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Roytman S, Paalanen R, Griggs A, David S, Pongmala C, Koeppe RA, Scott PJH, Marusic U, Kanel P, Bohnen NI. Cholinergic system correlates of postural control changes in Parkinson's disease freezers. Brain 2023; 146:3243-3257. [PMID: 37086478 PMCID: PMC10393403 DOI: 10.1093/brain/awad134] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 03/16/2023] [Accepted: 04/06/2023] [Indexed: 04/24/2023] Open
Abstract
Postural instability and freezing of gait are the most debilitating dopamine-refractory motor impairments in advanced stages of Parkinson's disease because of increased risk of falls and poorer quality of life. Recent findings suggest an inability to efficaciously utilize vestibular information during static posturography among people with Parkinson's disease who exhibit freezing of gait, with associated changes in cholinergic system integrity as assessed by vesicular acetylcholine transporter PET. There is a lack of adequate understanding of how postural control varies as a function of available sensory information in patients with Parkinson's disease with freezing of gait. The goal of this cross-sectional study was to examine cerebral cholinergic system changes that associate with inter-sensory postural control processing features as assessed by dynamic computerized posturography and acetylcholinesterase PET. Seventy-five participants with Parkinson's disease, 16 of whom exhibited freezing of gait, underwent computerized posturography on the NeuroCom© Equitest sensory organization test platform, striatal dopamine, and acetylcholinesterase PET scanning. Findings demonstrated that patients with Parkinson's disease with freezing of gait have greater difficulty maintaining balance in the absence of reliable proprioceptive cues as compared to those without freezing of gait [β = 0.28 (0.021, 0.54), P = 0.034], an effect that was independent of disease severity [β = 0.16 (0.062, 0.26), P < 0.01] and age [β = 0.092 (-0.005, 0.19), P = 0.062]. Exploratory voxel-based analysis revealed an association between postural control and right hemispheric cholinergic network related to visual-vestibular integration and self-motion perception. High anti-cholinergic burden predicted postural control impairment in a manner dependent on right hemispheric cortical cholinergic integrity [β = 0.34 (0.065, 0.61), P < 0.01]. Our findings advance the perspective that cortical cholinergic system might play a role in supporting postural control after nigro-striatal dopaminergic losses in Parkinson's disease. Failure of cortex-dependent visual-vestibular integration may impair detection of postural instability in absence of reliable proprioceptive cues. Better understanding of how the cholinergic system plays a role in this process may augur novel treatments and therapeutic interventions to ameliorate debilitating symptoms in patients with advanced Parkinson's disease.
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Affiliation(s)
- Stiven Roytman
- Department of Radiology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Rebecca Paalanen
- Department of Neurology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Alexis Griggs
- Department of Radiology, University of Michigan, Ann Arbor, MI 48109, USA
- Parkinson’s Foundation Research Center of Excellence, University of Michigan, Ann Arbor, MI 48109, USA
| | - Simon David
- Department of Radiology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Chatkaew Pongmala
- Department of Radiology, University of Michigan, Ann Arbor, MI 48109, USA
- Morris K. Udall Center of Excellence for Parkinson’s Disease Research, University of Michigan, Ann Arbor, MI 48109, USA
| | - Robert A Koeppe
- Department of Radiology, University of Michigan, Ann Arbor, MI 48109, USA
- Morris K. Udall Center of Excellence for Parkinson’s Disease Research, University of Michigan, Ann Arbor, MI 48109, USA
| | - Peter J H Scott
- Department of Radiology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Uros Marusic
- Department of Radiology, University of Michigan, Ann Arbor, MI 48109, USA
- Institute for Kinesiology Research, Science and Research Centre Koper, 6000 Koper, Slovenia
- Department of Health Sciences, Alma Mater Europaea—ECM, 2000 Maribor, Slovenia
| | - Prabesh Kanel
- Department of Radiology, University of Michigan, Ann Arbor, MI 48109, USA
- Parkinson’s Foundation Research Center of Excellence, University of Michigan, Ann Arbor, MI 48109, USA
- Morris K. Udall Center of Excellence for Parkinson’s Disease Research, University of Michigan, Ann Arbor, MI 48109, USA
| | - Nicolaas I Bohnen
- Department of Radiology, University of Michigan, Ann Arbor, MI 48109, USA
- Department of Neurology, University of Michigan, Ann Arbor, MI 48109, USA
- Parkinson’s Foundation Research Center of Excellence, University of Michigan, Ann Arbor, MI 48109, USA
- Morris K. Udall Center of Excellence for Parkinson’s Disease Research, University of Michigan, Ann Arbor, MI 48109, USA
- Neurology Service and GRECC, VA Ann Arbor Healthcare System, Ann Arbor, MI 48105, USA
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Wu H, Wu C, Qin J, Zhou C, Tan S, DuanMu X, Guan X, Bai X, Guo T, Wu J, Chen J, Wen J, Cao Z, Gao T, Gu L, Huang P, Zhang B, Xu X, Zhang M. Functional connectome predicting individual gait function and its relationship with molecular architecture in Parkinson's disease. Neurobiol Dis 2023:106216. [PMID: 37385459 DOI: 10.1016/j.nbd.2023.106216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 06/18/2023] [Accepted: 06/26/2023] [Indexed: 07/01/2023] Open
Abstract
