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Chen X, Zhang Y. A review of the neurotransmitter system associated with cognitive function of the cerebellum in Parkinson's disease. Neural Regen Res 2024; 19:324-330. [PMID: 37488885 PMCID: PMC10503617 DOI: 10.4103/1673-5374.379042] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 03/30/2023] [Accepted: 05/08/2023] [Indexed: 07/26/2023] Open
Abstract
The dichotomized brain system is a concept that was generalized from the 'dual syndrome hypothesis' to explain the heterogeneity of cognitive impairment, in which anterior and posterior brain systems are independent but partially overlap. The dopaminergic system acts on the anterior brain and is responsible for executive function, working memory, and planning. In contrast, the cholinergic system acts on the posterior brain and is responsible for semantic fluency and visuospatial function. Evidence from dopaminergic/cholinergic imaging or functional neuroimaging has shed significant insight relating to the involvement of the cerebellum in the cognitive process of patients with Parkinson's disease. Previous research has reported evidence that the cerebellum receives both dopaminergic and cholinergic projections. However, whether these two neurotransmitter systems are associated with cognitive function has yet to be fully elucidated. Furthermore, the precise role of the cerebellum in patients with Parkinson's disease and cognitive impairment remains unclear. Therefore, in this review, we summarize the cerebellar dopaminergic and cholinergic projections and their relationships with cognition, as reported by previous studies, and investigated the role of the cerebellum in patients with Parkinson's disease and cognitive impairment, as determined by functional neuroimaging. Our findings will help us to understand the role of the cerebellum in the mechanisms underlying cognitive impairment in Parkinson's disease.
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Affiliation(s)
- Xi Chen
- Department of Neurology, Guangdong Neuroscience Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong Province, China
- Shantou University Medical College, Shantou, Guangdong Province, China
| | - Yuhu Zhang
- Department of Neurology, Guangdong Neuroscience Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong Province, China
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2
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Hou Y, Zhang L, Ou R, Wei Q, Gu X, Liu K, Lin J, Yang T, Xiao Y, Gong Q, Shang H. Motor progression marker for newly diagnosed drug-naïve patients with Parkinson's disease: A resting-state functional MRI study. Hum Brain Mapp 2022; 44:901-913. [PMID: 36250699 PMCID: PMC9875914 DOI: 10.1002/hbm.26110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 09/30/2022] [Accepted: 10/01/2022] [Indexed: 01/28/2023] Open
Abstract
The effective early prediction of clinical outcomes of Parkinson's disease (PD) is of great significance in the implementation of appropriate interventions. We aimed to propose a method based on the use of baseline resting-state functional characteristics (i.e., fractional amplitude of low-frequency fluctuations, fALFF) to predict motor progression in PD patients. Resting-state functional magnetic resonance imaging was performed on 48 newly-diagnosed drug-naïve PD patients and 27 age- and sex- matched healthy controls (HCs). Two PD subgroups were defined with different annual increase of Unified PD Rating Scale Part III motor scores. Least absolute shrinkage and selection operator regression analysis was performed to explore the baseline region-functional indicators for PD discrimination as well as the predictors for future motor deficits. Two significant models composed of baseline fALFF values from cerebral subregions were proposed. The classification model that distinguished PD patients from HCs (area under the curve [AUC] = 0.897) showed the most significant imaging characteristics in the putamen and precentral gyrus. The other prediction model that evaluated the degree of future deterioration of motor symptoms in PD patients (AUC = 0.916) showed the most significant imaging characteristics in the superior occipital gyrus and caudate nucleus. Furthermore, the increased regional function in bilateral caudate nuclei was correlated with the lower annual increase in motor deficits in all PD patients. The caudate nucleus might be the core region responsible for future motor deficits in newly-diagnosed PD patients, which may aid the development of disease progression preventive strategies in clinical practice.
