Mapping Cortical Atrophy in Parkinson's Disease Patients with Dementia

Hwang, Kristy; Beyer, Mona K.; Green, Amity Ella; Chung, Christine; Thompson, Paul M.; Janvin, Carmen; Larsen, Jan Petter; Aarsland, Dag; Apostolova, Liana G.

doi:10.3233/jpd-120151

Cited by 39 publications

(29 citation statements)

References 53 publications

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“…Neurodegeneration of this network may be responsible for the unique right-lateralized cortical changes in PD. Similar findings of atrophy in these areas have been previously reported in PD patients (Madhyastha et al, 2015) and have been linked to cognitive impairment (Danti et al, 2015;Hwang et al, 2013;Mak et al, 2015). Our findings suggest a distinct susceptibility of bilateral occipital and right hemisphere degeneration that appears later in the disease course.…”

Section: Right Medial Olfssupporting

confidence: 90%

Cortical asymmetry in Parkinson's disease: early susceptibility of the left hemisphere

et al. 2016

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Background and PurposeClinically, Parkinson's disease (PD) presents with asymmetric motor symptoms. The left nigrostriatal system appears more susceptible to early degeneration than the right, and a left‐lateralized pattern of early neuropathological changes is also described in several neurodegenerative conditions, including Alzheimer's disease, frontotemporal dementia, and Huntington's disease. In this study, we evaluated hemispheric differences in estimated rates of atrophy in a large, well‐characterized cohort of PD patients.MethodsOur cohort included 205 PD patients who underwent clinical assessments and T1‐weighted brain MRI's. Patients were classified into Early (n = 109) and Late stage (n = 96) based on disease duration, defined as greater than or less than 10 years of motor symptoms. Cortical thickness was determined using FreeSurfer, and a bootstrapped linear regression model was used to estimate differences in rates of atrophy between Early and Late patients.ResultsOur results show that patients classified as Early stage exhibit a greater estimated rate of cortical atrophy in left frontal regions, especially the left insula and olfactory sulcus. This pattern was replicated in left‐handed patients, and was not influenced by the degree of motor symptom asymmetry (i.e., left‐sided predominant motor symptoms). Patients classified as Late stage exhibited greater atrophy in the bilateral occipital, and right hemisphere‐predominant cortical areas.ConclusionsWe show that cortical degeneration in PD differs between cerebral hemispheres, and findings suggest a pattern of early left, and late right hemisphere with posterior cortical atrophy. Further investigation is warranted to elucidate the underlying mechanisms of this asymmetry and pathologic implications.

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Section: Right Medial Olfssupporting

confidence: 90%

Cortical asymmetry in Parkinson's disease: early susceptibility of the left hemisphere

et al. 2016

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“…EEG analytics reliably characterized alterations in neurophysiological oscillatory activity associated with PD, and specific changes in the cortico-cortical and cortico-thalamic coupling were observable in the surface EEG recording during resting state. Abnormally high levels of beta (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) and gamma (25-40 Hz) frequency synchronization were observed across multiple cortico-cortical regions in the PD patients. The high levels of beta and gamma coherence were significantly positively correlated with UPDRS scores and [ 11 C]PE2I DAT PET, confirming that excessive high coherence is associated with higher disease severity and underlying pathophysiology [8].…”

Section: Discussionmentioning

confidence: 99%

“…Excessive slow EEG sources in the cingulate and medial frontal region may be associated with attention deficits and cognitive decline in PD, however substantial evidence has more recently highlighted the role of the cingulate in multiple symptoms, not just global measures of cognition. Changes in the cingulate cortex include reduced cortical thickness [30], altered regional cerebral blood flow associated with cognition impairment [31], reduced fractional anisotropy [32] and reduced dopamine-2 receptor binding in both cognitively intact and impaired PD populations [33]. An association was revealed between increased phosphorylation of alpha-synuclein and the abnormal EEG signatures of cognitive decline (delta and alpha) as well as beta bands in the cingulate cortex, further suggesting that EEG may provide an in vivo approximation of underlying Parkinson's pathology [9].…”