Gait impairment is a common symptom of Parkinson's disease (PD), but its neural signature remains unclear due to the interindividual variability of gait performance. Identifying a robust gait-brain correlation at the individual level would provide insight into a generalizable neural basis of gait impairment. In this context, this study aimed to detect connectome that can predict individual gait function of PD, and follow-up analyses assess the molecular architecture underlying the connectome by relating it to the neurotransmitter-receptor/transporter density maps. Resting-state functional magnetic resonance imaging was used to detect the functional connectome, and gait function was assessed via a 10 m-walking test. The functional connectome was first detected within drug-naive patients (N = 48) by using connectome-based predictive modeling following cross-validation and then successfully validated within drug-managed patients (N = 30). The results showed that the motor, subcortical, and visual networks played an important role in predicting gait function. The connectome generated from patients failed to predict the gait function of 33 normal controls (NCs) and had distinct connection patterns compared to NCs. The negative connections (connection negatively correlated with 10 m-walking-time) pattern of the PD connectome was associated with the density of the D2 receptor and VAChT transporter. These findings suggested that gait-associated functional alteration induced by PD pathology differed from that induced by aging degeneration. The brain dysfunction related to gait impairment was more commonly found in regions expressing more dopaminergic and cholinergic neurotransmitters, which may aid in developing targeted treatments.
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Affiliation(s)
- Haoting Wu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310009 Hangzhou, China
| | - Chenqing Wu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310009 Hangzhou, China
| | - Jianmei Qin
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310009 Hangzhou, China
| | - Cheng Zhou
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310009 Hangzhou, China
| | - Sijia Tan
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310009 Hangzhou, China
| | - Xiaojie DuanMu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310009 Hangzhou, China
| | - Xiaojun Guan
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310009 Hangzhou, China
| | - Xueqin Bai
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310009 Hangzhou, China
| | - Tao Guo
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310009 Hangzhou, China
| | - Jingjing Wu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310009 Hangzhou, China
| | - Jingwen Chen
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310009 Hangzhou, China
| | - Jiaqi Wen
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310009 Hangzhou, China
| | - Zhengye Cao
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310009 Hangzhou, China
| | - Ting Gao
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310009 Hangzhou, China
| | - Luyan Gu
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310009 Hangzhou, China
| | - Peiyu Huang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310009 Hangzhou, China
| | - Baorong Zhang
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310009 Hangzhou, China
| | - Xiaojun Xu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310009 Hangzhou, China
| | - Minming Zhang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310009 Hangzhou, China.
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Pongmala C, Roytman S, van Emde Boas M, Dickinson O, Kanel P, Bohnen NI. Composite measures of motor performance and self-efficacy are better determinants of postural instability and gait difficulties than individual clinical measures in Parkinson's disease. Parkinsonism Relat Disord 2023; 107:105251. [PMID: 36566525 PMCID: PMC10028594 DOI: 10.1016/j.parkreldis.2022.105251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/15/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Postural instability and gait difficulties (PIGD) are a significant cause of disability and loss of quality of life (QoL) in Parkinson's Disease. Most research on clinical predictors of PIGD measures have focused on individual clinical often motor performance variables, However, PIGD motor features often result in fear of falling (FoF) lowering a patient's mobility self-efficacy. The purpose of this study was to assess composite measures of motor and self-efficacy determinants PIGD motor features in PD and compare these to analysis of individual clinical metrics. METHODS 75 PD participants underwent detailed motor and non-motor test batteries. Principal component analysis (PCA) was used to identify clusters of covarying correlates of slow walking, imbalance, falls, freezing of gait, FoG and compare these to traditional univariate analyses. RESULTS A single PCA-derived composite measure of motor performance and self-efficacy of mobility was the most robust determinant of all PIGD motor features except for falls. In contrast, analysis of the individual clinical variables showed more limited and diverging findings, including evidence of better cognitive performance but more severe motor parkinsonian ratings in the fall group. CONCLUSION There are robust associations between composite measures of motor performance and self-efficacy of mobility and all PIGD motor features except for falls. Univariate analysis of individual clinical measures showed limited correlates of PIGD motor features. Patient's own perception of motor performance, FoF, and QoL deserve more attention as PIGD therapeutic targets in PD.