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Affiliation(s)
- Yanbing Hou
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China HospitalSichuan UniversityChengduSichuanChina
| | - Lingyu Zhang
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China HospitalSichuan UniversityChengduSichuanChina
| | - Ruwei Ou
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China HospitalSichuan UniversityChengduSichuanChina
| | - Qianqian Wei
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China HospitalSichuan UniversityChengduSichuanChina
| | - Xiaojing Gu
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China HospitalSichuan UniversityChengduSichuanChina
| | - Kuncheng Liu
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China HospitalSichuan UniversityChengduSichuanChina
| | - Junyu Lin
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China HospitalSichuan UniversityChengduSichuanChina
| | - Tianmi Yang
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China HospitalSichuan UniversityChengduSichuanChina
| | - Yi Xiao
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China HospitalSichuan UniversityChengduSichuanChina
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China HospitalSichuan UniversityChengduSichuanChina
| | - Huifang Shang
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China HospitalSichuan UniversityChengduSichuanChina
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Jin Yoon E, Ismail Z, Kathol I, Kibreab M, Hammer T, Lang S, Ramezani M, Auclair-Ouellet N, Sarna JR, Martino D, Furtado S, Monchi O. Patterns of brain activity during a set-shifting task linked to mild behavioral impairment in Parkinson's disease. NEUROIMAGE-CLINICAL 2021; 30:102590. [PMID: 33640685 PMCID: PMC7907973 DOI: 10.1016/j.nicl.2021.102590] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 12/24/2020] [Accepted: 02/03/2021] [Indexed: 11/15/2022]
Abstract
PD with mild behavioral impairment revealed deficits in cognitive flexibility. Brain activities during a set-shifting task linked with MBI in PD was evaluated. PD-MBI revealed reduced activity in the prefrontal and posterior parietal cortices. The prefrontal activity was associated with cognitive impairment in PD-MBI. High MBI-C score was associated with reduced deactivation in the hippocampus.
Mild behavioral impairment (MBI) is a neurobehavioral syndrome characterized by later life emergence of sustained neuropsychiatric symptoms, as an at-risk state for incident cognitive decline and dementia. Prior studies have reported that neuropsychiatric symptoms are associated with cognitive abilities in Parkinson’s disease (PD) patients, and we have recently found a strong correlation between MBI and cognitive performance. However, the underlying neural activity patterns of cognitive performance linked to MBI in PD are unknown. Fifty-nine non-demented PD patients and 26 healthy controls were scanned using fMRI during performance of a modified version of the Wisconsin card sorting task. MBI was evaluated using the MBI-checklist, and PD patients were divided into two groups, PD-MBI and PD-noMBI. Compared to the PD-noMBI group and healthy controls, the PD-MBI group revealed less activation in the prefrontal and posterior parietal cortices, and reduced deactivation in the medial temporal region. These results suggest that in PD, MBI reflects deficits in the frontoparietal control network and the hippocampal memory system.
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Affiliation(s)
- Eun Jin Yoon
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, Calgary, Alberta, Canada
| | - Zahinoor Ismail
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, Calgary, Alberta, Canada; Departments of Psychiatry and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Iris Kathol
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, Calgary, Alberta, Canada
| | - Mekale Kibreab
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, Calgary, Alberta, Canada
| | - Tracy Hammer
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, Calgary, Alberta, Canada
| | - Stefan Lang
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, Calgary, Alberta, Canada
| | - Mehrafarin Ramezani
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, Calgary, Alberta, Canada
| | | | - Justyna R Sarna
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, Calgary, Alberta, Canada
| | - Davide Martino
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, Calgary, Alberta, Canada
| | - Sarah Furtado
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, Calgary, Alberta, Canada
| | - Oury Monchi
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, Cumming School of Medicine, Calgary, Alberta, Canada; Department of Radiology, University of Calgary, Calgary, Alberta, Canada.
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Solstrand Dahlberg L, Lungu O, Doyon J. Cerebellar Contribution to Motor and Non-motor Functions in Parkinson's Disease: A Meta-Analysis of fMRI Findings. Front Neurol 2020; 11:127. [PMID: 32174883 PMCID: PMC7056869 DOI: 10.3389/fneur.2020.00127] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 02/04/2020] [Indexed: 01/19/2023] Open
Abstract
Background: Parkinson's disease (PD) results in both motor and non-motor symptoms. Traditionally, the underlying mechanism of PD has been linked to neurodegeneration of the basal ganglia. Yet it does not adequately account for the non-motor symptoms of the disease, suggesting that other brain regions may be involved. One such region is the cerebellum, which is known to be involved, together with the basal ganglia, in both motor and non-motor functions. Many studies have found the cerebellum to be hyperactive in PD patients, a finding that is seldom discussed in detail, and warrants further examination. The current study thus aims to examine quantitively the current literature on the cerebellar involvement in both motor and non-motor functioning in PD. Methods: A meta-analysis of functional neuroimaging literature was conducted with Seed-based D mapping. Only the studies testing functional activation in response to motor and non-motor paradigms in PD and healthy controls (HC) were included in the meta-analysis. Separate analyses were conducted by including only studies with non-motor paradigms, as well as meta-regressions with UPDRS III scores and disease duration. Results: A total of 57 studies with both motor and non-motor paradigms fulfilled our inclusion criteria and were included in the meta-analysis, which revealed hyperactivity in Crus I-II and vermal III in PD patients compared to HC. An analysis including only studies with cognitive paradigms revealed a cluster of increased activity in PD patients encompassing lobule VIIB and VIII. Another meta-analysis including the only 20 studies that employed motor paradigms did not reveal any significant group differences. However, a descriptive analysis of these studies revealed that 60% of them reported cerebellar hyperactivations in PD and included motor paradigm with significant cognitive task demands, as opposed to 40% presenting the opposite pattern and using mainly force grip tasks. The meta-regression with UPDRS III scores found a negative association between motor scores and activation in lobule VI and vermal VII-VIII. No correlation was found with disease duration. Discussion: The present findings suggest that one of the main cerebellar implications in PD is linked to cognitive functioning. The negative association between UPDRS scores and activation in regions implicated in motor functioning indicate that there is less involvement of these areas as the disease severity increases. In contrast, the lack of correlation with disease duration seems to indicate that the cerebellar activity may be a compensatory mechanism to the dysfunctional basal ganglia, where certain sub-regions of the cerebellum are employed to cope with motor demands. Yet future longitudinal studies are needed to fully address this possibility.
