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Noor MS, Steina AK, McIntyre CC. Dissecting deep brain stimulation evoked neural activity in the basal ganglia. Neurotherapeutics 2024; 21:e00356. [PMID: 38608373 PMCID: PMC11019280 DOI: 10.1016/j.neurot.2024.e00356] [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: 11/15/2023] [Revised: 03/26/2024] [Accepted: 04/01/2024] [Indexed: 04/14/2024] Open
Abstract
Deep brain stimulation (DBS) is an established therapeutic tool for the treatment of Parkinson's disease (PD). The mechanisms of DBS for PD are likely rooted in modulation of the subthalamo-pallidal network. However, it can be difficult to electrophysiologically interrogate that network in human patients. The recent identification of large amplitude evoked potential (EP) oscillations from DBS in the subthalamic nucleus (STN) or globus pallidus internus (GPi) are providing new scientific opportunities to expand understanding of human basal ganglia network activity. In turn, the goal of this review is to provide a summary of DBS-induced EPs in the basal ganglia and attempt to explain various components of the EP waveforms from their likely network origins. Our analyses suggest that DBS-induced antidromic activation of globus pallidus externus (GPe) is a key driver of these oscillatory EPs, independent of stimulation location (i.e. STN or GPi). This suggests a potentially more important role for GPe in the mechanisms of DBS for PD than typically assumed. And from a practical perspective, DBS EPs are poised to become clinically useful electrophysiological biomarker signals for verification of DBS target engagement.
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Affiliation(s)
- M Sohail Noor
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - Alexandra K Steina
- Institute of Clinical Neuroscience and Medical Psychology, Heinrich Heine University, Düsseldorf, Germany
| | - Cameron C McIntyre
- Department of Biomedical Engineering, Duke University, Durham, NC, USA; Department of Neurosurgery, Duke University, Durham, NC, USA.
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Ikezawa J, Yokochi F, Okiyama R, Isoo A, Agari T, Kamiyama T, Yugeta A, Tojima M, Kawasaki T, Watanabe K, Kumada S, Takahashi K. Pallidal deep brain stimulation for patients with myoclonus-dystonia without SGCE mutations. J Neurol 2024:10.1007/s00415-024-12334-z. [PMID: 38575756 DOI: 10.1007/s00415-024-12334-z] [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: 01/28/2024] [Revised: 03/14/2024] [Accepted: 03/15/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Pallidal deep brain stimulation (GPi-DBS) is effective for treating myoclonus and dystonia caused by SGCE mutations (DYT-SGCE, DYT11). However, it is unknown whether GPi-DBS is effective for the treatment of myoclonus-dystonia which is not associated with the SGCE gene mutations. In this study, we investigated the efficacy of GPi-DBS in treating myoclonus-dystonia in SGCE mutation-negative cases. METHODS Three patients with myoclonus-dystonia without SGCE mutations who underwent GPi-DBS were evaluated preoperatively and 6 months postoperatively using the Unified Myoclonus Rating Scale (UMRS) and Fahn-Marsden Dystonia Rating Scale (FMDRS) for myoclonus and dystonia, respectively. In two of the three patients, myoclonus was more evident during action. Myoclonus was predominant at rest in the other patient, and he was unaware of his dystonia symptoms. The results were compared with those of the four DYT-SGCE cases. RESULTS The mean UMRS score in patients with myoclonus-dystonia without SGCE mutations improved from 61.7 to 33.7 pre- and postoperatively, respectively, and the mean FMDRS score improved from 7.2 to 4.5. However, the degree of improvement in myoclonus-dystonia in patients without SGCE mutations was inferior to that in patients with DYT-SGCE (the UMRS score improved by 45% and 69%, respectively). CONCLUSIONS GPi-DBS is effective for treating myoclonus-dystonia in patients with and without SGCE mutations. GPi-DBS should be considered as a treatment option for myoclonus-dystonia without SGCE mutations.
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Affiliation(s)
- Jun Ikezawa
- Department of Neurology, Tokyo Metropolitan Neurological Hospital, 2-6-1 Musashidai, Fuchu, Tokyo, Japan.
| | - Fusako Yokochi
- Department of Neurology, Tokyo Metropolitan Neurological Hospital, 2-6-1 Musashidai, Fuchu, Tokyo, Japan
| | - Ryoichi Okiyama
- Department of Neurology, Tokyo Metropolitan Neurological Hospital, 2-6-1 Musashidai, Fuchu, Tokyo, Japan
- Department of Neurology, Prime Clinic, Tokyo, Japan
| | - Ayako Isoo
- Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan
| | - Takashi Agari
- Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan
- Department of Neurosurgery, International University of Health and Welfare Narita Hospital, Chiba, Japan
| | - Tsutomu Kamiyama
- Department of Neurology, Tokyo Metropolitan Neurological Hospital, 2-6-1 Musashidai, Fuchu, Tokyo, Japan
- Department of Neurology, Symphony Clinic in Utsunomiya, Tochigi, Japan
| | - Akihiro Yugeta
- Department of Neurology, Tokyo Metropolitan Neurological Hospital, 2-6-1 Musashidai, Fuchu, Tokyo, Japan
- Department of Neurology, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Maya Tojima
- Department of Neurology, Tokyo Metropolitan Neurological Hospital, 2-6-1 Musashidai, Fuchu, Tokyo, Japan
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takashi Kawasaki
- Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan
- Department of Neurosurgery, Yokohama City University Medical Center, Kanagawa, Japan
| | - Katsushige Watanabe
- Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan
- Department of Neurosurgery, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan
| | - Satoko Kumada
- Department of Neuropediatrics, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan
| | - Kazushi Takahashi
- Department of Neurology, Tokyo Metropolitan Neurological Hospital, 2-6-1 Musashidai, Fuchu, Tokyo, Japan
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Abdulbaki A, Wöhrle JC, Blahak C, Weigel R, Kollewe K, Capelle HH, Bäzner H, Krauss JK. Somatosensory evoked potentials recorded from DBS electrodes: the origin of subcortical N18. J Neural Transm (Vienna) 2024; 131:359-367. [PMID: 38456947 DOI: 10.1007/s00702-024-02752-8] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 01/30/2024] [Indexed: 03/09/2024]
Abstract
The different peaks of somatosensory-evoked potentials (SEP) originate from a variety of anatomical sites in the central nervous system. The origin of the median nerve subcortical N18 SEP has been studied under various conditions, but the exact site of its generation is still unclear. While it has been claimed to be located in the thalamic region, other studies indicated its possible origin below the pontomedullary junction. Here, we scrutinized and compared SEP recordings from median nerve stimulation through deep brain stimulation (DBS) electrodes implanted in various subcortical targets. We studied 24 patients with dystonia, Parkinson's disease, and chronic pain who underwent quadripolar electrode implantation for chronic DBS and recorded median nerve SEPs from globus pallidus internus (GPi), subthalamic nucleus (STN), thalamic ventral intermediate nucleus (Vim), and ventral posterolateral nucleus (VPL) and the centromedian-parafascicular complex (CM-Pf). The largest amplitude of the triphasic potential of the N18 complex was recorded in Vim. Bipolar recordings confirmed the origin to be close to Vim electrodes (and VPL/CM-Pf) and less close to STN electrodes. GPi recorded only far-field potentials in unipolar derivation. Recordings from DBS electrodes located in different subcortical areas allow determining the origin of certain subcortical SEP waves more precisely. The subcortical N18 of the median nerve SEP-to its largest extent-is generated ventral to the Vim in the region of the prelemniscal radiation/ zona incerta.
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Affiliation(s)
- Arif Abdulbaki
- Department of Neurosurgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
| | - Johannes C Wöhrle
- Department of Neurology, Katholisches Klinikum Koblenz Montabaur, Koblenz, Germany
| | - Christian Blahak
- Department of Neurology, Ortenau Klinikum Lahr-Ettenheim, Lahr, Germany
- Department of Neurology, Medical Faculty Mannheim, Universitätsmedizin Mannheim, University of Heidelberg, Mannheim, Germany
| | - Ralf Weigel
- Department of Neurosurgery, Sankt Katharinen Hospital, Frankfurt, Germany
| | - Katja Kollewe
- Department of Neurology, Hannover Medical School, Hannover, Germany
| | - H Holger Capelle
- Department of Neurosurgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Hansjörg Bäzner
- Department of Neurology, Katharinenhospital Stuttgart, Stuttgart, Germany
| | - Joachim K Krauss
- Department of Neurosurgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
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Romanò F, Valsasina P, Pagani E, De Simone A, Parolin E, Filippi M, Rocca MA. Structural and functional correlates of disability, motor and cognitive performances in multiple sclerosis: Focus on the globus pallidus. Mult Scler Relat Disord 2024; 86:105576. [PMID: 38579567 DOI: 10.1016/j.msard.2024.105576] [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: 12/18/2023] [Revised: 03/18/2024] [Accepted: 03/22/2024] [Indexed: 04/07/2024]
Abstract
OBJECTIVES To explore structural and functional alterations of external (GPe) and internal (GPi) globus pallidus in people with multiple sclerosis (pwMS) compared to healthy controls (HC) and analyze their relationship with measures of clinical disability, motor and cognitive impairment. METHODS Sixty pwMS and 30 HC comparable for age and sex underwent 3.0T MRI, including conventional, diffusion tensor MRI and resting state (RS) functional MRI. Expanded Disability Status Scale (EDSS) scores were rated and timed 25-foot walk (T25FW) test, nine-hole peg test (9HPT), and paced auditory serial addition test (PASAT) were administered. Two operators segmented the GP into GPe and GPi. Volumes, T1/T2 ratio, diffusivity indices and seed-based RS functional connectivity (FC) of the GP and its components were assessed. RESULTS PwMS had no atrophy or altered diffusivity measures of the GP. Compared to HC, pwMS had higher T1/T2 ratio in both GP regions, which correlated with EDSS score (r = 0.26-0.39, p = 0.01-0.05). RS FC analysis highlighted component-specific functional alterations in pwMS: the GPe had decreased RS FC with fronto-parietal cortices, whereas the GPi had decreased intra-GP RS FC and increased RS FC with the thalamus. Worse EDSS, 9HPT, T25FW and PASAT scores were associated with GP RS FC modifications (r=-0.51‒0.51, p < 0.001). CONCLUSIONS Structural GP involvement in MS was homogeneous across its portions. Increased T1/T2 ratio values, possibly representing iron accumulation, were related to more severe disability. RS FC alterations of the GPe and GPi were consistent with their roles within the basal ganglia network and correlated with worse functional status, suggesting less efficient communication between structures.
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Affiliation(s)
- Francesco Romanò
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Paola Valsasina
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Elisabetta Pagani
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alice De Simone
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Emma Parolin
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Maria A Rocca
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy.
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Koizumi R, Akagi A, Riku Y, Miyahara H, Sone J, Tanaka F, Yoshida M, Iwasaki Y. Correlation between clinical and neuropathological subtypes of progressive supranuclear palsy. Parkinsonism Relat Disord 2024:106076. [PMID: 38494398 DOI: 10.1016/j.parkreldis.2024.106076] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 02/24/2024] [Accepted: 02/27/2024] [Indexed: 03/19/2024]
Abstract
INTRODUCTION Progressive supranuclear palsy (PSP) is characterized by pathology prominently in the basal ganglia, the tegmentum of the brainstem, and the frontal cortex. However, pathology varies according to clinical features. This study aimed to statistically verify the correspondence between the clinical and pathological subtypes of PSP. METHODS We identified patients with a pathological diagnosis of PSP and classified the eight clinical subtypes of the Movement Disorders Society criteria for the clinical diagnosis of PSP (MDS-PSP criteria) into the Richardson, Akinesia, and Cognitive groups. We used anti-phosphorylated tau antibody immunostaining to semi-quantitatively evaluate neurofibrillary tangles (NFTs) and coiled bodies/threads (CB/Ths) in the globus pallidus, subthalamic nucleus, and midbrain tegmentum. In the frontal cortex, tufted astrocytes (TAs) and CB/Ths were assessed on a 3-point scale. We compared the pathology among the three groups, recorded the phenotypes ranked the second and lower in the multiple allocation extinction rule and examined whether the pathology changed depending on applying each phenotype. RESULTS The Richardson group exhibited severe NFTs and CB/Ths in the midbrain tegmentum. The Akinesia group showed severe NFTs in the globus pallidus. The Cognitive group had severe TAs and CB/Ths in the frontal cortex. TAs and CB/Ths in the frontal cortex correspond to behavioral variant frontotemporal dementia, and supranuclear vertical oculomotor palsy. CONCLUSION These clinical symptoms may reflect the distribution of tau pathologies in PSP.
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Affiliation(s)
- Ryuichi Koizumi
- Department of Neuropathology, Institute for Medical Science of Aging, Aichi Medical University, 1-1 Yazako Karimata, Nagakute City, Aichi prefecture, 480-1103, Japan; Department of Neurology and Stroke Medicine, Graduate School of Medicine, Yokohama City University, 3-9 Fukura, Kanazawa Ward, Yokohama City, Kanagawa prefecture, 236-0004, Japan.
| | - Akio Akagi
- Department of Neuropathology, Institute for Medical Science of Aging, Aichi Medical University, 1-1 Yazako Karimata, Nagakute City, Aichi prefecture, 480-1103, Japan.
| | - Yuichi Riku
- Department of Neuropathology, Institute for Medical Science of Aging, Aichi Medical University, 1-1 Yazako Karimata, Nagakute City, Aichi prefecture, 480-1103, Japan.
| | - Hiroaki Miyahara
- Department of Neuropathology, Institute for Medical Science of Aging, Aichi Medical University, 1-1 Yazako Karimata, Nagakute City, Aichi prefecture, 480-1103, Japan.
| | - Jun Sone
- Department of Neuropathology, Institute for Medical Science of Aging, Aichi Medical University, 1-1 Yazako Karimata, Nagakute City, Aichi prefecture, 480-1103, Japan.
| | - Fumiaki Tanaka
- Department of Neurology and Stroke Medicine, Graduate School of Medicine, Yokohama City University, 3-9 Fukura, Kanazawa Ward, Yokohama City, Kanagawa prefecture, 236-0004, Japan.
| | - Mari Yoshida
- Department of Neuropathology, Institute for Medical Science of Aging, Aichi Medical University, 1-1 Yazako Karimata, Nagakute City, Aichi prefecture, 480-1103, Japan.
| | - Yasushi Iwasaki
- Department of Neuropathology, Institute for Medical Science of Aging, Aichi Medical University, 1-1 Yazako Karimata, Nagakute City, Aichi prefecture, 480-1103, Japan.
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Cummins DD, Sandoval-Pistorius SS, Cernera S, Fernandez-Gajardo R, Hammer LH, Starr PA. Physiological effects of dual target DBS in an individual with Parkinson's disease and a sensing-enabled pulse generator. Parkinsonism Relat Disord 2024; 122:106089. [PMID: 38460490 DOI: 10.1016/j.parkreldis.2024.106089] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/28/2024] [Accepted: 03/03/2024] [Indexed: 03/11/2024]
Abstract
INTRODUCTION Deep brain stimulation (DBS) of the subthalamic nucleus (STN) or globus pallidus (GP) is an established therapy for Parkinson's disease (PD). Novel DBS devices can record local field potential (LFP) physiomarkers from the STN or GP. While beta (13-30 Hz) and gamma (40-90 Hz) STN and GP LFP oscillations correlate with PD motor severity and with therapeutic effects of treatments, STN-GP interactions in electrophysiology in patients with PD are not well characterized. METHODS Simultaneous bilateral STN and GP LFPs were recorded in a patient with PD who received bilateral STN-DBS and GP-DBS. Power spectra in each target and STN-GP coherence were assessed in various ON- and OFF-levodopa and DBS states, both at rest and with voluntary movement. RESULTS OFF-levodopa and OFF-DBS, beta peaks were present at bilateral STN and GP, coincident with prominent STN-GP beta coherence. Levodopa and dual-target-DBS (simultaneous STN-DBS and GP-DBS) completely suppressed STN-GP coherence. Finely-tuned gamma (FTG) activity at half the stimulation frequency (62.5 Hz) was seen in the STN during GP-DBS at rest. To assess the effects of movement on FTG activity, we recorded LFPs during instructed movement. We observed FTG activity in bilateral GP and bilateral STN during contralateral body movements while on GP-DBS and ON-levodopa. No FTG was seen with STN-DBS or dual-target-DBS. CONCLUSION Dual-target-DBS and levodopa suppressed STN-GP coherence. FTG throughout the basal ganglia was induced by GP-DBS in the presence of levodopa and movement. This bilateral STN-FTG and GP-FTG corresponded with the least severe bradykinesia state, suggesting a pro-kinetic role for FTG.
