Rehabilitation program based on sensorimotor recovery improves the static and dynamic balance and modifies the basal ganglia neurochemistry

Pizzi, Stefano Delli; Fulle, Stefania; Carmignano, Simona Maria; Ancona, Emilio; Franciotti, Raffaella; Supplizi, Marco; Barassi, Giovanni; Onofrj, Marco; Saggini, Raoul

doi:10.1097/md.0000000000008732

Cited by 11 publications

(6 citation statements)

References 52 publications

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“…This result indicates that PD affects not only brain local regions by dopaminergic denervation, but also the brain network within the hemisphere. The novel wbMRSI-detectable brain metabolic alterations in PD may serve as promising biomarkers for early PD diagnosis, differential diagnosis of Parkinsonism (32) and with emerging disease-modifying drugs also for treatment monitoring (65, 66).…”

Section: Resultsmentioning

confidence: 99%

Altered Neurometabolic Profile in Early Parkinson's Disease: A Study With Short Echo-Time Whole Brain MR Spectroscopic Imaging

et al. 2019

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Objective: To estimate alterations in neurometabolic profile of patients with early stage Parkinson's disease (PD) by using a short echo-time whole brain magnetic resonance spectroscopic imaging (wbMRSI) as possible biomarker for early diagnosis and monitoring of PD. Methods: 20 PD patients in early stage (H&Y ≤ 2) without evidence of severe other diseases and 20 age and sex matched healthy controls underwent wbMRSI. In each subject brain regional concentrations of metabolites N-acetyl-aspartate (NAA), choline (Cho), total creatine (tCr), glutamine (Gln), glutamate (Glu), and myo-inositol (mIns) were obtained in atlas-defined lobar structures including subcortical basal ganglia structures (the left and right frontal lobes, temporal lobes, parietal lobes, occipital lobes, and the cerebellum) and compared between patients and matched healthy controls. Clinical characteristics of the PD patients were correlated with spectroscopic findings. Results: In comparison to controls the PD patients revealed altered lobar metabolite levels in all brain lobes contralateral to dominantly affected body side, i.e., decreases of temporal NAA, Cho, and tCr, parietal NAA and tCr, and frontal as well as occipital NAA. The frontal NAA correlated negatively with the MDS-UPDRS II ( R = 22120.585, p = 0.008), MDS-UPDRS IV ( R = −0.458, p = 0.048) and total MDS-UPDRS scores ( R = −0.679, p = 0.001). Conclusion: In early PD stages metabolic alterations are evident in all contralateral brain lobes demonstrating that the neurodegenerative process affects not only local areas by dopaminergic denervation, but also the functional network within different brain regions. The wbMRSI-detectable brain metabolic alterations reveal the potential to serve as biomarkers for early PD.

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Section: Resultsmentioning

confidence: 99%

Altered Neurometabolic Profile in Early Parkinson's Disease: A Study With Short Echo-Time Whole Brain MR Spectroscopic Imaging

et al. 2019

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“…1 H‐MRS measures are quantitative, but the choice of reference signals remains a challenge. The tCr concentration has been extensively employed as a standard reference in 1 H‐MRS studies 21,38,71,72 ; however, its use in PD‐related studies is debatable as it is not clear whether the parameter is stable or changes in these patients 38,73‐77 . We have attempted to address this issue by performing additional analysis on unsuppressed spectra to calculate the tCr to water ratio for each individual.…”

Section: Discussionmentioning

confidence: 99%

“…The tCr concentration has been extensively employed as a standard reference in 1 H-MRS studies 21,38,71,72 ; however, its use in PD-related studies is debatable as it is not clear whether the parameter is stable or changes in these patients. 38,[73][74][75][76][77] We have attempted to address this issue by performing additional analysis on unsuppressed spectra to calculate the tCr to water ratio for each individual. As no significant difference in tCr/water was found among groups, we reasoned that the use of GABA+/tCr is a reliable method to investigate inhibitory neurotransmission changes that occur within the mPFC of patients with PD.…”

