristics and DC measurements. The AOS group exhibited increased DC in the right inferior frontal lobe, right fusiform gyrus and right thalamus (p < 0.05, AlphaSim correction). Whole-brain correlation analysis found that the DC value in the right parahippocampus was positively correlated with PANSS-positive symptom scores (r = 0.80); DC in the right superior parietal lobe (SPL) was positively correlated with PANSS-negative symptom scores (r = 0.79); DC in the left precuneus was positively correlated with self-certainty (SC) scores (r = 0.70); and DC in the left medial frontal gyrus (MFG) was negatively correlated with self-reflectiveness (SR) scores (r = 0.69). We conclude that frontoparietal network and cortico-thalamo-cortical pathway disruptions could play key roles in the neurophysiological mechanisms underlying AOS. In AOS patients, the right parahippocampus and SPL are important structures associated with positive and negative symptoms, respectively, and the left precuneus and MFG contribute to deficits in cognitive insights.
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Affiliation(s)
- Ming Zhou
- Center of Psychoradiology, Department of Radiology, The Third Hospital of Mianyang/Sichuan Mental Health Center, Mianyang, 621000, Sichuan, People's Republic of China
| | - Lihua Zhuo
- Center of Psychoradiology, Department of Radiology, The Third Hospital of Mianyang/Sichuan Mental Health Center, Mianyang, 621000, Sichuan, People's Republic of China
| | - Ruofei Ji
- Department of Psychiatry, The Third Hospital of Mianyang/Sichuan Mental Health Center, Mianyang, 621000, Sichuan, People's Republic of China
| | - Yingxue Gao
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Hongchao Yao
- Center of Psychoradiology, Department of Radiology, The Third Hospital of Mianyang/Sichuan Mental Health Center, Mianyang, 621000, Sichuan, People's Republic of China
| | - Ruohan Feng
- Center of Psychoradiology, Department of Radiology, The Third Hospital of Mianyang/Sichuan Mental Health Center, Mianyang, 621000, Sichuan, People's Republic of China.,Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Lianqing Zhang
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Guoping Huang
- Center of Psychoradiology, Department of Radiology, The Third Hospital of Mianyang/Sichuan Mental Health Center, Mianyang, 621000, Sichuan, People's Republic of China. .,Department of Psychiatry, The Third Hospital of Mianyang/Sichuan Mental Health Center, Mianyang, 621000, Sichuan, People's Republic of China.
| | - Xiaoqi Huang
- Center of Psychoradiology, Department of Radiology, The Third Hospital of Mianyang/Sichuan Mental Health Center, Mianyang, 621000, Sichuan, People's Republic of China. .,Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, 610041, China.
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12
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Pezzoli S, Sánchez-Valle R, Solanes A, Kempton MJ, Bandmann O, Shin JI, Cagnin A, Goldman JG, Merkitch D, Firbank MJ, Taylor JP, Pagonabarraga J, Kulisevsky J, Blanc F, Verdolini N, Venneri A, Radua J. Neuroanatomical and cognitive correlates of visual hallucinations in Parkinson's disease and dementia with Lewy bodies: Voxel-based morphometry and neuropsychological meta-analysis. Neurosci Biobehav Rev 2021; 128:367-382. [PMID: 34171324 DOI: 10.1016/j.neubiorev.2021.06.030] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 04/30/2021] [Accepted: 06/19/2021] [Indexed: 02/04/2023]
Abstract
Visual hallucinations (VH) are common in Parkinson's disease and dementia with Lewy bodies, two forms of Lewy body disease (LBD), but the neural substrates and mechanisms involved are still unclear. We conducted meta-analyses of voxel-based morphometry (VBM) and neuropsychological studies investigating the neuroanatomical and cognitive correlates of VH in LBD. For VBM (12 studies), we used Seed-based d Mapping with Permutation of Subject Images (SDM-PSI), including statistical parametric maps for 50% of the studies. For neuropsychology (35 studies), we used MetaNSUE to consider non-statistically significant unreported effects. VH were associated with smaller grey matter volume in occipital, frontal, occipitotemporal, and parietal areas (peak Hedges' g -0.34 to -0.49). In patients with Parkinson's disease without dementia, VH were associated with lower verbal immediate memory performance (Hedges' g -0.52). Both results survived correction for multiple comparisons. Abnormalities in these brain regions might reflect dysfunctions in brain networks sustaining visuoperceptive, attention, and executive abilities, with the latter also being at the basis of poor immediate memory performance.
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Affiliation(s)
- Stefania Pezzoli
- Department of Neuroscience, University of Sheffield, Sheffield, UK; Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, CA, USA; Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA, USA
| | - Raquel Sánchez-Valle
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Aleix Solanes
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain
| | - Matthew J Kempton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Department of Neuroimaging, Institute of Psychiatry, Psychology and Neurosciences, King's College London, UK
| | - Oliver Bandmann
- Department of Neuroscience, University of Sheffield, Sheffield, UK
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | | | - Jennifer G Goldman
- Shirley Ryan Ability Lab Parkinson's Disease and Movement Disorders program, Chicago, IL, USA; Northwestern University Feinberg School of Medicine, Departments of Physical Medicine and Neurology, Chicago, IL, USA
| | - Doug Merkitch
- Shirley Ryan Ability Lab Parkinson's Disease and Movement Disorders program, Chicago, IL, USA
| | - Michael J Firbank
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - John-Paul Taylor
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Javier Pagonabarraga
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital, Barcelona, Spain; Universitat Autònoma de Barcelona (U.A.B.), Barcelona, Spain; Institut d'Investigacions Biomèdiques - Sant Pau (IIB-Sant Pau), Barcelona, Spain; Biomedical Research Networking Center on Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Jaime Kulisevsky
- Movement Disorders Unit, Neurology Department, Sant Pau Hospital, Barcelona, Spain; Universitat Autònoma de Barcelona (U.A.B.), Barcelona, Spain; Institut d'Investigacions Biomèdiques - Sant Pau (IIB-Sant Pau), Barcelona, Spain; Biomedical Research Networking Center on Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Frederic Blanc
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK; Geriatrics Day Hospital and Neuropsychology Unit, Geriatrics Department and Neurology Service, Memory Resources and Research Centre (CMRR), University Hospital of Strasbourg, Strasbourg, France; Team IMIS/Neurocrypto, French National Center for Scientific Research (CNRS), ICube Laboratory and Fédération de Médecine Translationnelle de Strasbourg (FMTS), University of Strasbourg, Strasbourg, France
| | - Norma Verdolini
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain; Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Annalena Venneri
- Department of Neuroscience, University of Sheffield, Sheffield, UK; Department of Life Sciences, Brunel University London, London, UK
| | - Joaquim Radua
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institutet, Stockholm, Sweden.
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13
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Wang Z, Liu Y, Ruan X, Li Y, Li E, Zhang G, Li M, Wei X. Aberrant Amplitude of Low-Frequency Fluctuations in Different Frequency Bands in Patients With Parkinson's Disease. Front Aging Neurosci 2020; 12:576682. [PMID: 33343329 PMCID: PMC7744880 DOI: 10.3389/fnagi.2020.576682] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 10/26/2020] [Indexed: 12/16/2022] Open
Abstract
Previous studies reported abnormal spontaneous neural activity in Parkinson's disease (PD) patients using resting-state functional magnetic resonance imaging (R-fMRI). However, the frequency-dependent neural activity in PD is largely unknown. Here, 35 PD patients and 35 age- and education-matched healthy controls (HCs) underwent R-fMRI scanning to investigate abnormal spontaneous neural activity of PD using the amplitude of low-frequency fluctuation (ALFF) approach within the conventional band (typical band: 0.01-0.08 Hz) and specific frequency bands (slow-5: 0.010-0.027 Hz and slow-4: 0.027-0.073 Hz). Compared with HCs, PD patients exhibited increased ALFF in the parieto-temporo-occipital regions, such as the bilateral inferior temporal gyrus/fusiform gyrus (ITG/FG) and left angular gyrus/posterior middle temporal gyrus (AG/pMTG), and displayed decreased ALFF in the left cerebellum, right precuneus, and left postcentral gyrus/supramarginal gyrus (PostC/SMG) in the typical band. PD patients showed greater increased ALFF in the left caudate/putamen, left anterior cingulate cortex/medial superior frontal gyrus (ACC/mSFG), left middle cingulate cortex (MCC), right ITG, and left hippocampus, along with greater decreased ALFF in the left pallidum in the slow-5 band, whereas greater increased ALFF in the left ITG/FG/hippocampus accompanied by greater decreased ALFF in the precentral gyrus/PostC was found in the slow-4 band (uncorrected). Additionally, the left caudate/putamen was positively correlated with levodopa equivalent daily dose (LEDD), Hoehn and Yahr (HY) stage, and disease duration. Our results suggest that PD is related to widespread abnormal brain activities and that the abnormalities of ALFF in PD are associated with specific frequency bands. Future studies should take frequency band effects into account when examining spontaneous neural activity in PD.
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Affiliation(s)
- Zhaoxiu Wang
- Department of Radiology, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Yanjun Liu
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- Padova Neuroscience Center (PNC), University of Padova, Padua, Italy
| | - Xiuhang Ruan
- Department of Radiology, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Yuting Li
- Department of Radiology, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - E. Li
- Department of Radiology, Guangzhou First People’s Hospital, Guangzhou Medical University, Guangzhou, China
| | - Guoqin Zhang
- Department of Radiology, Guangzhou First People’s Hospital, Guangzhou Medical University, Guangzhou, China
| | - Mengyan Li
- Department of Neurology, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Xinhua Wei
- Department of Radiology, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China
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14
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Kurita A, Koshikawa H, Akiba T, Seki K, Ishikawa H, Suzuki M. Visual Hallucinations and Impaired Conscious Visual Perception in Parkinson Disease. J Geriatr Psychiatry Neurol 2020; 33:377-385. [PMID: 31808354 DOI: 10.1177/0891988719892318] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Visual hallucinations (VHs) are common in patients with Parkinson disease (PD), especially those with dementia, whereas auditory hallucinations are quite rare. Recent studies have revealed the involvement of several regions along the visual information-processing system that contribute to the pathophysiological mechanism of VHs: the eyes and retina, retinofugal projection, lateral geniculate nucleus, striate cortex, ventral pathways in the temporal cortices, and frontal and parietal cortices. In addition, the concurrent involvement of other systems in the brainstem and basal forebrain further modify VHs in PD. In this review, we discuss the pathophysiological association between the regional involvement of these areas and VHs.