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Affiliation(s)
- Daniel D Cummins
- School of Medicine, University of California San Francisco, 533 Parnassus Ave, San Francisco, CA, 94143, United States.
| | - Stephanie S Sandoval-Pistorius
- Department of Neurological Surgery, University of California San Francisco, 505 Parnassus Ave, Rm M779, San Francisco, CA, 94143, United States
| | - Stephanie Cernera
- Department of Neurological Surgery, University of California San Francisco, 505 Parnassus Ave, Rm M779, San Francisco, CA, 94143, United States
| | - Rodrigo Fernandez-Gajardo
- Department of Neurological Surgery, University of California San Francisco, 505 Parnassus Ave, Rm M779, San Francisco, CA, 94143, United States
| | - Lauren H Hammer
- Department of Neurology, University of California San Francisco, 1651 4th Street, East Care Center, San Francisco, CA, 94143, United States
| | - Philip A Starr
- School of Medicine, University of California San Francisco, 533 Parnassus Ave, San Francisco, CA, 94143, United States; Department of Neurological Surgery, University of California San Francisco, 505 Parnassus Ave, Rm M779, San Francisco, CA, 94143, United States
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Gos A, Steiner J, Trübner K, Ungewickell J, Mawrin C, Karnecki K, Kaliszan M, Gos T. Inverse pattern of GABAergic system impairment in the external versus internal globus pallidus in male heroin addicts. Eur Arch Psychiatry Clin Neurosci 2024; 274:445-452. [PMID: 37507486 PMCID: PMC10914887 DOI: 10.1007/s00406-023-01656-0] [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: 03/06/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023]
Abstract
Opioid addiction is a global problem that has been exacerbated in the USA and Europe by the COVID-19 pandemic. The globus pallidus (GP) plays a prominent neurobiological role in the regulation of behaviour as an output station of the striato-pallidal system. GABAergic large projection neurons are the main neuronal type in the external (EGP) and internal (IGP) parts of the GP, where addiction-specific molecular and functional abnormalities occur. In these neurons, glutamate decarboxylase (GAD) with isoforms GAD 65 and 67 is a key enzyme in GABA synthesis, and experimental studies suggest GAD dysregulation in the GP of heroin addicts. Our study, which was performed on paraffin-embedded brains from the Magdeburg Brain Bank, aimed to investigate abnormalities in the GABAergic function of large GP neurons by densitometric evaluation of their GAD 65/67-immunostained thick dendrites. The study revealed a bilaterally decreased fibres density in the EGP paralleled by the increase in the IGP in 11 male heroin addicts versus 11 healthy controls (significant U-test P values). The analysis of confounding variables found no interference of age, brain volume, and duration of formalin fixation with the results. Our findings suggest a dysregulation of GABAergic activity in the GP of heroin addicts, which is consistent with experimental data from animal models and plays potentially a role in the disturbed function of basal ganglia circuit in opioid addiction.
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Affiliation(s)
- Anna Gos
- Department of Psychiatry, Otto Von Guericke University, Magdeburg, Germany
| | - Johann Steiner
- Department of Psychiatry, Otto Von Guericke University, Magdeburg, Germany
| | - Kurt Trübner
- Institute of Legal Medicine, University of Duisburg-Essen, Essen, Germany
| | - Jonas Ungewickell
- Department of Psychiatry, Otto Von Guericke University, Magdeburg, Germany
| | - Christian Mawrin
- Department of Neuropathology, Otto Von Guericke University, Magdeburg, Germany
| | - Karol Karnecki
- Department of Forensic Medicine, Medical University of Gdańsk, Ul. Dębowa 23, 80-204, Gdańsk, Poland
| | - Michał Kaliszan
- Department of Forensic Medicine, Medical University of Gdańsk, Ul. Dębowa 23, 80-204, Gdańsk, Poland
| | - Tomasz Gos
- Department of Psychiatry, Otto Von Guericke University, Magdeburg, Germany.
- Department of Forensic Medicine, Medical University of Gdańsk, Ul. Dębowa 23, 80-204, Gdańsk, Poland.
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Remahi S, Mabika M, Côté S, Iorio-Morin C, Near J, Hui SCN, Edden RAE, Théoret H, Whittingstall K, Lepage JF. Neurotransmitter levels in the basal ganglia are associated with intracortical circuit activity of the primary motor cortex in healthy humans. Prog Neuropsychopharmacol Biol Psychiatry 2024; 129:110892. [PMID: 37952692 DOI: 10.1016/j.pnpbp.2023.110892] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 10/10/2023] [Accepted: 11/01/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND The basal ganglia are strongly connected to the primary motor cortex (M1) and play a crucial role in movement control. Interestingly, several disorders showing abnormal neurotransmitter levels in basal ganglia also present concomitant anomalies in intracortical function within M1. OBJECTIVE/HYPOTHESIS The main aim of this study was to clarify the relationship between neurotransmitter content in the basal ganglia and intracortical function at M1 in healthy individuals. We hypothesized that neurotransmitter content of the basal ganglia would be significant predictors of M1 intracortical function. METHODS We combined magnetic resonance spectroscopy (MRS) and transcranial magnetic stimulation (TMS) to test this hypothesis in 20 healthy adults. An extensive TMS battery probing common measures of intracortical, and corticospinal excitability was administered, and GABA and glutamate-glutamine levels were assessed from voxels placed over the basal ganglia and the occipital cortex (control region). RESULTS Regression models using metabolite concentration as predictor and TMS metrics as outcome measures showed that glutamate level in the basal ganglia significantly predicted short interval intracortical inhibition (SICI) and intracortical facilitation (ICF), while GABA content did not. No model using metabolite measures from the occipital control voxel was significant. CONCLUSIONS Taken together, these results converge with those obtained in clinical populations and suggest that intracortical circuits in human M1 are associated with the neurotransmitter content of connected but distal subcortical structures crucial for motor function.
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Affiliation(s)
- Sarah Remahi
- Sherbrooke University Hospital Research Center, Sherbrooke, Canada; Department of Pediatrics, Faculty of Medicine and Health Sciences, Sherbrooke University, Sherbrooke, Canada
| | - Madora Mabika
- University of Galway, School of Medicine, Galway, Ireland
| | - Samantha Côté
- Sherbrooke University Hospital Research Center, Sherbrooke, Canada; Department of Pediatrics, Faculty of Medicine and Health Sciences, Sherbrooke University, Sherbrooke, Canada; Department of Nuclear Medicine and Radiobiology, Faculty of Medicine and Health Sciences, Sherbrooke University, Sherbrooke, Canada
| | - Christian Iorio-Morin
- Sherbrooke University Hospital Research Center, Sherbrooke, Canada; Department of Surgery, Faculty of Medicine and Health Sciences, Sherbrooke University, Sherbrooke, Canada
| | - Jamie Near
- Physical Sciences Platform, SunnyBrook Health Sciences Center, Toronto, Canada
| | - Steve C N Hui
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Richard A E Edden
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Hugo Théoret
- Department of Psychology, Faculty of Arts and Sciences, Université de Montréal, Montréal, Canada
| | - Kevin Whittingstall
- Sherbrooke University Hospital Research Center, Sherbrooke, Canada; Department of Nuclear Medicine and Radiobiology, Faculty of Medicine and Health Sciences, Sherbrooke University, Sherbrooke, Canada
| | - Jean-François Lepage
- Sherbrooke University Hospital Research Center, Sherbrooke, Canada; Department of Pediatrics, Faculty of Medicine and Health Sciences, Sherbrooke University, Sherbrooke, Canada.
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Okumura A, Morioka I, Arai H, Hayakawa M, Maruo Y, Kusaka T, Kunikata T, Iwatani S. Second nationwide survey of bilirubin encephalopathy in preterm infants in Japan. Brain Dev 2024; 46:2-9. [PMID: 37690912 DOI: 10.1016/j.braindev.2023.08.009] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 08/13/2023] [Accepted: 08/30/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVES To determine the clinical features of bilirubin encephalopathy in preterm infants (pBE) in Japan. METHODS We performed a retrospective, nationwide questionnaire-based survey. The initial survey determined the number of children with pBE who were born after 2000. Using a structured questionnaire, the second survey clarified the clinical manifestations and characteristics of children with pBE, including demographic data, neurological symptoms, and MRI and auditory brainstem response (ABR) findings. RESULTS The initial survey identified 41 pBE infants from 18 institutions. After exclusion of patients included in previous studies, clinical information was collected from 30 patients (21 boys and 9 girls) during the secondary survey. The median gestational age was 26 weeks and the median birthweight was 846 g. Chronic lung disease and symptomatic patent ductus arteriosus were common neonatal complications. Head control was observed in 63% and functional gait in 17% of patients. Purposeful hand use was seen in 57% and verbal communication in 50% of patients. MRI showed T2 hyperintensities in the globus pallidus of 29 of 30 patients. ABR abnormalities were present in 11 of 15 patients. None of the variables were significantly different between the 2017 and 2021 surveys. CONCLUSIONS The pBE infants had severely impaired gross motor function and relatively preserved manual function and verbal communication. MRI and ABR findings aid in the diagnosis of pBE.
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Affiliation(s)
| | - Ichiro Morioka
- Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan
| | - Hiroshi Arai
- Department of Pediatric Neurology, Bobath Memorial Hospital, Osaka, Japan
| | - Masahiro Hayakawa
- Division of Neonatology, Center for Maternal-Neonatal Care, Nagoya University Hospital, Japan
| | - Yoshihiro Maruo
- Department of Pediatrics, Shiga University of Medical Science, Japan
| | - Takashi Kusaka
- Department of Pediatrics, Faculty of Medicine, Kagawa University, Japan
| | - Tetsuya Kunikata
- Division of Neonatal Medicine, Department of Pediatrics, Saitama Medical University Hospital, Japan
| | - Sota Iwatani
- Department of Neonatology, Hyogo Prefectural Kobe Children's Hospital, Japan
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10
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Bayar Kapici O, Kapici Y, Tekın A, Şırık M. A novel diagnosis method for schizophrenia based on globus pallidus data. Psychiatry Res Neuroimaging 2023; 336:111732. [PMID: 37922672 DOI: 10.1016/j.pscychresns.2023.111732] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 08/25/2023] [Accepted: 10/09/2023] [Indexed: 11/07/2023]
Abstract
This research aims to diagnose schizophrenia with machine learning-based algorithms. Bayesian neural network, logistic regression, decision tree, k-nearest neighbor, and gaussian kernel classification techniques are investigated to diagnose schizophrenia with data from 125 persons. This study showed that left lateral ventricles and left globus pallidus volumes and their percentages in the brain were significantly lower than HCs in FEP patients. Using brain volumes, we were able to diagnose FEP with an accuracy of 73.6 % via logistic regression and with an accuracy of 86.4 % using the SVM kernel classifier method. Therefore, brain volumes can be used to diagnose FEP with the SVM kernel classifier method.
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Affiliation(s)
- Olga Bayar Kapici
- Department of Radiology, Adıyaman Training and Research Hospital, Adıyaman, Turkey
| | - Yaşar Kapici
- Department of Psychiatry, Kahta State Hospital, Adıyaman, Turkey.
| | - Atilla Tekın
- Department of Psychiatry, Adıyaman University Faculty of Medicine, Adıyaman, Turkey
| | - Mehmet Şırık
- Department of Radiology, Adıyaman University Faculty of Medicine, Adıyaman, Turkey
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11
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Kinugawa K, Mano T, Fujimura S, Takatani T, Miyasaka T, Sugie K. Bradykinesia and rigidity modulated by functional connectivity between the primary motor cortex and globus pallidus in Parkinson's disease. J Neural Transm (Vienna) 2023; 130:1537-1545. [PMID: 37612469 DOI: 10.1007/s00702-023-02688-5] [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] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 08/18/2023] [Indexed: 08/25/2023]
Abstract
The mechanisms underlying motor fluctuations in patients with Parkinson's disease (PD) are currently unclear. Regional brain stimulation reported the changing of motor symptoms, but the correlation with functional connectivity (FC) in the brain network is not fully understood. Hence, our study aimed to explore the relationship between motor symptom severity and FC using resting-state functional magnetic resonance imaging (rsfMRI) in the "on" and "off" states of PD. In 26 patients with sporadic PD, FC was assessed using rsfMRI, and clinical severity was analyzed using the motor part of the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS Part III) in the on and off states. Correlations between FC values and MDS-UPDRS Part III scores were assessed using Pearson's correlation coefficient. The correlation between FC and motor symptoms differed in the on and off states. FC between the ipsilateral precentral gyrus (PreCG) and globus pallidus (GP) correlated with the total MDS-UPDRS Part III scores and those for bradykinesia/rigidity in the off state. Lateralization analysis indicated that FC between the PreCG and GP correlated with the contralateral total MDS-UPDRS Part III scores and those for bradykinesia/rigidity in the off state. Aberrant FC in cortico-striatal circuits correlated with the severity of motor symptoms in PD. Cortico-striatal hyperconnectivity, particularly in motor pathways involving PreCG and GP, is related to motor impairments in PD. These findings may facilitate our understanding of the mechanisms underlying motor symptoms in PD and aid in developing treatment strategies such as brain stimulation for motor impairment.
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Affiliation(s)
- Kaoru Kinugawa
- Department of Neurology, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8521, Japan
| | - Tomoo Mano
- Department of Neurology, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8521, Japan.
- Department of Rehabilitation Medicine, Nara Prefecture General Medical Center, Nara, Japan.
| | - Shigekazu Fujimura
- Department of Rehabilitation Medicine, Nara Medical University, Kashihara, Japan
| | - Tsunenori Takatani
- Division of Central Clinical Laboratory, Nara Medical University, Kashihara, Japan
| | | | - Kazuma Sugie
- Department of Neurology, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8521, Japan
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12
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Qi W, Wen Z, Chen J, Capichioni G, Ando F, Chen ZS, Wang J, Yoncheva Y, Castellanos FX, Milad M, Goff DC. Aberrant resting-state functional connectivity of the globus pallidus interna in first-episode schizophrenia. Schizophr Res 2023; 261:100-106. [PMID: 37716202 DOI: 10.1016/j.schres.2023.09.018] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 04/05/2023] [Accepted: 09/04/2023] [Indexed: 09/18/2023]
Abstract
BACKGROUND The striatal-pallidal pathway plays an important role in cognitive control and modulation of behaviors. Globus pallidus interna (GPi), as a primary output structure, is crucial in modulating excitation and inhibition. Studies of GPi in psychiatric illnesses are lacking given the technical challenges of examining this small and functionally diverse subcortical structure. METHODS 71 medication-naïve first episode schizophrenia (FES) participants and 73 healthy controls (HC) were recruited at the Shanghai Mental Health Center. Clinical symptoms and imaging data were collected at baseline and, in a subset of patients, 8 weeks after initiating treatment. Resting-state functional connectivity of sub-regions of the GP were assessed using a novel mask that combines two atlases to create 8 ROIs in the GP. RESULTS Baseline imaging data from 63 FES patients and 55 HC met quality standards and were analyzed. FES patients exhibited less negative connectivity and increased positive connectivity between the right anterior GPi and several cortical and subcortical areas at baseline compared to HC (PFWE < 0.05). Positive functional connectivity between the right anterior GPi and several brain areas, including the right dorsal anterior cingulate gyrus, was associated with severity of positive symptoms (PFWE < 0.05) and predicted treatment response after 8 weeks (n = 28, adjusted R2 = 0.486, p < 0.001). CONCLUSIONS Our results implicate striatal-pallidal-thalamic pathways in antipsychotic efficacy. If replicated, these findings may reflect failure of neurodevelopmental processes in adolescence and early adulthood that decrease functional connectivity as an index of failure of the limbic/associative GPi to appropriately inhibit irrelevant signals in psychosis.