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Affiliation(s)
- Chatkaew Pongmala
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA; Functional Neuroimaging, Cognitive, and Mobility Laboratory, Departments of Radiology and Neurology, University of Michigan, Ann Arbor, MI, USA; Morris K. Udall Center of Excellence for Parkinson's Disease Research, University of Michigan, Ann Arbor, MI, USA.
| | - Stiven Roytman
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA; Functional Neuroimaging, Cognitive, and Mobility Laboratory, Departments of Radiology and Neurology, University of Michigan, Ann Arbor, MI, USA
| | - Miriam van Emde Boas
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA; Functional Neuroimaging, Cognitive, and Mobility Laboratory, Departments of Radiology and Neurology, University of Michigan, Ann Arbor, MI, USA; Morris K. Udall Center of Excellence for Parkinson's Disease Research, University of Michigan, Ann Arbor, MI, USA
| | - Olivia Dickinson
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA; Functional Neuroimaging, Cognitive, and Mobility Laboratory, Departments of Radiology and Neurology, University of Michigan, Ann Arbor, MI, USA
| | - Prabesh Kanel
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA; Functional Neuroimaging, Cognitive, and Mobility Laboratory, Departments of Radiology and Neurology, University of Michigan, Ann Arbor, MI, USA; Morris K. Udall Center of Excellence for Parkinson's Disease Research, University of Michigan, Ann Arbor, MI, USA; Parkinson's Foundation Research Center of Excellence, University of Michigan, Ann Arbor, MI, USA
| | - Nicolaas I Bohnen
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA; Department of Neurology, University of Michigan, Ann Arbor, MI, USA; Functional Neuroimaging, Cognitive, and Mobility Laboratory, Departments of Radiology and Neurology, University of Michigan, Ann Arbor, MI, USA; Morris K. Udall Center of Excellence for Parkinson's Disease Research, University of Michigan, Ann Arbor, MI, USA; Parkinson's Foundation Research Center of Excellence, University of Michigan, Ann Arbor, MI, USA; Neurology Service and GRECC, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
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Artusi CA, Montanaro E, Erro R, Margraf N, Geroin C, Pilotto A, Magistrelli L, Spagnolo F, Marchet A, Sarro L, Cuoco S, Sacchetti M, Riello M, Capellero B, Berchialla P, Moeller B, Vullriede B, Zibetti M, Rini AM, Barone P, Comi C, Padovani A, Tinazzi M, Lopiano L. Visuospatial Deficits Are Associated with Pisa Syndrome and not Camptocormia in Parkinson's Disease. Mov Disord Clin Pract 2023; 10:64-73. [PMID: 36704069 PMCID: PMC9847315 DOI: 10.1002/mdc3.13605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 09/29/2022] [Accepted: 10/04/2022] [Indexed: 01/29/2023] Open
Abstract
Background Pisa syndrome (PS) and camptocormia (CC) are postural abnormalities frequently associated with Parkinson's disease (PD). Their pathophysiology remains unclear, but the role of cognitive deficits has been postulated. Objectives To identify differences in the neuropsychological functioning of patients with PD with PS or CC compared with matched patients with PD without postural abnormalities. Methods We performed a case-control study including 57 patients with PD with PS (PS+) or CC (CC+) and 57 PD controls without postural abnormalities matched for sex, age, PD duration, phenotype, and stage. Patients were divided into four groups: PS+ (n = 32), PS+ controls (PS-, n = 32), CC+ (n = 25), and CC+ controls (CC-, n = 25). We compared PS+ versus PS- and CC+ versus CC- using a neuropsychological battery assessing memory, attention, executive functions, visuospatial abilities, and language. Subjective visual vertical (SVV) perception was assessed by the Bucket test as a sign of vestibular function; the misperception of trunk position, defined as a mismatch between the objective versus subjective evaluation of the trunk bending angle >5°, was evaluated in PS+ and CC+. Results PS+ showed significantly worse visuospatial performances (P = 0.025) and SVV perception (P = 0.038) than their controls, whereas CC+ did not show significant differences compared with their control group. Reduced awareness of postural abnormality was observed in >60% of patients with PS or CC. Conclusions Low visuospatial performances and vestibular tone imbalance are significantly associated with PS but not with CC. These findings suggest different pathophysiology for the two main postural abnormalities associated with PD and can foster adequate therapeutic and prevention strategies.
