Resting‐state Functional MRI in Parkinsonian Syndromes

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Abstract

Functional MRI (fMRI) has been widely used to study abnormal patterns of functional connectivity at rest in patients with movement disorders such as idiopathic Parkinson's disease (PD) and atypical parkinsonisms. This manuscript provides an educational review of the current use of resting‐state fMRI in the field of parkinsonian syndromes. Resting‐state fMRI studies have improved the current knowledge about the mechanisms underlying motor and non‐motor symptom development and progression in movement disorders. Even if its inclusion in clinical practice is still far away, resting‐state fMRI has the potential to be a promising biomarker for early disease detection and prediction. It may also aid in differential diagnosis and monitoring brain responses to therapeutic agents and neurorehabilitation strategies in different movement disorders. There is urgent need to identify and validate prodromal biomarkers in PD patients, to perform further studies assessing both overlapping and disease‐specific fMRI abnormalities among parkinsonian syndromes, and to continue technical advances to fully realize the potential of fMRI as a tool to monitor the efficacy of chronic therapies.

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Regional homogeneity changes in patients with Parkinson's disease.

Tao Wu, Xiangyu Long, Yufeng Zang … (2008)

Resting state brain activity in Parkinson's disease (PD) can give clues to the pathophysiology of the disorder, and might be helpful in diagnosis, but it has never been explored using functional MRI (fMRI). In the current study, we used a regional homogeneity (ReHo) method to investigate PD-related modulations of neural activity in the resting state. FMRIs were acquired in 22 patients with PD at both before and after levodopa administration, as well as in 22 age- and sex-matched normal controls. In the PD group compared with the healthy controls, we found ReHo decreased in extensive brain regions, including the putamen, thalamus, and supplementary motor area; and increased in some other areas, including the cerebellum, primary sensorimotor cortex, and premotor area. The ReHo off medication was negatively correlated with the Unified Parkinson's Disease Rating Scale (UPDRS) in the putamen and some other regions, and was positively correlated with the UPDRS in the cerebellum. Administration of levodopa relatively normalized ReHo. Our findings demonstrate that neural activity in the resting state is changed in patients with PD. This change is secondary to dopamine deficiency, and related to the severity of the disease. The different neuronal activity at the baseline state should be considered in explaining fMRI findings obtained during tasks. . (c) 2008 Wiley-Liss, Inc.

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Depression in Parkinson disease--epidemiology, mechanisms and management.

Dag Aarsland, Sven Påhlhagen, Clive Ballard … (2011)

Depression occurs in around 35% of patients with Parkinson disease (PD) and is often persistent. Symptoms of depression can be evident in individuals at the time of diagnosis and might develop in the premotor stage of the disease. The underlying mechanisms of depression in PD are not known in detail, but changes in brain structure, signaling by neurotransmitters, and levels of inflammatory and neurotrophic factors are all suggested to contribute to its development. Psychosocial factors and pain could also have roles in depression. Changes in dopaminergic, noradrenergic and serotonergic systems in patients with PD might help to explain the incidence of depression in these individuals. Antidepressants that have dual serotonergic and noradrenergic effects are the drugs of choice for treating depression in PD. However, antiparkinsonian drugs might have beneficial effects not only on the motor symptoms of disease, but also on a patient's mood. Deep brain stimulation can worsen depression in some patients, but a preliminary study has suggested that transcranial magnetic stimulation could improve symptoms of depression. This Review describes the frequency and course of depression in patients with PD. The mechanisms that underlie depression in this disease are also discussed, and the management strategies for these patients are highlighted.

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Spatial remapping of cortico-striatal connectivity in Parkinson's disease.

Maaike Bakker, Bas R Bloem, Loes C Derikx … (2010)

Parkinson's disease (PD) is characterized by striatal dopamine depletion, especially in the posterior putamen. The dense connectivity profile of the striatum suggests that these local impairments may propagate throughout the whole cortico-striatal network. Here we test the effect of striatal dopamine depletion on cortico-striatal network properties by comparing the functional connectivity profile of the posterior putamen, the anterior putamen, and the caudate nucleus between 41 PD patients and 36 matched controls. We used multiple regression analyses of resting-state functional magnetic resonance imaging data to quantify functional connectivity across different networks. Each region had a distinct connectivity profile that was similarly expressed in patients and controls: the posterior putamen was uniquely coupled to cortical motor areas, the anterior putamen to the pre-supplementary motor area and anterior cingulate cortex, and the caudate nucleus to the dorsal prefrontal cortex. Differences between groups were specific to the putamen: although PD patients showed decreased coupling between the posterior putamen and the inferior parietal cortex, this region showed increased functional connectivity with the anterior putamen. We conclude that dopamine depletion in PD leads to a remapping of cerebral connectivity that reduces the spatial segregation between different cortico-striatal loops. These alterations of network properties may underlie abnormal sensorimotor integration in PD.

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Author and article information

Journal

Title: Movement Disorders Clinical Practice

Abbreviated Title: Mov Disord Clin Pract

Publisher: Wiley

ISSN (Print): 2330-1619

ISSN (Electronic): 2330-1619

Publication date Created: February 12 2019

Publication date Created: February 2019

Publication date (Electronic): February 08 2019

Publication date (Print): February 2019

Volume: 6

Issue: 2

Pages: 104-117

Affiliations

[1 ]Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific InstituteVita‐Salute San Raffaele University Milan Italy

[2 ]Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific InstituteVita‐Salute San Raffaele University Milan Italy

[3 ]Laboratory of Movement AnalysisSan Raffaele Scientific Institute Milan Italy