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Affiliation(s)
- Wei Qi
- Psychiatry Department, NYU Grossman School of Medicine, New York, NY, United States of America
| | - Zhenfu Wen
- Psychiatry Department, NYU Grossman School of Medicine, New York, NY, United States of America
| | - Jingyun Chen
- Clinical Consult Department, Icometrix, Boston, MA, United States of America
| | - Gillian Capichioni
- Psychiatry Department, NYU Grossman School of Medicine, New York, NY, United States of America
| | - Fumika Ando
- Psychiatry Department, NYU Grossman School of Medicine, New York, NY, United States of America
| | - Zhe Sage Chen
- Psychiatry Department, NYU Grossman School of Medicine, New York, NY, United States of America; Department of Biomedical Engineering, NYU Tandon School of Engineering, Brooklyn, NY, United States of America
| | - Jijun Wang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yuliya Yoncheva
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York, NY, United States of America
| | - Francisco X Castellanos
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, United States of America; Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York, NY, United States of America
| | - Mohammed Milad
- Psychiatry Department, NYU Grossman School of Medicine, New York, NY, United States of America
| | - Donald C Goff
- Psychiatry Department, NYU Grossman School of Medicine, New York, NY, United States of America; Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, United States of America.
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13
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Kim MS, Shin I, Park DG, Yoon JH. Post-stroke movement disorders disappearance: a report of disappearance of tardive dyskinesia after stroke and a literature review. Acta Neurol Belg 2023; 123:2005-2007. [PMID: 35997956 DOI: 10.1007/s13760-022-02062-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 08/10/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Min Seung Kim
- Department of Neurology, Ajou University School of Medicine, 5 San, Woncheon-dong, Yongtong-gu, Suwon-si, Kyunggi-do, 442-749, Republic of Korea
- Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea
| | - InJa Shin
- Department of Neurology, Ajou University School of Medicine, 5 San, Woncheon-dong, Yongtong-gu, Suwon-si, Kyunggi-do, 442-749, Republic of Korea
| | - Don Gueu Park
- Department of Neurology, Ajou University School of Medicine, 5 San, Woncheon-dong, Yongtong-gu, Suwon-si, Kyunggi-do, 442-749, Republic of Korea
| | - Jung Han Yoon
- Department of Neurology, Ajou University School of Medicine, 5 San, Woncheon-dong, Yongtong-gu, Suwon-si, Kyunggi-do, 442-749, Republic of Korea.
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14
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Liu X, Gao Z, Liu W, He X, Wang N. AoA-L2 and Usage-L2 modulate the functional neuroplasticity of the subcortex. Brain Lang 2023; 245:105323. [PMID: 37757503 DOI: 10.1016/j.bandl.2023.105323] [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] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 09/08/2023] [Accepted: 09/10/2023] [Indexed: 09/29/2023]
Abstract
Previous studies revealed structural differences in subcortical regions between monolinguals and bilinguals; however, whether the functional neuroplasticity of the subcortex is modulated by different bilingual experiences remains unclear. Here, we examined the effect of age of second language acquisition (AoA-L2) and usage of L2 (Usage-L2) on subcorto-cortical and intra-subcortical functional connectivity (FC) in bilinguals by using resting-state fMRI data. The relations between brain measurements and bilingual experiences were revealed by using multiple regression analysis. We found that increased AoA-L2 was mainly related to decreased subcortical FC involving the anterior thalamus, basal ganglia, and hippocampus. Increased Usage-L2 at home was mainly associated with decreased subcortical FC of the amygdala, globus pallidus, hippocampus, and nucleus accumbens. The FC of these subcortical regions displayed a positive relation with Usage-L2 in social settings. These findings reveal that bilingual experiences modulate the functional neuroplasticity of the subcortex in different ways.
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Affiliation(s)
- Xiaojin Liu
- Center for Educational Science and Technology, Beijing Normal University, Zhuhai 519087, China.
| | - Zhenni Gao
- Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu, China
| | - Wen Liu
- Center for Educational Science and Technology, Beijing Normal University, Zhuhai 519087, China
| | - Xintong He
- Center for Educational Science and Technology, Beijing Normal University, Zhuhai 519087, China
| | - Naiyi Wang
- Institute of Educational Psychology and School Counseling, Faculty of Education, Beijing Normal University, Beijing 100875, China; Lab for Educational Neuroscience, Center for Educational Science and Technology, Faculty of Education, Beijing Normal University, Beijing 100875, China
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15
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Patton MS, Sheats SH, Siclair AN, Mathur BN. Alcohol potentiates multiple GABAergic inputs to dorsal striatum fast-spiking interneurons. Neuropharmacology 2023; 232:109527. [PMID: 37011784 PMCID: PMC10122715 DOI: 10.1016/j.neuropharm.2023.109527] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 12/21/2022] [Revised: 03/16/2023] [Accepted: 03/28/2023] [Indexed: 04/04/2023]
Abstract
Parvalbumin-expressing dorsal striatal fast-spiking interneurons, comprising ∼1% of the total dorsal striatal neuronal population, are necessary for the expression of compulsive-like ethanol consumption mice. Fast-spiking interneurons are driven to fire by glutamatergic inputs derived primarily from the cortex. However, these neurons also receive substantial GABAergic input from two sources: the globus pallidus and the reticular nucleus of the thalamus. How ethanol modulates inhibitory input onto fast-spiking neurons is unclear and, more broadly, alcohol effects on GABAergic synaptic transmission onto GABAergic interneurons are understudied. Examining this, we found that acute bath application of ethanol (50 mM) potentiated GABAergic transmission from both the globus pallidus and the reticular nucleus of the thalamus onto fast-spiking interneurons in mouse of both sexes. This ethanol-induced potentiation required postsynaptic calcium and was not accompanied by a sustained change in presynaptic GABA release probability. Examining whether this ethanol effect persisted following chronic intermittent ethanol exposure, we found attenuated acute-ethanol potentiation of GABAergic transmission from both the globus pallidus and the reticular nucleus of the thalamus onto striatal fast-spiking interneurons. These data underscore the impact of ethanol on GABAergic signaling in the dorsal striatum and support the notion that ethanol may disinhibit the dorsolateral striatum.
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Affiliation(s)
- Michael S Patton
- Department of Pharmacology, University of Maryland School of Medicine, Baltimore, MD, 21201, USA
| | - Samuel H Sheats
- Department of Pharmacology, University of Maryland School of Medicine, Baltimore, MD, 21201, USA
| | - Allison N Siclair
- Department of Pharmacology, University of Maryland School of Medicine, Baltimore, MD, 21201, USA
| | - Brian N Mathur
- Department of Pharmacology, University of Maryland School of Medicine, Baltimore, MD, 21201, USA.
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16
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Villalobos N, Magdaleno-Madrigal VM. Pallidal GABA B receptors: involvement in cortex beta dynamics and thalamic reticular nucleus activity. J Physiol Sci 2023; 73:14. [PMID: 37328793 DOI: 10.1186/s12576-023-00870-8] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 06/07/2023] [Indexed: 06/18/2023]
Abstract
The external globus pallidus (GP) firing rate synchronizes the basal ganglia-thalamus-cortex network controlling GABAergic output to different nuclei. In this context, two findings are significant: the activity and GABAergic transmission of the GP modulated by GABA B receptors and the presence of the GP-thalamic reticular nucleus (RTn) pathway, the functionality of which is unknown. The functional participation of GABA B receptors through this network in cortical dynamics is feasible because the RTn controls transmission between the thalamus and cortex. To analyze this hypothesis, we used single-unit recordings of RTn neurons and electroencephalograms of the motor cortex (MCx) before and after GP injection of the GABA B agonist baclofen and the antagonist saclofen in anesthetized rats. We found that GABA B agonists increase the spiking rate of the RTn and that this response decreases the spectral density of beta frequency bands in the MCx. Additionally, injections of GABA B antagonists decreased the firing activity of the RTn and reversed the effects in the power spectra of beta frequency bands in the MCx. Our results proved that the GP modulates cortical oscillation dynamics through the GP-RTn network via tonic modulation of RTn activity.
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Affiliation(s)
- Nelson Villalobos
- Academia de Fisiología, Escuela Superior de Medicina, Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón, Colonia Casco de Santo Tomás, 11340, México City, México.
- Sección de Estudios de Posgrado e Investigación de la Escuela Superior de Medicina, Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón, Colonia Casco de Santo Tomás, 11340, Mexico City, Mexico.
| | - Victor Manuel Magdaleno-Madrigal
- Laboratorio de Neuromodulación Experimental, Dirección de Investigaciones en Neurociencias, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico
- Carrera de Psicología, Facultad de Estudios Superiores Zaragoza-UNAM, México City, México
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17
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Zhang R, Nie Y, Dai W, Wang S, Geng X. Balance between pallidal neural oscillations correlated with dystonic activity and severity. Neurobiol Dis 2023:106178. [PMID: 37268239 DOI: 10.1016/j.nbd.2023.106178] [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: 03/23/2023] [Revised: 05/14/2023] [Accepted: 05/28/2023] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND AND OBJECTIVE The balance between neural oscillations provides valuable insights into the organisation of neural oscillations related to brain states, which may play important roles in dystonia. We aim to investigate the relationship of the balance in the globus pallidus internus (GPi) with the dystonic severity under different muscular contraction conditions. METHODS Twenty-one patients with dystonia were recruited. All of them underwent bilateral GPi implantation, and local field potentials (LFPs) from the GPi were recorded via simultaneous surface electromyography. The power spectral ratio between neural oscillations was computed as the measure of neural balance. This ratio was calculated under high and low dystonic muscular contraction conditions, and its correlation with the dystonic severity was assessed using clinical scores. RESULTS The power spectral of the pallidal LFPs peaked in the theta and alpha bands. Within participant comparison showed that the power spectral of the theta oscillations significantly increased during high muscle contraction compared with that during low contraction. The power spectral ratios between the theta and alpha, theta and low beta, and theta and high gamma oscillations were significantly higher during high contraction than during low contraction. The total score and motor score were associated with the power spectral ratio between the low and high beta oscillations, which was correlated with the dystonic severity both during high and low contractions. The power spectral ratios between the low beta and low gamma and between the low beta and high gamma oscillations showed a significantly positive correlation with the total score during both high and low contractions; a correlation with the motor scale score was found only during high contraction. Meanwhile, the power spectral ratio between the theta and alpha oscillations during low contraction showed a significantly negative correlation with the total score. The power spectral ratios between the alpha and high beta, alpha and low gamma, and alpha and high gamma oscillations were significantly correlated with the dystonic severity only during low contraction. CONCLUSION The balance between neural oscillations, as quantified by the power ratio between specific frequency bands, differed between the high and low muscular contraction conditions and was correlated with the dystonic severity. The balance between the low and high beta oscillations was correlated with the dystonic severity during both conditions, making this parameter a new possible biomarker for closed-loop deep brain stimulation in patients with dystonia.
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Affiliation(s)
- Ruili Zhang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China; Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, China; MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China; Zhangjiang Fudan International Innovation Center, Shanghai, China
| | - Yingnan Nie
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China; Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, China; MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China; Zhangjiang Fudan International Innovation Center, Shanghai, China
| | - Wen Dai
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China; Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, China; MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China; Zhangjiang Fudan International Innovation Center, Shanghai, China
| | - Shouyan Wang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China; Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, China; MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China; Zhangjiang Fudan International Innovation Center, Shanghai, China; Shanghai Engineering Research Center of AI & Robotics, Fudan University, Shanghai, China; Engineering Research Center of AI & Robotics, Ministry of Education, Fudan University, Shanghai, China
| | - Xinyi Geng
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China; Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, China; MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China; Zhangjiang Fudan International Innovation Center, Shanghai, China.
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18
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Dzhalagoniya IZ, Usova SV, Gamaleya AA, Tomskiy AA, Shaikh AG, Sedov AS. DYT1 dystonia: Neurophysiological properties of the pallidal activity. Parkinsonism Relat Disord 2023; 112:105447. [PMID: 37267819 DOI: 10.1016/j.parkreldis.2023.105447] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 04/25/2023] [Accepted: 05/18/2023] [Indexed: 06/04/2023]
Abstract
OBJECTIVES The aim of this paper is to find the differences in the physiology of the pallidal neurons in DYT1 and non-DYT1 dystonia. METHODS We performed microelectrode recording of the single unit activity in both segments of the globus pallidus during stereotactic implantation of electrodes for deep brain stimulation (DBS). RESULTS We found a reduced firing rate, reduced burst rate, and increased pause index in both pallidal segments in DYT1. Also, in DYT1 the activity in both pallidal segments was similar, but not so in non-DYT1. CONCLUSION The results suggest a common pathological focus for both pallidal segments, located in the striatum. We also speculate that strong striatal influence on GPi and GPe overrides other input sources to the pallidal nuclei causing similarity in neuronal activity. SIGNIFICANCE We found significant differences in neuronal activity between DYT1 and non-DYT1 neurons. Our findings shed light on the pathophysiology of DYT-1 dystonia which can be very different from non-DYT1 dystonia and have other efficient treatment tactics.
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Affiliation(s)
- Indiko Z Dzhalagoniya
- N.N. Semenov Federal Research Center for Chemical Physics Russian Academy of Sciences, Novatorov st. 7A-1, Moscow, Russian Federation.
| | - Svetlana V Usova
- N.N. Semenov Federal Research Center for Chemical Physics Russian Academy of Sciences, Novatorov st. 7A-1, Moscow, Russian Federation
| | - Anna A Gamaleya
- N.N. Burdenko National Medical Research Center for Neurosurgery, 4th Tverskaya-Yamskaya st. 16, Moscow, Russian Federation
| | - Alexey A Tomskiy
- N.N. Burdenko National Medical Research Center for Neurosurgery, 4th Tverskaya-Yamskaya st. 16, Moscow, Russian Federation
| | - Aasef G Shaikh
- Department of Neurology, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH, USA; Daroff-DelOsso Ocular Motility Laboratory, Neurology Service, Louis Stoke VA Medical Center, 10701 East Blvd, Cleveland, OH, USA
| | - Alexey S Sedov
- N.N. Semenov Federal Research Center for Chemical Physics Russian Academy of Sciences, Novatorov st. 7A-1, Moscow, Russian Federation; Moscow Institute of Physics and Technology, 9 Institutskiy per., Dolgoprudny, Moscow Region, Russian Federation
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19
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Guarino S, Hagen C, Nguyen Q, Papini MR. Frustrative nonreward and the basal ganglia: Chemogenetic inhibition and excitation of the nucleus accumbens and globus pallidus externus during reward downshift. Neurobiol Learn Mem 2023; 200:107736. [PMID: 36822464 DOI: 10.1016/j.nlm.2023.107736] [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: 09/30/2022] [Revised: 01/27/2023] [Accepted: 02/16/2023] [Indexed: 02/25/2023]
Abstract
Frustrative nonreward contributes to anxiety disorders and addiction, and is included in the Research Domain Criteria initiative as a relevant endophenotype. These experiments explored the role of the basal ganglia in consummatory reward downshift (cRD) using inhibitory and excitatory DREADDs (designer receptors exclusively activated by designer drugs) infused in either the nucleus accumbens (NAc) or one of its downstream targets, the globus pallidus externus (GPe). NAc inhibition did not disrupt consummatory suppression during a 32-to-2% (Experiment 1) or 8-to-2% sucrose downshift (Experiment 2). However, NAc excitation enhanced consummatory suppression during a 32-to-2% sucrose downshift (Experiment 1). GPe inhibition caused a trend toward increased consummatory suppression after a 32-to-2% sucrose downshift, whereas GPe excitation eliminated consummatory suppression after an 8-to-2% sucrose downshift (Experiment 3). Chemogenetic manipulations of NAc and GPe had no detectable effects on open field activity. The effects of DREADD activation via clozapine N-oxide (CNO) administration were compared to controls that carried the DREADDs, but received vehicle injections. There was no evidence that CNO or vehicle injections in virus vector control (VVC) animals affected cRD or OF activity after either CNO or vehicle injections. NAc and GPe excitation led to opposite results in the cRD task, providing evidence that the basal ganglia circuit has a function in frustrative nonreward in the absence of detectable motor effects.
