Mild Parkinsonian Signs Are Related to Lower Cortico-Striatal Connectivity in Executive Networks

Mild Parkinsonian signs (MPS) affect up to 24% of community-dwelling older adults. We hypothesize that MPS are associated with Parkinson’s-like alterations of functional connectivity (FC) in sensorimotor, executive, and reward cortico-striatal networks. Participants (N=266; mean age=83; 57% female) without Parkinson’s completed resting-state fMRI and Unified Parkinsonian Disease Rating Scale (UPDRS). FC between striatum and cortex was measured within each network. Logistic regression tested associations of each network’s FC with MPS (UPDRS>0), adjusted for MPS risk factors, then including white matter hyperintensities (WMH). MPS was associated with lower cortical-striatal FC in the left executive cortico-striatal network (OR [95%CI]: 0.188 [0.043,0.824]). Association survived adjusting for risk factors (0.162 [0.030,0.874]) but was attenuated after including WMH (0.209 [0.036, 1.200]). In stratified analyses, left executive cortico-striatal FC was associated with MPS only for those with higher WMH (0.077 [0.010,0.599]). Future work should examine whether higher FC protects against the influence of WMH on MPS.

PALLIDOTOMY IN PARKINSONIAN DISEASE: THE RENAISSANCE

ABSTRACT: BACKGROUND & OBJECTIVE: To assess the results of pallidotomy in Parkinson’s disease, and its effect on improving the lifestyle of the patients and cost-effectiveness. METHODOLOGY: A descriptive study was conducted at Neuro-Spinal & Cancer Care Institute, Karachi from June 2014 to January 2020. Patients who were known case of Parkinson’s disease refractory to medication and developed side effects to medication were included in the study and patients with previous brain surgery, associated brain disorders like Alzheimer’s disease, basal ganglia lesion, brain trauma were excluded. All patients were treated by pallidotomy on the contralateral side. The significance of the difference between groups to compare between the pre-op or post-op treatments was calculated through non-parametric assessment Kruskal-Wallis tests. RESULTS: The mean age of the patients was around 57 years. There were 34(81%) male and 8(19%) female patients’ Maximum number of patients who were more than 45 years, were having a left-sided proportion. More male patients were having a left-sided proportion as compared to female patients. The majority of patients (57.5%) were having dyskinesia as q primary symptom. A significant difference (p-value <0.001) existed in pre & post-operative UPDRS-III scores. A significant difference (p-value <0.001) also existed between on & off medications UPDRS- III (pre-op/post-op) scores. CONCLUSION: The result of pallidotomy is promising especially for unilateral pallidotomy to minimize the risk of cognition and speech disorder and long-term follow-up is needed to prove the statement further. Currently, pallidotomy is associated with minimal complications, more effective, and improving the quality of life of Parkinsonian patients.

Berberis vulgaris alleviates Levodopa-induced dyskinesia in male mice

Summary Introduction: Parkinson’s disease is a chronic debilitating disease and many patients use Levodopa as a major treatment. However, this drug in long-term use causes a serious condition that is known as Levodopa-induced dyskinesia (LID). Berberis vulgaris (BV) has been known to be a good potential medication for neurologic diseases such as movement disorders. The aim of this study is to investigate the usefulness of BV for LID in mice. Material and methods: In this study, 48 adult male mice were randomly divided into six groups: 1) saline group, 2) MPTP + LID, 3) MPTP + LID + BV (5 mg/kg), 4) MPTP + LID + BV (10 mg/kg), 5) MPTP + LID + BV (20 mg/kg). MPTP (1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine) (30 mg/kg/day/i.p.) was used to induce Parkinson’s disease and Levodopa (50 mg/kg/day/i.p.) was used to induce LID. After induction of LID, mice received intraperitoneally (i.p.) different dosages of BV for 25 days. To investigate movement disorder improvement (dyskinesia), AIMS (Abnormal Involuntary Movement Scale) and cylinder tests were used. Results: Mice that received BV at dosages of 10 and 20 mg/kg/day showed improvement in AIMS and the cylinder test. Conclusion: BV is a useful drug for treating LID. So, parkinsonian disease patients may get a beneficial effect after treatment with BV for LID.