1
|
Hall SA, Brodar KE, LaBar KS, Berntsen D, Rubin DC. Neural responses to emotional involuntary memories in posttraumatic stress disorder: Differences in timing and activity. Neuroimage Clin 2018; 19:793-804. [PMID: 30013923 PMCID: PMC6024199 DOI: 10.1016/j.nicl.2018.05.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Revised: 04/30/2018] [Accepted: 05/08/2018] [Indexed: 01/18/2023]
Abstract
Background Involuntary memories are a hallmark symptom of posttraumatic stress disorder (PTSD), but studies of the neural basis of involuntary memory retrieval in posttraumatic stress disorder (PTSD) are sparse. The study of the neural correlates of involuntary memories of stressful events in PTSD focuses on the voluntary retrieval of memories that are sometimes recalled as intrusive involuntary memories, not on involuntary retrieval while being scanned. Involuntary memory retrieval in controls has been shown to elicit activity in the parahippocampal gyrus, precuneus, inferior parietal cortex, and posterior midline regions. However, it is unknown whether involuntary memories are supported by the same mechanisms in PTSD. Because previous work has shown that both behavioral and neural responsivity is slowed in PTSD, we examined the spatiotemporal dynamics of the neural activity underlying negative and neutral involuntary memory retrieval. Methods Twenty-one individuals with PTSD and 21 non-PTSD, trauma-exposed controls performed an involuntary memory task, while undergoing a functional magnetic resonance imaging scan. Environmental sounds served as cues for well-associated pictures of negative and neutral scenes. We used a finite impulse response model to analyze temporal differences between groups in neural responses. Results Compared with controls, participants with PTSD reported more involuntary memories, which were more emotional and more vivid, but which activated a similar network of regions. However, compared to controls, individuals with PTSD showed delayed neural responsivity in this network and increased vmPFC/ACC activity for negative > neutral stimuli. Conclusions The similarity between PTSD and controls in neural substrates underlying involuntary memories suggests that, unlike voluntary memories, involuntary memories elicit similar activity in regions critical for memory retrieval. Further, the delayed neural responsivity for involuntary memories in PTSD suggests that factors affecting cognition in PTSD, like increased fatigue, or avoidance behaviors could do so by delaying activity in regions necessary for cognitive processing. Finally, compared to neutral memories, negative involuntary memories elicit hyperactivity in the vmPFC, whereas the vmPFC is typically shown to be hypoactive in PTSD during voluntary memory retrieval. These patterns suggest that considering both the temporal dynamics of cognitive processes as well as involuntary cognitive processes would improve existing neurobiological models of PTSD.
Collapse
Key Words
- ACC, anterior cingulate cortex
- FDR, false detection rate
- FIR, finite impulse response
- FWE, family-wise error
- Finite impulse response (FIR)
- Functional magnetic resonance imaging (fMRI)
- IAPS, International Affective Picture System
- IPC, inferior parietal cortex
- Involuntary memory
- MTL, medial temporal lobes
- Memory network
- PCC, posterior cingulate cortex
- PTSD, posttraumatic stress disorder
- Posttraumatic stress disorder (PTSD)
- SPGR, spoiled gradient recalled
- SPM, Statistical Parametric Mapping
- TE, echo time
- TI, inverse recovery time
- TR, repetition time
- Ventromedial prefrontal cortex (vmPFC)
- vmPFC, ventromedial prefrontal cortex
Collapse
Affiliation(s)
- Shana A Hall
- Department of Psychology & Neuroscience, University of North Carolina, Chapel Hill, United States; Department of Psychology & Neuroscience, Duke University, United States.