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Affiliation(s)
- Sara Guarino
- Department of Psychology, Texas Christian University, Fort Worth, TX 76109, USA
| | - Christopher Hagen
- Department of Psychology, Texas Christian University, Fort Worth, TX 76109, USA
| | - Quynh Nguyen
- Department of Psychology, Texas Christian University, Fort Worth, TX 76109, USA
| | - Mauricio R Papini
- Department of Psychology, Texas Christian University, Fort Worth, TX 76109, USA.
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Wong JK, Lopes JMLJ, Hu W, Wang A, Au KLK, Stiep T, Frey J, Toledo JB, Raike RS, Okun MS, Almeida L. Double blind, nonrandomized crossover study of active recharge biphasic deep brain stimulation for primary dystonia. Parkinsonism Relat Disord 2023; 109:105328. [PMID: 36827951 DOI: 10.1016/j.parkreldis.2023.105328] [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: 12/21/2022] [Revised: 02/12/2023] [Accepted: 02/13/2023] [Indexed: 02/19/2023]
Abstract
BACKGROUND Deep brain stimulation (DBS) of the globus pallidus interna (GPi) is an effective therapy for select patients with primary dystonia. DBS programming for dystonia is often challenging due to variable time to symptomatic improvement or stimulation induced side effects (SISE) such as capsular or optic tract activation which can prolong device optimization. OBJECTIVE To characterize the safety and tolerability of active recharge biphasic DBS (bDBS) in primary dystonia and to compare it to conventional clinical DBS (clinDBS). METHODS Ten subjects with primary dystonia and GPi DBS underwent a single center, double blind, nonrandomized crossover study comparing clinDBS versus bDBS. The testing occurred over two-days. bDBS and clinDBS were administered on separate days and each was activated for 6 h. Rating scales were collected by video recording and scored by four blinded movement disorders trained neurologists. RESULTS The bDBS paradigm was safe and well-tolerated in all ten subjects. There were no persistent SISE reported. The mean change in the Unified Dystonia Rating Scale after 4 h of stimulation was greater in bDBS when compared to clinDBS (-6.5 vs 0.3, p < 0.04). CONCLUSION In this pilot study, we demonstrated that biphasic DBS is a novel stimulation paradigm which can be administered safely. The biphasic waveform revealed a greater immediate improvement. Further studies are needed to determine whether this immediate improvement persists with chronic stimulation or if clinDBS will eventually achieve similar levels of improvement to bDBS over time.
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Affiliation(s)
- Joshua K Wong
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, United States.
| | - Janine Melo Lobo Jofili Lopes
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, United States
| | - Wei Hu
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, United States
| | - Anson Wang
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, United States
| | - Ka Loong Kelvin Au
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, United States
| | - Tamara Stiep
- Department of Neurology, UCSF Weill Institute for Neurosciences, Movement Disorder and Neuromodulation Center, University of California San Francisco, CA, United States
| | - Jessica Frey
- Department of Neurology, Rockefeller Neurosciences Institute, West Virginia University, Morgantown, WV, United States
| | - Jon B Toledo
- Nantz National Alzheimer Center, Stanley H. Appel Department of Neurology, Houston Methodist Hospital, Houston, TX, United States
| | - Robert S Raike
- Restorative Therapies Group Implantables, Research and Core Technology, Medtronic Inc., Minneapolis, MN, United States
| | - Michael S Okun
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, United States
| | - Leonardo Almeida
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, United States
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21
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Moosa S, Bond AE, Wang TR, Farzad F, Asthagiri AR, Elias WJ. Stereotactic and Functional Neurosurgery Convection-Enhanced Delivery of Autologous Cerebrospinal Fluid Enhances Basal Ganglia Visualization during MRI-Guided Deep Brain Stimulation Surgery. Stereotact Funct Neurosurg 2023; 101:93-100. [PMID: 36724759 DOI: 10.1159/000528738] [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: 07/27/2022] [Accepted: 12/11/2022] [Indexed: 02/03/2023]
Abstract
INTRODUCTION The aim of this study was to determine the safety and feasibility of convection-enhanced delivery of autologous cerebrospinal fluid (CSF) for enhancing intraoperative magnetic resonance imaging (MRI) of the basal ganglia during stereotactic neurosurgery. METHODS This pilot study was conducted in 4 patients with Parkinson's disease (PD) who underwent MRI-guided deep brain stimulation of the globus pallidus internus (GPi). CSF was obtained via lumbar puncture after general anesthesia and prior to incision. A frameless stereotaxy system was installed, and an infusion catheter was inserted to the GPi using intraoperative MRI. Infusion of autologous CSF was performed at a convective rate of 5 µL/min with a maximum volume of infusion (Vi) of 500 mL. T2-weighted MRI scans were obtained every 15 min up to a maximum of 105 min in order to calculate the volume of distribution (Vd). Safety was assessed with adverse event monitoring, and clinical outcomes were measured with changes in unmedicated UPDRS part III and PDQ-39 scores from baseline to 6 months postoperatively. RESULTS All four infusions were safe and without adverse events. The mean unmedicated UPDRS part III and PDQ-39 scores improved by 24% and 26%, respectively. The Vd:Vi ratio ranged from 2.2 to 2.8 and peaked 45 min from the onset of infusion, which is when the borders of the GPi could generally be visualized based on T2-weighted MRI. Two patients underwent refinement of the stereotactic targeting based on infusion-enhanced images. CONCLUSIONS The convective administration of autologous CSF to deep brain structures appears safe and feasible for enhancing intraoperative MRI during stereotactic procedures. Infusion-enhanced imaging with target-specific infusates could be developed to visualize neurochemical circuits or cellular regions that currently are not seen with anatomic/structural MRI.
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Affiliation(s)
- Shayan Moosa
- Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia, USA
| | - Aaron E Bond
- Department of Neurological Surgery, Semmes Murphey Clinic, Memphis, Tennessee, USA
| | - Tony R Wang
- Department of Neurological Surgery, Swedish Neuroscience Institute, Seattle, Washington, USA
| | - Faraz Farzad
- School of Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - Ashok R Asthagiri
- Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia, USA
| | - W Jeffrey Elias
- Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia, USA
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22
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Sedov A, Gamaleya A, Semenova U, Medvednik R, Tomskiy A, Jinnah HA, Shaikh A. Does Pallidal Physiology Determine the Success of Unilateral Deep Brain Stimulation in Cervical Dystonia? Adv Neurobiol 2023; 31:211-221. [PMID: 37338704 DOI: 10.1007/978-3-031-26220-3_12] [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] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
Pallidal deep brain stimulation is a well-known surgical treatment for cervical dystonia. The resolution of dystonia typically requires bilateral pallidal stimulation, but in some instances, unilateral stimulation has been successful. In such instances, generally, the stimulated hemisphere was contralateral to the dystonic sternocleidomastoid, but rarely it was ipsilateral. We sought for the physiological features that determine the basis for success and laterality of deep brain stimulation for cervical dystonia with prominent torticollis. We found that pallidal physiology such as high burst to tonic ratio and significant interhemispheric differences in the neuronal firing rate and regularity are critical determinants of successful treatment with unilateral deep brain stimulation. We also found that higher lateralized differences in pallidal physiological parameters predict more robust improvement. In three out of four patients, the stimulation of the hemisphere ipsilateral to the dystonic sternocleidomastoid muscle was effective. These patients did not have any structural brain abnormalities on clinically available imaging studies. One patient responded to the unilateral deep brain stimulation in the hemisphere contralateral to the dystonic sternocleidomastoid. This patient had a structural putamen lesion on brain MRI. These results provide objective parameters determining the success of pallidal deep brain stimulation for treatment of cervical dystonia. The results also depict differences in the pallidal physiology in patients where ipsilateral versus contralateral deep brain stimulation was effective.
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Affiliation(s)
- Alexey Sedov
- Semenov Research Center of Chemical Physics, Russian Academy of Sciences, Moscow, Russia
- Phystech school of biological and medical physics, Moscow Institute of Physics and Technology, Dolgoprudny, Russia
| | - Anna Gamaleya
- N. N. Burdenko National Scientific and Practical Center for Neurosurgery, Moscow, Russia
| | - Ulia Semenova
- Semenov Research Center of Chemical Physics, Russian Academy of Sciences, Moscow, Russia
| | - Rita Medvednik
- Semenov Research Center of Chemical Physics, Russian Academy of Sciences, Moscow, Russia
| | - Alexey Tomskiy
- N. N. Burdenko National Scientific and Practical Center for Neurosurgery, Moscow, Russia
| | | | - Aasef Shaikh
- Departments of Neurology and Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
- Neurological Institute, University Hospitals, Cleveland, OH, USA
- Neurology Service, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA
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23
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Jergas H, Baldermann JC, Wirths J, Barbe MT, Visser-Vandewalle V, Andrade P. Pallidal deep brain stimulation in a patient with nonketotic hyperglycemic hemichorea. Surg Neurol Int 2023; 14:24. [PMID: 36895223 PMCID: PMC9990764 DOI: 10.25259/sni_716_2022] [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: 08/08/2022] [Accepted: 12/30/2022] [Indexed: 01/28/2023] Open
Abstract
Background Hyperkinetic movement disorders secondary to brain tissue damage due to hyperglycemia are a rare complication of diabetes mellitus. Nonketotic hyperglycemic hemichorea (NH-HC) is characterized by a rapid onset of involuntary movements after increased serum glucose levels. Case Description We report on a case of a 62-year-old male patient with a 28-year history of Type II diabetes mellitus with NH-HC following an infect-associated exacerbation of blood glucose levels. Choreiform movements of the right upper extremity, face, and trunk persisted 6 months after onset. Due to failure of conservative treatments, we opted for unilateral deep brain stimulation of the globus pallidus internus, which led to complete cessation of symptoms within a week after initial programming. Symptom control was still satisfactory 12 months after surgery. No side-effects or surgery-associated complications were observed. Conclusion Globus pallidus internus DBS is an effective and safe treatment option for hyperkinetic movement disorders secondary to brain tissue damage caused by hyperglycemia. Postoperatively, stimulation effects can be observed quickly and effects persist even after 12 months.
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Affiliation(s)
- Hannah Jergas
- Department of Neurology, University Hospital Cologne, Cologne, Germany
| | - Juan C Baldermann
- Department of Neurology, University Hospital Cologne, Cologne, Germany
| | - Jochen Wirths
- Department of Stereotactic and Functional Neurosurgery, University Hospital of Cologne, Cologne, Germany
| | - Michael T Barbe
- Department of Neurology, University Hospital Cologne, Cologne, Germany
| | - Veerle Visser-Vandewalle
- Department of Stereotactic and Functional Neurosurgery, University Hospital of Cologne, Cologne, Germany
| | - Pablo Andrade
- Department of Stereotactic and Functional Neurosurgery, University Hospital of Cologne, Cologne, Germany
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24
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Waggan I, Rissanen E, Tuisku J, Joutsa J, Helin S, Parkkola R, Rinne JO, Airas L. Adenosine A 2A receptor availability in patients with early- and moderate-stage Parkinson's disease. J Neurol 2023; 270:300-310. [PMID: 36053386 DOI: 10.1007/s00415-022-11342-1] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 08/06/2022] [Accepted: 08/17/2022] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Adenosine 2A (A2A) receptors co-localize with dopamine D2 receptors in striatopallidal medium spiny neurons of the indirect pathway. A2A receptor activation in the striatum or pallidum decreases D2 signaling. In contrast, A2A receptor antagonism may help potentiate it. Furthermore, previous PET studies have shown increased A2A receptor availability in striatum of late-stage PD patients with dyskinesia. However, human in vivo evidence for striatal A2A receptor availability in early-stage PD is limited. This study aimed to investigate possible differences in A2A receptor availability in the striatum and pallidum of early- and moderate-stage PD patients without dyskinesias. METHODS Brain MRI and PET with [11C]TMSX radioligand, targeting A2A receptors, was performed in 9 patients with early- and 9 with moderate-stage PD without dyskinesia and in 6 healthy controls. Distribution volume ratios (DVR) were calculated to assess specific [11C]TMSX binding in caudate, putamen and pallidum. RESULTS A2A receptor availability (DVR) was decreased in the bilateral caudate of early-stage PD patients when compared with healthy controls (P = 0.02). Conversely, DVR was increased bilaterally in the pallidum of moderate-stage PD patients compared to healthy controls (P = 0.03). Increased mean striatal DVR correlated with higher motor symptom severity ([Formula: see text] = 0.47, P = 0.02). CONCLUSION Our results imply regional and disease stage-dependent changes in A2A receptor signaling in PD pathophysiology and in response to dopaminergic medication.
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Affiliation(s)
- Imran Waggan
- Turku PET Centre, University of Turku, Itäinen Pitkäkatu 4A, 6th floor, 6007, 20520, Turku, Finland.
| | - Eero Rissanen
- Turku PET Centre, University of Turku, Itäinen Pitkäkatu 4A, 6th floor, 6007, 20520, Turku, Finland
- Division of Clinical Neurosciences, Turku University Hospital and University of Turku, Turku, Finland
| | - Jouni Tuisku
- Turku PET Centre, University of Turku, Itäinen Pitkäkatu 4A, 6th floor, 6007, 20520, Turku, Finland
| | - Juho Joutsa
- Turku PET Centre, University of Turku, Itäinen Pitkäkatu 4A, 6th floor, 6007, 20520, Turku, Finland
- Division of Clinical Neurosciences, Turku University Hospital and University of Turku, Turku, Finland
| | - Semi Helin
- Turku PET Centre, University of Turku, Itäinen Pitkäkatu 4A, 6th floor, 6007, 20520, Turku, Finland
| | - Riitta Parkkola
- Department of Radiology, Turku University Hospital and University of Turku, Turku, Finland
| | - Juha O Rinne
- Turku PET Centre, University of Turku, Itäinen Pitkäkatu 4A, 6th floor, 6007, 20520, Turku, Finland
- Division of Clinical Neurosciences, Turku University Hospital and University of Turku, Turku, Finland
| | - Laura Airas
- Turku PET Centre, University of Turku, Itäinen Pitkäkatu 4A, 6th floor, 6007, 20520, Turku, Finland
- Division of Clinical Neurosciences, Turku University Hospital and University of Turku, Turku, Finland
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25
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Diamond JM, Lopes MB, Elias WJ, Jansen LA. Gamma-Aminobutyric Acid A Receptor Subunit Expression and Cellular Localization in the Human Parkinsonian Globus Pallidus. World Neurosurg 2022; 165:e159-e168. [PMID: 35659589 DOI: 10.1016/j.wneu.2022.05.121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 03/02/2022] [Revised: 05/25/2022] [Accepted: 05/26/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND The gamma-aminobutyric acid A (GABAA) receptor is an important mediator of cellular signaling in the globus pallidus and might be implicated in the pathophysiology of Parkinson disease (PD). The goal of the present study was to characterize GABAA receptor subunit expression in the normal and parkinsonian human globus pallidus. METHODS Postmortem brain specimens were obtained from 8 patients with pathological evidence of PD at autopsy and from 4 control patients without such evidence. These tissues were exposed to primary antibodies directed against the α1 and α3 subunits of the GABAA receptor and were visualized and quantified using fluorescence microscopy. RESULTS No differences were found in the pallidal neuronal density in the control versus PD tissues. Projection neurons strongly expressed the α1, α3, and β2 GABAA receptor subunits. After normalizing the immunofluorescence intensities in the globus pallidus to those in the adjacent structures, no significant differences were found in GABAA receptor subunit expression in the globus pallidus between the PD specimens and the control specimens. CONCLUSIONS Compensatory changes in GABAA receptor α1 and α3 subunit expression in response to PD-related signaling abnormalities in the globus pallidus did not occur in our PD cohort.
