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Ragothaman A, Mancini M, Nutt JG, Wang J, Fair DA, Horak FB, Miranda-Dominguez O. Motor networks, but also non-motor networks predict motor signs in Parkinson's disease. Neuroimage Clin 2023; 40:103541. [PMID: 37972450 PMCID: PMC10685308 DOI: 10.1016/j.nicl.2023.103541] [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: 06/06/2023] [Revised: 10/31/2023] [Accepted: 11/10/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVE Investigate the brain functional networks associated with motor impairment in people with Parkinson's disease (PD). BACKGROUND PD is primarily characterized by motor dysfunction. Resting-state functional connectivity (RsFC) offers a unique opportunity to non-invasively characterize brain function. In this study, we hypothesized that the motor dysfunction observed in people with PD involves atypical connectivity not only in motor but also in higher-level attention networks. Understanding the interaction between motor and non-motor RsFC that are related to the motor signs could provide insights into PD pathophysiology. METHODS We used data from 88 people with PD (mean age: 68.2(SD:10), 55 M/33F) coming from 2 cohorts. Motor severity was assessed in practical OFF-medication state, using MDS-UPDRS Part-III motor scores (mean: 49 (SD:10)). RsFC was characterized using an atlas of 384 regions that were grouped into 13 functional networks. Associations between RsFC and motor severity were assessed independently for each RsFC using predictive modeling. RESULTS The top 5 % models that predicted the MDS-UPDRS-III motor scores with effect size >0.5 were the connectivity between (1) the somatomotor and Subcortical-Basal-ganglia, (2) somatomotor and Visual and (3) CinguloOpercular (CiO) and language/Ventral attention (Lan/VeA) network pairs. DISCUSSION Our findings suggest that, along with motor networks, visual- and attention-related cortical networks are also associated with the motor symptoms of PD. Non-motor networks may be involved indirectly in motor-coordination. When people with PD have deficits in motor networks, more attention may be needed to carry out formerly automatic motor functions, consistent with compensatory mechanisms in parkinsonian movement disorders.
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Affiliation(s)
| | - Martina Mancini
- Department of Neurology, Oregon Health and Science University, Portland, OR 97239, USA
| | - John G Nutt
- Department of Neurology, Oregon Health and Science University, Portland, OR 97239, USA
| | - Junping Wang
- Department of Radiology, Tianjin Medical University General Hospital, China
| | - Damien A Fair
- Masonic Institute for the Developing Brain (MIDB), University of Minnesota, Minneapolis, MN 55455, USA; Institute of Child Development, College of Education and Human Development, University of Minnesota, Minneapolis, MN 55455, USA; Department of Pediatrics, University of Minnesota Medical School, University of Minnesota, Minneapolis, MN 55455, USA; Department of Behavioral Neuroscience, Oregon Health and Science University, Portland, OR 97239, USA
| | - Fay B Horak
- Department of Neurology, Oregon Health and Science University, Portland, OR 97239, USA; Department of Behavioral Neuroscience, Oregon Health and Science University, Portland, OR 97239, USA.