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Affiliation(s)
- Akira Kurita
- Department of Neurology, 26403Teikyo University Chiba Medical Center, Ichihara, Japan
| | - Hiroaki Koshikawa
- Department of Neurology, 26403Teikyo University Chiba Medical Center, Ichihara, Japan
| | - Takeshi Akiba
- Department of Neurology, 26403Teikyo University Chiba Medical Center, Ichihara, Japan
| | - Kanako Seki
- Department of Neurology, 26403Teikyo University Chiba Medical Center, Ichihara, Japan
| | - Hiroaki Ishikawa
- Department of Neurology, 26403Teikyo University Chiba Medical Center, Ichihara, Japan
| | - Megumi Suzuki
- Department of Neurology, 26403Teikyo University Chiba Medical Center, Ichihara, Japan
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15
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Sattin D, Rossi Sebastiano D, D’Incerti L, Guido D, Marotta G, Benti R, Tirelli S, Magnani FG, Bersano A, Duran D, Ferraro S, Minati L, Nigri A, Rosazza C, Bianchi Marzoli S, Leonardi M. Visual behaviors in disorders of consciousness: Disentangling conscious visual processing by a multimodal approach. Eur J Neurosci 2020; 52:4345-4355. [DOI: 10.1111/ejn.14875] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 06/15/2020] [Accepted: 06/16/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Davide Sattin
- Neurology, Public health, Disability Unit / Coma Research Centre Fondazione IRCCS Istituto Neurologico Carlo Besta Milan Italy
| | - Davide Rossi Sebastiano
- Neurophysiology and Diagnostic Epileptology Unit Fondazione IRCCS Istituto Neurologico Carlo Besta Milan Italy
| | - Ludovico D’Incerti
- Neuroradiology Unit Fondazione IRCCS Istituto Neurologico Carlo Besta Milan Italy
| | - Davide Guido
- Neurology, Public health, Disability Unit / Coma Research Centre Fondazione IRCCS Istituto Neurologico Carlo Besta Milan Italy
| | - Giorgio Marotta
- Department of Nuclear Medicine Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico Milan Italy
| | - Riccardo Benti
- Department of Nuclear Medicine Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico Milan Italy
| | - Simone Tirelli
- Neurology, Public health, Disability Unit / Coma Research Centre Fondazione IRCCS Istituto Neurologico Carlo Besta Milan Italy
| | - Francesca Giulia Magnani
- Neurology, Public health, Disability Unit / Coma Research Centre Fondazione IRCCS Istituto Neurologico Carlo Besta Milan Italy
| | - Anna Bersano
- Neurology Unit UCV Fondazione IRCCS Istituto Neurologico Carlo Besta Milan Italy
| | - Dunja Duran
- Neurophysiology and Diagnostic Epileptology Unit Fondazione IRCCS Istituto Neurologico Carlo Besta Milan Italy
| | - Stefania Ferraro
- Neuroradiology Unit Fondazione IRCCS Istituto Neurologico Carlo Besta Milan Italy
| | - Ludovico Minati
- Direzione Scientifica Fondazione IRCCS Istituto Neurologico Carlo Besta Milan Italy
| | - Anna Nigri
- Neuroradiology Unit Fondazione IRCCS Istituto Neurologico Carlo Besta Milan Italy
| | - Cristina Rosazza
- Neuroradiology Unit Fondazione IRCCS Istituto Neurologico Carlo Besta Milan Italy
- Dipartimento di Studi Umanistici (DISTUM) Università degli Studi di Urbino Carlo Bo Urbino PU Italy
| | - Stefania Bianchi Marzoli
- Neuro‐Ophthalmology Center IRCCS Istituto Auxologico Italiano, Scientific Institute Capitanio Hospital Milan Italy
| | - Matilde Leonardi
- Neurology, Public health, Disability Unit / Coma Research Centre Fondazione IRCCS Istituto Neurologico Carlo Besta Milan Italy
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16
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Revankar GS, Hattori N, Kajiyama Y, Nakano T, Mihara M, Mori E, Mochizuki H. Ocular fixations and presaccadic potentials to explain pareidolias in Parkinson's disease. Brain Commun 2020; 2:fcaa073. [PMID: 32954309 PMCID: PMC7425388 DOI: 10.1093/braincomms/fcaa073] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 03/27/2020] [Accepted: 05/04/2020] [Indexed: 01/05/2023] Open
Abstract
In Parkinson's disease, a precursor phenomenon to visual hallucinations presents as 'pareidolias' which make ambiguous forms appear meaningful. To evoke and detect pareidolias in patients, a noise pareidolia test was recently developed, although its task-dependent mechanisms are yet to be revealed. When subjected to this test, we hypothesized that patients exhibiting pareidolias would show altered top-down influence of visual processing allowing us to demonstrate the influence of pareidolic illusionary behaviour in Parkinson's disease patients. To that end, we evaluated eye-movement strategies and fixation-related presaccadic activity on scalp EEG when participants performed the test. Twelve healthy controls and 21 Parkinson's disease patients, evaluated for cognitive, visuo-spatial and executive functions, took a modified computer-based version of the noise pareidolia test in a free-viewing EEG eye-tracking experiment. Eye-tracking metrics (fixation-related durations and counts) documented the eye movement behaviour employed in correct responses (face/noise) and misperceptions (pareidolia/missed) during early and late visual search conditions. Simultaneously, EEG recorded the presaccadic activity in frontal and parietal areas of the brain. Based on the noise pareidolia test scores, we found certain Parkinson's disease patients exhibited pareidolias whereas others did not. ANOVA on eye-tracking data showed that patients dwelled significantly longer to detect faces and pareidolias which affected both global and local search dynamics depending on their visuo-perceptual status. Presaccadic activity in parietal electrodes for the groups was positive for faces and pareidolias, and negative for noise, though these results depended mainly on saccade size. However, patients sensitive to pareidolias showed a significantly higher presaccadic potential on frontal electrodes independent of saccade sizes, suggesting a stronger frontal activation for pareidolic stimuli. We concluded with the following interpretations (i) the noise pareidolia test specifically characterizes visuo-perceptual inadequacies in patients despite their wide range of cognitive scores, (ii) Parkinson's disease patients dwell longer to converge attention to pareidolic stimuli due to abnormal saccade generation proportional to their visuo-perceptual deficit during early search, and during late search, due to time-independent alteration of visual attentional network and (iii) patients with pareidolias show increased frontal activation reflecting the allocation of attention to irrelevant targets that express the pareidolic phenomenon. While the disease per se alters the visuo-perceptual and oculomotor dynamics, pareidolias occur in Parkinson's disease due to an abnormal top-down modulation of visual processing that affects visual attention and guidance to ambiguous stimuli.
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Affiliation(s)
- Gajanan S Revankar
- Department of Neurology, Graduate School of Medicine, Osaka University, Osaka 5650871, Japan
| | - Noriaki Hattori
- Department of Neurology, Graduate School of Medicine, Osaka University, Osaka 5650871, Japan.,Endowed Research Department of Clinical Neuroengineering, Global Center for Medical Engineering and Informatics, Osaka University, Osaka 5650871, Japan
| | - Yuta Kajiyama
- Department of Neurology, Graduate School of Medicine, Osaka University, Osaka 5650871, Japan
| | - Tomohito Nakano
- Department of Neurology, Graduate School of Medicine, Osaka University, Osaka 5650871, Japan
| | - Masahito Mihara
- Department of Neurology, Graduate School of Medicine, Osaka University, Osaka 5650871, Japan
| | - Etsuro Mori
- Department of Behavioral Neurology and Neuropsychiatry, Osaka University, Osaka 5650871, Japan
| | - Hideki Mochizuki
- Department of Neurology, Graduate School of Medicine, Osaka University, Osaka 5650871, Japan
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17
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Disposable ultrasound-sensing chronic cranial window by soft nanoimprinting lithography. Nat Commun 2019; 10:4277. [PMID: 31537800 PMCID: PMC6753120 DOI: 10.1038/s41467-019-12178-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 08/27/2019] [Indexed: 01/31/2023] Open
Abstract
Chronic cranial window (CCW) is an essential tool in enabling longitudinal imaging and manipulation of various brain activities in live animals. However, an active CCW capable of sensing the concealed in vivo environment while simultaneously providing longitudinal optical access to the brain is not currently available. Here we report a disposable ultrasound-sensing CCW (usCCW) featuring an integrated transparent nanophotonic ultrasonic detector fabricated using soft nanoimprint lithography process. We optimize the sensor design and the associated fabrication process to significantly improve detection sensitivity and reliability, which are critical for the intend longitudinal in vivo investigations. Surgically implanting the usCCW on the skull creates a self-contained environment, maintaining optical access while eliminating the need for external ultrasound coupling medium for photoacoustic imaging. Using this usCCW, we demonstrate photoacoustic microscopy of cortical vascular network in live mice over 28 days. This work establishes the foundation for integrating photoacoustic imaging with modern brain research. Chronic cranial windows (CCW) enable long-term imaging of brain activity, but usually they only provide passive optical access to the tissue. Here the authors develop an active CCW integrated with an ultrasound detector which enables long-term photoacoustic imaging of the cortical vasculature in live mice with higher image quality.
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18
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Yoon EJ, Ismail Z, Hanganu A, Kibreab M, Hammer T, Cheetham J, Kathol I, Sarna JR, Martino D, Furtado S, Monchi O. Mild behavioral impairment is linked to worse cognition and brain atrophy in Parkinson disease. Neurology 2019; 93:e766-e777. [PMID: 31320470 DOI: 10.1212/wnl.0000000000007968] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 03/27/2019] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To evaluate the associations of mild behavioral impairment (MBI) with cognitive deficits and patterns of gray matter changes in Parkinson disease (PD). METHODS Sixty patients with PD without dementia and 29 healthy controls underwent a cognitive neuropsychological evaluation and structural MRI scan. MBI was evaluated with the MBI Checklist (MBI-C), a rating scale designed to elicit emergent neuropsychiatric symptoms in accordance with MBI criteria. We divided the patients with PD into 2 groups: 1 group with high MBI-C scores (PD-MBI) and the other with low MBI-C scores (PD-noMBI). RESULTS Among 60 patients with PD, 20 were categorized as having PD-MBI (33.33%). In healthy controls, no participants met the MBI cut-point threshold. The PD-MBI group had significantly lower Montreal Cognitive Assessment and z scores in all 5 domains and the global score compared to healthy controls and those with PD-noMBI. In addition, all cognitive domains except language and global cognition negatively correlated with the MBI-C total score in all patients with PD. For cortical structures, the PD-MBI group revealed middle temporal cortex thinning and decreased volume compared with the PD-noMBI group, and decreased volume in this area negatively correlated with the MBI-C total score. CONCLUSIONS The impaired cognitive function over all domains and atrophy in the temporal area in the PD-MBI group are in line with posterior cortical circuit deficits in PD, which have been associated with a faster rate of progression to dementia. These initial results suggest that MBI might be an early and important marker for incident cognitive decline and dementia in patients with PD.