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Affiliation(s)
- Joshua M Diamond
- Department of Neurological Surgery, University of Virginia Medical Center, Charlottesville, Virginia, USA
| | - M Beatriz Lopes
- Department of Pathology, University of Virginia Medical Center, Charlottesville, Virginia, USA
| | - W Jeff Elias
- Department of Neurological Surgery, University of Virginia Medical Center, Charlottesville, Virginia, USA.
| | - Laura A Jansen
- Department of Neurology, University of Virginia Medical Center, Charlottesville, Virginia, USA
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Villalobos N, Almazán-Alvarado S, Magdaleno-Madrigal VM. Elevation of GABA levels in the globus pallidus disinhibits the thalamic reticular nucleus and desynchronized cortical beta oscillations. J Physiol Sci 2022; 72:17. [PMID: 35896962 DOI: 10.1186/s12576-022-00843-3] [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: 01/12/2022] [Accepted: 07/12/2022] [Indexed: 11/10/2022]
Abstract
The external globus pallidus (GP) is a GABAergic node involved in motor control regulation and coordinates firing and synchronization in the basal ganglia-thalamic-cortical network through inputs and electrical activity. In Parkinson's disease, high GABA levels alter electrical activity in the GP and contribute to motor symptoms. Under normal conditions, GABA levels are regulated by GABA transporters (GATs). GAT type 1 (GAT-1) is highly expressed in the GP, and pharmacological blockade of GAT-1 increases the duration of currents mediated by GABA A receptors and induces tonic inhibition. The functional contribution of the pathway between the GP and the reticular thalamic nucleus (RTn) is unknown. This pathway is important since the RTn controls the flow of information between the thalamus and cortex, suggesting that it contributes to cortical dynamics. In this work, we investigated the effect of increased GABA levels on electrical activity in the RTn by obtaining single-unit extracellular recordings from anesthetized rats and on the motor cortex (MCx) by corticography. Our results show that high GABA levels increase the spontaneous activity rate of RTn neurons and desynchronize oscillations in the beta frequency band in the MCx. Our findings provide evidence that the GP exerts tonic control over RTn activity through the GP-reticular pathway and functionally contributes to cortical oscillation dynamics.
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Affiliation(s)
- Nelson Villalobos
- Academia de Fisiología, Escuela Superior de Medicina, Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón, Colonia Casco de Santo Tomás, 11340, Ciudad de México, Mexico. .,Sección de Estudios de Posgrado e Investigación de la Escuela Superior de Medicina, Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón, Colonia Casco de Santo Tomás, 11340, Ciudad de México, Mexico.
| | - Salvador Almazán-Alvarado
- Laboratorio de Neurofisiología del Control y la Regulación, Dirección de Investigaciones en Neurociencias, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, Mexico
| | - Victor Manuel Magdaleno-Madrigal
- Laboratorio de Neurofisiología del Control y la Regulación, Dirección de Investigaciones en Neurociencias, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, Mexico. .,Carrera de Psicología, Facultad de Estudios Superiores Zaragoza-UNAM, Ciudad de México, Mexico.
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27
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Woo KA, Kim HJ, Jeon SH, Park HR, Park KW, Lee SH, Chung SJ, Chae JH, Paek SH, Jeon B. Long-Term Outcomes of Deep Brain Stimulation in Pantothenate Kinase-Associated Neurodegeneration-Related Dystonia. J Mov Disord 2022; 15:241-248. [PMID: 35880383 DOI: 10.14802/jmd.22002] [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: 01/06/2022] [Accepted: 03/29/2022] [Indexed: 11/24/2022] Open
Abstract
Objective To investigate the long-term clinical outcomes of pallidal deep brain stimulation (GPi-DBS) in patients with pantothenate kinase-associated neurodegeneration (PKAN). Methods We reviewed the records of patients with genetically confirmed PKAN who received bilateral GPi-DBS for refractory dystonia and were clinically followed up for at least 2 years postoperatively at two centers in Korea. Pre- and postoperative Burke- Fahn-Marsden Dystonia Rating Scale motor subscale (BFMDRS-M) scores, disability subscale (BFMDRS-D) scores, and qualitative clinical information were prospectively collected. Descriptive analysis was performed for BFMDRS-M scores, BFMDRSD scores, and the orofacial, axial, and limb subscores of the BFMDRS-M at 6-12, 24-36, and 60-72 months postoperatively. Results Five classic-type, four atypical-type, and one unknown-type PKAN cases were identified. The mean preoperative BFMDRS-M score was 92.1 for the classic type and 38.5 for the atypical or unknown type, with a mean BFMDRS follow-up of 50.7 months and a clinical follow-up of 69.0 months. The mean improvements in BFMDRS-M score were 11.3%, 41.3%, and 30.5% at 6-12, 24-36, and 60-72 months, respectively. In four patients with full regular evaluations until 60-72 months, improvements in the orofacial, axial, and limb subscores persisted, but the disability scores worsened from 24-36 months post-operation compared to the baseline, mainly owing to the aggravation of eating and feeding disabilities. Conclusion The benefits of GPi-DBS on dystonia may persist for more than 5 years in PKAN. The effects on patients' subjective disability may have a shorter duration despite improvements in dystonia owing to the complex manifestations of PKAN.
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Affiliation(s)
- Kyung Ah Woo
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Han-Joon Kim
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Seung-Ho Jeon
- Department of Neurology, Jeonbuk National University Hospital, Jeonju, Korea
| | - Hye Ran Park
- Department of Neurosurgery, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Kye Won Park
- Department of Neurology, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu, Korea
| | - Seung Hyun Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sun Ju Chung
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jong-Hee Chae
- Department of Pediatrics, Pediatric Clinical Neuroscience Center, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Sun Ha Paek
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Beomseok Jeon
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
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Kim H, Jang J, Kang J, Jang S, Nam Y, Choi Y, Shin NY, Ahn KJ, Kim BS. Clinical Implications of Focal Mineral Deposition in the Globus Pallidus on CT and Quantitative Susceptibility Mapping of MRI. Korean J Radiol 2022; 23:742-751. [PMID: 35695315 PMCID: PMC9240299 DOI: 10.3348/kjr.2022.0003] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/02/2022] [Accepted: 03/23/2022] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To assess focal mineral deposition in the globus pallidus (GP) by CT and quantitative susceptibility mapping (QSM) of MRI scans and evaluate its clinical significance, particularly cerebrovascular degeneration. MATERIALS AND METHODS This study included 105 patients (66.1 ± 13.7 years; 40 male and 65 female) who underwent both CT and MRI with available QSM data between January 2017 and December 2019. The presence of focal mineral deposition in the GP on QSM (GPQSM) and CT (GPCT) was assessed visually using a three-point scale. Cerebrovascular risk factors and small vessel disease (SVD) imaging markers were also assessed. The clinical and radiological findings were compared between the different grades of GPQSM and GPCT. The relationship between GP grades and cerebrovascular risk factors and SVD imaging markers was assessed using univariable and multivariable linear regression analyses. RESULTS GPCT and GPQSM were significantly associated (p < 0.001) but were not identical. Higher GPCT and GPQSM grades showed smaller gray matter (p = 0.030 and p = 0.025, respectively) and white matter (p = 0.013 and p = 0.019, respectively) volumes, as well as larger GP volumes (p < 0.001 for both). Among SVD markers, white matter hyperintensity was significantly associated with GPCT (p = 0.006) and brain atrophy was significantly associated with GPQSM (p = 0.032) in at univariable analysis. In multivariable analysis, the normalized volume of the GP was independently positively associated with GPCT (p < 0.001) and GPQSM (p = 0.002), while the normalized volume of the GM was independently negatively associated with GPCT (p = 0.040) and GPQSM (p = 0.035). CONCLUSION Focal mineral deposition in the GP on CT and QSM might be a potential imaging marker of cerebral vascular degeneration. Both were associated with increased GP volume.
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Affiliation(s)
- Hyojin Kim
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jinhee Jang
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
| | - Junghwa Kang
- Division of Biomedical Engineering, Hankuk University of Foreign Studies, Yongin, Korea
| | - Seungun Jang
- Division of Biomedical Engineering, Hankuk University of Foreign Studies, Yongin, Korea
| | - Yoonho Nam
- Division of Biomedical Engineering, Hankuk University of Foreign Studies, Yongin, Korea
| | - Yangsean Choi
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Na-Young Shin
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kook-Jin Ahn
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Bum-Soo Kim
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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29
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Zhang X, Gao W, Cao W, Kuang L, Niu J, Guo Y, Cui D, Jiao Q, Qiu J, Su L, Lu G. Pallidal volume reduction and prefrontal-striatal-thalamic functional connectivity disruption in pediatric bipolar disorders. J Affect Disord 2022; 301:281-8. [PMID: 35031334 DOI: 10.1016/j.jad.2022.01.049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 12/14/2021] [Accepted: 01/10/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND As a crucial node of the corticolimbic model, the striatum has been demonstrated in modulating emotional cues in pediatric bipolar disorders (PBD), the striatal distinction in structure and function between PBD-I and PBD-II remains unclear. METHODS MRI data of 36 patients in PBD-I, 22 patients in PBD-II and 19 age-gender matched healthy controls (HCs) were processed. Here, we investigated structural and functional alterations of 8 subregions of striatum (bilateral nucleus accumbens, caudate, putamen and globus pallidus) by analyzing MRI data. RESULTS We found volume reduction of the right pallidum, the significant positive correlation between the number of episodes and the functional connectivity between left pallidum and right caudate in PBD-I patients, abrupted prefrontal-striatal-thalamic functional connectivity in PBD-I group and decreased functional connectivity in PBD-II relative to HCs and PBD-I. LIMITATIONS Future studies should enroll more subjects and adopt a longitudinal perspective, which could help to discover striatum structural or functional alterations during subject-specific clinical progress in different states. CONCLUSIONS Results of the present study confirmed that structural and functional abnormality of striatum may be helpful in identifying PBD clinical types as distinctive biomarkers. The interruptions of the prefrontal-striatal-thalamic circuits may provide advantageous evidence for expounding the role of striatum in bipolar disorders etiology. Thus, potential mechanisms of dysfunction striatum need to be formulated and reconceptualized with multimodal neuroimaging studies in future.
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Olivares E, Higgs MH, Wilson CJ. Local inhibition in a model of the indirect pathway globus pallidus network slows and deregularizes background firing, but sharpens and synchronizes responses to striatal input. J Comput Neurosci 2022; 50:251-272. [PMID: 35274227 DOI: 10.1007/s10827-022-00814-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 10/25/2021] [Revised: 02/17/2022] [Accepted: 02/24/2022] [Indexed: 11/24/2022]
Abstract
The external segment of globus pallidus (GPe) is a network of oscillatory neurons connected by inhibitory synapses. We studied the intrinsic dynamic and the response to a shared brief inhibitory stimulus in a model GPe network. Individual neurons were simulated using a phase resetting model based on measurements from mouse GPe neurons studied in slices. The neurons showed a broad heterogeneity in their firing rates and in the shapes and sizes of their phase resetting curves. Connectivity in the network was set to match experimental measurements. We generated statistically equivalent neuron heterogeneity in a small-world model, in which 99% of connections were made with near neighbors and 1% at random, and in a model with entirely random connectivity. In both networks, the resting activity was slowed and made more irregular by the local inhibition, but it did not show any periodic pattern. Cross-correlations among neuron pairs were limited to directly connected neurons. When stimulated by a shared inhibitory input, the individual neuron responses separated into two groups: one with a short and stereotyped period of inhibition followed by a transient increase in firing probability, and the other responding with a sustained inhibition. Despite differences in firing rate, the responses of the first group of neurons were of fixed duration and were synchronized across cells.
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Affiliation(s)
- Erick Olivares
- Department of Biology, University of Texas at San Antonio, San Antonio, TX, USA
| | - Matthew H Higgs
- Department of Biology, University of Texas at San Antonio, San Antonio, TX, USA
| | - Charles J Wilson
- Department of Biology, University of Texas at San Antonio, San Antonio, TX, USA.
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Eisinger RS, Cagle JN, Alcantara JD, Opri E, Cernera S, Le A, Torres Ponce EM, Lanese J, Nelson B, Lopes J, Hundley C, Ravy T, Wu SS, Foote KD, Okun MS, Gunduz A. Distinct Roles of the Human Subthalamic Nucleus and Dorsal Pallidum in Parkinson's Disease Impulsivity. Biol Psychiatry 2022; 91:370-379. [PMID: 33993998 PMCID: PMC8419208 DOI: 10.1016/j.biopsych.2021.03.002] [Citation(s) in RCA: 2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 02/27/2021] [Accepted: 03/01/2021] [Indexed: 11/02/2022]
Abstract
BACKGROUND Impulsivity and impulse control disorders are common in Parkinson's disease and lead to increased morbidity and reduced quality of life. Impulsivity is thought to arise from aberrant reward processing and inhibitory control, but it is unclear why deep brain stimulation of either the subthalamic nucleus (STN) or globus pallidus internus (GPi) affects levels of impulsivity. Our aim was to assess the role of the STN and GPi in impulsivity using invasive local field potential (LFP) recordings from deep brain stimulation electrodes. METHODS We measured LFPs during a simple rewarding Go/NoGo paradigm in 39 female and male human patients with Parkinson's disease manifesting variable amounts of impulsivity who were undergoing unilateral deep brain stimulation of either the STN (18 nuclei) or GPi (28 nuclei). We identified reward-specific LFP event-related potentials and correlated them to impulsivity severity. RESULTS LFPs in both structures modulated during reward-specific Go and NoGo stimulus evaluation, reward feedback, and loss feedback. Motor and limbic functions were anatomically separable in the GPi but not in the STN. Across participants, LFP reward processing responses in the STN and GPi uniquely depended on the severity of impulsivity. CONCLUSIONS This study establishes LFP correlates of impulsivity within the STN and GPi regions. We propose a model for basal ganglia reward processing that includes the bottom-up role of the GPi in reward salience and the top-down role of the STN in cognitive control.
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Affiliation(s)
- Robert S Eisinger
- Department of Neuroscience, University of Florida, Gainesville, Florida.
| | - Jackson N Cagle
- J. Crayton Pruitt Department of Biomedical Engineering, University of Florida, Gainesville, Florida
| | - Jose D Alcantara
- J. Crayton Pruitt Department of Biomedical Engineering, University of Florida, Gainesville, Florida
| | - Enrico Opri
- J. Crayton Pruitt Department of Biomedical Engineering, University of Florida, Gainesville, Florida
| | - Stephanie Cernera
- J. Crayton Pruitt Department of Biomedical Engineering, University of Florida, Gainesville, Florida
| | - Anh Le
- Department of Neuroscience, University of Florida, Gainesville, Florida
| | | | - Joseph Lanese
- Department of Neuroscience, University of Florida, Gainesville, Florida
| | - Brawn Nelson
- Department of Neuroscience, University of Florida, Gainesville, Florida
| | - Janine Lopes
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, Florida
| | | | - Tasmeah Ravy
- Department of Neuroscience, University of Florida, Gainesville, Florida
| | - Samuel S Wu
- Department of Biostatistics, University of Florida, Gainesville, Florida
| | - Kelly D Foote
- Department of Neurosurgery, Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, Florida
| | - Michael S Okun
- Department of Neuroscience, University of Florida, Gainesville, Florida; Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, Florida; Department of Neurosurgery, Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, Florida
| | - Aysegul Gunduz
- Department of Neuroscience, University of Florida, Gainesville, Florida; J. Crayton Pruitt Department of Biomedical Engineering, University of Florida, Gainesville, Florida
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Giorni A, Coyne T, Silburn PA, Mellick GD, Sah P, Windels F. Changes in pallidal neural activity following long-term symptom improvement from botulinum toxin treatment in DYT6 dystonia: a case report. J Med Case Rep 2022; 16:15. [PMID: 34998426 PMCID: PMC8742936 DOI: 10.1186/s13256-021-03215-4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 12/01/2021] [Indexed: 11/10/2022] Open
Abstract
Background The globus pallidus internus is the main target for the treatment of dystonia by deep brain stimulation. Unfortunately, for some genetic etiologies, the therapeutic outcome of dystonia is less predictable. In particular, therapeutic outcomes for deep brain stimulation in craniocervical and orolaryngeal dystonia in DYT6-positive patients are poor. Little is known about the neurophysiology of the globus pallidus internus in DYT6-positive dystonia, and how symptomatic treatment affects the neural activity of this region. Case presentation We present here the case of a 55-year-old Caucasian female DYT6-dystonic patient with blepharospasm, spasmodic dysphonia, and oromandibular dystonia where single-unit and local field potential activity was recorded from the globus pallidus internus during two deep brain stimulation revision surgeries 4 years apart with no symptomatic improvement. Botulinum toxin injections consistently improved dysphonia, while some of the other symptoms were only inconsistently or marginally improved. Neural activity in the globus pallidus internus during both revision surgeries were compared with previously published results from an idiopathic dystonic cohort. Single-cell firing characteristics and local field potential from the first revision surgery showed no differences with our control group. However, during the second revision surgery, the mean firing rate of single units and local field potential power in the gamma range were lower than those present during the first revision surgery or the control group. Conclusions Symptoms related to facial movements were greatly improved by botulinum toxin treatment between revision surgeries, which coincided with lower discharge rate and changes in gamma local field oscillations.