| | - Kaitlyn E Brodar
- Department of Psychology, University of Miami, United States; Department of Psychology & Neuroscience, Duke University, United States
| | - Kevin S LaBar
- Department of Psychology & Neuroscience, Duke University, United States
| | - Dorthe Berntsen
- Center on Autobiographical Memory Research, Aarhus University, Denmark
| | - David C Rubin
- Department of Psychology & Neuroscience, Duke University, United States; Center on Autobiographical Memory Research, Aarhus University, Denmark
| |
Collapse
|
2
|
Liu S, Wang Y, Xu K, Ping F, Li F, Wang R, Cheng X. Voxel-based comparison of brain glucose metabolism between patients with Cushing's disease and healthy subjects. Neuroimage Clin 2017; 17:354-358. [PMID: 29159047 PMCID: PMC5681338 DOI: 10.1016/j.nicl.2017.10.038] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 10/30/2017] [Accepted: 10/31/2017] [Indexed: 11/13/2022]
Abstract
Cognitive impairment and psychiatric symptoms are common in patients with Cushing's disease (CD) owing to elevated levels of glucocorticoids. Molecular neuroimaging methods may help to detect changes in the brain of patients with CD. The aim of this study was to investigate the characteristics of brain metabolism and its association with serum cortisol level in CD. We compared brain metabolism, as measured using [18F]-fluorodeoxyglucose positron emission tomography (FDG PET), between 92 patients with CD and 118 normal subjects on a voxel-wise basis. Pearson correlation was performed to evaluate the association between cerebral FDG uptake and serum cortisol level in patients with CD. We demonstrated that certain brain regions in patients with CD showed significantly increased FDG uptake, including the basal ganglia, anteromedial temporal lobe, thalamus, precentral cortex, and cerebellum. The clusters that demonstrated significantly decreased uptake were mainly located in the medial and lateral frontal cortex, superior and inferior parietal lobule, medial occipital cortex, and insular cortex. The metabolic rate of the majority of these regions was found to be significantly correlated with the serum cortisol level. Our findings may help to explain the underlying mechanisms of cognitive impairment and psychiatric symptoms in patients exposed to excessive glucocorticoids and evaluate the efficacy of treatments during follow-up. Hypercortisolism leads to metabolic changes in specific brain regions of CD patients. These brain regions involve in the regulation of cortisol and the symptoms of CD. The metabolism of 6 specific brain regions is correlated with cortisol level.
Collapse
Affiliation(s)
- Shuai Liu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yinyan Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Kaibin Xu
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing, China; National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China; University of Chinese Academy of Sciences, Beijing, China
| | - Fan Ping
- Departments of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fang Li
- Departments of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Renzhi Wang
- Departments of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xin Cheng
- Departments of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| |
Collapse
|
3
|
Holiga Š, Mueller K, Möller HE, Urgošík D, Růžička E, Schroeter ML, Jech R. Resting-state functional magnetic resonance imaging of the subthalamic microlesion and stimulation effects in Parkinson's disease: Indications of a principal role of the brainstem. Neuroimage Clin 2015; 9:264-74. [PMID: 26509113 PMCID: PMC4576412 DOI: 10.1016/j.nicl.2015.08.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 07/31/2015] [Accepted: 08/14/2015] [Indexed: 01/05/2023]
Abstract
During implantation of deep-brain stimulation (DBS) electrodes in the target structure, neurosurgeons and neurologists commonly observe a “microlesion effect” (MLE), which occurs well before initiating subthalamic DBS. This phenomenon typically leads to a transitory improvement of motor symptoms of patients suffering from Parkinson's disease (PD). Mechanisms behind MLE remain poorly understood. In this work, we exploited the notion of ranking to assess spontaneous brain activity in PD patients examined by resting-state functional magnetic resonance imaging in response to penetration of DBS electrodes in the subthalamic nucleus. In particular, we employed a hypothesis-free method, eigenvector centrality (EC), to reveal motor-communication-hubs of the highest rank and their reorganization following the surgery; providing a unique opportunity to evaluate the direct impact of disrupting the PD motor circuitry in vivo without prior assumptions. Penetration of electrodes was associated with increased EC of functional connectivity in the brainstem. Changes in connectivity were quantitatively related to motor improvement, which further emphasizes the clinical importance of the functional integrity of the brainstem. Surprisingly, MLE and DBS were associated with anatomically different EC maps despite their similar clinical benefit on motor functions. The DBS solely caused an increase in connectivity of the left premotor region suggesting separate pathophysiological mechanisms of both interventions. While the DBS acts at the cortical level suggesting compensatory activation of less affected motor regions, the MLE affects more fundamental circuitry as the dysfunctional brainstem predominates in the beginning of PD. These findings invigorate the overlooked brainstem perspective in the understanding of PD and support the current trend towards its early diagnosis. DBS surgery in Parkinson's patients is often associated with a “microlesion effect” (MLE). Mechanisms behind MLE remain poorly understood. Using resting-state fMRI, we identified the brainstem as the principal hub responding to MLE. This invigorates the overlooked brainstem perspective in the understanding of Parkinson's disease.
