Concomitant improvement in anti-saccade success rate and postural instability gait difficulty after rTMS treatment for Parkinson’s disease

Okada, Ken Ichi; Takahira, Mizuki; Mano, Tomoo; Uga, Taichi; Konaka, Kuni; Hosomi, Koichi; Saitoh, Youichi

doi:10.1038/s41598-021-81795-3

Cited by 6 publications

(6 citation statements)

References 59 publications

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“…Patients with FOG show significantly worse anti-saccade performance, indicating mutually impaired inhibitory control for gait and anti-saccade ( Ewenczyk et al, 2017 ). Okada et al (2021) confirmed that bilateral 10 Hz rTMS to the leg region of the MC improved MDS-UPDRS motor scores and the anti-saccade success rate, both of which require adequate inhibition of the reflexive response. The improvement in the anti-saccade success rate was correlated with that of the postural instability gait difficulty sub-scores of the MDS-UPDRS ( Okada et al, 2021 ).…”

Section: Resultsmentioning

confidence: 52%

Therapeutic Devices for Motor Symptoms in Parkinson’s Disease: Current Progress and a Systematic Review of Recent Randomized Controlled Trials

Fujikawa

Morigaki

Yamamoto

et al. 2022

Front. Aging Neurosci.

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BackgroundPharmacotherapy is the first-line treatment option for Parkinson’s disease, and levodopa is considered the most effective drug for managing motor symptoms. However, side effects such as motor fluctuation and dyskinesia have been associated with levodopa treatment. For these conditions, alternative therapies, including invasive and non-invasive medical devices, may be helpful. This review sheds light on current progress in the development of devices to alleviate motor symptoms in Parkinson’s disease.MethodsWe first conducted a narrative literature review to obtain an overview of current invasive and non-invasive medical devices and thereafter performed a systematic review of recent randomized controlled trials (RCTs) of these devices.ResultsOur review revealed different characteristics of each device and their effectiveness for motor symptoms. Although invasive medical devices are usually highly effective, surgical procedures can be burdensome for patients and have serious side effects. In contrast, non-pharmacological/non-surgical devices have fewer complications. RCTs of non-invasive devices, especially non-invasive brain stimulation and mechanical peripheral stimulation devices, have proven effectiveness on motor symptoms. Nearly no non-invasive devices have yet received Food and Drug Administration certification or a CE mark.ConclusionInvasive and non-invasive medical devices have unique characteristics, and several RCTs have been conducted for each device. Invasive devices are more effective, while non-invasive devices are less effective and have lower hurdles and risks. It is important to understand the characteristics of each device and capitalize on these.

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Section: Resultsmentioning

confidence: 52%

Therapeutic Devices for Motor Symptoms in Parkinson’s Disease: Current Progress and a Systematic Review of Recent Randomized Controlled Trials

Fujikawa

Morigaki

Yamamoto

et al. 2022

Front. Aging Neurosci.

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“…For example, in a pilot study performed by Waldthaler and colleagues (Waldthaler et al 2021a ), 25 PD patients with and without deep brain stimulation (DBS) underwent clinical assessment and an oculometric evaluation over a 1-year period, and found that anti-saccades were correlated with change in MDS-UPDRS III in both groups. Okada and colleagues (Okada et al 2021 ) examined the effects of transcranial magnetic stimulation as a potential treatment of PD, and compared the changes in both eye movement performance and MDS-UPDRS motor scores in 14 PD patients before and after administration of treatment. Despite the small sample, they found that the reduction in anti-saccade error rate was correlated with the sub-scores of postural instability and gait difficulty.…”

Section: Discussionmentioning

confidence: 99%

Oculometric measures as a tool for assessment of clinical symptoms and severity of Parkinson’s disease

