scholarly journals Prefrontal dysfunction following unilateral posteroventral pallidotomy in Parkinson's disease

1999 ◽  
Vol 6 (4) ◽  
pp. E2
Author(s):  
Tetsuo Yokoyama ◽  
Yoko Imamura ◽  
Kenji Sugiyama ◽  
Shigeru Nishizawa ◽  
Naoki Yokota ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Function ◽  
Digit Span ◽  
Preoperative Evaluation ◽  
Japanese Version ◽  
Word Fluency ◽  
Yahr Stage ◽  
Posteroventral Pallidotomy ◽  
The Right

Object Pre- and postoperative cognitive function were evaluated in 25 patients with Parkinson's disease (PD) who underwent unilateral posteroventral pallidotomy (PVP) to clarify the effects of this operation on cognitive function. Methods Cognitive function was assessed before surgery and 1 month and 3 months afterward by using a battery of neuropsychological tests consisting of orientation, digit span (forward and backward), digit learning, 5-minute memory of five words, similarities, serial sevens, animal name listing, and the kana pick-out test, as well as the Japanese version of the Mini-Mental State. Preoperative evaluation revealed that patients experienced difficulties in performing the neuropsychological tasks of reasoning and abstraction, working memory of numerals, word fluency, and concept formation compared with 36 healthy volunteers (p < 0.05). A simple regression analysis showed strong relationships in a negative fashion between preoperative (r = 0.81, p = 0.002) and 1-month (r = 0.79, p = 0.0059) and 3-month (r = 0.85, p = 0.0016) postoperative gross-total scores and Hoehn and Yahr staging. Preoperative and postoperative scores at 1 month and 3 months were analyzed by analysis of variance, but only the Fisher's post hoc test revealed the source of difference. All tasks except orientation (p = 0.0292) were unchanged in the 10 patients who underwent surgery on the right side. The scores for this task at 1 month postsurgery were significantly lower (p = 0.0203) but improved to preoperative values by 3 months. In the 15 patients who underwent surgery on the left side significant differences among tasks were revealed for serial sevens (p = 0.0471) and animal naming (p = 0.0425). The scores for these tasks were significantly lower at 1 month postoperatively (p = 0.0431 for serial sevens and p = 0.0408 for animal naming), but improved by 3 months after the operation. Conclusions The present data revealed that cognitive dysfunction in patients with PD relates to advancement of Hoehn and Yahr stage, but PVP is not associated with significant long-lasting cognitive deficits.

Prefrontal dysfunction following unilateral posteroventral pallidotomy in Parkinson's disease

1999 ◽  
Vol 90 (6) ◽  
pp. 1005-1010 ◽  
Author(s):  
Tetsuo Yokoyama ◽  
Yoko Imamura ◽  
Kenji Sugiyama ◽  
Shigeru Nishizawa ◽  
Naoki Yokota ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Function ◽  
Digit Span ◽  
Preoperative Evaluation ◽  
Word Fluency ◽  
Yahr Stage ◽  
Content Type ◽  
Posteroventral Pallidotomy ◽  
Fine Print

Object. Pre- and postoperative cognitive function was evaluated in patients with Parkinson's disease (PD) who underwent unilateral posteroventral pallidotomy (PVP) to clarify the effects of this operation on cognitive function.Methods. Cognitive function was assessed before surgery and 1 month and 3 months afterward by using a battery of neuropsychological tests consisting of orientation, digit span (forward and backward), digit learning, 5-minute memory of five words, similarities, serial sevens, animal name listing, and the kana pick-out test, as well as the Japanese version of the Mini-Mental State. Preoperative evaluation revealed that patients experienced difficulties in performing the neuropsychological tasks of reasoning and abstraction, working memory of numerals, word fluency, and concept formation compared with 36 healthy volunteers (p < 0.05). A simple regression analysis showed strong relationships in a negative fashion between preoperative (r = 0.81, p = 0.002) and 1-month (r = 0.79, p = 0.0059) and 3-month (r = 0.85, p = 0.0016) postoperative gross-total scores and Hoehn and Yahr staging. Preoperative and postoperative scores at 1 month and 3 months were analyzed by analysis of variance, but only the Fisher's post hoc test revealed the source of difference. All tasks except orientation (p = 0.0292) were unchanged in the 10 patients who underwent surgery on the right side. The scores for this task at 1 month postsurgery were significantly lower (p = 0.0203) but improved to preoperative values by 3 months. In the 15 patients who underwent surgery on the left side significant differences among tasks were revealed for serial sevens (p = 0.0471) and animal naming (p = 0.0425). The scores for these tasks were significantly lower at 1 month postoperatively (p = 0.0431 for serial sevens and p = 0.0408 for animal naming), but improved by 3 months after the operation.Conclusions. The present data revealed that cognitive dysfunction in patients with PD relates to advancement of Hoehn and Yahr stage, but PVP is not associated with significant long-lasting cognitive deficits.

scholarly journals Neurofeedback-guided kinesthetic motor imagery training in Parkinson's disease: Randomized trial