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Affiliation(s)
- Andrea Giorni
- Synaptic Plasticity Laboratory, The Queensland Brain Institute, The University of Queensland, Saint Lucia, QLD, 4072, Australia.,Asia Pacific Center for Neuromodulation, St Andrews War Memorial Hospital, Brisbane, QLD, Australia
| | - Terry Coyne
- Synaptic Plasticity Laboratory, The Queensland Brain Institute, The University of Queensland, Saint Lucia, QLD, 4072, Australia.,Asia Pacific Center for Neuromodulation, St Andrews War Memorial Hospital, Brisbane, QLD, Australia
| | - Peter A Silburn
- Synaptic Plasticity Laboratory, The Queensland Brain Institute, The University of Queensland, Saint Lucia, QLD, 4072, Australia.,Asia Pacific Center for Neuromodulation, St Andrews War Memorial Hospital, Brisbane, QLD, Australia
| | - George D Mellick
- Griffith Institute of Drug Discovery (GRIDD), Griffith University, Brisbane, Australia
| | - Pankaj Sah
- Synaptic Plasticity Laboratory, The Queensland Brain Institute, The University of Queensland, Saint Lucia, QLD, 4072, Australia.,Brain Research Centre and Department of Biology, Southern University of Science and Technology, Nanshan District, Shenzhen, Guangdong Province, People's Republic of China
| | - François Windels
- Synaptic Plasticity Laboratory, The Queensland Brain Institute, The University of Queensland, Saint Lucia, QLD, 4072, Australia.
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Moussawi K, Kim MJ, Baybayan S, Wood M, Mills KA. Deep brain stimulation effect on anterior pallidum reduces motor impulsivity in Parkinson's disease. Brain Stimul 2022; 15:23-31. [PMID: 34749005 PMCID: PMC8816820 DOI: 10.1016/j.brs.2021.11.006] [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] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 10/09/2021] [Accepted: 11/04/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Deep Brain Stimulation (DBS) of the subthalamic nucleus or globus pallidus internus is used to treat the motor symptoms of Parkinson's disease. The former can worsen impulsive and compulsive behaviors after controlling for the reduction of dopaminergic medications. However, the effect of pallidal DBS on such behaviors in PD patients is less clear. OBJECTIVE/HYPOTHESIS We hypothesized that greater stimulation spread to the pallidum with prefrontal connectivity would reduce motor impulsivity. METHODS Seven Parkinson's patients with stable globus pallidus internus DBS settings for 3 months, disease duration of 13 ± 1.3 years, and Montreal Cognitive Assessment of 26.8 ± 1.1 each had two stimulation settings defined based on reconstructions of lead placement and volume of tissue activation targeting either a dorsal or ventral position along the DBS electrode but still within the globus pallidus internus. Subjects performed a stop signal reaction time task with the DBS turned off vs. on in each of the defined stimulation settings, which was correlated with the degree of stimulation effect on pallidal subregions. RESULTS A shorter distance between the volume of tissue activation and the right prefrontally-connected GPi correlated with less impulsivity on the stop signal reaction time task (r = 0.69, p < 0.05). Greater volume of tissue activation overlap with the non-prefrontally-connected globus pallidus internus was associated with increased impulsivity. CONCLUSION These data can be leveraged to optimize DBS programming in PD patients with problematic impulsivity or in other disorders involving impulsive behaviors such as substance use disorders.
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Affiliation(s)
- Khaled Moussawi
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
- Corresponding Author: Kelly A. Mills, Johns Hopkins University School of Medicine, Dept. of Neurology, Meyer 6-181D, 600 N. Wolfe Street, Baltimore, MD 21287, Phone: 410-502-0133,
| | - Min Jae Kim
- Department of Neurology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
- Department of Biomedical Engineering, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Sydney Baybayan
- Department of Neurology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Myles Wood
- Department of Neurology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Kelly A. Mills
- Department of Neurology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
- Corresponding Author: Kelly A. Mills, Johns Hopkins University School of Medicine, Dept. of Neurology, Meyer 6-181D, 600 N. Wolfe Street, Baltimore, MD 21287, Phone: 410-502-0133,
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Lee SH, Lee J, Kim MS, Hwang YS, Jo S, Park KW, Jeon SR, Chung SJ. Factors correlated with therapeutic effects of globus pallidus deep brain stimulation on freezing of gait in advanced Parkinson's disease: A pilot study. Parkinsonism Relat Disord 2021; 94:111-116. [PMID: 34915449 DOI: 10.1016/j.parkreldis.2021.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/06/2021] [Accepted: 12/07/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Deep brain stimulation (DBS) has showed variable therapeutic effect on freezing of gait (FOG) in Parkinson's disease (PD). It is unclear which factors associated with the effect of DBS on FOG in patients with advanced PD. In this study, we investigated the correlation of pre and postoperative factors with the therapeutic effect of globus pallidus interna (GPi) DBS on FOG in PD patients. METHODS We retrospectively analyzed PD patients with FOG (N = 20) who underwent GPi DBS surgery. Postoperatively, video-based analysis for FOG severity was performed at the first DBS programming and patients were categorized into two groups according to DBS effect on FOG (11 FOG responders and 9 FOG non-responders) at medication-off state. We analyzed preoperative clinical characteristics, cognitive function, striatal dopamine transporter availability, postoperative DBS programming parameters, lead locations, and volume of tissue activated in functional subregions of GPi. Bootstrap enhanced Elastic-Net logistic regression was used to select pre and postoperative factors associated with the effect of GPi DBS. RESULTS Therapeutic effect of GPi DBS on FOG were correlated with the disease duration of PD before DBS surgery, preoperative improvement in FOG severity by levodopa medication, and the distance from active contact of DBS electrode to the prefrontal region of GPi anatomical site. CONCLUSIONS Our study results suggest that the effect of GPi DBS on FOG is correlated with disease duration, levodopa responsiveness on FOG before DBS surgery and DBS electrode location, providing useful information to predict FOG outcome after GPi DBS in PD patients.
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Affiliation(s)
- Seung Hyun Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jooyoung Lee
- Department of Applied Statistics, Chung-Ang University, Seoul, South Korea
| | - Mi Sun Kim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Yun Su Hwang
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Sungyang Jo
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Kye Won Park
- Department of Neurology, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu-si, South Korea
| | - Sang Ryong Jeon
- Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Sun Ju Chung
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
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Barón-Quiroz K, García-Ramirez M, Chuc-Meza E. Dopaminergic denervation of the globus pallidus produces short-memory impairment in rats. Physiol Behav 2021; 240:113535. [PMID: 34303714 DOI: 10.1016/j.physbeh.2021.113535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 04/15/2021] [Revised: 07/13/2021] [Accepted: 07/19/2021] [Indexed: 10/20/2022]
Abstract
Rats with low-level globus pallidus (GP) dopaminergic denervation can develop anxiety without any motor alterations. The aim of this study was to evaluate the effect of low-level 6-OHDA-induced unilateral and bilateral GP lesions in male Wistar rats (n = 8/group) on recognition memory, motor activity, and the number of TH+ neurons in the SNc. For unilateral- and bilateral-lesioned animals, there was a significant decrease in the number of TH+ neurons (27% and 42%, respectively) and in the object, location, and temporal order discrimination indexes of recognition memory tests. Motor activity was unaffected. Thus, GP dopamine denervation was detrimental to short-memory.
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Affiliation(s)
- Katia Barón-Quiroz
- Unidad Profesional Interdisciplinaria de Biotecnología, Instituto Politécnico Nacional, Av. Acueducto, La Laguna Ticoman, CP 07340, Ciudad de México, México
| | - Martha García-Ramirez
- Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Wilfrido Massieu sn, San Pedro Zacatenco, CP 07738, Ciudad de México, México
| | - Eliezer Chuc-Meza
- Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Wilfrido Massieu sn, San Pedro Zacatenco, CP 07738, Ciudad de México, México.
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Hong SI, Kang S, Baker M, Choi DS. Astrocyte-neuron interaction in the dorsal striatum-pallidal circuits and alcohol-seeking behaviors. Neuropharmacology 2021; 198:108759. [PMID: 34433087 DOI: 10.1016/j.neuropharm.2021.108759] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 05/26/2021] [Revised: 07/21/2021] [Accepted: 08/11/2021] [Indexed: 12/31/2022]
Abstract
In the striatum, two main types of GABAergic medium spiny neurons (MSNs), denoted striatonigral (or direct-pathway MSNs, dMSNs) and striatopallidal neurons (indirect-pathway MSNs, iMSNs), form circuits with distinct pallidal nuclei, which sends "GO" or "NO-GO" signals through the thalamus. These striatopallidal circuits evaluate and execute reward-seeking and taking behaviors. Especially, the dorsal striatum can be further divided into the dorsomedial striatum (DMS, equivalent to caudate in primates and humans) and dorsolateral striatum (DLS, equivalent to putamen), which orchestrates goal-directed and habitual reward-seeking and taking behaviors, respectively. Using optogenetics, chemogenetics and in vivo calcium imaging technologies combined with electrophysiology and digitalized behavior phenotyping, recent studies have revealed cell-, circuit- and context-specific functions of these microcircuits in addictive behaviors. Also, region-specific astrocytes regulate the homeostatic activities of the dMSNs and iMSNs as well as the downstream circuits, which determine the net balance of cortico-striato-pallidal activities to the thalamic neurons. This review will summarize the recent progress of striatopallidal circuits focusing on astrocyte-neuron interaction and, reward- and alcohol-seeking behaviors. Our review will also discuss the translational and clinical implications of these microcircuit studies. This article is part of the special Issue on "Neurocircuitry Modulating Drug and Alcohol Abuse".
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Affiliation(s)
- Sa-Ik Hong
- Department of Molecular Pharmacology and Experimental Therapeutics, Rochester, MN, 55905, USA
| | - Seungwoo Kang
- Department of Molecular Pharmacology and Experimental Therapeutics, Rochester, MN, 55905, USA
| | - Matthew Baker
- Department of Molecular Pharmacology and Experimental Therapeutics, Rochester, MN, 55905, USA
| | - Doo-Sup Choi
- Department of Molecular Pharmacology and Experimental Therapeutics, Rochester, MN, 55905, USA; Department of Psychiatry and Psychology, Mayo Clinic College of Medicine and Science, Rochester, MN, 55905, USA.
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Bonomo R, Elia AE, Bonomo G, Romito LM, Mariotti C, Devigili G, Cilia R, Giossi R, Eleopra R. Deep brain stimulation in Huntington's disease: a literature review. Neurol Sci 2021; 42:4447-4457. [PMID: 34471947 DOI: 10.1007/s10072-021-05527-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 07/25/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Huntington's disease (HD) is a neurodegenerative disorder characterized by involuntary movements, cognitive decline, and behavioral changes. The complex constellation of clinical symptoms still makes the therapeutic management challenging. In the new era of functional neurosurgery, deep brain stimulation (DBS) may represent a promising therapeutic approach in selected HD patients. METHODS Articles describing the effect of DBS in patients affected by HD were selected from Medline and PubMed by the association of text words with MeSH terms as follows: "Deep brain stimulation," "DBS," and "HD," "Huntington's disease," and "Huntington." Details on repeat expansion, age at operation, target of operation, duration of follow-up, stimulation parameters, adverse events, and outcome measures were collected. RESULTS Twenty eligible studies, assessing 42 patients with HD, were identified. The effect of globus pallidus internus (GPi) DBS on Unified Huntington's Disease Rating Scale (UHDRS) total score revealed in 10 studies an improvement of total score from 5.4 to 34.5%, and in 4 studies, an increase of motor score from 3.8 to 97.8%. Bilateral GPi-DBS was reported to be effective in reducing Chorea subscore in all studies, with a mean percentage reduction from 21.4 to 73.6%. CONCLUSIONS HD patients with predominant choreic symptoms may be the best candidates for surgery, but the role of other clinical features and of disease progression should be elucidated. For this reason, there is a need for more reliable criteria that may guide the selection of HD patients suitable for DBS. Accordingly, further studies including functional outcomes as primary endpoints are needed.
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Affiliation(s)
- Roberta Bonomo
- Department of Clinical Neurosciences, Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, Milan, Italy
- Experimental Neurology Unit, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Antonio E Elia
- Department of Clinical Neurosciences, Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, Milan, Italy.
| | - Giulio Bonomo
- Neurosurgery Department, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Luigi M Romito
- Department of Clinical Neurosciences, Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, Milan, Italy
| | - Caterina Mariotti
- Unit of Medical Genetics, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Grazia Devigili
- Department of Clinical Neurosciences, Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, Milan, Italy
| | - Roberto Cilia
- Department of Clinical Neurosciences, Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, Milan, Italy
| | - Riccardo Giossi
- Neuroimmunology and Neuromuscular Diseases Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
- Department of Oncology and Onco-Hematology, Postgraduate School of Clinical Pharmacology and Toxicology, University of Milan, Milan, Italy
| | - Roberto Eleopra
- Department of Clinical Neurosciences, Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, Milan, Italy
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Okumura A, Kitai Y, Arai H, Hayakawa M, Maruo Y, Kusaka T, Kunikata T, Kumada S, Morioka I. Magnetic Resonance Imaging Findings in Preterm Infants With Bilirubin Encephalopathy Beyond Three Years Corrected Age. Pediatr Neurol 2021; 121:56-58. [PMID: 34153814 DOI: 10.1016/j.pediatrneurol.2021.05.019] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 05/18/2021] [Accepted: 05/23/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Magnetic resonance imaging (MRI) abnormalities in preterm infants with bilirubin encephalopathy (BE) become less clear as the infants age. We assessed MRI findings in children with preterm BE older than 36 months corrected age (CA). METHODS In a previous questionnaire survey, hospitals were asked to provide head MRI data of patients older than 36 months CA. MRI findings were reviewed by three pediatric neurology specialists and classified as no abnormalities, partial globus pallidus (GP) lesions, or diffuse GP lesions. RESULTS In total, 33 MRI scans were available from 28 patients. The median gestational age and birth weight were 26 weeks and 824 g, respectively. The prevalence of MRI abnormalities was 100% in patients at 37 to 48 months CA, 71% in those at 49 to 60 months CA, 50% in those at 61 to 72 months CA, 67% in those at 73 to 84 months CA, and 38% in those at 85 months CA or older. Partial GP lesions were more common than diffuse GP lesions at all ages. No significant differences in sex, gestational age, birth weight, or gross motor function impairment were observed among lesion groups. CONCLUSIONS GP lesions were detected on MRI in most children with preterm BE when studied after 36 months CA, although MRI abnormalities became less apparent along with age. Partial GP lesions may be a characteristic of older children with preterm BE.