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Affiliation(s)
- Eun Jin Yoon
- From the Department of Clinical Neurosciences (E.J.Y., Z.I., A.H., M.K., T.H., J.C., I.K., J.R.S., D.M., S.F., O.M.) and Departments of Psychiatry and Community Health Sciences (Z.I.), University of Calgary; Hotchkiss Brain Institute (E.J.Y., Z.I., A.H., M.K., T.H., J.C., I.K., J.R.S., D.M., S.F., O.M.), Cumming School of Medicine, Calgary, Alberta; Centre de Recherche (A.H., O.M.), Institut Universitaire de Gériatrie de Montréal; and Department of Psychology (A.H.), University of Montréal, Québec, Canada
| | - Zahinoor Ismail
- From the Department of Clinical Neurosciences (E.J.Y., Z.I., A.H., M.K., T.H., J.C., I.K., J.R.S., D.M., S.F., O.M.) and Departments of Psychiatry and Community Health Sciences (Z.I.), University of Calgary; Hotchkiss Brain Institute (E.J.Y., Z.I., A.H., M.K., T.H., J.C., I.K., J.R.S., D.M., S.F., O.M.), Cumming School of Medicine, Calgary, Alberta; Centre de Recherche (A.H., O.M.), Institut Universitaire de Gériatrie de Montréal; and Department of Psychology (A.H.), University of Montréal, Québec, Canada
| | - Alexandru Hanganu
- From the Department of Clinical Neurosciences (E.J.Y., Z.I., A.H., M.K., T.H., J.C., I.K., J.R.S., D.M., S.F., O.M.) and Departments of Psychiatry and Community Health Sciences (Z.I.), University of Calgary; Hotchkiss Brain Institute (E.J.Y., Z.I., A.H., M.K., T.H., J.C., I.K., J.R.S., D.M., S.F., O.M.), Cumming School of Medicine, Calgary, Alberta; Centre de Recherche (A.H., O.M.), Institut Universitaire de Gériatrie de Montréal; and Department of Psychology (A.H.), University of Montréal, Québec, Canada
| | - Mekale Kibreab
- From the Department of Clinical Neurosciences (E.J.Y., Z.I., A.H., M.K., T.H., J.C., I.K., J.R.S., D.M., S.F., O.M.) and Departments of Psychiatry and Community Health Sciences (Z.I.), University of Calgary; Hotchkiss Brain Institute (E.J.Y., Z.I., A.H., M.K., T.H., J.C., I.K., J.R.S., D.M., S.F., O.M.), Cumming School of Medicine, Calgary, Alberta; Centre de Recherche (A.H., O.M.), Institut Universitaire de Gériatrie de Montréal; and Department of Psychology (A.H.), University of Montréal, Québec, Canada
| | - Tracy Hammer
- From the Department of Clinical Neurosciences (E.J.Y., Z.I., A.H., M.K., T.H., J.C., I.K., J.R.S., D.M., S.F., O.M.) and Departments of Psychiatry and Community Health Sciences (Z.I.), University of Calgary; Hotchkiss Brain Institute (E.J.Y., Z.I., A.H., M.K., T.H., J.C., I.K., J.R.S., D.M., S.F., O.M.), Cumming School of Medicine, Calgary, Alberta; Centre de Recherche (A.H., O.M.), Institut Universitaire de Gériatrie de Montréal; and Department of Psychology (A.H.), University of Montréal, Québec, Canada
| | - Jenelle Cheetham
- From the Department of Clinical Neurosciences (E.J.Y., Z.I., A.H., M.K., T.H., J.C., I.K., J.R.S., D.M., S.F., O.M.) and Departments of Psychiatry and Community Health Sciences (Z.I.), University of Calgary; Hotchkiss Brain Institute (E.J.Y., Z.I., A.H., M.K., T.H., J.C., I.K., J.R.S., D.M., S.F., O.M.), Cumming School of Medicine, Calgary, Alberta; Centre de Recherche (A.H., O.M.), Institut Universitaire de Gériatrie de Montréal; and Department of Psychology (A.H.), University of Montréal, Québec, Canada
| | - Iris Kathol
- From the Department of Clinical Neurosciences (E.J.Y., Z.I., A.H., M.K., T.H., J.C., I.K., J.R.S., D.M., S.F., O.M.) and Departments of Psychiatry and Community Health Sciences (Z.I.), University of Calgary; Hotchkiss Brain Institute (E.J.Y., Z.I., A.H., M.K., T.H., J.C., I.K., J.R.S., D.M., S.F., O.M.), Cumming School of Medicine, Calgary, Alberta; Centre de Recherche (A.H., O.M.), Institut Universitaire de Gériatrie de Montréal; and Department of Psychology (A.H.), University of Montréal, Québec, Canada
| | - Justyna R Sarna
- From the Department of Clinical Neurosciences (E.J.Y., Z.I., A.H., M.K., T.H., J.C., I.K., J.R.S., D.M., S.F., O.M.) and Departments of Psychiatry and Community Health Sciences (Z.I.), University of Calgary; Hotchkiss Brain Institute (E.J.Y., Z.I., A.H., M.K., T.H., J.C., I.K., J.R.S., D.M., S.F., O.M.), Cumming School of Medicine, Calgary, Alberta; Centre de Recherche (A.H., O.M.), Institut Universitaire de Gériatrie de Montréal; and Department of Psychology (A.H.), University of Montréal, Québec, Canada
| | - Davide Martino
- From the Department of Clinical Neurosciences (E.J.Y., Z.I., A.H., M.K., T.H., J.C., I.K., J.R.S., D.M., S.F., O.M.) and Departments of Psychiatry and Community Health Sciences (Z.I.), University of Calgary; Hotchkiss Brain Institute (E.J.Y., Z.I., A.H., M.K., T.H., J.C., I.K., J.R.S., D.M., S.F., O.M.), Cumming School of Medicine, Calgary, Alberta; Centre de Recherche (A.H., O.M.), Institut Universitaire de Gériatrie de Montréal; and Department of Psychology (A.H.), University of Montréal, Québec, Canada
| | - Sarah Furtado
- From the Department of Clinical Neurosciences (E.J.Y., Z.I., A.H., M.K., T.H., J.C., I.K., J.R.S., D.M., S.F., O.M.) and Departments of Psychiatry and Community Health Sciences (Z.I.), University of Calgary; Hotchkiss Brain Institute (E.J.Y., Z.I., A.H., M.K., T.H., J.C., I.K., J.R.S., D.M., S.F., O.M.), Cumming School of Medicine, Calgary, Alberta; Centre de Recherche (A.H., O.M.), Institut Universitaire de Gériatrie de Montréal; and Department of Psychology (A.H.), University of Montréal, Québec, Canada
| | - Oury Monchi
- From the Department of Clinical Neurosciences (E.J.Y., Z.I., A.H., M.K., T.H., J.C., I.K., J.R.S., D.M., S.F., O.M.) and Departments of Psychiatry and Community Health Sciences (Z.I.), University of Calgary; Hotchkiss Brain Institute (E.J.Y., Z.I., A.H., M.K., T.H., J.C., I.K., J.R.S., D.M., S.F., O.M.), Cumming School of Medicine, Calgary, Alberta; Centre de Recherche (A.H., O.M.), Institut Universitaire de Gériatrie de Montréal; and Department of Psychology (A.H.), University of Montréal, Québec, Canada.
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Motor Improvement-Related Regional Cerebral Blood Flow Changes in Parkinson's Disease in Response to Antiparkinsonian Drugs. PARKINSON'S DISEASE 2019; 2019:7503230. [PMID: 30944721 PMCID: PMC6421789 DOI: 10.1155/2019/7503230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 01/10/2019] [Accepted: 01/27/2019] [Indexed: 11/17/2022]
Abstract
Little is known about the relationship between regional cerebral blood flow (rCBF) change and clinical improvement in patients with Parkinson's disease (PD). Single-photon emission computed tomography (SPECT) measurement of cerebral blood flow allows evaluation of temporal changes in brain function, and using SPECT, we aimed to identify motor improvement-related rCBF changes in response to the administration of antiparkinsonian drugs. Thirty PD patients (16 without dementia; 14 with dementia) were scanned with technetium-99m labeled ethyl cysteinate dimer SPECT and were rated with the Movement Disorder Society-Unified Parkinson's Disease Rating Scale part III, both before and after a single administration of antiparkinsonian drugs. The SPECT data were processed using Statistical Parametric Mapping 2, the easy Z-score Imaging System, and voxel-based Stereotactic Extraction Estimation. The rCBF responses in the deep brain structures after administration of antiparkinsonian drugs tended to be larger than those in cortical areas. Among these deep brain structures, the rCBF increases in the substantia nigra (SN), lateral geniculate (LG) body, and medial geniculate (MG) body correlated with drug efficacy (p < 0.05, respectively). A subgroup analysis revealed that the motor improvement-related rCBF change in the MG was statistically significant, irrespective of cognitive function, but the significant changes in the LG and SN were not found in subjects with dementia. In conclusion, our SPECT study clearly exhibited drug-driven rCBF changes in PD patients, and we newly identified motor improvement-related rCBF changes in the LG and MG. These results suggest that rCBF changes in these regions could be considered as candidates for clinical indicators for objective evaluation of disease progression. Furthermore, functional studies focusing on the LG and MG, especially in relation to therapies using audio-visual stimuli, may bring some new clues to explain the pathophysiology of PD.
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20
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Zhang K, Tang Y, Meng L, Zhu L, Zhou X, Zhao Y, Yan X, Tang B, Guo J. The Effects of SNCA rs894278 on Resting-State Brain Activity in Parkinson's Disease. Front Neurosci 2019; 13:47. [PMID: 30778284 PMCID: PMC6369188 DOI: 10.3389/fnins.2019.00047] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 01/18/2019] [Indexed: 12/21/2022] Open
Abstract
The pathogenesis of Parkinson's disease (PD) is not well established. The rs894278 polymorphism of SNCA has been associated with PD. We performed this study to investigate the relationship between rs894278 and PD status on resting-state brain activity, by analyzing the amplitude of low-frequency fluctuation (ALFF). A total of 81 PD patients and 64 healthy controls were recruited. Disease severity and PD stage were evaluated in PD patients using the unified Parkinson's disease rating scale (UPDRS) and the Hoehn and Yahr (HY) scale, while the cognitive function of all participants was assessed using the mini-mental state examination (MMSE). All participants were genotyped for the rs894278 SNP and underwent a resting state functional magnetic resonance imaging scan. We found that the ALFF values of PD patients in the lingual gyrus and left caudate were lower than those of HCs; and the ALFF values for the right fusiform of participants with G allele were lower than those of participants without G allele. And we further revealed higher ALFF values in bilateral fusiform in rs894278-G carriers than in rs894278-G non-carriers in the PD group and lower ALFF values in bilateral fusiform in rs894278-G carriers than in rs894278-G non-carriers in the HC group. Our findings show that rs894278 and PD status interactively affect the brain activity of PD patients and HCs, and changes in the brain connectomes may play a key role in the pathogenesis of PD. Thus, our work sheds light on the mechanism underlying PD pathogenesis.
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Affiliation(s)
- Kailin Zhang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Yan Tang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China.,School of Information Science and Engineering, Central South University, Changsha, China
| | - Li Meng
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China
| | - Liping Zhu
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China
| | - Xiaoting Zhou
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Yuwen Zhao
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Xinxiang Yan
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Beisha Tang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China.,Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China.,Center for Medical Genetics, School of Life Sciences, Central South University, Changsha, China.,Parkinson's Disease Center of Beijing Institute for Brain Disorders, Beijing China.,Collaborative Innovation Center for Brain Science, Shanghai, China
| | - Jifeng Guo
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China.,Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China.,Center for Medical Genetics, School of Life Sciences, Central South University, Changsha, China
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21
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Nicastro N, Eger AF, Assal F, Garibotto V. Feeling of presence in dementia with Lewy bodies is related to reduced left frontoparietal metabolism. Brain Imaging Behav 2018; 14:1199-1207. [PMID: 30511120 PMCID: PMC7381475 DOI: 10.1007/s11682-018-9997-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Feeling of presence (FOP) refers to the vivid sensation of a person’s presence near oneself and is common in Dementia with Lewy Bodies (DLB). Based on previous observations on epileptic subjects, we hypothesized that DLB subjects with FOP would harbour 18F-fluorodeoxyglucose PET hypometabolism in left parietal areas. 25 subjects (mean age 71.9 ± 6.7, disease duration at scan 1.7 ± 1.5 years) were included in the study, of whom nine (36%) experienced FOP. No significant between-group difference was observed regarding dopamine transporters striatal uptake (p = 0.64), daily dopaminergic treatment dosage (p = 0.88) and visual hallucinations (p = 0.83). Statistical parametric mapping showed that subjects with FOP had a significantly reduced glucose metabolism in several left frontoparietal areas (p < 0.001), including superior parietal lobule and precuneus. Interregional correlation analysis of these areas showed specific connectivity with right insula and putamen in the FOP subgroup and right orbitofrontal and superior frontal in subjects without FOP. This provides further evidence about the role of a left frontoparietal network and suggest a possible contribution of impaired orbitofrontal reality filtering associated with FOP.