2022 ◽  
Author(s):  
Sule Tinaz ◽  
Serageldin Kamel ◽  
Sai S Aravala ◽  
Mohamed Elfil ◽  
Ahmed Bayoumi ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Functional Connectivity ◽  
Motor Function ◽  
Motor Imagery ◽  
Resting State ◽  
Visual Imagery ◽  
Body Awareness ◽  
Yahr Stage ◽  
The Right

Background: Parkinson's disease (PD) causes difficulty with maintaining the speed, size, and vigor of movements, especially when they are internally generated. We previously proposed that the insula is important in motivating intentional movement via its connections with the dorsomedial frontal cortex (dmFC). We demonstrated that subjects with PD can increase the right insula-dmFC functional connectivity using fMRI-based neurofeedback (NF) combined with kinesthetic motor imagery (MI). The current study is a randomized clinical trial testing whether NF-guided kinesthetic MI training can improve motor performance and increase task-based and resting-state right insula-dmFC functional connectivity in subjects with PD. Methods: We assigned nondemented subjects with mild PD (Hoehn & Yahr stage ≤ 3) to the experimental kinesthetic MI with NF (MI-NF, n=22) and active control visual imagery (VI, n=22) groups. Only the MI-NF group received NF-guided MI training (10-12 runs). The NF signal was based on the right insula-dmFC functional connectivity strength. All subjects also practiced their respective imagery tasks at home daily for 4 weeks. Post-training changes in 1) task-based and resting-state right insula-dmFC functional connectivity were the imaging outcomes, and 2) MDS-UPDRS motor exam and motor function scores were the clinical outcomes. Results: The MI-NF group did not show significant NF regulation and was not significantly different from the VI group in any of the imaging or clinical outcome measures. The MI-NF group reported subjective improvement in kinesthetic body awareness. There was significant and comparable improvement only in motor function scores in both groups. This improvement correlated with NF regulation of the right insula-dmFC functional connectivity only in the MI-NF group. Both groups showed specific training effects in whole-brain functional connectivity with distinct neural circuits supporting kinesthetic motor and visual imagery (exploratory outcome). Conclusions: The functional connectivity-based NF regulation was unsuccessful in our cohort with mild PD. However, kinesthetic MI practice by itself or in combination with other imagery techniques is a promising tool in motor rehabilitation in PD.

scholarly journals Relationship between cognitive performance and mobility in patients with Parkinson’s disease: A cross-sectional study

2019 ◽  
Vol 13 (4) ◽  
pp. 403-409 ◽  
Author(s):  
Nariana Mattos Figueiredo Sousa ◽  
Roberta Correa Macedo
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Digit Span ◽  
Cross Sectional Study ◽  
Timed Up And Go ◽  
Yahr Stage ◽  
Cross Sectional ◽  
Verbal Fluency Task ◽  
Trail Making

ABSTRACT Gait disorders may be associated with cognitive impairment, and slow speed predicts cognitive impairment and dementia. Objective: To investigate the relationships between cognitive function and gait performance in patients with Parkinson’s disease (PD) who attended a hospital neurorehabilitation program. Methods: Descriptive and inferential statistics (Pearson’s correlation) were used for data analysis. The cognitive functions were evaluated through Digit Span, Mental Control, Trail Making Test, Phonemic Verbal Fluency Task, and Addenbrooke’s Cognitive Examination III. The motor function was assessed through 10-meter walk test, Mini BESTest and Timed Up and Go Test. Results: A total of 65 patients were included in this study. Of these, 66.15% were males, mean age was 61.14 (8.39) years, mean educational was 12 (8) years, disease progression time was 5.45 (4.37) years. 64.61% were in stages I and II of the Hoehn and Yahr stage. The correlation analyses showed that balance skills are significantly correlated with the ability to switch attention between two tasks and visuospatial function. The function mobility showed a significant correlation with cognitive tests. Conclusion: Data suggest the importance of the aspects of switch attention and mental flexibility in gait, evidencing the greater difficulty for double tasks.

scholarly journals P.043 Perceptual descriptors and clinical determinants of pain in Parkinson’s disease: focus on patients’ experiences

2016 ◽  
Vol 43 (S2) ◽  
pp. S31-S31
Author(s):  
A Rana ◽  
U Saeed ◽  
I Abdullah
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Motor Symptom ◽  
Structured Interviews ◽  
Clinical Predictors ◽  
Yahr Stage ◽  
Clinical Pain ◽  
Pain Prevalence ◽  
Perceived Effects ◽  
The Right