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Affiliation(s)
- Carlo Alberto Artusi
- Department of Neuroscience “Rita Levi Montalcini”University of TorinoTorinoItaly
- Neurology 2 UnitAzienda Ospedaliero‐Universitaria Città della Salute e della Scienza di TorinoTorinoItaly
| | - Elisa Montanaro
- Department of Neuroscience “Rita Levi Montalcini”University of TorinoTorinoItaly
- Neurology 2 UnitAzienda Ospedaliero‐Universitaria Città della Salute e della Scienza di TorinoTorinoItaly
| | - Roberto Erro
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”University of SalernoBaronissiItaly
| | - Nils Margraf
- Department of NeurologyUniversity Medical Center Schleswig‐Holstein, Campus Kiel, Christian‐Albrechts‐UniversityKielGermany
| | - Christian Geroin
- Department of Neurosciences, Biomedicine and Movement SciencesSection of Neurology University of VeronaVeronaItaly
| | | | - Luca Magistrelli
- Department of Translational Medicine, Section of NeurologyUniversity of Eastern PiedmontNovaraItaly
| | | | - Alberto Marchet
- Neurology 3 Azienda Sanitaria Locale Città di TorinoMartini HospitalTorinoItaly
| | - Lidia Sarro
- Neurology 3 Azienda Sanitaria Locale Città di TorinoMartini HospitalTorinoItaly
| | - Sofia Cuoco
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”University of SalernoBaronissiItaly
| | - Marta Sacchetti
- Clinical Psychology UnitAzienda ospedaliero universitaria Maggiore della Carità di NovaraNovaraItaly
| | - Marianna Riello
- Department of Neurosciences, Biomedicine and Movement SciencesSection of Neurology University of VeronaVeronaItaly
| | - Barbara Capellero
- Neurology 3 Azienda Sanitaria Locale Città di TorinoMartini HospitalTorinoItaly
| | - Paola Berchialla
- Department of Clinical and Biological SciencesUniversity of TorinoTorinoItaly
| | - Bettina Moeller
- Department of NeurologyUniversity Medical Center Schleswig‐Holstein, Campus Kiel, Christian‐Albrechts‐UniversityKielGermany
| | - Beeke Vullriede
- Department of NeurologyUniversity Medical Center Schleswig‐Holstein, Campus Kiel, Christian‐Albrechts‐UniversityKielGermany
| | - Maurizio Zibetti
- Department of Neuroscience “Rita Levi Montalcini”University of TorinoTorinoItaly
- Neurology 2 UnitAzienda Ospedaliero‐Universitaria Città della Salute e della Scienza di TorinoTorinoItaly
| | | | - Paolo Barone
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”University of SalernoBaronissiItaly
| | - Cristoforo Comi
- Department of Translational Medicine, Section of NeurologyUniversity of Eastern PiedmontNovaraItaly
| | | | - Michele Tinazzi
- Department of Neurosciences, Biomedicine and Movement SciencesSection of Neurology University of VeronaVeronaItaly
| | - Leonardo Lopiano
- Department of Neuroscience “Rita Levi Montalcini”University of TorinoTorinoItaly
- Neurology 2 UnitAzienda Ospedaliero‐Universitaria Città della Salute e della Scienza di TorinoTorinoItaly
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Bohnen NI, Roytman S, Griggs A, David SM, Beaulieu ML, Müller MLTM. Decreased vestibular efficacy contributes to abnormal balance in Parkinson's disease. J Neurol Sci 2022; 440:120357. [PMID: 35932698 PMCID: PMC9444904 DOI: 10.1016/j.jns.2022.120357] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 07/07/2022] [Accepted: 07/24/2022] [Indexed: 10/16/2022]
Abstract
BACKGROUND AND PURPOSE Abnormal balance is poorly responsive to dopaminergic therapy in Parkinson's disease (PD). Decreased vestibular efficacy may contribute to imbalance in PD. The purpose of this study was to investigate the relationship between vestibular measures of dynamic posturography and imbalance in PD while accounting for confounder variables. METHODS 106 patients with PD underwent dynamic posturography for the 6 conditions of the sensory integration test (SOT) using the Neurocom Equitest device. All SOT measures, nigrostriatal dopaminergic denervation ((+)-[11C]DTBZ PET), brain acetylcholinesterase ([11C]PMP PET), age, duration of disease, cognitive and parkinsonian motor scores, and ankle vibration sensitivity were used as regressors in a stepwise logistic regression model comparing PD patients with versus without imbalance defined as Hoehn and