Section: Discussionmentioning

confidence: 99%

Neurophysiological Biomarkers of Parkinson’s Disease

Waninger

Berka

Karić

et al. 2020

JPD

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Background: There is a need for reliable and robust Parkinson's disease biomarkers that reflect severity and are sensitive to disease modifying investigational therapeutics. Objective: To demonstrate the utility of EEG as a reliable, quantitative biomarker with potential as a pharmacodynamic endpoint for use in clinical assessments of neuroprotective therapeutics for Parkison's disease. Methods: A multi modal study was performed including aquisition of resting state EEG data and dopamine transporter PET imaging from Parkinson's disease patients off medication and compared against age-matched controls. Results: Qualitative and test/retest analysis of the EEG data demonstrated the reliability of the methods. Source localization using low resolution brain electromagnetic tomography identified significant differences in Parkinson's patients versus control subjects in the anterior cingulate and temporal lobe, areas with established association to Parkinson's disease pathology. Changes in cortico-cortical and cortico-thalamic coupling were observed as excessive EEG beta coherence in Parkinson's disease patients, and correlated with UPDRS scores and dopamine transporter activity, supporting the potential for cortical EEG coherence to serve as a reliable measure of disease severity. Using machine learning approaches, an EEG discriminant function analysis classifier was identified that parallels the loss of dopamine synapses as measured by dopamine transporter PET. Conclusion: Our results support the utility of EEG in characterizing alterations in neurophysiological oscillatory activity associated with Parkinson's disease and highlight potential as a reliable method for monitoring disease progression and as a pharmacodynamic endpoint for Parkinson's disease modification therapy.

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“…14 BrainSuite is an automatic cortical surface identification integrated toolbox with the updated version of Brain Surface Extraction (BSE), 15,16 which is commonly used in aging studies. 17,18 We mapped the individual CT on the basis of Automated Anatomical Labeling (AAL) template by applying the following procedures: Firstly, we corrected the motion and removed the nonbrain voxels. Secondly, we segmented brain into gray matter, white matter, and cerebrospinal fluid.…”

Section: Study 1 Surface-based Morphometrymentioning

confidence: 99%

Scalp‐to‐cortex distance of left primary motor cortex and its computational head model: Implications for personalized neuromodulation

Lam

Ning

2019

CNS Neurosci Ther

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BackgroundNon‐invasive brain stimulation (NIBS) is increasingly used as a probe of function and therapeutics in experimental neuroscience and neurorehabilitation. Scalp‐to‐cortex distance (SCD), as a key parameter, has been shown to potentially impact on the electric field. This study aimed to examine the region‐specific SCD and its relationship with cognitive function in the context of age‐related brain atrophy.MethodsWe analyzed the SCD and cortical thickness (CT) of left primary motor cortex (M1) in 164 cognitively normal (CN) adults and 43 dementia patients drawn from the Open Access Series of Imaging Studies (OASIS). The degree of brain atrophy was measured by the volume of ventricular system. Computational head model was developed to simulate the impact of SCD on the electric field.ResultsIncreased SCD of left M1 was only found in dementia patients (P < .001). When considering CT, the ratio of SCD to CT (F = 27.41, P < .001) showed better differential value than SCD. The SCD of left M1 was associated with worse global cognition (r = −.207, P = .011) and enlarged third ventricle (r = .241, P < .001). The electric field was consequently reduced with the increased SCD across cognitively normal elderly and dementia groups.ConclusionsScalable distance measures, including SCD and CT, are markedly correlated with reduced electric field in dementia patients. The findings suggest that it is important to be aware of region‐specific distance measures when conducting NIBS‐based rehabilitation in individuals with brain atrophy.

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Mapping Cortical Atrophy in Parkinson's Disease Patients with Dementia

Cited by 39 publications

References 53 publications

Cortical asymmetry in Parkinson's disease: early susceptibility of the left hemisphere

Cortical asymmetry in Parkinson's disease: early susceptibility of the left hemisphere

Neurophysiological Biomarkers of Parkinson’s Disease

Scalp‐to‐cortex distance of left primary motor cortex and its computational head model: Implications for personalized neuromodulation

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