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Affiliation(s)
- Akihisa Okumura
- Department of Pediatrics, Aichi Medical University, Nagakute, Aichi, Japan.
| | - Yukihiro Kitai
- Department of Pediatric Neurology, Bobath Memorial Hospital, Joto-ku, Osaka, Japan
| | - Hiroshi Arai
- Department of Pediatric Neurology, Bobath Memorial Hospital, Joto-ku, Osaka, Japan
| | - Masahiro Hayakawa
- Division of Neonatology, Center for Maternal-Neonatal Care, Nagoya University Hospital, Showa-ku, Nagoya, Japan
| | - Yoshihiro Maruo
- Department of Pediatrics, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Takashi Kusaka
- Department of Pediatrics, Faculty of Medicine, Kagawa University, Kita-gun, Kagawa, Japan
| | - Tetsuya Kunikata
- Division of Neonatal Medicine, Department of Pediatrics, Saitama Medical University Hospital, Iruma-gun, Saitama, Japan
| | - Satoko Kumada
- Department of Neuropediatrics, Tokyo Metropolitan Neurological Hospital, Fuchu, Tokyo, Japan
| | - Ichiro Morioka
- Department of Pediatrics and Child Health, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan
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Krug KB, Burke CJ, Weiss K, Baltzer PAT, Rhiem K, Maintz D, Schlamann M, Hellmich M. Influence of aging and gadolinium exposure on T1, T2, and T2*-relaxation in healthy women with an increased risk of breast cancer with and without prior exposure to gadoterate meglumine at 3.0-T brain MR imaging. Eur Radiol 2021. [PMID: 34218287 DOI: 10.1007/s00330-021-08069-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 04/30/2021] [Accepted: 05/11/2021] [Indexed: 11/09/2022]
Abstract
Objectives We examined the effects of aging and of gadolinium-based contrast agent (GBCA) exposure on MRI measurements in brain nuclei of healthy women. Methods This prospective, IRB-approved single-center case-control study enrolled 100 healthy participants of our high-risk screening center for hereditary breast cancer, who had received at least six doses of macrocyclic GBCA (exposed group) or were newly entering the program (GBCA-naïve group). The cutoff “at least six doses” was chosen to be able to include a sufficient number of highly exposed participants. All participants underwent unenhanced 3.0-T brain MRI including quantitative T1, T2, and R2* mapping and T1- and T2-weighted imaging. The relaxation times/signal intensities were derived from region of interest measurements in the brain nuclei performed by a radiologist and a neuroradiologist, both board certified. Statistical analysis was based on descriptive evaluations and uni-/multivariable analyses. Results The participants (exposed group: 49, control group: 51) were aged 42 ± 9 years. In a multivariable model, age had a clear impact on R2* (p < 0.001–0.012), T2 (p = 0.003–0.048), and T1 relaxation times/signal intensities (p < 0.004–0.046) for the majority of deep brain nuclei, mostly affecting the substantia nigra, globus pallidus (GP), nucleus ruber, thalamus, and dentate nucleus (DN). The effect of prior GBCA administration on T1 relaxation times was statistically significant for the DN, GP, and pons (p = 0.019–0.037). Conclusions In a homogeneous group of young to middle-aged healthy females aging had an effect on T2 and R2* relaxation times and former GBCA applications influenced the measured T1 relaxation times. Key Points The quantitative T1, T2, and R2* relaxation times measured in women at high risk of developing breast cancer showed characteristic bandwidth for all brain nuclei examined at 3.0-T MRI. The effect of participant age had a comparatively strong impact on R2*, T2, and T1 relaxation times for the majority of brain nuclei examined. The effect of prior GBCA administrations on T1 relaxation times rates was comparatively less pronounced, yielding statistically significant results for the dentate nucleus, globus pallidus, and pons.
Summary statement Healthy women with and without previous GBCA-enhanced breast MRI exhibited age-related T2* and T2 relaxation alterations at 3.0 T-brain MRI. T1 relaxation alterations due to prior GBCA administration were comparatively less pronounced. Supplementary Information The online version contains supplementary material available at 10.1007/s00330-021-08069-4.
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Heerdegen M, Zwar M, Franz D, Hörnschemeyer MF, Neubert V, Plocksties F, Niemann C, Timmermann D, Bahls C, van Rienen U, Paap M, Perl S, Lüttig A, Richter A, Köhling R. Mechanisms of pallidal deep brain stimulation: Alteration of cortico-striatal synaptic communication in a dystonia animal model. Neurobiol Dis 2021; 154:105341. [PMID: 33753292 DOI: 10.1016/j.nbd.2021.105341] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 03/02/2021] [Accepted: 03/15/2021] [Indexed: 10/21/2022] Open
Abstract
Pallidal deep brain stimulation (DBS) is an important option for patients with severe dystonias, which are thought to arise from a disturbance in striatal control of the globus pallidus internus (GPi). The mechanisms of GPi-DBS are far from understood. Although a disturbance of striatal function is thought to play a key role in dystonia, the effects of DBS on cortico-striatal function are unknown. We hypothesised that DBS, via axonal backfiring, or indirectly via thalamic and cortical coupling, alters striatal function. We tested this hypothesis in the dtsz hamster, an animal model of inherited generalised, paroxysmal dystonia. Hamsters (dystonic and non-dystonic controls) were bilaterally implanted with stimulation electrodes in the GPi. DBS (130 Hz), and sham DBS, were performed in unanaesthetised animals for 3 h. Synaptic cortico-striatal field potentials, as well as miniature excitatory postsynaptic currents (mEPSC) and firing properties of medium spiny striatal neurones were recorded in brain slice preparations obtained immediately after EPN-DBS. The main findings were as follows: a. DBS increased cortico-striatal evoked responses in healthy, but not in dystonic tissue. b. Commensurate with this, DBS increased inhibitory control of these evoked responses in dystonic, and decreased inhibitory control in healthy tissue. c. Further, DBS reduced mEPSC frequency strongly in dystonic, and less prominently in healthy tissue, showing that also a modulation of presynaptic mechanisms is likely involved. d. Cellular properties of medium-spiny neurones remained unchanged. We conclude that DBS leads to dampening of cortico-striatal communication, and restores intrastriatal inhibitory tone.
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Affiliation(s)
- Marco Heerdegen
- Oscar Langendorff Institute of Physiology, Rostock University Medical Center, Germany
| | - Monique Zwar
- Oscar Langendorff Institute of Physiology, Rostock University Medical Center, Germany
| | - Denise Franz
- Oscar Langendorff Institute of Physiology, Rostock University Medical Center, Germany
| | | | - Valentin Neubert
- Oscar Langendorff Institute of Physiology, Rostock University Medical Center, Germany
| | - Franz Plocksties
- Institute of Applied Microelectronics and Computer Engineering, Faculty of Computer Science and Electrical Engineering, University of Rostock, Germany
| | - Christoph Niemann
- Institute of Applied Microelectronics and Computer Engineering, Faculty of Computer Science and Electrical Engineering, University of Rostock, Germany
| | - Dirk Timmermann
- Institute of Applied Microelectronics and Computer Engineering, Faculty of Computer Science and Electrical Engineering, University of Rostock, Germany
| | - Christian Bahls
- Institute of General Electrical Engineering, Faculty of Computer Science and Electrical Engineering, University of Rostock, Germany
| | - Ursula van Rienen
- Institute of General Electrical Engineering, Faculty of Computer Science and Electrical Engineering, University of Rostock, Germany; Department Life, Light & Matter, University of Rostock, Germany
| | - Maria Paap
- Institute of Pharmacology, Pharmacy und Toxicology, Faculty of Veterinary Medicine, University of Leipzig, Germany
| | - Stefanie Perl
- Institute of Pharmacology, Pharmacy und Toxicology, Faculty of Veterinary Medicine, University of Leipzig, Germany
| | - Anika Lüttig
- Institute of Pharmacology, Pharmacy und Toxicology, Faculty of Veterinary Medicine, University of Leipzig, Germany
| | - Angelika Richter
- Institute of Pharmacology, Pharmacy und Toxicology, Faculty of Veterinary Medicine, University of Leipzig, Germany
| | - Rüdiger Köhling
- Oscar Langendorff Institute of Physiology, Rostock University Medical Center, Germany; Department of Ageing of Individuals and Society, University of Rostock, Germany.
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Giovanniello J, Ahrens S, Yu K, Li B. Sex-Specific Stress-Related Behavioral Phenotypes and Central Amygdala Dysfunction in a Mouse Model of 16p11.2 Microdeletion. Biol Psychiatry Glob Open Sci 2021; 1:59-69. [PMID: 36324434 PMCID: PMC9616311 DOI: 10.1016/j.bpsgos.2021.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/08/2021] [Accepted: 01/26/2021] [Indexed: 12/27/2022] Open
Abstract
Background Substantial evidence indicates that a microdeletion on human chromosome 16p11.2 is linked to neurodevelopmental disorders, including autism spectrum disorder (ASD). Carriers of this deletion show divergent symptoms besides the core features of autism spectrum disorder, such as anxiety and emotional symptoms. The neural mechanisms underlying these symptoms are poorly understood. Methods We used mice heterozygous for a deletion allele of the genomic region corresponding to the human 16p11.2 microdeletion locus (i.e., 16p11.2 del/+ mice) and their sex-matched wild-type littermates for the study and examined their anxiety-related behaviors, auditory perception, and central amygdala circuit function using behavioral, circuit tracing, and electrophysiological techniques. Results Mice heterozygous for a deletion allele of the genomic region corresponding to the human 16p11.2 microdeletion locus (i.e., 16p11.2 del/+ mice) had sex-specific anxiety-related behavioral and neural circuit changes. Specifically, we found that female, but not male, 16p11.2 del/+ mice showed enhanced fear generalization-a hallmark of anxiety disorders-after auditory fear conditioning and displayed increased anxiety-like behaviors after physical restraint stress. Notably, such sex-specific behavioral changes were paralleled by an increase in activity in central amygdala neurons projecting to the globus pallidus in female, but not male, 16p11.2 del/+ mice. Conclusions Together, these results reveal female-specific anxiety phenotypes related to 16p11.2 microdeletion syndrome and a potential underlying neural circuit mechanism. Our study therefore identifies previously underappreciated sex-specific behavioral and neural changes in a genetic model of 16p11.2 microdeletion syndrome and highlights the importance of investigating female-specific aspects of this syndrome for targeted treatment strategies.
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Affiliation(s)
- Jacqueline Giovanniello
- School of Biological Sciences, Cold Spring Harbor, New York
- Cold Spring Harbor Laboratory, Cold Spring Harbor, New York
| | - Sandra Ahrens
- Cold Spring Harbor Laboratory, Cold Spring Harbor, New York
| | - Kai Yu
- Cold Spring Harbor Laboratory, Cold Spring Harbor, New York
| | - Bo Li
- School of Biological Sciences, Cold Spring Harbor, New York
- Cold Spring Harbor Laboratory, Cold Spring Harbor, New York
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Oyama J, Yokoyama K, Fujioka T, Nariai T, Karakama J, Maehara T, Tateishi U. Incidental T2 hyperintensities in the medial part of the bilateral globus pallidus are possibly an age-related physiological finding. Neuroradiol J 2021; 34:575-584. [PMID: 33949230 DOI: 10.1177/19714009211014129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND AND PURPOSE Bilateral T2 hyperintensities in the medial part of the globus pallidus (GP) are sometimes incidentally observed in patients without a known history of diseases that present with such lesions. The purpose of this study was to evaluate the frequency of this finding and the association between this finding and age, lifestyle diseases and GP calcification. METHODS We retrospectively investigated the brain magnetic resonance imaging (MRI) of 742 patients, which included between 104 and 108 consecutive patients from each decade of life between the 20s and 80s. The signal intensity ratio of the medial part to the lateral part of the GP in T2-weighted images (T2 medial/lateral ratio) was evaluated. For cases in which brain computed tomography images were available (N=437), GP calcifications were also evaluated. The associations between the T2 medial/lateral ratio and age, sex, history of lifestyle diseases and GP calcification were investigated. RESULTS Bilateral T2 medial/lateral ratios >1.10, 1.30 and 1.50 were observed in 29.8%, 7.1% and 1.8% of all cases, respectively. A high bilateral T2 medial/lateral ratio was observed less frequently in young patients (p<0.01), more frequently in elderly patients and those with hypertension or dyslipidaemia (p<0.05) and more frequently in patients with a calcified GP (p<0.01). CONCLUSION Incidental bilateral T2 hyperintensities in the medial part of the GP on brain MRI are most likely an age-related physiological finding.
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Affiliation(s)
- Jun Oyama
- Department of Diagnostic Radiology and Nuclear Medicine, Tokyo Medical and Dental University, Japan
| | - Kota Yokoyama
- Department of Diagnostic Radiology and Nuclear Medicine, Tokyo Medical and Dental University, Japan
| | - Tomoyuki Fujioka
- Department of Diagnostic Radiology and Nuclear Medicine, Tokyo Medical and Dental University, Japan
| | - Tadashi Nariai
- Department of Neurosurgery, Tokyo Medical and Dental University, Japan
| | - Jun Karakama
- Department of Neurosurgery, Tokyo Medical and Dental University, Japan
| | - Taketoshi Maehara
- Department of Neurosurgery, Tokyo Medical and Dental University, Japan
| | - Ukihide Tateishi
- Department of Diagnostic Radiology and Nuclear Medicine, Tokyo Medical and Dental University, Japan
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Sedov A, Usova S, Semenova U, Gamaleya A, Tomskiy A, Beylergil SB, Jinnah HA, Shaikh AG. Pallidal Activity in Cervical Dystonia with and Without Head Tremor. Cerebellum 2021; 19:409-418. [PMID: 32095996 DOI: 10.1007/s12311-020-01119-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The relationship between two common movement disorders, dystonia and tremor, is controversial. Both deficits have correlates in the network that includes connections between the cerebellum and the basal ganglia. In order to assess the physiological relationship between tremor and dystonia, we measured the activity of 727 pallidal single-neurons during deep brain stimulation surgery in patients with cervical dystonia without head oscillations, cervical dystonia plus jerky oscillations, and cervical dystonia with sinusoidal oscillations. Cluster analyses of spike-train recordings allowed classification of the pallidal activity into burst, pause, and tonic. Burst neurons were more common, and number of spikes within spike and inter-burst intervals was shorter in pure dystonia and jerky oscillation groups compared to the sinusoidal oscillation group. Pause neurons were more common and irregular in pure tremor group compared to pure dystonia and jerky oscillation groups. There was bihemispheric asymmetry in spontaneous firing discharge in pure dystonia and jerky oscillation groups, but not in sinusoidal oscillation group. These results demonstrate that the physiology of pallidal neurons in patients with pure cervical dystonia is similar to those who have cervical dystonia combined with jerky oscillations, but different from those who have cervical dystonia combined with sinusoidal oscillations. These results imply distinct mechanistic underpinnings for different types of head oscillations in cervical dystonia.
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Affiliation(s)
- Alexey Sedov
- Semenov Institute of chemical physics, Russian Academy of Sciences, Moscow, Russia.,Moscow Institute of physics and technology, Moscow, Dolgoprudny, Russia
| | - Svetlana Usova
- Semenov Institute of chemical physics, Russian Academy of Sciences, Moscow, Russia
| | - Ulia Semenova
- Semenov Institute of chemical physics, Russian Academy of Sciences, Moscow, Russia
| | - Anna Gamaleya
- N .N. Burdenko National Scientific and Practical Center for Neurosurgery, Moscow, Russia
| | - Alexey Tomskiy
- N .N. Burdenko National Scientific and Practical Center for Neurosurgery, Moscow, Russia
| | - Sinem B Beylergil
- Departments of Neurology and Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - H A Jinnah
- Department of Neurology, Pediatrics, and Genetics, Emory University, Atlanta, GA, USA
| | - Aasef G Shaikh
- Departments of Neurology and Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA. .,Neurological Institute, University Hospitals, Cleveland, OH, USA. .,Neurology Service, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA. .,Department of Neurology, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH, 44106, USA.
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Hannoun S, Kocevar G, Codjia P, Maucort-Boulch D, Cotton F, Vukusic S, Durand-Dubief F, Sappey-Marinier D. Signal Intensity Evaluation in the Dentate Nucleus and Subcortical Gray Matter : Effect of Several Administrations of Gadoterate Meglumine in Multiple Sclerosis. Clin Neuroradiol 2021; 32:677-685. [PMID: 33630120 DOI: 10.1007/s00062-021-00995-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 07/15/2020] [Accepted: 01/15/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE Several studies reported gadolinium deposition in the dentate nuclei (DN) and the globus pallidus (GP) that was associated to linear GBCA administrations rather than macrocyclic. It is therefore imperative to evaluate and assess the safety of cumulative administration of gadoterate meglumine (macrocyclic). Thus, T1-weighted images (T1WI) of multiple sclerosis (MS) patients longitudinally followed for 4 years were retrospectively analyzed. METHODS In this study 44 patients, 10 with clinically isolated syndrome (CIS), 24 relapsing-remitting MS (RRMS) and 10 primary-progressive MS (PPMS) were examined every 6 months (first four scans) and then with a 1-year interval (last two scans). Image processing consisted in reorienting unenhanced T1WI to standard space, followed by B1 inhomogeneity correction. A patient-specific template was then generated to normalize T1WI signal intensity (SI) and segment the DN and subcortical GM structures. All structures were then transformed to each patient space in order to measure the SI in each region. The cerebellar peduncles (CP) and semi-oval (SO) white matter were then manually delineated and used as reference to calculate SI ratios in the DN and subcortical GM structures. A linear mixed-effect model was finally applied to longitudinally analyze SI variations. RESULTS The SI measurements performed in all structures showed no significant increases with the cumulative GBCA administration. CONCLUSION This study showed no significant SI increases within the DN and subcortical GM structures of longitudinally followed MS patients even with the cumulative administration of the macrocyclic GBCA gadoterate meglumine.