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Affiliation(s)
- Linda Solstrand Dahlberg
- Department of Neurology & Neurosurgery, McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Ovidiu Lungu
- Department of Neurology & Neurosurgery, McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
- Department of Psychiatry, University of Montreal, Montreal, QC, Canada
| | - Julien Doyon
- Department of Neurology & Neurosurgery, McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
- Functional Neuroimaging Unit, Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada
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Saredakis D, Collins-Praino LE, Gutteridge DS, Stephan BC, Keage HA. Conversion to MCI and dementia in Parkinson's disease: a systematic review and meta-analysis. Parkinsonism Relat Disord 2019; 65:20-31. [DOI: 10.1016/j.parkreldis.2019.04.020] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 04/15/2019] [Accepted: 04/28/2019] [Indexed: 12/20/2022]
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Nagano-Saito A, Bellec P, Hanganu A, Jobert S, Mejia-Constain B, Degroot C, Lafontaine AL, Lissemore JI, Smart K, Benkelfat C, Monchi O. Why Is Aging a Risk Factor for Cognitive Impairment in Parkinson's Disease?-A Resting State fMRI Study. Front Neurol 2019; 10:267. [PMID: 30967835 PMCID: PMC6438889 DOI: 10.3389/fneur.2019.00267] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 02/27/2019] [Indexed: 01/12/2023] Open
Abstract
Using resting-state functional MRI (rsfMRI) data of younger and older healthy volunteers and patients with Parkinson's disease (PD) with and without mild cognitive impairment (MCI) and applying two different analytic approaches, we investigated the effects of age, pathology, and cognition on brain connectivity. When comparing rsfMRI connectivity strength of PD patients and older healthy volunteers, reduction between multiple brain regions in PD patients with MCI (PD-MCI) compared with PD patients without MCI (PD-non-MCI) was observed. This group difference was not affected by the number and location of clusters but was reduced when age was included as a covariate. Next, we applied a graph-theory method with a cost-threshold approach to the rsfMRI data from patients with PD with and without MCI as well as groups of younger and older healthy volunteers. We observed decreased hub function (measured by degree and betweenness centrality) mainly in the medial prefrontal cortex (mPFC) in older healthy volunteers compared with younger healthy volunteers. We also found increased hub function in the posterior medial structure (precuneus and the cingulate cortex) in PD-non-MCI patients compared with older healthy volunteers and PD-MCI patients. Hub function in these posterior medial structures was positively correlated with cognitive function in all PD patients. Together these data suggest that overlapping patterns of hub modifications could mediate the effect of age as a risk factor for cognitive decline in PD, including age-related reduction of hub function in the mPFC, and recruitment availability of the posterior medial structure, possibly to compensate for impaired basal ganglia function.