Collapse
Key Words
- BOLD, blood-oxygenation-level dependent
- Brainstem
- DBS, deep-brain stimulation
- Deep-brain stimulation
- EC, eigenvector centrality
- FDG-PET, fluorodeoxyglucose positron emission tomography
- FDR, false discovery rate
- FWE, family-wise error
- GP, globus pallidus
- ICA, independent component analysis
- MLE, microlesion effect
- MNI, Montreal Neurological Institute
- Microlesion effect
- PD, Parkinson's disease
- PPN, pedunculopontine nucleus
- Parkinson's disease
- Resting-state fMRI
- SD, standard deviation
- STN, subthalamic nucleus
- Subthalamic nucleus
- UPDRS-III, motor part of the Unified Parkinson's Disease Rating Scale.
- fMRI, functional magnetic resonance imaging
- rm-ANOVA, repeated measures analysis of variance
- rs-fMRI, resting-state fMRI
Collapse
Affiliation(s)
- Štefan Holiga
- Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstr. 1A, Leipzig 04103, Germany ; Leipzig Research Center for Civilization Diseases & Clinic for Cognitive Neurology, University of Leipzig, Liebigstr. 16, Leipzig 04103, Germany
| | - Karsten Mueller
- Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstr. 1A, Leipzig 04103, Germany
| | - Harald E Möller
- Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstr. 1A, Leipzig 04103, Germany
| | - Dušan Urgošík
- Department of Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Roentgenova 2, Prague 15030, Czech Republic
| | - Evžen Růžička
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University In Prague, Kateřinská 30, Prague 12821, Czech Republic
| | - Matthias L Schroeter
- Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstr. 1A, Leipzig 04103, Germany ; Leipzig Research Center for Civilization Diseases & Clinic for Cognitive Neurology, University of Leipzig, Liebigstr. 16, Leipzig 04103, Germany
| | - Robert Jech
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University In Prague, Kateřinská 30, Prague 12821, Czech Republic
| |
Collapse
|
4
|
Weiss C, Tursunova I, Neuschmelting V, Lockau H, Nettekoven C, Oros-Peusquens AM, Stoffels G, Rehme AK, Faymonville AM, Shah NJ, Langen KJ, Goldbrunner R, Grefkes C. Improved nTMS- and DTI-derived CST tractography through anatomical ROI seeding on anterior pontine level compared to internal capsule. Neuroimage Clin 2015; 7:424-37. [PMID: 25685709 PMCID: PMC4314616 DOI: 10.1016/j.nicl.2015.01.006] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 01/07/2015] [Accepted: 01/08/2015] [Indexed: 12/16/2022]
Abstract
Imaging of the course of the corticospinal tract (CST) by diffusion tensor imaging (DTI) is useful for function-preserving tumour surgery. The integration of functional localizer data into tracking algorithms offers to establish a direct structure–function relationship in DTI data. However, alterations of MRI signals in and adjacent to brain tumours often lead to spurious tracking results. We here compared the impact of subcortical seed regions placed at different positions and the influences of the somatotopic location of the cortical seed and clinical co-factors on fibre tracking plausibility in brain tumour patients. The CST of 32 patients with intracranial tumours was investigated by means of deterministic DTI and neuronavigated transcranial magnetic stimulation (nTMS). The cortical seeds were defined by the nTMS hot spots of the primary motor area (M1) of the hand, the foot and the tongue representation. The CST originating from the contralesional M1 hand area was mapped as intra-individual reference. As subcortical region of interests (ROI), we used the posterior limb of the internal capsule (PLIC) and/or the anterior inferior pontine region (aiP). The plausibility of the fibre trajectories was assessed by a-priori defined anatomical criteria. The following potential co-factors were analysed: Karnofsky Performance Scale (KPS), resting motor threshold (RMT), T1-CE tumour volume, T2 oedema volume, presence of oedema within the PLIC, the fractional anisotropy threshold (FAT) to elicit a minimum amount of fibres and the minimal fibre length. The results showed