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Affiliation(s)
- Salem Hannoun
- Medical Imaging Sciences Program, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Gabriel Kocevar
- CREATIS-CNRS UMR5220 & INSERM U1206, INSA-Lyon, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France.,Datascience pole, Seenovate, Lyon, France
| | - Pekes Codjia
- Service de Neurologie A, Hôpital Neurologique, Hospices Civils de Lyon, Bron, France
| | | | - François Cotton
- CREATIS-CNRS UMR5220 & INSERM U1206, INSA-Lyon, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France.,Service de Radiologie, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - Sandra Vukusic
- Service de Neurologie A, Hôpital Neurologique, Hospices Civils de Lyon, Bron, France
| | - Françoise Durand-Dubief
- CREATIS-CNRS UMR5220 & INSERM U1206, INSA-Lyon, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France.,Service de Neurologie A, Hôpital Neurologique, Hospices Civils de Lyon, Bron, France
| | - Dominique Sappey-Marinier
- CREATIS-CNRS UMR5220 & INSERM U1206, INSA-Lyon, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France. .,CERMEP-Imagerie du Vivant, Université de Lyon, Bron, France.
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Bai X, Vajkoczy P, Faust K. Morphological Abnormalities in the Basal Ganglia of Dystonia Patients. Stereotact Funct Neurosurg 2021; 99:351-362. [PMID: 33472209 DOI: 10.1159/000512599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 06/04/2020] [Accepted: 10/23/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The pathophysiology of dystonia is poorly understood. As opposed to secondary forms of dystonia, primary dystonia has long been believed to lack any neuroanatomical substrate. During trajectory planning for DBS, however, conspicuous T2-hyperinstensive signal alterations (SA) were registered within the target region, even in young patients, where ischemia is rare. METHODS Fifty MRIs of primary dystonia patients scheduled for DBS were analyzed. Total basal ganglia (BG) volumes, as well as proportionate SA volumes, were measured and compared to 50 age-matched control patients. RESULTS There was a 10-fold preponderance of percentaged SA within the globus pallidus (GP) in dystonia patients. The greatest disparity was in young patients <25 years. Also, total BG volume differences were observed with larger GP and markedly smaller putamen and caudate in the dystonia group. CONCLUSIONS BG morphology in primary dystonia differed from a control population. Volume reductions of the putamen and caudate may reflect functional degeneration, while volume increases of the GP may indicate overactivity. T2-hyperintensive SA in the GP of young primary dystonia patients, where microvascular lesions are highly unlikely, are striking. Their pathogenic role remains unclear.
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Affiliation(s)
- Xi Bai
- Department of Neurosurgery, Charité University Clinic, Berlin, Germany
| | - Peter Vajkoczy
- Department of Neurosurgery, Charité University Clinic, Berlin, Germany
| | - Katharina Faust
- Department of Neurosurgery, Charité University Clinic, Berlin, Germany,
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Lotz A, Pesch B, Casjens S, Lehnert M, Zschiesche W, Taeger D, Yeh CL, Weiss T, Schmidt-Wilcke T, Quetscher C, Gabriel S, Zella MAS, Woitalla D, Dydak U, van Thriel C, Brüning T, Behrens T. Association of exposure to manganese and fine motor skills in welders - Results from the WELDOX II study. Neurotoxicology 2021; 82:137-45. [PMID: 33301826 DOI: 10.1016/j.neuro.2020.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 10/23/2020] [Accepted: 12/02/2020] [Indexed: 11/20/2022]
Abstract
The aim of this study was to evaluate the effect of exposure to manganese (Mn) on fine motor functions. A total of 48 welders and 30 unexposed workers as controls completed questionnaires, underwent blood examinations, and a motor test battery. The shift exposure of welders to respirable Mn was measured with personal samplers. For all subjects accumulations of Mn in the brain were assessed with T1-weighted magnetic resonance imaging. Welders showed normal motor functions on the Movement Disorder Society-Sponsored Revision of the Unified Parkinson Disease Rating Scale part III. Furthermore welders performed excellent on a steadiness test, showing better results than controls. However, welders were slightly slower than controls in motor tests. There was no association between fine motor test results and the relaxation rates R1 in globus pallidus and substantia nigra as MRI-based biomarkers to quantify Mn deposition in the brain.
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Stepler KE, Mahoney ER, Kofler J, Hohman TJ, Lopez OL, Robinson RAS. Inclusion of African American/Black adults in a pilot brain proteomics study of Alzheimer's disease. Neurobiol Dis 2020; 146:105129. [PMID: 33049317 PMCID: PMC7990397 DOI: 10.1016/j.nbd.2020.105129] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 07/31/2020] [Accepted: 10/02/2020] [Indexed: 12/13/2022] Open
Abstract
Alzheimer's disease (AD) disproportionately affects certain racial and ethnic subgroups, such as African American/Black and Hispanic adults. Genetic, comorbid, and socioeconomic risk factors contribute to this disparity; however, the molecular contributions have been largely unexplored. Herein, we conducted a pilot proteomics study of postmortem brains from African American/Black and non-Hispanic White adults neuropathologically diagnosed with AD compared to closely-matched cognitively normal individuals. Examination of hippocampus, inferior parietal lobule, and globus pallidus regions using quantitative proteomics resulted in 568 differentially-expressed proteins in AD. These proteins were consistent with the literature and included glial fibrillary acidic protein, peroxiredoxin-1, and annexin A5. In addition, 351 novel proteins in AD were identified, which could partially be due to cohort diversity. From linear regression analyses, we identified 185 proteins with significant race x diagnosis interactions across various brain regions. These differences generally were reflective of differential expression of proteins in AD that occurred in only a single racial/ethnic group. Overall, this pilot study suggests that disease understanding can be furthered by including diversity in racial/ethnic groups; however, this must be done on a larger scale.
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Affiliation(s)
- Kaitlyn E Stepler
- Department of Chemistry, Vanderbilt University, Nashville, TN 37235, United States of America
| | - Emily R Mahoney
- Vanderbilt Memory & Alzheimer's Center, Vanderbilt University Medical Center, Nashville, TN 37212, United States of America; Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN 37232, United States of America
| | - Julia Kofler
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, United States of America
| | - Timothy J Hohman
- Vanderbilt Memory & Alzheimer's Center, Vanderbilt University Medical Center, Nashville, TN 37212, United States of America; Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN 37232, United States of America; Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37232, United States of America; Vanderbilt Brain Institute, Vanderbilt University Medical Center, Nashville, TN 37232, United States of America
| | - Oscar L Lopez
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA 15213, United States of America; Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15213, United States of America
| | - Renã A S Robinson
- Department of Chemistry, Vanderbilt University, Nashville, TN 37235, United States of America; Vanderbilt Memory & Alzheimer's Center, Vanderbilt University Medical Center, Nashville, TN 37212, United States of America; Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37232, United States of America; Vanderbilt Brain Institute, Vanderbilt University Medical Center, Nashville, TN 37232, United States of America; Vanderbilt Institute of Chemical Biology, Vanderbilt University, Nashville, TN 37232, United States of America.
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Mercado-Pimentel R, Piedimonte F, Micheli F, Montilla-Uzcátegui V, Barbosa N, Ramírez-Gómez C, Zúñiga-Ramírez C. Successful Unilateral Surgical Approach to Internal Globus Pallidus and Ventral Intermediate Nucleus of the Thalamus in 3 Cases of Myoclonus-Dystonia Syndrome. Stereotact Funct Neurosurg 2020; 99:250-255. [PMID: 33242869 DOI: 10.1159/000511715] [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: 06/05/2020] [Accepted: 09/18/2020] [Indexed: 11/19/2022]
Abstract
Surgical approaches of internal globus pallidus (GPi) and ventral intermediate thalamic nucleus (Vim) have been used to treat different movement disorders. Three subjects with myoclonus-dystonia syndrome were surgically treated, one of them with GPi and Vim stimulation, while radiofrequency ablation of these structures was performed in the other 2 subjects. Surgical approach of both targets was performed simultaneously on each subject. Mean follow-up was of 33.3 months (22-48 months), the Unified Myoclonus Rating Scale action myoclonus (AM), functional tests (FT), patient questionnaire (PQ) sub-scores, and the Unified Dystonia Rating Scale (UDRS) were used during assessments. Improvement in all scales were seen 6 months after surgery (AM: 74%, FT: 60%, PQ: 63%, UDRS: 65%), and this benefit persisted throughout follow-up (AM: 61%, FT:62%, PQ: 65%, UDRS: 86%). No adverse events were noticed. Simultaneous unilateral procedures of GPi and Vim by either stimulation or ablation techniques improve both motor and functional scores in myoclonus-dystonia syndrome.
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Affiliation(s)
- Rodrigo Mercado-Pimentel
- Functional Neurosugery Clinic, Department of Neurosurgery, Hospital Civil de Guadalajara "Fray Antonio Alcalde", University of Guadalajara, Guadalajara, Mexico
| | - Fabian Piedimonte
- CENIT Foundation for Neuroscience Research, Buenos Aires, Argentina.,Neuroscience Institute, University of Buenos Aires, Buenos Aires, Argentina
| | - Federico Micheli
- Parkinson's Disease and Movement Disorders Program, Neurology Department, Hospital de Clínicas "José de San Martín", Buenos Aires University, Buenos Aires, Argentina
| | - Verónica Montilla-Uzcátegui
- CENIT Foundation for Neuroscience Research, Buenos Aires, Argentina.,Parkinson's Disease and Movement Disorders Program, Neurology Department, Hospital de Clínicas "José de San Martín", Buenos Aires University, Buenos Aires, Argentina
| | - Nicolás Barbosa
- CENIT Foundation for Neuroscience Research, Buenos Aires, Argentina
| | - Carolina Ramírez-Gómez
- CENIT Foundation for Neuroscience Research, Buenos Aires, Argentina.,Parkinson's Disease and Movement Disorders Program, Neurology Department, Hospital de Clínicas "José de San Martín", Buenos Aires University, Buenos Aires, Argentina
| | - Carlos Zúñiga-Ramírez
- Movement Disorders and Neurodegenerative Diseases Unit, Hospital Civil de Guadalajara "Fray Antonio Alcalde", University of Guadalajara, Guadalajara, Mexico,
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Nagtegaal SHJ, David S, Philippens MEP, Snijders TJ, Leemans A, Verhoeff JJC. Dose-dependent volume loss in subcortical deep grey matter structures after cranial radiotherapy. Clin Transl Radiat Oncol 2021; 26:35-41. [PMID: 33294645 DOI: 10.1016/j.ctro.2020.11.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/09/2020] [Accepted: 11/10/2020] [Indexed: 12/12/2022] Open
Abstract
Subcortical grey matter is susceptible to dose-dependent volume loss after RT. Hippocampal age increases 1 year after radiotherapy, by a median of 11 years. We may need to reconsider current sparing strategies in RT for brain tumours. Future studies should examine the impact of deep GM volume loss on cognition.
Background and purpose The relation between radiotherapy (RT) dose to the brain and morphological changes in healthy tissue has seen recent increased interest. There already is evidence for changes in the cerebral cortex and white matter, as well as selected subcortical grey matter (GM) structures. We studied this relation in all deep GM structures, to help understand the aetiology of post-RT neurocognitive symptoms. Materials and methods We selected 31 patients treated with RT for grade II-IV glioma. Pre-RT and 1 year post-RT 3D T1-weighted MRIs were automatically segmented, and the changes in volume of the following structures were assessed: amygdala, nucleus accumbens, caudate nucleus, hippocampus, globus pallidus, putamen, and thalamus. The volumetric changes were related to the mean RT dose received by each structure. Hippocampal volumes were entered into a population-based nomogram to estimate hippocampal age. Results A significant relation between RT dose and volume loss was seen in all examined structures, except the caudate nucleus. The volume loss rates ranged from 0.16 to 1.37%/Gy, corresponding to 4.9–41.2% per 30 Gy. Hippocampal age, as derived from the nomogram, was seen to increase by a median of 11 years. Conclusion Almost all subcortical GM structures are susceptible to radiation-induced volume loss, with higher volume loss being observed with increasing dose. Volume loss of these structures is associated with neurological deterioration, including cognitive decline, in neurodegenerative diseases. To support a causal relationship between radiation-induced deep GM loss and neurocognitive functioning in glioma patients, future studies are needed that directly correlate volumetrics to clinical outcomes.
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Key Words
- Amygdala
- Brain neoplasms
- CAT12, computational anatomy toolbox 12
- CT, computed tomography
- Caudate nucleus
- FWER, family-wise error rate
- GM, grey matter
- Globus pallidus
- Gray matter
- Hippocampus
- MRI, magnetic resonance imaging
- Nucleus accumbens
- PALM, permutation analysis of linear models
- PTV, planning target volume
- Putamen
- RT, radiotherapy
- Radiotherapy
- SPM, statistical parametric mapping
- TFE, turbo fast echo
- Thalamus
- WBRT, whole-brain radiotherapy
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Hu B, Xu M, Wang Z, Jiang D, Wang D, Zhang D. The theoretical mechanism of Parkinson's oscillation frequency bands: a computational model study. Cogn Neurodyn 2020; 15:721-731. [PMID: 34367370 DOI: 10.1007/s11571-020-09651-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 06/01/2020] [Revised: 10/24/2020] [Accepted: 11/02/2020] [Indexed: 12/27/2022] Open
Abstract
Excessive synchronous oscillation activities appear in the brain is a key pathological feature of Parkinson's disease, the mechanism of which is still unclear. Although some previous studies indicated that β oscillation (13-30 Hz) may directly originate in the network composed of the subthalamic nucleus (STN) and external globus pallidus (GPe) neurons, specific onset mechanisms of which are unclear, especially theoretical evidences in numerical simulation are still little. In this paper, we employ a STN-GPe mean-field model to explore the onset mechanism of Parkinson's oscillation. In addition to β oscillation, we find that some other common oscillation frequency bands can appear in this network, such as the α oscillation band (8-12 Hz), the θ oscillation band (4-7 Hz) and δ oscillation band (1-3 Hz). In addition to the coupling weight between the STN and GPe, the delay is also a critical factor to affect oscillatory activities, which can not be neglected compared to other parameters. Through simulation and analysis, we propose two possible theories may induce the system to transfer from the stable state to the oscillatory state in this model: (1). The oscillation activity can be induced when the firing activation level of the population increases to large enough; (2). In some special cases, the population may stay in the high firing rate stable state and the mean discharge rate of which is too large to induce oscillations, then oscillation activities may be induced as the MD decreases to moderate value. In most situations, the change trends of the MD and oscillation dominant frequency are contrary, which may be an important physiological phenomenon shown in this model. The delays and firing rates were obtained by simulating, which may be verified in the experiment in the future.
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Affiliation(s)
- Bing Hu
- Department of Applied Mathematics, Zhejiang University of Technology, Hangzhou, 310023 China.,Key Laboratory of Systems Biology, Center for Excellence in Molecular Cell Science, Institute of Biochemistry and Cell Biology, Shanghai Institute of Biological Sciences, Chinese Academy of Sciences, Shanghai, 200031 China
| | - Minbo Xu
- Department of Applied Mathematics, Zhejiang University of Technology, Hangzhou, 310023 China
| | - Zhizhi Wang
- Department of Applied Mathematics, Zhejiang University of Technology, Hangzhou, 310023 China
| | - Danhua Jiang
- Department of Applied Mathematics, Zhejiang University of Technology, Hangzhou, 310023 China
| | - Dingjiang Wang
- Department of Applied Mathematics, Zhejiang University of Technology, Hangzhou, 310023 China
| | - Dongmei Zhang
- Department of Applied Mathematics, Zhejiang University of Technology, Hangzhou, 310023 China
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