Imaging of compensatory mechanisms in Parkinson's disease

Abstract

Ascertaining which changes in brain activation in Parkinson's disease are, in fact, compensatory represents a serious challenge. Compensatory mechanisms have been demonstrated from the microscopic, synaptic level to the macroscopic, system level. Augmentation of compensatory mechanisms, in addition to ameliorating the loss of dopaminergic neurons, may represent a joint strategy for overall minimization of disability.

Impact of 6-month earlier versus postponed initiation of rotigotine on long-term outcome:post hocanalysis of patients with early Parkinson’s disease with mild symptom severity

“…The results of the current post hoc analyses do not provide information on the mechanism/s for the potential additional longterm benefit of 6-month earlier treatment with rotigotine. However, the data are in support of the concept that treatment intervention in the early stages of PD, when there may be a strain on the intrinsic compensatory mechanisms counteracting the dopaminergic deficit and a rapid rate of deterioration, may be beneficial due to supplementation of dopaminergic activity [1,2,6]. Early restoration of the dopaminergic 'tone' may thus help support the compensatory events; if initiation of treatment is delayed, patients may not have the full opportunity to support the compensatory mechanisms and may be less able to stabilize the symptoms of PD.…”

“…Original Research Impact of 6-month earlier versus postponed initiation of rotigotine on long-term outcome: post hoc analysis of patients with early Parkinson's disease with mild symptom severity 1…”

“…The progressive loss of dopaminergic neurons in the substantia nigra pars compacta of the basal ganglia and the corresponding loss of striatal dopamine levels, which define PD, is likely subject to compensatory mechanisms that help delay the emergence of symptoms and maintain motor function [1][2][3]. Therefore, treatment early in the course of the disease may not only provide symptom relief, but also act to alleviate the stress on the intrinsic physiological compensatory mechanisms.…”

Sensorimotor rhythm neurofeedback as adjunct therapy for Parkinson's disease

“…Both groups had no difference in TH‐positive SNpc neurons, ruling out neuroprotective effects. SMR neurofeedback training might enhance compensatory mechanisms, comparable with presymptomatic PD compensation17, 18 or paradoxical movement 19. We found that during L‐DOPA treatment, ON and OFF scores were significantly smaller in SMR neurofeedback‐trained monkeys compared to controls, respectively.…”

Neurological Diseases from a Systems Medicine Point of View

“…Disruption of this network is associated with pathological states of the brain. On the other hand, changes in the brain wiring may happen also due to compensatory mechanisms [ 146 ]. Similarly to network representations on other levels, we face certain simplifi cation of extremely complex structure of the brain to a set of elements and interactions.…”