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Affiliation(s)
- Nicolas Nicastro
- Department of Psychiatry, Addenbrooke's Hospital, University of Cambridge, Hills Road, Cambridge, CB2 0QQ, UK. .,Division of Neurorehabilitation, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland.
| | - Antoine F Eger
- Division of Neurology, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland
| | - Frederic Assal
- Division of Neurology, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland
| | - Valentina Garibotto
- Department of Nuclear Medicine, Geneva University Hospitals, Geneva, Switzerland.,NiMTLab, Faculty of Medicine, University of Geneva, Geneva, Switzerland
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22
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Nakaoku Y, Oishi N, Hase Y, Hase M, Saito S, Mitsueda T, Matsui M, Toyoda K, Nagatsuka K, Kalaria RN, Fukuyama H, Ihara M, Takahashi R. Montreal Cognitive Assessment score correlates with regional cerebral blood flow in post-stroke patients. Clin Neurol Neurosurg 2018; 174:68-74. [DOI: 10.1016/j.clineuro.2018.09.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 08/28/2018] [Accepted: 09/03/2018] [Indexed: 12/21/2022]
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Altered intrinsic brain functional connectivity in drug-naïve Parkinson's disease patients with LRRK2 mutations. Neurosci Lett 2018; 675:145-151. [PMID: 29567424 DOI: 10.1016/j.neulet.2018.03.038] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 02/24/2018] [Accepted: 03/18/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND Leucine-rich repeat kinase 2 (LRRK2) has been recently identified as a causative gene of Parkinson's disease (PD), and the LRRK2 R1628P and G2385R mutations are common in ethnic Han-Chinese PD patients. However, the pathogenic mechanism of LRRK2 mutations in PD remains largely unknown. METHODS Resting-state functional MRI (fMRI) was used to assess the functional connectivity (FC) of the striatal subregions of 11 ethnic Han-Chinese drug-naïve PD patients with the LRRK2 R1628P or G2385R mutations, 11 ethnic Han-Chinese drug-naïve PD patients without such mutations, and 22 healthy control (HC) subjects. RESULTS Compared with the HC subjects, both subgroups of the PD patients showed alterations in the FC within the sensorimotor-striatal and posterior putamen-striatal circuits. In addition, relative to the subgroup of PD patients without the LRRK2 mutations, the subgroup of PD patients with the LRRK2 mutation exhibited decreased FC between the putamen and the bilateral superior frontal gyri, precuneus and calcarine gyri. The FC between the putamen and the bilateral superior frontal gyri decreased with age in the LRRK2 mutation carriers but not in the non-carriers. CONCLUSION Differences in the FC between ethnic Han-Chinese drug-naïve PD patients with and without the LRRK2 mutation may provide new insights into the understanding of the neural functional changes in ethnic Han-Chinese PD patients with LRRK2 mutations. However, our results are preliminary, and further investigations are needed.
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Prell T. Structural and Functional Brain Patterns of Non-Motor Syndromes in Parkinson's Disease. Front Neurol 2018; 9:138. [PMID: 29593637 PMCID: PMC5858029 DOI: 10.3389/fneur.2018.00138] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 02/26/2018] [Indexed: 11/26/2022] Open
Abstract
Parkinson’s disease (PD) is a common, progressive and multisystem neurodegenerative disorder characterized by motor and non-motor symptoms. Advanced magnetic resonance imaging, positron emission tomography, and functional magnetic resonance imaging can render the view toward understanding the neural basis of these non-motor syndromes, as they help to understand the underlying pathophysiological abnormalities. This review provides an up-to-date description of structural and functional brain alterations in patients with PD with cognitive deficits, visual hallucinations, fatigue, impulsive behavior disorders, sleep disorders, and pain.
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Affiliation(s)
- Tino Prell
- Department of Neurology, Jena University Hospital, Jena, Germany
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25
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Hepp DH, Foncke EMJ, Olde Dubbelink KTE, van de Berg WDJ, Berendse HW, Schoonheim MM. Loss of Functional Connectivity in Patients with Parkinson Disease and Visual Hallucinations. Radiology 2017; 285:896-903. [DOI: 10.1148/radiol.2017170438] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- Dagmar H. Hepp
- From the Department of Neurology (D.H.H., E.M.J.F., K.T.E.O.D., H.W.B.) and Department of Anatomy and Neurosciences (D.H.H., W.D.J.v.d.B., M.M.S.), Neuroscience Campus Amsterdam, VU University Medical Center, De Boelelaan 1108, Postbus 7057, 1007 MB Amsterdam, the Netherlands
| | - Elisabeth M. J. Foncke
- From the Department of Neurology (D.H.H., E.M.J.F., K.T.E.O.D., H.W.B.) and Department of Anatomy and Neurosciences (D.H.H., W.D.J.v.d.B., M.M.S.), Neuroscience Campus Amsterdam, VU University Medical Center, De Boelelaan 1108, Postbus 7057, 1007 MB Amsterdam, the Netherlands
| | - Kim T. E. Olde Dubbelink
- From the Department of Neurology (D.H.H., E.M.J.F., K.T.E.O.D., H.W.B.) and Department of Anatomy and Neurosciences (D.H.H., W.D.J.v.d.B., M.M.S.), Neuroscience Campus Amsterdam, VU University Medical Center, De Boelelaan 1108, Postbus 7057, 1007 MB Amsterdam, the Netherlands
| | - Wilma D. J. van de Berg
- From the Department of Neurology (D.H.H., E.M.J.F., K.T.E.O.D., H.W.B.) and Department of Anatomy and Neurosciences (D.H.H., W.D.J.v.d.B., M.M.S.), Neuroscience Campus Amsterdam, VU University Medical Center, De Boelelaan 1108, Postbus 7057, 1007 MB Amsterdam, the Netherlands
| | - Henk W. Berendse
- From the Department of Neurology (D.H.H., E.M.J.F., K.T.E.O.D., H.W.B.) and Department of Anatomy and Neurosciences (D.H.H., W.D.J.v.d.B., M.M.S.), Neuroscience Campus Amsterdam, VU University Medical Center, De Boelelaan 1108, Postbus 7057, 1007 MB Amsterdam, the Netherlands
| | - Menno M. Schoonheim
- From the Department of Neurology (D.H.H., E.M.J.F., K.T.E.O.D., H.W.B.) and Department of Anatomy and Neurosciences (D.H.H., W.D.J.v.d.B., M.M.S.), Neuroscience Campus Amsterdam, VU University Medical Center, De Boelelaan 1108, Postbus 7057, 1007 MB Amsterdam, the Netherlands
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26
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Cortical afferent inhibition abnormalities reveal cholinergic dysfunction in Parkinson’s disease: a reappraisal. J Neural Transm (Vienna) 2017; 124:1417-1429. [DOI: 10.1007/s00702-017-1775-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 07/31/2017] [Indexed: 12/14/2022]
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27
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Morbelli S, Bauckneht M, Arnaldi D, Picco A, Pardini M, Brugnolo A, Buschiazzo A, Pagani M, Girtler N, Nieri A, Chincarini A, De Carli F, Sambuceti G, Nobili F. 18F-FDG PET diagnostic and prognostic patterns do not overlap in Alzheimer's disease (AD) patients at the mild cognitive impairment (MCI) stage. Eur J Nucl Med Mol Imaging 2017; 44:2073-2083. [PMID: 28785843 DOI: 10.1007/s00259-017-3790-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 07/23/2017] [Indexed: 11/24/2022]
Abstract
PURPOSE We aimed to identify the cortical regions where hypometabolism can predict the speed of conversion to dementia in mild cognitive impairment due to Alzheimer's disease (MCI-AD). METHODS We selected from the clinical database of our tertiary center memory clinic, eighty-two consecutive MCI-AD that underwent 18F-fluorodeoxyglucose (FDG) PET at baseline during the first diagnostic work-up and were followed up at least until their clinical conversion to AD dementia. The whole group of MCI-AD was compared in SPM8 with a group of age-matched healthy controls (CTR) to verify the presence of AD diagnostic-pattern; then the correlation between conversion time and brain metabolism was assessed to identify the prognostic-pattern. Significance threshold was set at p < 0.05 False-Discovery-Rate (FDR) corrected at peak and at cluster level. Each MCI-AD was then compared with CTR by means of a SPM single-subject analysis and grouped according to presence of AD diagnostic-pattern and prognostic-pattern. Kaplan-Meier-analysis was used to evaluate if diagnostic- and/or prognostic-patterns can predict speed of conversion to dementia. RESULTS Diagnostic-pattern corresponded to typical posterior hypometabolism (BA 7, 18, 19, 30, 31 and 40) and did not correlate with time to conversion, which was instead correlated with metabolic levels in right middle and inferior temporal gyri as well as in the fusiform gyrus (prognostic-pattern, BA 20, 21 and 38). At Kaplan-Meier analysis, patients with hypometabolism in the prognostic pattern converted to AD-dementia significantly earlier than patients not showing significant hypometabolism in the right middle and inferior temporal cortex (9 versus 19 months; Log rank p < 0.02, Breslow test: p < 0.003, Tarone-Ware test: p < 0.007). CONCLUSION The present findings support the role of FDG PET as a robust progression biomarker even in a naturalist population of MCI-AD. However, not the AD-typical diagnostic-pattern in posterior regions but the middle and inferior temporal metabolism captures speed of conversion to dementia in MCI-AD since baseline. The highlighted prognostic pattern is a further, independent source of heterogeneity in MCI-AD and affects a primary-endpoint on interventional clinical trials (time of conversion to dementia).
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Affiliation(s)
- Silvia Morbelli
- Nuclear Medicine Unit, IRCCS AOU San Martino, IST and Department of Health Sciences, University of Genoa, Largo R. Benzi 10, 16132, Genoa, Italy.