a higher proportion of plausible fibre tracts for the aiP-ROI compared to the PLIC-ROI. Low FAT values and the presence of peritumoural oedema within the PLIC led to less plausible fibre tracking results. Most plausible results were obtained when the FAT ranged above a cut-off of 0.105. In addition, there was a strong effect of somatotopic location of the seed ROI; best plausibility was obtained for the contralateral hand CST (100%), followed by the ipsilesional hand CST (>95%), the ipsilesional foot (>85%) and tongue (>75%) CST. In summary, we found that the aiP-ROI yielded better tracking results compared to the IC-ROI when using deterministic CST tractography in brain tumour patients, especially when the M1 hand area was tracked. In case of FAT values lower than 0.10, the result of the respective CST tractography should be interpreted with caution with respect to spurious tracking results. Moreover, the presence of oedema within the internal capsule should be considered a negative predictor for plausible CST tracking. Somatotopic CST tractography was done in 32 patients with eloquent brain tumours. Seeding ROIs were defined by navigated TMS of the M1 hot spot (hand, foot, tongue). Using the anterior pons as a second ROI yielded more plausible tracts than the PLIC. Low FAT and oedema of the internal capsule were negative predictors.
Collapse
Key Words
- ANOVA, analysis of variance
- APB, abductor pollicis brevis muscle
- AUC, area under the curve
- BOLD, blood oxygenation level dependent
- CST
- CST, corticospinal tract
- DTI
- DTI, diffusion tensor imaging
- FA(T), fractional anisotropy (threshold)
- FACT, fibre assignment by continuous tracking
- FMRI, functional magnetic resonance imaging
- FOV, field-of-view
- FWE, family-wise error
- Fractional anisotropy
- KPS, Karnofsky performance scale
- LDA/C, linear discriminant analysis/coefficient
- LT, lateral tongue muscle, anterior third
- M1, primary motor cortex
- MEP, motor evoked potential
- MFL, minimal fibre length
- MPRAGE, magnetization prepared rapid acquisition gradient echo (T1 MR sequence)
- OR, odd's ratio
- PLIC, posterior limb of the internal capsule
- PM, plantar muscle
- RMT, resting motor threshold
- ROI
- ROI, region-of-interest
- SD, standard deviation
- SE, standard error
- Somatotopic
- X-sq, X-squared (Pearson's chi-square test)
- aiP, anterior inferior pons
- nTMS
- nTMS, neuronavigated transcranial magnetic stimulation
- pxsq, p-value according to Pearson's chi-square test.
Collapse
Affiliation(s)
- Carolin Weiss
- Department of Neurosurgery, University of Cologne, Cologne 50924, Germany
| | - Irada Tursunova
- Department of Neurosurgery, University of Cologne, Cologne 50924, Germany ; Department of Neurosurgery, University of Cologne, Cologne 50924, Germany
| | | | - Hannah Lockau
- Department of Radiology, University of Cologne, Cologne 50937, Germany
| | - Charlotte Nettekoven
- Institute of Neuroscience and Medicine, Research Centre Jülich, Jülich 52425, Germany
| | | | - Gabriele Stoffels
- Institute of Neuroscience and Medicine, Research Centre Jülich, Jülich 52425, Germany
| | - Anne K Rehme
- Institute of Neuroscience and Medicine, Research Centre Jülich, Jülich 52425, Germany ; Department of Neurology, University of Cologne, Cologne 50924, Germany
| | | | - N Jon Shah
- Institute of Neuroscience and Medicine, Research Centre Jülich, Jülich 52425, Germany ; Department of Neurology, University Clinic Aachen, RWTH Aachen University, Aachen 52074, Germany
| | - Karl Josef Langen
- Institute of Neuroscience and Medicine, Research Centre Jülich, Jülich 52425, Germany
| | - Roland Goldbrunner
- Department of Neurosurgery, University of Cologne, Cologne 50924, Germany
| | - Christian Grefkes
- Institute of Neuroscience and Medicine, Research Centre Jülich, Jülich 52425, Germany ; Department of Neurology, University of Cologne, Cologne 50924, Germany
| |
Collapse
|
5
|