| | - Oscar Miranda-Dominguez
- Masonic Institute for the Developing Brain (MIDB), University of Minnesota, Minneapolis, MN 55455, USA; Department of Pediatrics, University of Minnesota Medical School, University of Minnesota, Minneapolis, MN 55455, USA
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Vignoud G, Desjardins C, Salardaine Q, Mongin M, Garcin B, Venance L, Degos B. Video-Based Automated Assessment of Movement Parameters Consistent with MDS-UPDRS III in Parkinson's Disease. J Parkinsons Dis 2022; 12:2211-2222. [PMID: 35964204 PMCID: PMC9661322 DOI: 10.3233/jpd-223445] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/24/2022] [Indexed: 06/01/2023]
Abstract
BACKGROUND Among motor symptoms of Parkinson's disease (PD), including rigidity and resting tremor, bradykinesia is a mandatory feature to define the parkinsonian syndrome. MDS-UPDRS III is the worldwide reference scale to evaluate the parkinsonian motor impairment, especially bradykinesia. However, MDS-UPDRS III is an agent-based score making reproducible measurements and follow-up challenging. OBJECTIVE Using a deep learning approach, we developed a tool to compute an objective score of bradykinesia based on the guidelines of the gold-standard MDS-UPDRS III. METHODS We adapted and applied two deep learning algorithms to detect a two-dimensional (2D) skeleton of the hand composed of 21 predefined points, and transposed it into a three-dimensional (3D) skeleton for a large database of videos of parkinsonian patients performing MDS-UPDRS III protocols acquired in the Movement Disorder unit of Avicenne University Hospital. RESULTS We developed a 2D and 3D automated analysis tool to study the evolution of several key parameters during the protocol repetitions of the MDS-UPDRS III. Scores from 2D automated analysis showed a significant correlation with gold-standard ratings of MDS-UPDRS III, measured with coefficients of determination for the tapping (0.609) and hand movements (0.701) protocols using decision tree algorithms. The individual correlations of the different parameters measured with MDS-UPDRS III scores carry meaningful information and are consistent with MDS-UPDRS III guidelines. CONCLUSION We developed a deep learning-based tool to precisely analyze movement parameters allowing to reliably score bradykinesia for parkinsonian patients in a MDS-UPDRS manner.
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Affiliation(s)
- Gaëtan Vignoud
- Center for Interdisciplinary Research in Biology (CIRB), Collège de France, CNRS, INSERM, Université PSL, Paris, France
- INRIA Paris, MAMBA (Modelling and Analysis in Medical and Biological Applications), Paris, France
| | - Clément Desjardins
- APHP, Hôpital Avicenne, Hôpitaux Universitaires de Paris-Seine Saint Denis (HUPSSD), Department of Neurology, Sorbonne Paris Nord, NS-PARK/FCRIN network, Bobigny, France
| | - Quentin Salardaine
- APHP, Hôpital Avicenne, Hôpitaux Universitaires de Paris-Seine Saint Denis (HUPSSD), Department of Neurology, Sorbonne Paris Nord, NS-PARK/FCRIN network, Bobigny, France
| | - Marie Mongin
- APHP, Hôpital Avicenne, Hôpitaux Universitaires de Paris-Seine Saint Denis (HUPSSD), Department of Neurology, Sorbonne Paris Nord, NS-PARK/FCRIN network, Bobigny, France
| | - Béatrice Garcin
- APHP, Hôpital Avicenne, Hôpitaux Universitaires de Paris-Seine Saint Denis (HUPSSD), Department of Neurology, Sorbonne Paris Nord, NS-PARK/FCRIN network, Bobigny, France
| | - Laurent Venance
- Center for Interdisciplinary Research in Biology (CIRB), Collège de France, CNRS, INSERM, Université PSL, Paris, France
| | - Bertrand Degos
- Center for Interdisciplinary Research in Biology (CIRB), Collège de France, CNRS, INSERM, Université PSL, Paris, France
- APHP, Hôpital Avicenne, Hôpitaux Universitaires de Paris-Seine Saint Denis (HUPSSD), Department of Neurology, Sorbonne Paris Nord, NS-PARK/FCRIN network, Bobigny, France
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Bos MJ, de Korte-de Boer D, Alzate Sanchez AM, Duits A, Ackermans L, Temel Y, Absalom AR, Buhre WF, Roberts MJ, Janssen MLF. Impact of Procedural Sedation on the Clinical Outcome of Microelectrode Recording Guided Deep Brain Stimulation in Patients with Parkinson's Disease. J Clin Med 2021; 10:1557. [PMID: 33917205 PMCID: PMC8068017 DOI: 10.3390/jcm10081557] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/01/2021] [Accepted: 04/05/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Subthalamic nucleus (STN) deep brain stimulation (DBS) has become a routine treatment of advanced Parkinson's disease (PD). DBS surgery is commonly performed under local anesthesia (LA) to obtain reliable microelectrode recordings. However, procedural sedation and/or analgesia (PSA) is often desirable to improve patient comfort. The impact of PSA in addition to LA on outcome is largely unknown. Therefore, we performed an observational study to assess the effect of PSA compared to LA alone during STN DBS surgery on outcome in PD patients. METHODS Seventy PD patients (22 under LA, 48 under LA + PSA) scheduled for STN DBS implantation were included. Dexmedetomidine, clonidine or remifentanil were used for PSA. The primary outcome was the change in Movement Disorders Society Unified Parkinson's Disease Rating Score III (MDS-UPDRS III) and levodopa equivalent daily dosage (LEDD) between baseline, one month before surgery, and twelve months postoperatively. Secondary outcome measures were motor function during activities of daily living (MDS-UPDRS II), cognitive alterations and surgical adverse events. Postoperative assessment was conducted in "on" stimulation and "on" medication conditions. RESULTS At twelve months follow-up, UPDRS III and UPDRS II scores in "on" medication conditions were similar between the LA and PSA groups. The two groups showed a similar LEDD reduction and an equivalent decline in executive function measured by the Stroop Color-Word Test, Trail Making Test-B, and verbal fluency. The incidence of perioperative and postoperative adverse events was similar between groups. CONCLUSION This study demonstrates that PSA during STN DBS implantation surgery in PD patients was not associated with differences in motor and non-motor outcome after twelve months compared with LA only.