Section: Discussionmentioning

confidence: 99%

High γ‐Aminobutyric Acid Content Within the Medial Prefrontal Cortex Is a Functional Signature of Somatic Symptoms Disorder in Patients With Parkinson's Disease

et al. 2020

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Background: The dysfunctional activity of the medial prefrontal cortex has been associated with the appearance of the somatic symptom disorder, a key feature of the Parkinson's disease (PD) psychosis complex. Objectives: The objectives of this study were to investigate whether the basal contents of inhibitory γ-aminobutyric acid and excitatory glutamate plus glutamine neurotransmitter levels are changed in the medial prefrontal cortex of patients with PD with somatic symptom disorder and whether this alteration represents a marker of susceptibility of PD to somatic symptom disorder, thus representing a signature of psychosis complex of PD. Methods: Levels of the γ-aminobutyric acid and glutamate plus glutamine were investigated, at rest, with proton magnetic resonance spectroscopy. Total creatine was used as an internal reference. The study cohort included 23 patients with somatic symptom disorder plus PD, 19 patients with PD without somatic symptom disorder, 19 healthy control subjects, and 14 individuals with somatic symptom disorder who did not show other psychiatric or neurological disorders. Results: We found that, compared with patients with PD without somatic symptom disorder or healthy control individuals, patients with somatic symptom disorder, with or without PD, show increased γ-aminobutyric acid/total creatine levels in the medial prefrontal cortex. The medial prefrontal cortex contents of glutamate plus glutamine/ total creatine levels or γ-aminobutyric acid/glutamate plus glutamine were not different among groups. Conclusions: Our findings highlight a crucial pathophysiologic role played by high γ-aminobutyric acid within the medial prefrontal cortex in the production of somatic symptom disorder. This phenomenon represents a signature of psychosis complex in patients with PD.

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“…All the generated images were visually assessed to validate the positioning of the MRS voxel and evaluate the output of tissue segmentation. 1 H‐MRS outcomes were shown as ratios of metabolites/tCr 40 because: (1) this quantification exhibits a performance equal to, or better than, water referencing 41 ; (2) the tCr concentrations are independent of SSD or PD 32 ; (3) tCr‐referenced metabolite values are expected to be less sensitive to changes related to tissue atrophy 41 . GABA signal‐to‐noise ratio is in the Gannet output and has been compared to the “Big GABA” output as a benchmark 42 …”

Section: Methodsmentioning

confidence: 99%

Altered Medial Prefrontal Connectivity in Parkinson's Disease Patients with Somatic Symptoms

et al. 2022

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Background The high co‐occurrence of somatic symptom disorder (SSD) in Parkinson's disease (PD) patients suggests overlapping pathophysiology. However, little is known about the neural correlates of SSD and their possible interactions with PD. Existing studies have shown that SSD is associated with reduced task‐evoked activity in the medial prefrontal cortex (mPFC), a central node of the default‐mode network (DMN). SSD is also associated with abnormal γ‐aminobutyric acid (GABA) content, a marker of local inhibitory tone and regional hypoactivity, in the same area when SSD co‐occurs with PD. Objectives To disentangle the individual and shared effects of SSD and PD on mPFC neurotransmission and connectivity patterns and help disclose the neural mechanisms of comorbidity in the PD population. Methods The study cohort included 18 PD patients with SSD (PD + SSD), 18 PD patients, 13 SSD patients who did not exhibit neurologic disorders, and 17 healthy subjects (HC). Proton magnetic resonance (MR) spectroscopy evaluated GABA levels within a volume of interest centered on the mPFC. Resting‐state functional MR imaging investigated the region's functional connectivity patterns. Results Compared to HC or PD groups, the mPFC of SSD subjects exhibited higher GABA levels and connectivity. Higher mPFC connectivity involved DMN regions in SSD patients without PD and regions of the executive and attentional networks (EAN) in patients with PD comorbidity. Conclusions Aberrant reconfigurations of connectivity patterns between the mPFC and the EAN are distinct features of the PD + SSD comorbidity. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society

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Rehabilitation program based on sensorimotor recovery improves the static and dynamic balance and modifies the basal ganglia neurochemistry

Abstract: Supplemental Digital Content is available in the text

Cited by 11 publications

References 52 publications

Altered Neurometabolic Profile in Early Parkinson's Disease: A Study With Short Echo-Time Whole Brain MR Spectroscopic Imaging

Altered Neurometabolic Profile in Early Parkinson's Disease: A Study With Short Echo-Time Whole Brain MR Spectroscopic Imaging

High γ‐Aminobutyric Acid Content Within the Medial Prefrontal Cortex Is a Functional Signature of Somatic Symptoms Disorder in Patients With Parkinson's Disease

Altered Medial Prefrontal Connectivity in Parkinson's Disease Patients with Somatic Symptoms

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