Yahr (HY) stage 2.5 or higher. RESULTS The presence of imbalance was significantly associated with vestibular ratio COP RMS (P = 0.002) independently from visual ratio COP velocity (P = 0.012), thalamic acetylcholinesterase activity (P = 0.0032), cognition (P = 0.006), motor severity (P = 0.0039), age (P = 0.001), ankle vibration sensitivity (P = 0.0008), and borderline findings for somatosensory ratio COP velocity (P = 0.074) and visual ratio COP RMS (P = 0.078). Nigrostriatal dopaminergic denervation did not achieve significance. CONCLUSIONS The inability to efficaciously utilize vestibular information to retain upright stance is a determinant of imbalance in PD independent from visual and somatosensory processing changes and nigrostriatal dopaminergic losses. Thalamic, but not cortical, cholinergic denervation incrementally predicted balance abnormality. Further research is needed to investigate an intrinsic role of the cholinergic thalamus in multi-sensory, in particular vestibular, processing functions of postural control in PD.
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Affiliation(s)
- Nicolaas I Bohnen
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA; Department of Neurology, University of Michigan, Ann Arbor, MI, USA; Neurology Service and GRECC, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA; Morris K. Udall Center of Excellence for Parkinson's Disease Research, University of Michigan, Ann Arbor, MI, USA; Parkinson's Foundation Research Center of Excellence, University of Michigan, Ann Arbor, MI, USA.
| | - Stiven Roytman
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA
| | - Alexis Griggs
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA
| | - Simon M David
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA
| | - Mélanie L Beaulieu
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA; Morris K. Udall Center of Excellence for Parkinson's Disease Research, University of Michigan, Ann Arbor, MI, USA; Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Martijn L T M Müller
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA; Morris K. Udall Center of Excellence for Parkinson's Disease Research, University of Michigan, Ann Arbor, MI, USA; Parkinson's Foundation Research Center of Excellence, University of Michigan, Ann Arbor, MI, USA
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Smith PF. Recent developments in the understanding of the interactions between the vestibular system, memory, the hippocampus, and the striatum. Front Neurol 2022; 13:986302. [PMID: 36119673 PMCID: PMC9479733 DOI: 10.3389/fneur.2022.986302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 08/08/2022] [Indexed: 12/05/2022] Open
Abstract
Over the last two decades, evidence has accumulated to demonstrate that the vestibular system has extensive connections with areas of the brain related to spatial memory, such as the hippocampus, and also that it has significant interactions with areas associated with voluntary motor control, such as the striatum in the basal ganglia. In fact, these functions are far from separate and it is believed that interactions between the striatum and hippocampus are important for memory processing. The data relating to vestibular-hippocampal-striatal interactions have considerable implications for the understanding and treatment of Alzheimer's Disease and Parkinson's Disease, in addition to other neurological disorders. However, evidence is accumulating rapidly, and it is difficult to keep up with the latest developments in these and related areas. The aim of this review is to summarize and critically evaluate the relevant evidence that has been published over the last 2 years (i.e., since 2021), in order to identify emerging themes in this research area.
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Affiliation(s)
- Paul F. Smith
- Department of Pharmacology and Toxicology, School of Biomedical Sciences and Brain Health Research Centre, University of Otago, Dunedin, New Zealand
- Eisdell Moore Centre for Hearing and Balance Research, University of Auckland, Auckland, New Zealand
- *Correspondence: Paul F. Smith
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