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Affiliation(s)
- Atsuko Nagano-Saito
- Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada.,Department of Neurology & Neurosurgery, and Psychiatry, McGill University, Montreal, QC, Canada
| | - Pierre Bellec
- Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada.,Université de Montréal, Montreal, QC, Canada
| | - Alexandru Hanganu
- Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada.,Université de Montréal, Montreal, QC, Canada.,Cumming School of Medicine, Hotchkiss Brain Institute, Calgary, AB, Canada.,Department of Clinical Neurosciences and Department of Radiology, University of Calgary, Calgary, AB, Canada
| | - Stevan Jobert
- Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada
| | - Béatriz Mejia-Constain
- Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada
| | - Clotilde Degroot
- Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada.,Department of Neurology & Neurosurgery, and Psychiatry, McGill University, Montreal, QC, Canada
| | - Anne-Louise Lafontaine
- Department of Neurology & Neurosurgery, and Psychiatry, McGill University, Montreal, QC, Canada.,Movement Disorders Unit, McGill University Health Center, Montreal, QC, Canada.,Department of Neurology, Montreal Neurological Hospital, Montreal, QC, Canada.,Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Jennifer I Lissemore
- Department of Neurology & Neurosurgery, and Psychiatry, McGill University, Montreal, QC, Canada
| | - Kelly Smart
- Department of Neurology & Neurosurgery, and Psychiatry, McGill University, Montreal, QC, Canada
| | - Chawki Benkelfat
- Department of Neurology & Neurosurgery, and Psychiatry, McGill University, Montreal, QC, Canada
| | - Oury Monchi
- Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada.,Department of Neurology & Neurosurgery, and Psychiatry, McGill University, Montreal, QC, Canada.,Université de Montréal, Montreal, QC, Canada.,Cumming School of Medicine, Hotchkiss Brain Institute, Calgary, AB, Canada.,Department of Clinical Neurosciences and Department of Radiology, University of Calgary, Calgary, AB, Canada.,Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
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7
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McDonald AP, D'Arcy RCN, Song X. Functional MRI on executive functioning in aging and dementia: A scoping review of cognitive tasks. Aging Med (Milton) 2018; 1:209-219. [PMID: 31942499 PMCID: PMC6880681 DOI: 10.1002/agm2.12037] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 08/14/2018] [Indexed: 12/23/2022] Open
Abstract
Cognitive decline with aging and dementia is especially poignant with regard to the executive functioning that is necessary for activities of daily independent living. The relationship between age-related neurodegeneration in the prefrontal cortex and executive functioning has been uniquely investigated using task-phase functional magnetic resonance imaging (fMRI) to detect brain activity in response to stimuli; however, a comprehensive list of task designs that have been implemented to task-phase fMRI is absent in the literature. The purpose of this review was to recognize what methods have been used to study executive functions with aging and dementia in fMRI tasks, and to describe and categorize them. The following cognitive subdomains were emphasized: cognitive flexibility, planning and decision-making, working memory, cognitive control/inhibition, semantic processing, attention and concentration, emotional functioning, and multitasking. Over 30 different task-phase fMRI designs were found to have been implemented in the literature, all adopted from standard neuropsychological assessments. Cognitive set-shifting and decision-making tasks were particularly well studied in regard to age-related neurodegeneration, while emotional functioning and multitasking designs were found to be the least utilized. Summarizing the information on which tasks have shown the greatest usability will assist in the future design and implementation of effective fMRI experiments targeting executive functioning.
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Affiliation(s)
- Andrew P. McDonald
- Health Sciences and InnovationFraser Health AuthoritySurreyBritish ColumbiaCanada
- Department of MedicineUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Ryan C. N. D'Arcy
- Health Sciences and InnovationFraser Health AuthoritySurreyBritish ColumbiaCanada
- ImageTech LaboratorySimon Fraser UniversitySurreyBritish ColumbiaCanada
| | - Xiaowei Song
- Health Sciences and InnovationFraser Health AuthoritySurreyBritish ColumbiaCanada
- ImageTech LaboratorySimon Fraser UniversitySurreyBritish ColumbiaCanada
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Apathy in individuals with Parkinson's disease associated with mild cognitive impairment. A neuropsychological investigation. Neuropsychologia 2018; 118:4-11. [DOI: 10.1016/j.neuropsychologia.2018.05.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 05/18/2018] [Accepted: 05/18/2018] [Indexed: 12/31/2022]
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Wang Z, Jia X, Chen H, Feng T, Wang H. Abnormal Spontaneous Brain Activity in Early Parkinson's Disease With Mild Cognitive Impairment: A Resting-State fMRI Study. Front Physiol 2018; 9:1093. [PMID: 30154730 PMCID: PMC6102476 DOI: 10.3389/fphys.2018.01093] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2017] [Accepted: 07/23/2018] [Indexed: 01/27/2023] Open
Abstract