Background: Pain is a disabling non-motor symptom of Parkinson’s disease (PD), which remains underacknowledged, undertreated and often undeclared by patients in the clinical practice. Prevalence of pain ranges from 40-75% among PD patients; however, clinical determinants and self-reported perceptual experiences of pain require further research. Methods: 121 PD patients (age: 67.3±11.4) from community-based clinic were analyzed cross-sectionally. Perceptual experiences and clinical predictors of pain were assessed using structured interviews, questionnaires and neurological examinations. Results: 80 (66%) PD patients reported pain; 65 (54%) described the severity as ‘moderate/high’. Dystonic was the most frequent clinical pain 37/80 (48%), followed by neuropathic (36%), akathisia (29%) and musculoskeletal (28%). More than one type of clinical pain was assessed in 22 (28%) patients. Aching was the most common perceptual descriptor of pain (46%), followed by sharp/deep (30%), tension (18%) and dull (14%). PD localized on the right side quadrupled the odds of pain on the right (OR=4.4, 95%CI [1.1-18.2]); and pain described as ‘sharp’ predicted neuropathic pain (OR=5.6, 95%CI [1.1-29.2]). Pain prevalence also increased with progressive Hoehn-and-Yahr stage. Interestingly, only 51% of patients perceived effects of PD medications on pain symptomology. Conclusions: Perceptual descriptors of pain can provide novel approaches to classify, treat and manage PD. Longitudinal investigations with larger sample are warranted.

scholarly journals Emotional Processing Impairments in Apathetic Patients with Parkinson’s Disease: An ERP Study in Early Time Windows

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Wei Wei ◽  
Jianghai Ruan ◽  
Xiaodong Duan ◽  
Hua Luo
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Emotional Processing ◽  
Right Hemisphere ◽  
Digit Span ◽  
Time Windows ◽  
Early Time ◽  
Event Related Potentials ◽  
Related Potentials ◽  
The Right

We investigated emotional processing in apathetic patients with Parkinson’s disease (PD) by observing components of event-related potentials (ERPs) in early time windows. Forty PD patients and 21 healthy controls (HCs) were enrolled. The Starkstein Apathy Scale (SAS) was used to divide the PD patients into apathetic and nonapathetic groups. Cognitive function was evaluated by the forward and backward Digit Span tests, Trail Making Test (TMT), and Word Fluency Test. The participants were required to recognize positive, neutral, and negative emotional faces and engage in an emotion categorization task while EEG was recorded. The time to completion for the TMT (Part A and Part B) from highest to lowest was in the order of apathetic group > nonapathetic group > HC group. Compared with the nonapathetic and HC groups, in the apathetic group, P100 amplitudes were smaller for positive expressions in the right hemisphere and latencies were longer for positive expressions in the left hemisphere, while latencies were longer for neutral expressions bilaterally. Compared with the nonapathetic group, in the apathetic group, N170 amplitudes were attenuated and latencies were delayed for neutral and negative expressions in the right hemisphere. A trend towards larger N170 amplitudes in the right hemisphere than in the left was observed in the nonapathetic and HC groups, but this difference was not significant in the apathetic group. In the apathetic group, bilateral P100 amplitudes elicited by negative expressions were negatively correlated with SAS scores, and SAS scores were positively correlated with Part B of the TMT. N170 amplitudes elicited by negative expressions in the right hemisphere were negatively correlated with SAS in the apathetic group and with Part B of TMT in both PD groups. Our findings suggested that emotional processing was impaired in apathetic PD patients and that the right hemisphere was more sensitive to reflecting this impairment in the early time windows of ERPs.

scholarly journals Dizziness in Parkinson’s disease patients is associated with vestibular function

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jeong-Ho Park ◽  
Suk Yun Kang
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Orthostatic Hypotension ◽  
Rating Scale ◽  
Treatment Plan ◽  
Vestibular Function ◽  
Vestibular Evoked Myogenic Potentials ◽  
Yahr Stage ◽  
The Right ◽  
And Function

AbstractDizziness is common in Parkinson’s disease (PD) patients. It is known that orthostatic hypotension (OH) is the main cause of such dizziness, but even without OH, quite a few PD patients complain of dizziness in the clinic. It can be regarded as non-specific because most of these patients have no neurological abnormalities. We hypothesized that this type of dizziness would be associated with vestibular function, although included patients did not have clinically confirmed vestibulopathy. We studied 84 patients without OH among 121 PD patients. Their clinical features and function were compared between patients with and without dizziness. Hoehn and Yahr stage (H&Y stage), the Unified Parkinson's Disease Rating Scale (UPDRS) part III, the Korean version of the Mini-Mental State Examination (K-MMSE), education years, disease duration, total levodopa equivalent daily dose (LEDD), the presence of dizziness, the dizziness severity, and orthostatic hypotension were tested. Vestibular evoked myogenic potentials (VEMPs) were used to characterize vestibular function. Ocular (oVEMPs) and cervical (cVEMPs) were recorded. oVEMPs in the right side showed significantly reduced potentials (p = 0.016) in PD patients with dizziness, but cVEMPs did not (all ps > 0.2). Bilateral absent oVEMP responses were more common in PD patients with dizziness (p = 0.022), but the frequencies of bilateral absent cVEMP responses were not different between the dizzy and non-dizzy groups (p = 0.898). Dizziness in PD patients without orthostatic hypotension may be associated with vestibular hypofunction. Our results provide evidence that can aid clinicians when making a treatment plan for patients with dizziness. i.e., strategies to enhance reduced vestibular function may be helpful, but this suggestion remains to be evaluated.

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