Meoded A, Morrissette AE, Katipally R, Schanz O, Gotts SJ, Floeter MK. Cerebro-cerebellar connectivity is increased in primary lateral sclerosis. Neuroimage Clin 2014; 7:288-96. [PMID: 25610792 PMCID: PMC4300015 DOI: 10.1016/j.nicl.2014.12.009] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Revised: 11/02/2014] [Accepted: 12/05/2014] [Indexed: 12/12/2022]
Abstract
Increased functional connectivity in resting state networks was found in several studies of patients with motor neuron disorders, although diffusion tensor imaging studies consistently show loss of white matter integrity. To understand the relationship between structural connectivity and functional connectivity, we examined the structural connections between regions with altered functional connectivity in patients with primary lateral sclerosis (PLS), a long-lived motor neuron disease. Connectivity matrices were constructed from resting state fMRI in 16 PLS patients to identify areas of differing connectivity between patients and healthy controls. Probabilistic fiber tracking was used to examine structural connections between regions of differing connectivity. PLS patients had 12 regions with increased functional connectivity compared to controls, with a predominance of cerebro-cerebellar connections. Increased functional connectivity was strongest between the cerebellum and cortical motor areas and between the cerebellum and frontal and temporal cortex. Fiber tracking detected no difference in connections between regions with increased functional connectivity. We conclude that functional connectivity changes are not strongly based in structural connectivity. Increased functional connectivity may be caused by common inputs, or by reduced selectivity of cortical activation, which could result from loss of intracortical inhibition when cortical afferents are intact. Functional connectivity is increased in primary lateral sclerosis. Functional connections with the cerebellum were prominent. Cortico-cerebellar connectivity correlated with clinical measures. No corresponding changes occurred in structural connectivity.
Collapse
Key Words
- AFNI, analysis of functional neuroimages
- ALS, amyotrophic lateral sclerosis
- ALSFRS-R, amyotrophic lateral sclerosis rating scale
- ANCOVA, analysis of covariance
- BOLD, blood oxygen-level dependent
- Cerebellum
- Connectivity
- DTI, diffusion tensor imaging
- Epi, echo planar imaging
- FA, fractional anisotropy
- FSL, FMRIB Software Library
- FWE, family-wise error
- MNI, Montreal Neurological Institute
- Motor neuron disease
- PLS, primary lateral sclerosis
- Primary lateral sclerosis
- ROI, region of interest
- Resting state functional MRI
- TBSS, tract based spatial statistics
- TFCE, threshold-free cluster enhancement
- TORTOISE, tolerably obsessive registration and tensor optimization indolent software ensemble
- fMRI, functional magnetic resonance imaging
Collapse
Affiliation(s)
- Avner Meoded
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Arthur E Morrissette
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Rohan Katipally
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Olivia Schanz
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Stephen J Gotts
- National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Mary Kay Floeter
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| |
Collapse
|
6
|
Al-Bachari S, Parkes LM, Vidyasagar R, Hanby MF, Tharaken V, Leroi I, Emsley HCA. Arterial spin labelling reveals prolonged arterial arrival time in idiopathic Parkinson's disease. Neuroimage Clin 2014; 6:1-8. [PMID: 25379411 PMCID: PMC4215519 DOI: 10.1016/j.nicl.2014.07.014] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Revised: 07/24/2014] [Accepted: 07/29/2014] [Indexed: 12/30/2022]
Abstract