| | - Matteo Bauckneht
- Nuclear Medicine Unit, IRCCS AOU San Martino, IST and Department of Health Sciences, University of Genoa, Largo R. Benzi 10, 16132, Genoa, Italy
| | - Dario Arnaldi
- Clinical Neurology, Department of Neuroscience (DINOGMI), University of Genoa and IRCCS AOU San Martino-IST, Genoa, Italy
| | - Agnese Picco
- Clinical Neurology, Department of Neuroscience (DINOGMI), University of Genoa and IRCCS AOU San Martino-IST, Genoa, Italy
| | - Matteo Pardini
- Clinical Neurology, Department of Neuroscience (DINOGMI), University of Genoa and IRCCS AOU San Martino-IST, Genoa, Italy
| | - Andrea Brugnolo
- Clinical Neurology, Department of Neuroscience (DINOGMI), University of Genoa and IRCCS AOU San Martino-IST, Genoa, Italy
| | - Ambra Buschiazzo
- Nuclear Medicine Unit, IRCCS AOU San Martino, IST and Department of Health Sciences, University of Genoa, Largo R. Benzi 10, 16132, Genoa, Italy
| | - Marco Pagani
- Institute of Cognitive Sciences and Technologies, CNR, Rome, Italy
- Department of Nuclear Medicine, Karolinska Hospital, Stockholm, Sweden
| | - Nicola Girtler
- Clinical Neurology, Department of Neuroscience (DINOGMI), University of Genoa and IRCCS AOU San Martino-IST, Genoa, Italy
| | - Alberto Nieri
- Nuclear Medicine Unit, IRCCS AOU San Martino, IST and Department of Health Sciences, University of Genoa, Largo R. Benzi 10, 16132, Genoa, Italy
| | - Andrea Chincarini
- Istituto Nazionale di Fisica Nucleare, Sezione di Genova, Genoa, Italy
| | - Fabrizio De Carli
- Institute of Bioimaging and Molecular Physiology, National Research Council, Genoa, Italy
| | - Gianmario Sambuceti
- Nuclear Medicine Unit, IRCCS AOU San Martino, IST and Department of Health Sciences, University of Genoa, Largo R. Benzi 10, 16132, Genoa, Italy
| | - Flavio Nobili
- Clinical Neurology, Department of Neuroscience (DINOGMI), University of Genoa and IRCCS AOU San Martino-IST, Genoa, Italy
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Pezzoli S, Cagnin A, Bandmann O, Venneri A. Structural and Functional Neuroimaging of Visual Hallucinations in Lewy Body Disease: A Systematic Literature Review. Brain Sci 2017; 7:E84. [PMID: 28714891 PMCID: PMC5532597 DOI: 10.3390/brainsci7070084] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 06/27/2017] [Accepted: 07/09/2017] [Indexed: 01/01/2023] Open
Abstract
Patients with Lewy body disease (LBD) frequently experience visual hallucinations (VH), well-formed images perceived without the presence of real stimuli. The structural and functional brain mechanisms underlying VH in LBD are still unclear. The present review summarises the current literature on the neural correlates of VH in LBD, namely Parkinson's disease (PD), and dementia with Lewy bodies (DLB). Following a systematic literature search, 56 neuroimaging studies of VH in PD and DLB were critically reviewed and evaluated for quality assessment. The main structural neuroimaging results on VH in LBD revealed grey matter loss in frontal areas in patients with dementia, and parietal and occipito-temporal regions in PD without dementia. Parietal and temporal hypometabolism was also reported in hallucinating PD patients. Disrupted functional connectivity was detected especially in the default mode network and fronto-parietal regions. However, evidence on structural and functional connectivity is still limited and requires further investigation. The current literature is in line with integrative models of VH suggesting a role of attention and perception deficits in the development of VH. However, despite the close relationship between VH and cognitive impairment, its associations with brain structure and function have been explored only by a limited number of studies.
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Affiliation(s)
- Stefania Pezzoli
- Department of Neuroscience, University of Sheffield, Sheffield, S10 2RX, UK.
| | - Annachiara Cagnin
- Department of Neurosciences, University of Padua, 35128 Padua, Italy.
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione Ospedale San Camillo, 30126 Venice, Italy.
| | - Oliver Bandmann
- Department of Neuroscience, University of Sheffield, Sheffield, S10 2RX, UK.
| | - Annalena Venneri
- Department of Neuroscience, University of Sheffield, Sheffield, S10 2RX, UK.
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Yousaf T, Wilson H, Politis M. Imaging the Nonmotor Symptoms in Parkinson's Disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2017; 133:179-257. [PMID: 28802921 DOI: 10.1016/bs.irn.2017.05.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Parkinson's disease is acknowledged to be a multisystem syndrome, manifesting as a result of multineuropeptide dysfunction, including dopaminergic, cholinergic, serotonergic, and noradrenergic deficits. This multisystem disorder ultimately leads to the presentation of a range of nonmotor symptoms, now appreciated to be an integral part of the disease-specific spectrum of symptoms, often preceding the diagnosis of motor Parkinson's disease. In this chapter, we review the dopaminergic and nondopaminergic basis of these symptoms by exploring the neuroimaging evidence based on several techniques including positron emission tomography, single-photon emission computed tomography molecular imaging, magnetic resonance imaging, functional magnetic resonance imaging, and diffusion tensor imaging. We discuss the role of these neuroimaging techniques in elucidating the underlying pathophysiology of NMS in Parkinson's disease.
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Affiliation(s)
- Tayyabah Yousaf
- Neurodegeneration Imaging Group, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, United Kingdom
| | - Heather Wilson
- Neurodegeneration Imaging Group, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, United Kingdom
| | - Marios Politis
- Neurodegeneration Imaging Group, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, United Kingdom.
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Chang A, Fox SH. Psychosis in Parkinson's Disease: Epidemiology, Pathophysiology, and Management. Drugs 2017; 76:1093-118. [PMID: 27312429 DOI: 10.1007/s40265-016-0600-5] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Psychotic symptoms are common in Parkinson's disease (PD) and are associated with poorer quality of life and increased caregiver burden. PD psychosis is correlated with several factors, such as more advanced disease, cognitive impairment, depression, and sleep disorders. The underlying causes of psychosis in PD thus involve a complex interplay between exogenous (e.g., drugs, intercurrent illnesses) and endogenous (e.g., PD disease pathology) factors. Current theories of the pathophysiology of PD psychosis have come from several neuropathological and neuroimaging studies that implicate pathways involving visual processing and executive function, including temporo-limbic structures and neocortical gray matter with altered neurotransmitter functioning (e.g., dopamine, serotonin, and acetylcholine). Treatment of PD psychosis requires a step-wise process, including initial careful investigation of treatable triggering conditions and a comprehensive evaluation with adjustment of PD medications and/or initiation of specific antipsychotic therapies. Clozapine remains the only recommended drug for the treatment of PD psychosis; however, because of regular blood monitoring, quetiapine is usually first-line therapy, although less efficacious. Emerging studies have focused on agents involving other neurotransmitters, including the serotonin 5-HT2A receptor inverse agonist pimavanserin, cholinesterase inhibitors, and antidepressants and anxiolytics.
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Affiliation(s)
- Anna Chang
- Morton and Gloria Shulman Movement Disorder Clinic, University of Toronto, Toronto Western Hospital, 7th Floor, McLaughlin Pavilion, 399 Bathurst Street, Toronto, ON, M5T 2S8, Canada.,Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Susan H Fox
- Morton and Gloria Shulman Movement Disorder Clinic, University of Toronto, Toronto Western Hospital, 7th Floor, McLaughlin Pavilion, 399 Bathurst Street, Toronto, ON, M5T 2S8, Canada.
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Ffytche DH, Creese B, Politis M, Chaudhuri KR, Weintraub D, Ballard C, Aarsland D. The psychosis spectrum in Parkinson disease. Nat Rev Neurol 2017; 13:81-95. [PMID: 28106066 PMCID: PMC5656278 DOI: 10.1038/nrneurol.2016.200] [Citation(s) in RCA: 203] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
In 2007, the clinical and research profile of illusions, hallucinations, delusions and related symptoms in Parkinson disease (PD) was raised with the publication of a consensus definition of PD psychosis. Symptoms that were previously deemed benign and clinically insignificant were incorporated into a continuum of severity, leading to the rapid expansion of literature focusing on clinical aspects, mechanisms and treatment. Here, we review this literature and the evolving view of PD psychosis. Key topics include the prospective risk of dementia in individuals with PD psychosis, and the causal and modifying effects of PD medication. We discuss recent developments, including recognition of an increase in the prevalence of psychosis with disease duration, addition of new visual symptoms to the psychosis continuum, and identification of frontal executive, visual perceptual and memory dysfunction at different disease stages. In addition, we highlight novel risk factors - for example, autonomic dysfunction - that have emerged from prospective studies, structural MRI evidence of frontal, parietal, occipital and hippocampal involvement, and approval of pimavanserin for the treatment of PD psychosis. The accumulating evidence raises novel questions and directions for future research to explore the clinical management and biomarker potential of PD psychosis.
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Affiliation(s)
- Dominic H Ffytche
- KCL-PARCOG group, Institute of Psychiatry, Psychology &Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology &Neuroscience, King's College London, UK. De Crespigny Park, London SE5 8AF, UK
| | - Byron Creese
- KCL-PARCOG group, Institute of Psychiatry, Psychology &Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
- University of Exeter Medical School, University of Exeter, EX1 2LU, UK
| | - Marios Politis
- KCL-PARCOG group, Institute of Psychiatry, Psychology &Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
- Neurodegeneration Imaging Group, Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology &Neuroscience, King's College London, 125 Coldharbour Lane, London SE5 9NU, UK
| | - K Ray Chaudhuri
- KCL-PARCOG group, Institute of Psychiatry, Psychology &Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
- Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, National Parkinson Foundation Centre of Excellence, King's College London/Kings College Hospital, 5 Cutcombe Road, London SE5 9RT, UK
| | - Daniel Weintraub
- KCL-PARCOG group, Institute of Psychiatry, Psychology &Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
- Departments of Psychiatry and Neurology, Perelman School of Medicine at the University of Pennsylvania 3615 Chestnut Street, #330, Philadelphia, Pennsylvania 19104, USA
- Parkinson's Disease and Mental Illness Research, Education and Clinical Centres (PADRECC and MIRECC), Philadelphia Veterans Affairs Medical Centre 3900 Woodland Avenue, Philadelphia, Pennsylvania 19104, USA
| | - Clive Ballard
- KCL-PARCOG group, Institute of Psychiatry, Psychology &Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
- University of Exeter Medical School, University of Exeter, EX1 2LU, UK
| | - Dag Aarsland
- KCL-PARCOG group, Institute of Psychiatry, Psychology &Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology &Neuroscience, King's College London, UK. De Crespigny Park, London SE5 8AF, UK
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Cho SS, Strafella AP, Duff-Canning S, Zurowski M, Vijverman AC, Bruno V, Aquino CC, Criaud M, Rusjan PM, Houle S, Fox SH. The Relationship Between Serotonin-2A Receptor and Cognitive Functions in Nondemented Parkinson's Disease Patients with Visual Hallucinations. Mov Disord Clin Pract 2017; 4:698-709. [PMID: 30363421 DOI: 10.1002/mdc3.12466] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 11/10/2016] [Accepted: 12/01/2016] [Indexed: 01/17/2023] Open
Abstract
Background There is growing evidence that the serotonergic system, in particular serotonin 2A receptors, is involved in neuropsychiatric symptoms in Parkinson's disease (PD), including cognitive processing and visual hallucinations. However, the relationship between serotonin 2A receptor availability, visual hallucinations, and cognitive profile is unknown. The objective of this study was to investigate the level of serotonin 2A receptor availability in brain regions affected by visual hallucinations and to test the association with cognitive/behavioral changes in patients who have PD with visual hallucinations. Methods Nondemented patients who had PD with (n = 11) and without (n = 8) visual hallucinations and age-matched controls (n = 10) were recruited. All participants completed neuropsychological testing, which consisted of visuoperceptual, executive, memory, language, and frontal-behavioral function. Positron emission tomography scans using [18F]setoperone, a serotonin 2A antagonist radioligand, were acquired in patients with PD, and a parametric binding potential map of [18F]setoperone was calculated with the simplified reference tissue model using the cerebellum as a reference. Results Patients who had PD with visual hallucinations exhibited significantly lower scores on measures of executive and visuoperceptual functions compared with age-matched controls. These changes were paralleled by decreased [18F]setoperone binding in the right insula, bilateral dorsolateral prefrontal cortex, right orbitofrontal cortex, right middle temporal gyrus, and right fusiform gyrus. The psychometric correlation analysis revealed significant relationships among tests associated with visuoperceptual function, memory and learning, and serotonin 2A binding in different prefrontal and ventral visual stream regions. There was also reduced serotonin 2A receptor binding in patients who had PD with depression. Conclusions These findings support a complex interaction between serotonin 2A receptor function and cognitive processing in patients who have PD with visual hallucinations.
