Parkinson's Disease : From Genetics to Clinical Practice

Breakthroughs in genetics over the last decade have radically advanced our understanding of the etiological basis of Parkinson's disease (PD). Although much research remains to be done, the main genetic causes of this neurodegenerative disorder are now partially unraveled, allowing us to feel more confident that our knowledge about the genetic architecture of PD will continue to increase exponentially. How and when these discoveries will be introduced into general clinical practice, however, remains uncertain. In this review, we provide a general summary of the progress in the genetics of PD and discuss how this knowledge will contribute to the diagnosis and clinical management of patients with, or at risk of this disorder

Effects of a Green Oat Herb Extract on Cognitive Performance and Neurophysiological Activity : A Randomized Double-Blind Placebo-Controlled Study

Green oat extracts have been used for centuries in traditional medicine in view of their supposed beneficial effects on cognition and mood. Recently, a specific green oat formulation (Neuravena) showed to have significant bioactive compounds potentially associated with the enhancement of processing speed, working memory and attention. The main aim of the current study was to compare the potential effect of acute administration of 800 mg of Neuravena with placebo on a set of neurophysiological correlates of processing speed, attention, performance-monitoring and inhibitory control. Twenty healthy participants were randomized to receive either Neuravena or placebo. Electroencephalographic (EEG) signal acquisition was obtained while participants carried out the modified Eriksen flanker and oddball tasks. Both groups were compared on measures of behavioral task performance, and a set of event-related potentials (ERPs) components related to performance monitoring (the error-related negativity; ERN and the N2), target detection, and attention (P3a/P3b). Following active-intervention N2, ERN, and P3a/P3b were significantly reduced and performance was faster, with no loss of accuracy. Conversely, no neurophysiological differences were found in the placebo group before and after treatment and performance worsened significantly in terms of reaction time and accuracy. Acute administration of 800 mg of Neuravena appears to enhance the optimization of neural resources and positively influences cognitive performance in tasks associated with executive functions, processing speed and attention. Moreover, Neuravena prevents the deleterious effects of tiredness during task performance

Telling true from false: cannabis users show increased susceptibility to false memories

Previous studies on the neurocognitive impact of cannabis use have found working and declarative memory deficits that tend to normalize with abstinence. An unexplored aspect of cognitive function in chronic cannabis users is the ability to distinguish between veridical and illusory memories, a crucial aspect of reality monitoring that relies on adequate memory function and cognitive control. Using functional magnetic resonance imaging, we show that abstinent cannabis users have an increased susceptibility to false memories, failing to identify lure stimuli as events that never occurred. In addition to impaired performance, cannabis users display reduced activation in areas associated with memory processing within the lateral and medial temporal lobe (MTL), and in parietal and frontal brain regions involved in attention and performance monitoring. Furthermore, cannabis consumption was inversely correlated with MTL activity, suggesting that the drug is especially detrimental to the episodic aspects of memory. These findings indicate that cannabis users have an increased susceptibility to memory distortions even when abstinent and drug-free, suggesting a long-lasting compromise of memory and cognitive control mechanisms involved in reality monitoring

Dynamic nuclear polarization enhanced solid-state NMR studies of surface modification of gamma-alumina

Dynamic nuclear polarization (DNP) gives large (>100-fold) signal enhancements in solid-state NMR spectra via the transfer of spin polarization from unpaired electrons from radicals implanted in the sample. This means that the detailed information about local molecular environment available for bulk samples from solid-state NMR spectroscopy can now be obtained for dilute species, such as sites on the surfaces of catalysts and catalyst supports. In this paper we describe a DNP-enhanced solid-state NMR study of the widely used catalyst gamma-alumina which is often modified at the surface by the incorporation of alkaline earth oxides in order to control the availability of catalytically active penta-coordinate surface Al sites. DNP-enhanced 27Al solid-state NMR allows surface sites in gamma-alumina to be observed and their 27Al NMR parameters measured. In addition changes in the availability of different surface sites can be detected after incorporation of BaO