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Affiliation(s)
- Michael J. Bos
- Department of Anesthesiology and Pain Medicine, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands; (D.d.K.-d.B.); (W.F.B.)
- Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, The Netherlands; (A.M.A.S.); (A.D.); (Y.T.); (M.L.F.J.)
| | - Dianne de Korte-de Boer
- Department of Anesthesiology and Pain Medicine, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands; (D.d.K.-d.B.); (W.F.B.)
| | - Ana Maria Alzate Sanchez
- Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, The Netherlands; (A.M.A.S.); (A.D.); (Y.T.); (M.L.F.J.)
| | - Annelien Duits
- Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, The Netherlands; (A.M.A.S.); (A.D.); (Y.T.); (M.L.F.J.)
- Department of Medical Psychology, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands
| | - Linda Ackermans
- Department of Neurosurgery, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands;
| | - Yasin Temel
- Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, The Netherlands; (A.M.A.S.); (A.D.); (Y.T.); (M.L.F.J.)
- Department of Neurosurgery, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands;
| | - Anthony R. Absalom
- Department of Anesthesiology, University Medical Center Groningen, Groningen University, Hanzeplein 1, 9713 GZ Groningen, The Netherlands;
| | - Wolfgang F. Buhre
- Department of Anesthesiology and Pain Medicine, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands; (D.d.K.-d.B.); (W.F.B.)
- Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, The Netherlands; (A.M.A.S.); (A.D.); (Y.T.); (M.L.F.J.)
| | - Mark J. Roberts
- Faculty of Psychology and Neuroscience, Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, The Netherlands;
| | - Marcus L. F. Janssen
- Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, The Netherlands; (A.M.A.S.); (A.D.); (Y.T.); (M.L.F.J.)
- Department of Clinical Neurophysiology, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands
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Wang Q, Han CL, Wang KL, Sui YP, Li ZB, Chen N, Fan SY, Shimabukuro M, Wang F, Meng FG. Integrated analysis of exosomal lncRNA and mRNA expression profiles reveals the involvement of lnc-MKRN2-42:1 in the pathogenesis of Parkinson's disease. CNS Neurosci Ther 2019; 26:527-537. [PMID: 31814304 PMCID: PMC7163584 DOI: 10.1111/cns.13277] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [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: 07/31/2019] [Revised: 11/14/2019] [Accepted: 11/22/2019] [Indexed: 12/19/2022] Open
Abstract
Background Parkinson's disease (PD) is a common movement disorder for which diagnosis mainly depends on the medical history and clinical symptoms. Exosomes are now considered an additional mechanism for intercellular communication, allowing cells to exchange proteins, lipids, and genetic material. Long noncoding (lnc) RNA in exosomes plays a critical role in many diseases, including neurodegenerative disease. Aim To study expression differences for lncRNAs in peripheral blood exosomes of PD patients compared with healthy individuals and to look for lncRNAs that might be related to the pathogenesis of PD. Materials and Methods We recruited PD patients along with age‐ and sex‐matched healthy individuals as healthy controls and evaluated levels of lncRNAs extracted from exosomes in plasma samples via next‐generation sequencing and real‐time quantitative PCR. Correlation analysis was conducted for the clinical characteristics of PD patients and the expression of selected lncRNAs. Results We found 15 upregulated and 24 downregulated exosomal lncRNAs in the PD group. According to bioinformatics analyses, we chose lnc‐MKRN2‐42:1 for further study. Interestingly, lnc‐MKRN2‐42:1 was positively correlated with the MDS‐UPDRS III score for PD patients. Conclusion Our study suggested that lnc‐MKRN2‐42:1 may be involved in the occurrence and development of PD.