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Affiliation(s)
- Sang Soo Cho
- Division of Brain, Imaging and Behavior-Systems Neuroscience Krembil Research Institute University Health Network University of Toronto Toronto Ontario Canada.,Research Imaging Center Center for Addiction and Mental Health University of Toronto Toronto Ontario Canada
| | - Antonio P Strafella
- Division of Brain, Imaging and Behavior-Systems Neuroscience Krembil Research Institute University Health Network University of Toronto Toronto Ontario Canada.,Research Imaging Center Center for Addiction and Mental Health University of Toronto Toronto Ontario Canada.,Movement Disorder Unit and E. J. Safra Parkinson Disease Program Toronto Western Hospital University Health Network University of Toronto Toronto Ontario Canada
| | - Sarah Duff-Canning
- Movement Disorder Unit and E. J. Safra Parkinson Disease Program Toronto Western Hospital University Health Network University of Toronto Toronto Ontario Canada
| | - Mateusz Zurowski
- Department of Psychiatry University of Toronto Toronto Ontario Canada
| | | | - Veronica Bruno
- Movement Disorder Unit and E. J. Safra Parkinson Disease Program Toronto Western Hospital University Health Network University of Toronto Toronto Ontario Canada
| | - Camila C Aquino
- Movement Disorder Unit and E. J. Safra Parkinson Disease Program Toronto Western Hospital University Health Network University of Toronto Toronto Ontario Canada
| | - Marion Criaud
- Division of Brain, Imaging and Behavior-Systems Neuroscience Krembil Research Institute University Health Network University of Toronto Toronto Ontario Canada.,Research Imaging Center Center for Addiction and Mental Health University of Toronto Toronto Ontario Canada
| | - Pablo M Rusjan
- Research Imaging Center Center for Addiction and Mental Health University of Toronto Toronto Ontario Canada
| | - Sylvain Houle
- Research Imaging Center Center for Addiction and Mental Health University of Toronto Toronto Ontario Canada
| | - Susan H Fox
- Movement Disorder Unit and E. J. Safra Parkinson Disease Program Toronto Western Hospital University Health Network University of Toronto Toronto Ontario Canada
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ffytche DH, Aarsland D. Psychosis in Parkinson's Disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2017; 133:585-622. [DOI: 10.1016/bs.irn.2017.04.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Szatmari S, Illigens BMW, Siepmann T, Pinter A, Takats A, Bereczki D. Neuropsychiatric symptoms in untreated Parkinson's disease. Neuropsychiatr Dis Treat 2017; 13:815-826. [PMID: 28352181 PMCID: PMC5360401 DOI: 10.2147/ndt.s130997] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Neuropsychiatric and cognitive symptoms are common in Parkinson's disease (PD) and may precede and exceed motor symptoms as major factors impacting disease course and quality of life. Neuropsychiatric symptoms (NPS) in PD are various and are attributed to pathologic changes within multiple brain regions, to psychological stress, and to adverse effects of dopamine replacement therapy. Sleep disorders and mood symptoms such as apathy, depression, and anxiety may antedate the development of motor symptoms by years, while other NPS such as impulse control disorders, psychosis, and cognitive impairment are more common in later stages of the disease. Few studies report on NPS in the early, untreated phase of PD. We reviewed the current literature on NPS in PD with a focus on the early, drug-naive stages of PD. Among these early disease stages, premotor and early motor phases were separately addressed in our review, highlighting the underlying pathophysiological mechanisms as well as epidemiological characteristics, clinical features, risk factors, and available techniques of clinical assessment.
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Affiliation(s)
- Szabolcs Szatmari
- Department of Neurology, Sibiu County Emergency Hospital, Sibiu; 2nd Department of Neurology, Targu Mures Emergency Clinical County Hospital, Targu Mures, Romania; János Szentágothai Doctoral School of Neurosciences, Semmelweis University, Budapest, Hungary
| | - Ben Min-Woo Illigens
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Timo Siepmann
- Center for Clinical Research and Management Education, Division of Health Care Sciences, Dresden International University; Department of Neurology, University Hospital Carl Gustav Carus, Technical University of Dresden, Dresden, Germany
| | - Alexandra Pinter
- Center for Clinical Research and Management Education, Division of Health Care Sciences, Dresden International University; Department of Family Medicine
| | - Annamaria Takats
- Department of Neurology, Semmelweis University, Budapest, Hungary
| | - Daniel Bereczki
- Department of Neurology, Semmelweis University, Budapest, Hungary
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Cilia R, Tunesi S, Marotta G, Cereda E, Siri C, Tesei S, Zecchinelli AL, Canesi M, Mariani CB, Meucci N, Sacilotto G, Zini M, Barichella M, Magnani C, Duga S, Asselta R, Soldà G, Seresini A, Seia M, Pezzoli G, Goldwurm S. Survival and dementia inGBA-associated Parkinson's disease: The mutation matters. Ann Neurol 2016; 80:662-673. [DOI: 10.1002/ana.24777] [Citation(s) in RCA: 249] [Impact Index Per Article: 31.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 09/05/2016] [Accepted: 09/06/2016] [Indexed: 12/13/2022]
Affiliation(s)
- Roberto Cilia
- Parkinson Institute, ASST “Gaetano Pini-CTO”; Milan Italy
| | - Sara Tunesi
- Department of Translational Medicine, Unit of Medical Statistics and Cancer Epidemiology; University of Piemonte Orientale; Novara Italy
- Center for Cancer Epidemiology and Prevention (CPO); University Hospital “Città della Salute e della Scienza di Torino”; Turin Italy
| | - Giorgio Marotta
- Nuclear Medicine Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico; Milan Italy
| | | | - Chiara Siri
- Parkinson Institute, ASST “Gaetano Pini-CTO”; Milan Italy
| | - Silvana Tesei
- Parkinson Institute, ASST “Gaetano Pini-CTO”; Milan Italy
| | | | | | | | | | | | - Michela Zini
- Parkinson Institute, ASST “Gaetano Pini-CTO”; Milan Italy
| | | | - Corrado Magnani
- Department of Translational Medicine, Unit of Medical Statistics and Cancer Epidemiology; University of Piemonte Orientale; Novara Italy
| | - Stefano Duga
- Department of Biomedical Sciences; Humanitas University, Rozzano, Milan, Italy; and Humanitas Clinical and Research Center; Rozzano Milan Italy
| | - Rosanna Asselta
- Department of Biomedical Sciences; Humanitas University, Rozzano, Milan, Italy; and Humanitas Clinical and Research Center; Rozzano Milan Italy
| | - Giulia Soldà
- Department of Biomedical Sciences; Humanitas University, Rozzano, Milan, Italy; and Humanitas Clinical and Research Center; Rozzano Milan Italy
| | - Agostino Seresini
- Molecular Genetics Laboratory, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico; Milan Italy
| | - Manuela Seia
- Molecular Genetics Laboratory, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico; Milan Italy
| | - Gianni Pezzoli
- Parkinson Institute, ASST “Gaetano Pini-CTO”; Milan Italy
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Mapping brain morphological and functional conversion patterns in predementia late-onset bvFTD. Eur J Nucl Med Mol Imaging 2016; 43:1337-47. [DOI: 10.1007/s00259-016-3335-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Accepted: 02/08/2016] [Indexed: 02/01/2023]
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Arnaldi D, Famà F, De Carli F, Morbelli S, Ferrara M, Picco A, Accardo J, Primavera A, Sambuceti G, Nobili F. The Role of the Serotonergic System in REM Sleep Behavior Disorder. Sleep 2015; 38:1505-9. [PMID: 25845692 PMCID: PMC4531419 DOI: 10.5665/sleep.5000] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 02/20/2015] [Indexed: 11/03/2022] Open
Abstract
STUDY OBJECTIVES REM sleep behavior disorder (RBD) can be induced by antidepressants, especially serotonin reuptake inhibitors (SSRI), thus a role of the serotonergic system in the pathogenesis of RBD has been proposed. However, the serotonergic system integrity in idiopathic RBD (iRBD) is still unknown. We aimed to study brain stem serotonergic system integrity, by means of (123)I-FP-CIT-SPECT, in a group of iRBD patients as compared to normal subjects. DESIGN Single-center, prospective observational study. SETTING University hospital. PATIENTS OR PARTICIPANTS Twenty iRBD outpatients and 23 age-matched normal controls. MEASUREMENTS AND RESULTS The diagnosis of RBD was determined clinically and confirmed by means of overnight, laboratory-based video-polysomnography. Both iRBD patients and normal subjects underwent (123)I-FP-CIT-SPECT as a marker of dopamine transporter (DAT) at basal ganglia level and of serotonin transporter (SERT) at brainstem and thalamus levels. (123)I-FP-CIT-SPECT images were analyzed and compared between iRBD patients and controls by means of both region of interest analysis at basal ganglia, midbrain, pons and thalamus levels, and voxel-based analysis, taking into account age and the use of SSRI as confounding factors. No difference in (123)I-FP-CIT-SPECT specific to nondisplaceable binding ratios (SBR) values was found between iRBD and normal subjects at brainstem and thalamus levels while iRBD patients showed lower SBR values in all basal ganglia nuclei (P < 0.0001) compared to controls. CONCLUSIONS These results suggest that the serotonergic system is not directly involved in RBD pathogenesis while confirming nigro-striatal dopaminergic deafferentation in iRBD.
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Affiliation(s)
- Dario Arnaldi
- Clinical Neurology, Department of Neuroscience (DINOGMI), University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy
| | - Francesco Famà
- Clinical Neurology, Department of Neuroscience (DINOGMI), University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy
| | - Fabrizio De Carli
- Institute of Bioimaging and Molecular Physiology, National Research Council, Genoa, Italy
| | - Silvia Morbelli
- Nuclear Medicine, Department of Health Sciences (DISSAL), University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy
| | - Michela Ferrara
- Clinical Neurology, Department of Neuroscience (DINOGMI), University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy
| | - Agnese Picco
- Clinical Neurology, Department of Neuroscience (DINOGMI), University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy
| | - Jennifer Accardo
- Clinical Neurology, Department of Neuroscience (DINOGMI), University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy
| | - Alberto Primavera
- Clinical Neurology, Department of Neuroscience (DINOGMI), University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy
| | - Gianmario Sambuceti
- Nuclear Medicine, Department of Health Sciences (DISSAL), University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy
| | - Flavio Nobili
- Clinical Neurology, Department of Neuroscience (DINOGMI), University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy
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Alzahrani H, Venneri A. Cognitive and neuroanatomical correlates of neuropsychiatric symptoms in Parkinson's disease: A systematic review. J Neurol Sci 2015; 356:32-44. [DOI: 10.1016/j.jns.2015.06.037] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2014] [Revised: 05/25/2015] [Accepted: 06/17/2015] [Indexed: 12/13/2022]
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Orbitofrontal (18) F-DOPA Uptake and Movement Preparation in Parkinson's Disease. PARKINSONS DISEASE 2015; 2015:180940. [PMID: 26171275 PMCID: PMC4480935 DOI: 10.1155/2015/180940] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Revised: 05/27/2015] [Accepted: 05/30/2015] [Indexed: 11/29/2022]
Abstract
In Parkinson's disease (PD) degeneration of mesocortical dopaminergic projections may determine cognitive and behavioral symptoms. Choice reaction time task is related to attention, working memory, and goal-directed behavior. Such paradigm involves frontal cortical circuits receiving mesocortical dopamine which are affected early in PD. The aim of this study is to characterize the role of dopamine on the cognitive processes that precede movement in a reaction time paradigm in PD. We enrolled 16 newly diagnosed and untreated patients with PD without cognitive impairment or depression and 10 control subjects with essential tremor. They performed multiple-choice reaction time task with the right upper limb and brain 18F-DOPA PET/CT scan. A significant inverse correlation was highlighted between average reaction time and 18F-DOPA uptake in the left lateral orbitofrontal cortex. No correlations were found between reaction time and PD disease severity or between reaction time and 18F-DOPA uptake in controls. Our study shows that in PD, but not in controls, reaction time is inversely related to the levels of dopamine in the left lateral orbitofrontal cortex. This novel finding underlines the role of dopamine in the lateral orbitofrontal cortex in the early stages of PD, supporting a relation between the compensatory cortical dopamine and movement preparation.
