Functional Role of the Cerebellum in Parkinson Disease: A PET Study

OBJECTIVES:To test for cerebellar involvement in motor and nonmotor impairments in Parkinson’s disease (PD), and to determine patterns of metabolic correlations with supratentorial brain structures, we correlated clinical motor, cognitive and psychiatric scales with cerebellar metabolism.METHODS:We included 90 patients with PD. Motor, cognitive and psychiatric domains were assessed, and resting-state 18FDG-PET metabolic imaging was performed. The motor, cognitive and psychiatric scores were entered separately in a principal component analysis. We looked for correlations between these three principal components and cerebellar metabolism. Furthermore, we extracted the mean glucose metabolism value for each significant cerebellar cluster and looked for patterns of cerebrum-cerebellum metabolic correlations.RESULTS:Severity of impairment was correlated with increased metabolism in the anterior lobes and vermis (motor domain), and the right Crus I, Crus II, and declive (cognitive domain), and the right Crus I and Crus II (psychiatric domain). There were no results surviving multiple testing corrections regarding the psychiatric domain. Moreover, we found distributed and overlapping - but not identical- patterns of metabolic correlations for motor and cognitive domains. Specific supratentorial structures (cortical structures, basal ganglia, and thalamus) were strongly correlated with each of the cerebellar clusters.CONCLUSIONS:These results confirm the role of the cerebellum in nonmotor domains of Parkinson’s disease, with differential but overlapping patterns of metabolic correlations suggesting the involvement of cerebello-thalamo-striatal-cortical loops.

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Exercise as Medicine for the Treatment of Brain Dysfunction: Evidence for Cortical Stroke, Cerebellar Ataxia, and Parkinson’s Disease

Kinesiology Review ◽

10.1123/kr.2016-0036 ◽

2017 ◽

Vol 6 (1) ◽

pp. 30-41

Author(s):

Yu-Ting Tseng ◽

Sanaz Khosravani ◽

Arash Mahnan ◽

Jürgen Konczak

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Cerebellar Ataxia ◽

Current Knowledge ◽

Neurological Diseases ◽

Scientific Evidence ◽

Brain Structures ◽

Brain Dysfunction ◽

Cortical Stroke

This review addresses the role of exercise as an intervention for treating neurological disease. It focuses on three major neurological diseases that either present in acute or neurodegenerative forms—Parkinson’s disease, cerebellar ataxia, and cortical stroke. Each of the diseases affects primarily different brain structures, namely the basal ganglia, the cerebellum, and the cerebrum. These structures are all known to be involved in motor control, and the dysfunction of each structure leads to distinct movement deficits. The review summarizes current knowledge on how exercise can aid rehabilitation or therapeutic efforts. In addition, it addresses the role of robotic devices in enhancing available therapies by reviewing how robot-aided therapies may promote the recovery for stroke survivors. It highlights recent scientific evidence in support of exercise as a treatment for brain dysfunction, but also outlines the still open challenges for unequivocally demonstrating the benefits of exercise.

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Emotional Processing following Cortical and Subcortical Brain Damage: Contribution of the Fronto-Striatal Circuitry

Behavioural Neurology ◽

10.1155/1998/579029 ◽

1998 ◽

Vol 11 (1) ◽

pp. 29-42 ◽

Cited By ~ 92

Author(s):

Caterina Breitenstein ◽

Irene Daum ◽

Hermann Ackermann

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Emotional Processing ◽

Brain Structures ◽

Emotional Perception ◽

Subcortical Brain ◽

Subcortical Brain Structures ◽

Advanced Stages ◽

Standardized Measure ◽

The Right

The present study examined the differential contribution of cortical and subcortical brain structures in emotional processing by comparing patients with focal cortical lesions (n= 32) to those with primarily subcortical dysregulation of the basal ganglia (Parkinson’s diseasen= 14). A standardized measure of emotional perception (Tübingen Affect Battery) was used. Only patients in the more advanced stages of Parkinson’s disease and patients with focal damage to the (right) frontal lobe differed significantly from controls in both facial expression and affective prosody recognition. The findings imply involvement of the fronto-striatal circuitry in emotional processing.

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Serotonin transporter binding and anxiety symptoms in Parkinson’s disease

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2017-316193 ◽

2017 ◽

Vol 89 (1) ◽

pp. 89-94 ◽

Cited By ~ 13

Author(s):

Merijn Joling ◽

Odile A van den Heuvel ◽

Henk W Berendse ◽

Jan Booij ◽

Chris Vriend

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Serotonin Transporter ◽

Multiple Testing ◽

Single Photon ◽

Photon Emission ◽

Negative Association ◽

Anxiety Symptoms ◽

The Right

BackgroundAnxiety is a common neuropsychiatric symptom in Parkinson’s disease (PD), yet the neural mechanisms have been scarcely investigated. Disturbances in dopaminergic and serotonergic signalling may play a role in its pathophysiology. 123I-N-ω-fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl)nortropane (123I-FP-CIT) is a single-photon emission CT radiotracer, and its binding in striatal and extrastriatal subcortical brain areas represents predominant binding to the presynaptic dopamine transporter (DAT) and the serotonin transporter (SERT), respectively. Availability of DAT and SERT may thus provide an in vivo measure for the integrity of both dopamine and serotonin neurons.MethodsWe studied the association between anxiety symptoms, measured with an affective subscale of the Beck Anxiety Inventory, and (extra)striatal 123I-FP-CIT binding in 127 non-demented patients with PD with a median disease duration of 2.55 (IQR 2.90) years. We conducted the analyses on patients currently on or not on dopamine replacement therapy (DRT).ResultsSeverity of anxiety symptoms showed a significant negative association with 123I-FP-CIT binding ratios in the right thalamus (β=−0.203, p=0.019; ΔR2=0.040) (multiple testing pcorr <0.020). In the subgroup of patients not on DRT (n=81), we found a significant negative association between anxiety and thalamic 123I-FP-CIT binding ratios bilaterally (right: β=−0.349, p=0.001, ΔR2=0.119; left: β=−0.269, p=0.017, ΔR2=0.071) (pcorr <0.020).ConclusionThis study shows that higher levels of anxiety in patients with PD are associated with lower thalamic 123I-FP-CIT binding, pointing towards a contribution of serotonergic degeneration to anxiety symptoms in PD.

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