Idiopathic Parkinson's disease (IPD) is the second most common neurodegenerative disease, yet effective disease modifying treatments are still lacking. Neurodegeneration involves multiple interacting pathological pathways. The extent to which neurovascular mechanisms are involved is not well defined in IPD. We aimed to determine whether novel magnetic resonance imaging (MRI) techniques, including arterial spin labelling (ASL) quantification of cerebral perfusion, can reveal altered neurovascular status (NVS) in IPD. Fourteen participants with IPD (mean ± SD age 65.1 ± 5.9 years) and 14 age and cardiovascular risk factor matched control participants (mean ± SD age 64.6 ± 4.2 years) underwent a 3T MRI scan protocol. ASL images were collected before, during and after a 6 minute hypercapnic challenge. FLAIR images were used to determine white matter lesion score. Quantitative images of cerebral blood flow (CBF) and arterial arrival time (AAT) were calculated from the ASL data both at rest and during hypercapnia. Cerebrovascular reactivity (CVR) images were calculated, depicting the change in CBF and AAT relative to the change in end-tidal CO2. A significant (p = 0.005) increase in whole brain averaged baseline AAT was observed in IPD participants (mean ± SD age 1532 ± 138 ms) compared to controls (mean ± SD age 1335 ± 165 ms). Voxel-wise analysis revealed this to be widespread across the brain. However, there were no statistically significant differences in white matter lesion score, CBF, or CVR between patients and controls. Regional CBF, but not AAT, in the IPD group was found to correlate positively with Montreal cognitive assessment (MoCA) scores. These findings provide further evidence of alterations in NVS in IPD. Investigation of neurovascular status (NVS) in IPD using arterial spin labelling Diffuse prolonged arterial arrival time in IPD compared to controls Reduced regional CBF in the IPD group correlated with cognitive impairment. Clinical evidence of altered NVS in IPD warrants further research.
Collapse
Key Words
- 3T, 3 Tesla
- AAT, arterial arrival time
- AD, Alzheimer’s disease
- ASL, arterial spin labelling
- Arterial arrival time
- Arterial spin labelling
- CBF, cerebral blood flow
- CO2, carbon dioxide
- CV, cerebrovascular
- CVD, cerebrovascular disease
- CVR, cerebrovascular reactivity
- CVRAAT, cerebrovascular reactivity measures of arterial arrival time
- CVRCBF, cerebrovascular reactivity measures of cerebral blood flow
- Cerebral blood flow
- Cerebrovascular reactivity
- DS, digit span
- DSST, digit symbol substitution test
- DWMH, deep white matter hyperintensity
- EPI, echo planar imaging
- ETCO2, end-tidal carbon dioxide
- FAS, (verbal) fluency assessment scale
- FLAIR, fluid attenuation inversion recovery
- FWE, family-wise error
- HAM-D, Hamilton depression rating scale
- IPD, idiopathic Parkinson's disease
- Idiopathic Parkinson's disease
- L-dopa, levodopa
- LARS, Lille apathy rating scale
- LEDD, levodopa equivalent daily dose
- MCI, mild cognitive impairment
- MRI, magnetic resonance imaging
- MoCA
- MoCA, Montreal cognitive assessment
- NPI, neuropsychiatric inventory
- NVU, Neurovascular unit
- O2−, oxygen
- PET, positron emission tomography
- PIGD, Postural instability and gait disorder
- PL, parietal lobe
- PVH, periventricular hyperintensity
- ROI, region of interest
- SPECT, single positron emission computed tomography
- SPM, statistical parametric mapping
- STAR, signal targeting with alternating radiofrequency
- TD, tremor dominant
- TE, echo time
- TI, inversion time
- TL, temporal lobe
- TMT-B, trail making test B
- TR, repetition time
- UKPDS BB, United Kingdom Parkinson's Disease Society Brain Bank
- UPDRS, Unified Parkinson's disease Rating Scale
- WAIS-R, Wechsler adult intelligence scale-revised
- WML, white matter lesion
- fMRI, functional magnetic resonance imaging
Collapse
Affiliation(s)
- Sarah Al-Bachari
- Department of Neurology, Royal Preston Hospital, Preston, UK ; Centre for Imaging Science, Institute of Population Health, University of Manchester, UK
| | - Laura M Parkes
- Centre for Imaging Science, Institute of Population Health, University of Manchester, UK
| | - Rishma Vidyasagar
- Centre for Imaging Science, Institute of Population Health, University of Manchester, UK
| | - Martha F Hanby
- Department of Neurology, Royal Preston Hospital, Preston, UK
| | - Vivek Tharaken
- Institute of Brain, Behaviour and Mental Health, University of Manchester, UK
| | - Iracema Leroi