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Gratwicke J, Jahanshahi M, Foltynie T. Parkinson's disease dementia: a neural networks perspective. Brain 2015; 138:1454-76. [PMID: 25888551 PMCID: PMC4614131 DOI: 10.1093/brain/awv104] [Citation(s) in RCA: 279] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 03/15/2015] [Accepted: 03/23/2015] [Indexed: 12/16/2022] Open
Abstract
In the long-term, with progression of the illness, Parkinson's disease dementia affects up to 90% of patients with Parkinson's disease. With increasing life expectancy in western countries, Parkinson's disease dementia is set to become even more prevalent in the future. However, current treatments only give modest symptomatic benefit at best. New treatments are slow in development because unlike the pathological processes underlying the motor deficits of Parkinson's disease, the neural mechanisms underlying the dementing process and its associated cognitive deficits are still poorly understood. Recent insights from neuroscience research have begun to unravel the heterogeneous involvement of several distinct neural networks underlying the cognitive deficits in Parkinson's disease dementia, and their modulation by both dopaminergic and non-dopaminergic transmitter systems in the brain. In this review we collate emerging evidence regarding these distinct brain networks to give a novel perspective on the pathological mechanisms underlying Parkinson's disease dementia, and discuss how this may offer new therapeutic opportunities.
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Affiliation(s)
- James Gratwicke
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London, UK, WC1N 3BG
| | - Marjan Jahanshahi
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London, UK, WC1N 3BG
| | - Thomas Foltynie
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London, UK, WC1N 3BG
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Lenka A, Jhunjhunwala KR, Saini J, Pal PK. Structural and functional neuroimaging in patients with Parkinson's disease and visual hallucinations: A critical review. Parkinsonism Relat Disord 2015; 21:683-91. [PMID: 25920541 DOI: 10.1016/j.parkreldis.2015.04.005] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 04/05/2015] [Accepted: 04/08/2015] [Indexed: 12/16/2022]
Abstract
Patients with Parkinson's disease (PD) may develop various non-motor symptoms (NMS) during the course of the illness and psychosis is one of the common NMS of PD. Visual hallucinations (VH) are the most common manifestation of psychosis in PD. The exact pathogenesis of VH in patients with PD is not clearly understood. Presence of VH has been described to be associated with rapid cognitive decline and increased nursing home placements in PD patients. A large number of structural and functional neuroimaging studies have been conducted to understand the cerebral basis of VH in PD. Structural imaging studies (Voxel Based Morphometry) have reported grey matter atrophy in multiple regions of the brain such as primary visual cortex, visual association cortex, limbic regions, cholinergic structures such as pedunculopontine nucleus and substantia innominata, which conclude possible alterations of brain regions associated with functions such as visuospatial-perception, attention control and memory. Most functional neuroimaging studies (functional MRI, positron emission tomography and single photon emission computerized tomography) have reported altered activation, blood flow, or reduced metabolism in both dorsal and ventral visual pathways, which probably indicates an alteration in the normal bottom-top visual processing and the presence of an aberrant top-down visual processing. This review critically analyzes the published studies on the structural and functional neuroimaging in PD patients with VH.
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Affiliation(s)
- Abhishek Lenka
- Department of Clinical Neurosciences, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India; Department of Neurology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India
| | - Ketan Ramakant Jhunjhunwala
- Department of Clinical Neurosciences, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India; Department of Neurology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India
| | - Jitender Saini
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India
| | - Pramod Kumar Pal
- Department of Neurology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India.
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Brain (18)F-DOPA PET and cognition in de novo Parkinson's disease. Eur J Nucl Med Mol Imaging 2015; 42:1062-70. [PMID: 25820675 DOI: 10.1007/s00259-015-3039-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 03/05/2015] [Indexed: 02/08/2023]
Abstract
PURPOSE The role of mesocortical dopaminergic pathways in the cognitive function of patients with early Parkinson's disease (PD) needs to be further clarified. METHODS The study groups comprised 15 drug-naive patients with de novo PD and 10 patients with essential tremor (controls) who underwent (18)F-DOPA PET (static acquisition, normalization on mean cerebellar counts) and an extended neuropsychological test battery. Factor analysis with varimax rotation was applied to the neuropsychological test scores, to yield five factors from 16 original scores, which explained 82 % of the total variance. Correlations between cognitive factors and (18)F-DOPA uptake were assessed with SPM8, taking age and gender as nuisance variables. RESULTS (18)F-DOPA uptake was significantly lower in PD patients than in controls in the bilateral striatum, mainly in the more affected (right) hemisphere, and in a small right temporal region. Significant positive correlations were found only in PD patients between the executive factor and (18)F-DOPA uptake in the bilateral anterior cingulate cortex (ACC) and the middle frontal gyrus, between the verbal fluency factor and (18)F-DOPA uptake in left BA 46 and the bilateral striatum, and between the visuospatial factor and (18)F-DOPA uptake in the left ACC and bilateral striatum. No correlations were found between (18)F-DOPA uptake and either the verbal memory factor or the abstraction-working memory factor. CONCLUSION These data clarify the role of the mesocortical dopaminergic pathways in cognitive function in early PD, highlighting the medial frontal lobe, anterior cingulate, and left BA 46 as the main sites of cortical correlation with executive and language functions.
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Moustafa AA, Krishna R, Frank MJ, Eissa AM, Hewedi DH. Cognitive correlates of psychosis in patients with Parkinson's disease. Cogn Neuropsychiatry 2015; 19:381-98. [PMID: 24446773 DOI: 10.1080/13546805.2013.877385] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Psychosis and hallucinations occur in 20-30% of patients with Parkinson's disease (PD). In the current study, we investigate cognitive functions in relation to the occurrence of psychosis in PD patients. METHODS We tested three groups of subjects - PD with psychosis, PD without psychosis and healthy controls - on working memory, learning and transitive inference tasks, which are known to assess prefrontal, basal ganglia and hippocampal functions. RESULTS In the working memory task, results show that patients with and without psychosis were more impaired than the healthy control group. In the transitive inference task, we did not find any difference among the groups in the learning phase performance. Importantly, PD patients with psychosis were more impaired than both PD patients without psychosis and controls at transitive inference. We also found that the severity of psychotic symptoms in PD patients [as measured by the Unified Parkinson Disease Rating Scale Thought Disorder (UPDRS TD) item] is directly associated with the severity of cognitive impairment [as measured by the mini-mental status exam (MMSE)], sleep disturbance [as measured by the Scales for Outcome in Parkinson Disease (SCOPA) sleep scale] and transitive inference (although the latter did not reach significance). CONCLUSIONS Although hypothetical, our data may suggest that the hippocampus is a neural substrate underlying the occurrence of psychosis, sleep disturbance and cognitive impairment in PD patients.
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Affiliation(s)
- Ahmed A Moustafa
- a Department of Veterans Affairs , New Jersey Health Care System , East Orange , NJ , USA
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Zhang J, Bi W, Zhang Y, Zhu M, Zhang Y, Feng H, Wang J, Zhang Y, Jiang T. Abnormal functional connectivity density in Parkinson's disease. Behav Brain Res 2014; 280:113-8. [PMID: 25496782 DOI: 10.1016/j.bbr.2014.12.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 11/27/2014] [Accepted: 12/01/2014] [Indexed: 10/24/2022]
Abstract
The pathology of Parkinson's disease (PD) is not confined to the nigrostriatal pathway, but also involves widespread cerebral cortical areas. Using seed-based resting state functional connectivity, many previous studies have demonstrated that PD patients have abnormal functional integration. However, this technique strongly relies on a priori selection of the seed regions and may miss important unpredictable findings. Using an ultrafast voxel-wise functional connectivity density approach, this study performed a whole brain functional connectivity analysis to investigate the abnormal resting-state functional activities in PD patients. Compared with healthy controls, PD patients exhibited decreased short-range functional connectivity densities in regions that were mainly located in the ventral visual pathway and decreased long-range functional connectivity densities in the right middle and superior frontal gyrus, which have been speculated to be associated with visual hallucinations and cognitive dysfunction, respectively. PD patients also exhibited increased short- and long-range functional connectivity densities in the bilateral precuneus and posterior cingulate cortex, which may represent a compensatory process for maintaining normal brain function. The observed functional connectivity density alterations might be related to the disturbed structural connectivity of PD patients, leading to abnormal functional integration. Our results suggest that functional connectivity density mapping may provide a useful means to assess PD-related neurodegeneration and to study the pathophysiology of PD.
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Affiliation(s)
- Jiuquan Zhang
- Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing 400038, PR China
| | - Wenwei Bi
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, PR China
| | - Yuling Zhang
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, PR China
| | - Maohu Zhu
- Elementary Educational College, Jiangxi Normal University, Nanchang 330027, PR China
| | - Yanling Zhang
- Department of Neurology, Southwest Hospital, Third Military Medical University, Chongqing 400038, PR China
| | - Hua Feng
- Department of Neurosurgery, Southwest Hospital, Third Military Medical University, Chongqing 400038, PR China
| | - Jian Wang
- Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing 400038, PR China
| | - Yuanchao Zhang
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, PR China.
| | - Tianzi Jiang
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, PR China; National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, PR China.
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Yao N, Pang S, Cheung C, Chang RSK, Lau KK, Suckling J, Yu K, Mak HKF, McAlonan G, Ho SL, Chua SE. Resting activity in visual and corticostriatal pathways in Parkinson's disease with hallucinations. Parkinsonism Relat Disord 2014; 21:131-7. [PMID: 25511330 DOI: 10.1016/j.parkreldis.2014.11.020] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Revised: 11/20/2014] [Accepted: 11/25/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Visual hallucinations are an important non-motor complication of Parkinson's disease (PD) and carry a negative prognosis. Their biological basis is uncertain, but may relate to the activity of resting state networks in brain. We therefore aimed to investigate functional activity of brain in patients with visual hallucinations (PDVH) in resting state compared to patients without hallucinations (PDnonVH) and a healthy control group (HC). METHODS Resting state functional MRI was acquired and the primary analysis compared the amplitude of low-frequency fluctuations (ALFF) across groups. This informed a secondary analysis, in the PD groups only, comparing functional connectivity between a 'seed' region in the occipital lobe and the rest of the brain. RESULTS Individuals with PDVH showed lower ALFF in bilateral lingual gyrus and cuneus and greater ALFF in temporo-parietal regions, medial temporal gyrus and cerebellum than PDnonVH and HC. PDnonVH also had lower ALFF in occipitoparietal region and greater ALFF in medial temporal gyrus, temporo-parietal and cerebellum regions than HC. Functional connectivity analysis revealed that, although both PD groups had lower occipital functional connectivity relative to the HC group, occipital - corticostriatal connectivity was significantly higher in those with PDVH compared with PDnonVH. CONCLUSION Our study reveals widespread hemodynamic alterations in PD. However, within a functionally abnormal occipital lobe, those with PDVH have even lower ALFF than non-hallucinators, but have higher occipital functional connectivity with cortical-striatal regions. These findings suggest disruption of pathways underpinning both primary visual perceptual and intrinsic visual integration may contribute to visual hallucinations in PD.