Reiner

Franken

Raveh³

et al. 2023

J Neural Transm

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Abnormalities of oculometric measures (OM) are widely described in people with Parkinson's disease (PD). However, knowledge of correlations between abnormal OM, disease severity and clinical assessment in PD patients is still lacking. To evaluate these correlations, PD patients (215 patients, mean age 69 ± 9.1 years, 79 females) with severe (H&Y > 3) and mild to moderate (H&Y ≤ 2) disease, and 215 age-matched healthy subjects were enrolled. All patients were evaluated using MDS-UPDRS and an oculometric test using computer vision and deep learning algorithms. Comparisons of OM between groups and correlations between OM and MDS-UPDRS scores were calculated. Saccadic latency (ms) was prolonged in patients with severe compared with mild to moderate disease (pro-saccades: 267 ± 69 vs. 238 ± 53, p = 0.0011; anti-saccades: 386 ± 119 vs. 352 ± 106, p = 0.0393) and in patients with mild to moderate disease versus healthy subjects (pro-saccades: 238 ± 53 vs. 220 ± 45, p = 0.0003; anti-saccades: 352 ± 106 vs. 289 ± 71, p < 0.0001). Error rate (%) was higher among patients with severe (64.06 ± 23.08) versus mild to moderate disease (49.84 ± 24.81, p = 0.0001), and versus healthy subjects (49.84 ± 24.81 vs. 28.31 ± 21.72, p = 0.00001). Response accuracy (%) was lower for patients with severe (75.66 ± 13.11) versus mild to moderate disease (79.66 ± 13.56, p = 0.0462), and versus healthy subjects (79.66 ± 13.56 vs. 90.27 ± 8.79, p < 0.0001). Pro- and anti-saccadic latency, error rate and accuracy were correlated with MDS-UPDRS scores (r = 0.32, 0.28, 0.36 and -0.30, respectively, p < 0.0001) and similar correlations were found with its axial subscore (R = 0.38, 0.29, 0.44, and -0.30, respectively, p < 0.0001). Several OM were different in patients under levodopa treatment. OM worsened as PD severity increases, and were correlated with MDS-UPDRS scores. Using OM can be implemented for PD patients’ assessment as a tool to follow disease progression.

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“…These alterations in the SC are linked with deficits in the coordination of action and perception (Pretegiani et al, 2019). Notably, a recent study with PD patients show that repetitive transcranial magnetic stimulation in the motor cortex improved anti-saccade success rate and postural instability gait difficulty (Okada et al, 2021). In this line, optogenetic stimulation of the M2 cortex reverts motor dysfunction in a mouse model of PD (Magno et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

Altered M2 Cortex - Superior Colliculus visual perception circuit in Huntington’s Disease

Conde-Berriozabal

García-Gilabert

García-García

et al. 2022

Preprint

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The premotor cortical area -M2 cortex in rodents- connection to the striatum is involved in movement and prominently affected in Huntington’s Disease (HD). M2 cortex also projects to the superior colliculus (SC), implicated in oculomotor functions (i.e. saccades) and visual perception. Here, we investigated the contribution of M2 cortex – SC circuit to HD physiopathology in male mice. Using fMRI, we observed that M2 cortex functional connectivity with the SC was the most prominently affected circuit in the symptomatic R6/1 HD mouse model. Structural alterations were also detected by tractography and viral tracing. HD mice showed decreased defensive behavioral responses towards an unexpected visual stimuli, such as a moving robo-beetle, and decreased locomotion upon unexpected flash of light. Additionally, optogenetic M2 cortex – SC stimulation promoted avoidance responses towards the robo-beetle in WT, but not HD mice. Though, DWI measurements in vivo and ex vivo electrophysiological responses to optogenetic and electrical stimuli in the SC suggested preserved brain structure. Finally, GCamp6f fluorescence recordings with fiber photometry indicated that aberrant M2 cortex engagement might be the underlying mechanism of visual perception alterations in HD. Collectively, our findings point to a key role of M2 cortex - SC circuit alterations in HD pathophysiology.

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Concomitant improvement in anti-saccade success rate and postural instability gait difficulty after rTMS treatment for Parkinson’s disease

Cited by 6 publications

References 59 publications

Therapeutic Devices for Motor Symptoms in Parkinson’s Disease: Current Progress and a Systematic Review of Recent Randomized Controlled Trials

Therapeutic Devices for Motor Symptoms in Parkinson’s Disease: Current Progress and a Systematic Review of Recent Randomized Controlled Trials

Oculometric measures as a tool for assessment of clinical symptoms and severity of Parkinson’s disease

Altered M2 Cortex - Superior Colliculus visual perception circuit in Huntington’s Disease

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