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Affiliation(s)
- Qiao Wang
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Neurostimulation, Beijing, China
| | - Chun-Lei Han
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Neurostimulation, Beijing, China
| | - Kai-Liang Wang
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Neurostimulation, Beijing, China
| | - Yun-Peng Sui
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Neurostimulation, Beijing, China
| | - Zhi-Bao Li
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Neurostimulation, Beijing, China
| | - Ning Chen
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Shi-Ying Fan
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Neurostimulation, Beijing, China
| | - Michitomo Shimabukuro
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Neurostimulation, Beijing, China
| | - Feng Wang
- Department of Neurosurgery, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Fan-Gang Meng
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Neurostimulation, Beijing, China.,Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Li X, Xing Y, Martin-Bastida A, Piccini P, Auer DP. Patterns of grey matter loss associated with motor subscores in early Parkinson's disease. Neuroimage Clin 2017; 17:498-504. [PMID: 29201638 PMCID: PMC5700824 DOI: 10.1016/j.nicl.2017.11.009] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 09/13/2017] [Accepted: 11/08/2017] [Indexed: 12/22/2022]
Abstract
Classical motor symptoms of Parkinson's disease (PD) such as tremor, rigidity, bradykinesia, and axial symptoms are graded in the Movement Disorders Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) III. It is yet to be ascertained whether parkinsonian motor symptoms are associated with different anatomical patterns of neurodegeneration as reflected by brain grey matter (GM) alteration. This study aimed to investigate associations between motor subscores and brain GM at voxel level. High resolution structural MRI T1 scans from the Parkinson's Progression Markers Initiative (PPMI) repository were employed to estimate brain GM intensity of PD subjects. Correlations between GM intensity and total MDS-UPDRS III and its four subscores were computed. The total MDS-UPDRS III score was significantly negatively correlated bilaterally with putamen and caudate GM density. Lower anterior striatal GM intensity was significantly associated with higher rigidity subscores, whereas left-sided anterior striatal and precentral cortical GM reduction were correlated with severity of axial symptoms. No significant morphometric associations were demonstrated for tremor subscores. In conclusion, we provide evidence for neuroanatomical patterns underpinning motor symptoms in early PD.
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Affiliation(s)
- Xingfeng Li
- Radiological Sciences, Division of Clinical Neuroscience, University of Nottingham, Queen's Medical Centre, Nottingham NG7 2UH, UK; Sir Peter Mansfield Imaging Centre, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK; NIHR Nottingham Biomedical Research Centre, Nottingham NG7 2UH, UK.
| | - Yue Xing
- Radiological Sciences, Division of Clinical Neuroscience, University of Nottingham, Queen's Medical Centre, Nottingham NG7 2UH, UK; Sir Peter Mansfield Imaging Centre, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK
| | - Antonio Martin-Bastida
- Centre for Neurodegeneration and Neuroinflammation, Division of Brain Sciences, Imperial College London, London W12 0NN, UK
| | - Paola Piccini
- Centre for Neurodegeneration and Neuroinflammation, Division of Brain Sciences, Imperial College London, London W12 0NN, UK
| | - Dorothee P Auer
- Radiological Sciences, Division of Clinical Neuroscience, University of Nottingham, Queen's Medical Centre, Nottingham NG7 2UH, UK; Sir Peter Mansfield Imaging Centre, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK; NIHR Nottingham Biomedical Research Centre, Nottingham NG7 2UH, UK.
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