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Affiliation(s)
- Nailin Yao
- Department of Psychiatry, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong
| | - Shirley Pang
- Division of Neurology, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - Charlton Cheung
- Department of Psychiatry, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong; State Key Laboratory for Cognitive Sciences, The University of Hong Kong, Pokfulam, Hong Kong
| | - Richard Shek-Kwan Chang
- Division of Neurology, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - Kui Kai Lau
- Division of Neurology, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - John Suckling
- Department of Psychiatry and Behavioural and Clinical Neuroscience Institute, University of Cambridge, United Kingdom & Cambridge and Peterborough Foundation NHS Trust, UK
| | - Kevin Yu
- Department of Psychiatry, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong
| | - Henry Ka-Fung Mak
- Department of Diagnostic Radiology, The University of Hong Kong, Pokfulam, Hong Kong
| | - Grainne McAlonan
- Department of Psychiatry, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong; State Key Laboratory for Cognitive Sciences, The University of Hong Kong, Pokfulam, Hong Kong; Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, King's College London, London SE5 8AZ, UK.
| | - Shu-Leong Ho
- Division of Neurology, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong.
| | - Siew-Eng Chua
- Department of Psychiatry, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong; State Key Laboratory for Cognitive Sciences, The University of Hong Kong, Pokfulam, Hong Kong
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Micarelli A, Pagani M, Chiaravalloti A, Bruno E, Pavone I, Candidi M, Danieli R, Schillaci O, Alessandrini M. Cortical metabolic arrangement during olfactory processing: proposal for a 18F FDG PET/CT methodological approach. Medicine (Baltimore) 2014; 93:e103. [PMID: 25340494 PMCID: PMC4616321 DOI: 10.1097/md.0000000000000103] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The aim of this article is to investigate the cortical metabolic arrangements in olfactory processing by using F fluorodeoxyglucose (FDG) positron emission tomography/computed tomography.Twenty-six normosmic individuals (14 women and 12 men; mean age 46.7 ± 10 years) were exposed to a neutral olfactory condition (NC) and, after 1 month, to a pure olfactory condition (OC) in a relatively ecological environment, that is, outside the scanner. All the subjects were injected with 185-210 megabecquerel of F FDG during both stimulations. Statistical parametric mapping version 2 was used in order to assess differences between NC and OC.As a result, we found a significant higher glucose consumption during OC in the cuneus, lingual, and parahippocampal gyri, mainly in the left hemisphere. During NC, our results show a relative higher glucose metabolism in the left superior, inferior, middle, medial frontal, and orbital gyri as well as in the anterior cingulate cortex.The present investigation, performed with a widely available functional imaging clinical tool, may help to better understand the neural responses associated to olfactory processing in healthy individuals and in patients with olfactory disorders by acquiring data in an ecologic, noise-free, and resting condition in which possible cerebral activations related to unwanted attentional processes might be avoided.
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Affiliation(s)
- Alessandro Micarelli
- Department of Clinical Sciences and Translational Medicine (AM, EB, IP, MA), Tor Vergata University; Institute of Cognitive Sciences and Technologies-CNR (MP), Rome, Italy; Department of Nuclear Medicine (MP), Karolinska University Hospital, Stockholm, Sweden; Department of Biomedicine and Prevention (AC, RD, OS), Tor Vergata University; Department of Psychology (MC), "Sapienza" University, Rome; and IRCCS Neuromed (OS), Pozzilli, Italy
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Zhong J, Wu S, Zhao Y, Chen H, Zhao N, Zheng K, Zhao Z, Chen W, Wang B, Wu K. Why psychosis is frequently associated with Parkinson's disease? Neural Regen Res 2014; 8:2548-56. [PMID: 25206565 PMCID: PMC4145938 DOI: 10.3969/j.issn.1673-5374.2013.27.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2013] [Accepted: 07/23/2013] [Indexed: 11/18/2022] Open
Abstract
Psychosis is a common non-motor symptom of Parkinson's disease whose pathogenesis remains poorly understood. Parkinson's disease in conjunction with psychosis has been shown to induce injury to extracorticospinal tracts as well as within some cortical areas. In this study, Parkinson's disease patients with psychosis who did not receive antipsychotic treatment and those without psychosis underwent diffusion tensor imaging. Results revealed that in Parkinson's disease patients with psychosis, damage to the left frontal lobe, bilateral occipital lobe, left cingulated gyrus, and left hippocampal white-matter fibers were greater than damage to the substantia nigra or the globus pallidus. Damage to white-matter fibers in the right frontal lobe and right cingulate gyrus were also more severe than in the globus pallidus, but not the substantia nigra. Damage to frontal lobe and cingulate gyrus white-matter fibers was more apparent than that to occipital or hippocampal fiber damage. Compared with Parkinson's disease patients without psychosis, those with psychosis had significantly lower fractional anisotropy ratios of left frontal lobe, bilateral occipital lobe, left cingu-lated gyrus, and left hippocampus to ipsilateral substantia nigra or globus pallidus, indicating more severe damage to white-matter fibers. These results suggest that psychosis associated with Par-kinson's disease is probably associated with an imbalance in the ratio of white-matter fibers be-tween brain regions associated with psychiatric symptoms (frontal lobe, occipital lobe, cingulate gyrus, and hippocampus) and those associated with the motor symptoms of Parkinson's disease (the substantia nigra and globus pallidus). The relatively greater damage to white-matter fibers in psychiatric symptom-related brain regions than in extracorticospinal tracts might explain why chosis often occurs in Parkinson's disease patients.
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Affiliation(s)
- Jingmei Zhong
- Department of Neurology, First People's Hospital of Yunnan Province, Kunming 650032, Yunnan Province, China
| | - Shaoyuan Wu
- Department of Neurology, First People's Hospital of Yunnan Province, Kunming 650032, Yunnan Province, China
| | - Ying Zhao
- Department of Magnetic Resonance Imaging, First People's Hospital of Yunnan Province, Kunming 650032, Yunnan Province, China
| | - Hui Chen
- Department of Neurology, First People's Hospital of Yunnan Province, Kunming 650032, Yunnan Province, China
| | - Naiwei Zhao
- Department of Neurology, First People's Hospital of Yunnan Province, Kunming 650032, Yunnan Province, China
| | - Kunwen Zheng
- Department of Neurology, First People's Hospital of Yunnan Province, Kunming 650032, Yunnan Province, China
| | - Zhong Zhao
- Department of Neurology, First People's Hospital of Yunnan Province, Kunming 650032, Yunnan Province, China
| | - Wenli Chen
- Department of Neurology, First People's Hospital of Yunnan Province, Kunming 650032, Yunnan Province, China
| | - Bo Wang
- Department of Magnetic Resonance Imaging, First People's Hospital of Yunnan Province, Kunming 650032, Yunnan Province, China
| | - Kunhua Wu
- Department of Magnetic Resonance Imaging, First People's Hospital of Yunnan Province, Kunming 650032, Yunnan Province, China
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Cortico-subcortical metabolic correlates of olfactory processing in healthy resting subjects. Sci Rep 2014; 4:5146. [PMID: 24888510 PMCID: PMC4042120 DOI: 10.1038/srep05146] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 05/02/2014] [Indexed: 12/03/2022] Open
Abstract
A wide network of interconnected areas was previously found in neuroimaging studies involving normal as well as pathological subjects; however literature seems to suffer from a lack of investigation in glucose metabolism behaviour under olfactory condition. Thus, the present work describe for the first time a pure olfactory related brain response of metabolism by using 18F-fluorodeoxyglucose-Positron Emission Tomography/Computer Tomography in eleven resting subjects undergoing a neutral and a pure olfactory condition. By contrasting these experimental phases, it was possible to depict a re-organization pattern of default mode network structures in a relatively ecological environment. Moreover, by correlating such pattern with a battery of validated olfactory and neuropsychological tests, our work allowed in showing peculiar correlation data that could cluster the subjects sample in a certain range of normality. We believe the present study could integrate the current knowledge in olfactory research and could be a start-up for future contributions.
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Klupp E, Förster S, Grimmer T, Tahmasian M, Yakushev I, Sorg C, Yousefi BH, Drzezga A. In Alzheimer's Disease, Hypometabolism in Low-Amyloid Brain Regions May Be a Functional Consequence of Pathologies in Connected Brain Regions. Brain Connect 2014; 4:371-83. [PMID: 24870443 DOI: 10.1089/brain.2013.0212] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Elisabeth Klupp
- Department of Nuclear Medicine, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Stefan Förster
- Department of Nuclear Medicine, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
- TUM Neuroimaging Center (TUM-NIC), Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Timo Grimmer
- Department of Psychiatry, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Masoud Tahmasian
- Department of Nuclear Medicine, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
- TUM Neuroimaging Center (TUM-NIC), Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Igor Yakushev
- Department of Nuclear Medicine, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
- TUM Neuroimaging Center (TUM-NIC), Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Christian Sorg
- TUM Neuroimaging Center (TUM-NIC), Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
- Department of Neuroradiology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | - Behrooz H. Yousefi
- TUM Neuroimaging Center (TUM-NIC), Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
- Pharmaceutical Radiochemistry, Technische Universität München, Garching, Germany
| | - Alexander Drzezga
- Department of Nuclear Medicine, University Hospital of Cologne, Cologne, Germany
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Kiferle L, Ceravolo R, Giuntini M, Linsalata G, Puccini G, Volterrani D, Bonuccelli U. Caudate dopaminergic denervation and visual hallucinations: evidence from a ¹²³I-FP-CIT SPECT study. Parkinsonism Relat Disord 2014; 20:761-5. [PMID: 24787757 DOI: 10.1016/j.parkreldis.2014.04.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 03/27/2014] [Accepted: 04/06/2014] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The pathogenesis of visual hallucinations (VHs) in Parkinson's disease (PD) has been considered multifactorial. In the pathophysiology of VHs a combination of impaired visual processing and attention has been reported. Imaging studies evidenced a role of the primary visual system and visual association areas as well as a dysfunctional activation of frontal areas in the occurrence of VHs. Due to the functional connections between basal ganglia and frontal areas, a role of basal ganglia and of the fronto-striatal circuits in the pathogenesis of VHs may be postulated. Aim of this study is to unveil whether a presynaptic dopamine deficiency at baseline may predict the development of VHs. METHODS A group of 18 non demented PD patients with VHs was matched with 18 non demented PD patients without VHs as regards age of onset of disease, disease duration and severity and levodopa equivalent dose. We retrospectively analyzed the (123)I-FP CIT SPECT performed on the two groups at the onset of their disease. The striatal uptake values in the two groups were examined, in order to evaluate nigrostriatal differences between the groups with different behavioral phenotype. RESULTS The group of patients with VHs had a significant reduction (p < 0.05) in right caudate uptake values at baseline when compared with patients without VHs. No significant differences were found between the groups regarding left caudate and putaminal uptake values. CONCLUSIONS The frontal impairment reported in PD patients with VHs may be due to a right caudate dysfunction, as it is connected to the frontal brain areas via neuronal loops.
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Affiliation(s)
- Lorenzo Kiferle
- Section of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Roberto Ceravolo
- Section of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
| | - Martina Giuntini
- Section of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giuseppe Linsalata
- Section of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giulia Puccini
- Regional Center of Nuclear Medicine, University of Pisa, Italy
| | | | - Ubaldo Bonuccelli
- Section of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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