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      Reduced gray matter volume and respiratory dysfunction in Parkinson’s disease: a voxel-based morphometry study

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          Abstract

          Background

          The respiratory dysfunction of patients with Parkinson’s disease (PD) has drawn increasing attention. This study evaluated the relationship between gray matter volume (GMV), as determined by voxel-based morphometry (VBM), and respiratory dysfunction in patients with PD and correlated it with systemic inflammatory markers.

          Methods

          Whole-brain VBM analysis was performed on 3-dimensional T1-weighted images in 25 PD patients with abnormal pulmonary function (13 men, 12 women; mean age: 62.9 ± 10.8 years) and, for comparison, on 25 sex- and age-matched PD patients with normal pulmonary function (14 men, 11 women; mean age: 62.3 ± 6.9 years). Inflammatory markers were determined by flow cytometry. The differences and correlations in regional GMV, clinical severity and inflammatory markers were determined after adjusting for age, gender and total intracranial volume (TIV).

          Results

          Compared with the normal pulmonary function group, the abnormal pulmonary function group had smaller GMV in several brain regions, including the left parahippocampal formation, right fusiform gyrus, right cerebellum crus, and left postcentral gyri. Forced expiratory volume in 1 s (FEV1) and maximal expiratory flow after expiration of 50% of forced vital capacity (MEF50) were positively correlated with regional GMV. There were no significant differences in the level of serum inflammatory markers between two groups.

          Conclusion

          Our findings suggested that involvement of the central autonomic network and GM loss may underlie the respiratory dysfunction in PD patients.

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          Most cited references23

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          Oxidative stress and inflammation in Parkinson's disease: is there a causal link?

          Parkinson's disease (PD) is a neurodegenerative disorder characterized by a dramatic loss of dopaminergic neurons in the substantia nigra (SN). Among the many pathogenic mechanisms thought to contribute to the demise of these cells, dopamine-dependent oxidative stress has classically taken center stage due to extensive experimental evidence showing that dopamine-derived reactive oxygen species and oxidized dopamine metabolites are toxic to nigral neurons. In recent years, however, the involvement of neuro-inflammatory processes in nigral degeneration has gained increasing attention. Not only have activated microglia and increased levels of inflammatory mediators been detected in the striatum of deceased PD patients, but a large body of animal studies points to a contributory role of inflammation in dopaminergic cell loss. Recently, postmortem examination of human subjects exposed to the parkinsonism-inducing toxin, 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP), revealed the presence of activated microglia decades after drug exposure, suggesting that even a brief pathogenic insult can induce an ongoing inflammatory response. Perhaps not surprisingly, non-steroidal anti-inflammatory drugs (NSAIDs) have been shown to reduce the risk of developing PD. In the past few years, various pathways have come to light that could link dopamine-dependent oxidative stress and microglial activation, finally ascribing a pathogenic trigger to the chronic inflammatory response characteristic of PD.
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            Level and value of circulating endothelial progenitor cells in patients after acute ischemic stroke.

            Endothelial progenitor cells (EPCs) migrate from bone marrow to systemic circulation in response to tissue ischemia where they differentiate into mature endothelial cells for angiogenesis in situ. This study tested the hypothesis that the level of circulating EPCs is substantially increased and predictive of prognostic outcomes after acute ischemic stroke (IS). The level of circulating EPCs (staining markers: CD31/CD34 [E(1)], CD62E/CD34 [E(2)], and KDR/CD34 [E(3)]) were examined using flow cytometry at 48 hours after acute IS in 138 consecutive patients. The EPC level was also evaluated once in 20 healthy volunteers and in 40 at-risk control subjects. Level of circulating EPCs (E(1-3)) was significantly higher in patients with IS than in at-risk control subjects (P or=12 on the National Institutes of Health Stroke Scale) than in patients with less severe impairment (National Institutes of Health Stroke Scale or=4 on day 21 after IS (P=0.0004). Furthermore, low circulating EPC level was independently predictive of severe neurological impairment (National Institutes of Health Stroke Scale >or=12) at 48 hours (E(1-3)) and combined major adverse clinical outcomes (defined as recurrent IS, any cause of death, or National Institutes of Health Stroke Scale of >or=12) on day 90 (E(1)) after IS (P<0.001). Level of circulating EPCs is independently predictive of prognosis after IS.
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              Cortico-limbic circuitry and the airways: insights from functional neuroimaging of respiratory afferents and efferents.

              After nearly two decades of active research, functional neuroimaging has demonstrated utility in the identification of cortical, limbic, and paralimbic (cortico-limbic) brain regions involved in respiratory control and respiratory perception. Before the recent boon of human neuroimaging studies, the location of the principal components of respiratory-related cortico-limbic circuitry had been unknown and their function had been poorly understood. Emerging neuroimaging evidence in both healthy and patient populations suggests that cognitive and emotional/affective processing within cortico-limbic circuitry modulates respiratory control and respiratory perception. This paper will review functional neuroimaging studies of respiration with a focus on whole brain investigations of sensorimotor pathways that have identified respiratory-related neural circuitry known to overlap emotional/affective cortico-limbic circuitry. To aid the interpretation of present and future findings, the complexities and challenges underlying neuroimaging methodologies will also be reviewed as applied to the study of respiration physiology. Copyright © 2010 Elsevier B.V. All rights reserved.
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                Author and article information

                Contributors
                siehyang418@hotmail.com
                sperfect1101@gmail.com
                lovage@cgmh.org.tw
                suring.tw@gmail.com
                dargonchow@gmail.com
                yssamchen@gmail.com
                yuchiunchieh@gmail.com
                tsainw@yahoo.com.tw
                lee0624@adm.cgmh.org.tw
                +886-7-731-7123 , chlu99@cgmh.org.tw
                +886-7-731-7123 , u64lin@yahoo.com.tw
                Journal
                BMC Neurol
                BMC Neurol
                BMC Neurology
                BioMed Central (London )
                1471-2377
                26 May 2018
                26 May 2018
                2018
                : 18
                : 73
                Affiliations
                [1 ]GRID grid.145695.a, Department of Diagnostic Radiology, , Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, ; 123 Ta-Pei Road, Niao-Sung, Kaohsiung, 83305 Taiwan
                [2 ]ISNI 0000 0001 0425 5914, GRID grid.260770.4, Brain Research Center, , National Yang-Ming University, ; Taipei, Taiwan
                [3 ]ISNI 0000 0001 0425 5914, GRID grid.260770.4, Institute of Neuroscience, , National Yang-Ming University, ; Taipei, Taiwan
                [4 ]GRID grid.145695.a, Department of Neurology, , Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, ; 123 Ta-Pei Road, Niao-Sung, Kaohsiung, 83305 Taiwan
                [5 ]GRID grid.145695.a, Department of Oncology and Hematology, , Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, ; Kaohsiung, Taiwan
                Author information
                http://orcid.org/0000-0002-1326-0587
                Article
                1074
                10.1186/s12883-018-1074-8
                5970473
                29803228
                8fdc1c90-6466-4c11-9790-d368587b2fd7
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 26 February 2018
                : 14 May 2018
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100001868, National Science Council;
                Award ID: NMRPG8G0141
                Award ID: NMRPG8G6142
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2018

                Neurology
                parkinson’s disease,magnetic resonance imaging,gray matter,respiratory system,autonomic nervous system

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