Mild cognitive impairment (MCI) is a common symptom at the baseline of early Parkinson's disease (PD) diagnosis, but the neural mechanism is unclear. To address the issue, the present study employed resting-state functional magnetic resonance imaging data of 19 drug-naïve PD patients with normal cognition (PD-NC), 10 PD patients with MCI (PD-MCI) and 13 age- and gender-matched healthy controls (HC) from the Parkinson's progression markers initiative (PPMI) (http://www.ppmi-info.org/), and examined abnormal spontaneous brain activities in the PD-MCI. The pattern of spontaneous brain activity was measured by examining the amplitude of low-frequency fluctuations (ALFF) of blood oxygen level dependent signal. Voxel-wise one-way analysis of covariance and post hoc analyses of ALFF were performed under non-parametric permutation tests in a general linear model among the three groups, with age, gender and data center as additional covariates. Statistical significances in the post hoc analysis were corrected by a small volume correction with a cluster-level threshold of p < 0.05 (n = 10000 permutations, FWE-corrected). Correlations of clinical and neuropsychological assessments [i.e., Unified Parkinson's Disease Rating Scale (UPDRS) total score, Montreal Cognitive Assessment (MoCA) and cognitive domains] with the regional ALFF were performed in the PD-MCI group. Compared with the HC, both PD groups exhibited reduced ALFF in the occipital area (Calcarine_R/Cuneus_R). Specially, the PD-MCI group additionally exhibited increased ALFF in the opercular part of right inferior frontal gyrus (Frontal_Inf_Oper_R). Comparing with the PD-NC, the PD-MCI group exhibited significantly higher ALFF in the Frontal_Inf_Oper_R and left fusiform gyus (ps < 0.05). The correlation analysis revealed that the ALFF in the Frontal_Inf_Oper_R was positively correlated with the UPDRS total score (p < 0.05), but marginally negatively correlated with the MoCA score. For cognitive domains, the ALFF in the region also showed a significantly negative correlation with the score of SF test (p < 0.01) and a marginally negative correlation with the score of Symbol-Digit Modalities Test. Together, we concluded hyperactivity in the right inferior frontal gyrus in early PD with MCI, suggesting a compensatory recruitment in response to cognitive decline, which may shed light on thought of dementia progression and potentially comprehensive treatment in PD.
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Affiliation(s)
- Zhijiang Wang
- Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
- National Clinical Research Center for Mental Disorders and Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
- Beijing Municipal Key Laboratory for Translational Research on Diagnosis and Treatment of Dementia, Beijing, China
| | - Xiuqin Jia
- Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Huimin Chen
- Center for Neurodegenerative Disease, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Tao Feng
- Center for Neurodegenerative Disease, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Huali Wang
- Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
- National Clinical Research Center for Mental Disorders and Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
- Beijing Municipal Key Laboratory for Translational Research on Diagnosis and Treatment of Dementia, Beijing, China
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10
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Papagno C, Trojano L. Cognitive and behavioral disorders in Parkinson's disease: an update. I: cognitive impairments. Neurol Sci 2017; 39:215-223. [PMID: 29043468 DOI: 10.1007/s10072-017-3154-8] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 10/10/2017] [Indexed: 01/12/2023]
Abstract
Parkinson's disease (PD) is a progressive neurodegenerative disease characterized by motor symptoms such as rigidity, rest tremor, and bradykinesia. However, a growing body of evidence demonstrated that PD encompasses several non-motor disturbances as well, such as cognitive impairment. Cognitive defects can be present since early stages of the disease but tend to dominate the clinical picture as the disease progresses. Around 40% of patients with PD present with cognitive impairments in several cognitive domains including attention, working memory and executive functions, language, visuospatial skills, and episodic memory; in later stages of the disease, cognitive defects and associated behavioral disorders concur to determine clinically relevant PD-associated dementia. Part of these defects is ascribed to a dopamine-dependent dysfunction of fronto-striatal pathways, but there is a considerable heterogeneity in the cognitive impairments as well as a suggestion of the role of other neurotransmitter systems, such as the cholinergic one, mainly responsible for Parkinson-dementia syndrome. In this paper, we review recent literature with particular attention to the last 5 years on the main cognitive deficits described in PD patients as well as on the hypothesized neuro-functional substrate of such impairments. Finally, we provide some suggestions on how to test cognitive functions in PD appropriately.
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Affiliation(s)
- Costanza Papagno
- CIMeC, University of Trento, Trento, Italy. .,Department of Psychology, University of Milano-Bicocca, Piazza dell'Ateneo 1, 02100, Milan, Italy.
| | - Luigi Trojano
- Department of Psychology, University of Campania 'Luigi Vanvitelli', Viale Ellittico 31, 81100, Caserta, Italy. .,ICS Maugeri, IRCCS, Telese Terme, Italy.
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