- Institute of Brain, Behaviour and Mental Health, University of Manchester, UK
| | - Hedley C A Emsley
- Department of Neurology, Royal Preston Hospital, Preston, UK ; School of Medicine, University of Manchester, UK
| |
Collapse
|
7
|
Arnold C, Gehrig J, Gispert S, Seifried C, Kell CA. Pathomechanisms and compensatory efforts related to Parkinsonian speech. Neuroimage Clin 2013; 4:82-97. [PMID: 24319656 PMCID: PMC3853351 DOI: 10.1016/j.nicl.2013.10.016] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Revised: 10/17/2013] [Accepted: 10/23/2013] [Indexed: 12/16/2022]
Abstract
Voice and speech in Parkinson's disease (PD) patients are classically affected by a hypophonia, dysprosody, and dysarthria. The underlying pathomechanisms of these disabling symptoms are not well understood. To identify functional anomalies related to pathophysiology and compensation we compared speech-related brain activity and effective connectivity in early PD patients who did not yet develop voice or speech symptoms and matched controls. During fMRI 20 PD patients ON and OFF levodopa and 20 control participants read 75 sentences covertly, overtly with neutral, or with happy intonation. A cue-target reading paradigm allowed for dissociating task preparation from execution. We found pathologically reduced striato-prefrontal preparatory effective connectivity in early PD patients associated with subcortical (OFF state) or cortical (ON state) compensatory networks. While speaking, PD patients showed signs of diminished monitoring of external auditory feedback. During generation of affective prosody, a reduced functional coupling between the ventral and dorsal striatum was observed. Our results suggest three pathomechanisms affecting speech in PD: While diminished energization on the basis of striato-prefrontal hypo-connectivity together with dysfunctional self-monitoring mechanisms could underlie hypophonia, dysarthria may result from fading speech motor representations given that they are not sufficiently well updated by external auditory feedback. A pathological interplay between the limbic and sensorimotor striatum could interfere with affective modulation of speech routines, which affects emotional prosody generation. However, early PD patients show compensatory mechanisms that could help improve future speech therapies.
Collapse
Key Words
- AC, auditory cortex
- CN, caudate nucleus
- COMT, catechol-O-methyltransferase
- CON, control participant
- DAT1, dopamine transporter
- DLPFC, dorsolateral prefrontal cortex
- Dysarthria
- Dysarthrophonia
- EPI, echo-planar imaging
- FWE, family-wise error
- Functional MRI
- GLM, general linear model
- HRF, hemodynamic response function
- Hypophonia
- IFG, inferior frontal gyrus
- LSVT, Lee Silverman Voice Treatment
- PD, Parkinson's disease
- PPI, psycho-physiological interaction
- PUT, putamen
- Parkinson's disease
- ROI, region of interest
- SEM, standard error of the mean
- SMA, supplementary motor area
- SPL, superior parietal lobule
- STS, superior temporal sulcus
- SVC, small volume correction
- Speech production
- T, Tesla
- UPDRS, Unified Parkinson's Disease Rating Scale
- dPMC, dorsal premotor cortex
- dstriatum, dorsal striatum
- fMRI, functional magnetic response imaging
- mPFC, medial prefrontal cortex
- vstriatum, ventral striatum
Collapse
Affiliation(s)
- Christiane Arnold
- Cognitive Neuroscience Group, Brain Imaging Center, Goethe University, Frankfurt, Germany
- Department of Neurology, Goethe University, Frankfurt, Germany
| | - Johannes Gehrig
- Cognitive Neuroscience Group, Brain Imaging Center, Goethe University, Frankfurt, Germany
- Department of Neurology, Goethe University, Frankfurt, Germany
| | - Suzana Gispert
- Experimental Neurology, Goethe University, Frankfurt, Germany
| | - Carola Seifried
- Department of Neurology, Goethe University, Frankfurt, Germany
| | - Christian A. Kell
- Cognitive Neuroscience Group, Brain Imaging Center, Goethe University, Frankfurt, Germany
- Department of Neurology, Goethe University, Frankfurt, Germany
| |
Collapse
|