La importància de l'avaluació cognitiva i conductual en la malaltia de Parkinson

La malaltia de Parkinson és una malaltia neurodegenerativa progressiva que afecta el sistema nerviós central, el que provoca l'aparició de símptomes motors i no motors. En aquest article, s'hi destaca la importància d'avaluar i estandarditzar els símptomes no motors, és a dir, el deteriorament cognitiu i alteracions conductuals, per un millor seguiment i tractament d'aquesta malaltia.La enfermedad de Parkinson es una enfermedad neurodegenerativa progresiva que afecta el sistema nervioso central, lo que provoca la aparición de síntomas motores y no motores. En este artículo, se destaca la importancia de evaluar y estandarizar los síntomas no motores (el deterioro cognitivo y alteraciones conductuales) para un mejor seguimiento y tratamiento de esta enfermedad.Parkinson's disease is a progressive neurodegenerative disease that affects the central nervous system, which causes the appearance of motor and non-motor symptoms. This article highlights the importance of non-motor symptoms (cognitive and behavioral alterations) assessment since it will translate into better patient follow-up and treatment of this disease

Structural brain correlates of dementia in Huntington's disease

Altres ajuts: The present study was partially funded by the "Human Biology Project Grant" of the Huntington's Disease Society of America (USA).Huntington's disease (HD) is a fatal genetic neurodegenerative disorder with no effective treatment currently available. Progressive basal ganglia and whole-brain atrophy and concurrent cognitive deterioration are prototypical aspects of HD. However, the specific patterns of brain atrophy underlying cognitive impairment of different severity in HD are poorly understood. The aim of this study was to investigate the specific structural brain correlates of major cognitive deficits in HD and to explore its association with neuropsychological indicators. Thirty-five symptomatic early-to-mild HD patients and 15 healthy controls (HC) with available T1-MRI imaging were included in this study. In this cross-sectional study, HD patients were classified as patients with (HD-Dem) and without (HD-ND) major cognitive impairment in the range of dementia. This classification was based on previously validated PD-CRS cutoff scores for HD. Differences in brain atrophy across groups were studied by means of grey-matter volume voxel-based morphometry (GMV-VBM) and cortical thickness (Cth). Voxelwise and vertexwise general linear models were used to assess the group comparisons, controlling for the effects of age, sex, education, CAG repeat length and severity of motor symptoms. Clusters surviving p < 0.05 and family-wise error (FWE) correction were considered statistically significant. In order to characterize the impact on cognitive performance of the observed brain differences across groups, GMV and Cth values in the set of significant regions were computed and correlated with specific neuropsychological tests. All groups had similar sociodemographic profiles, and the HD groups did not significantly differ in terms of CAG repeat length. Compared to HC, both HD groups exhibited significant atrophy in multiple subcortical and parietal brain regions. However, compared to HC and HD-ND groups, HD-Dem patients showed a more prominent pattern of reduced GMV and cortical thinning. Importantly, this thinning was restricted to regions of the parietal-temporal and occipital cortices. Furthermore, these brain alterations were further associated with poorer cognitive performance in tasks assessing frontal-executive and attention domains as well as memory, language and constructional abilities. Major cognitive impairment in the range of dementia in HD is associated with brain and cognitive alterations exceeding the prototypical frontal-executive deficits commonly recognized in HD. The observed posterior-cortical damage identified by MRI and its association with memory, language, and visuoconstructive dysfunction suggest a strong involvement of extra-striatal atrophy in the onset of severe cognitive dysfunction in HD patients. Critically, major cognitive impairment in this sample was not associated with CAG repeat length, age or education. This finding could support a possible involvement of additional neuropathological mechanisms aggravating cognitive deterioration in HD

A collection of three integration-free iPSCs derived from old male and female healthy subjects

Here, we present the characterization of three iPSC lines derived from dermal fibroblasts of old healthy subjects. Fibroblasts were reprogrammed using Sendai viral vectors encoding OCT4, SOX2, KLF4 and c-MYC. The iPSCs expressed endogenous pluripotency markers, could generate the three germ layers (ectoderm, mesoderm and endoderm), maintained a stable karyotype, and were free from Sendai vectors and reprogramming factors. These integration-free iPSCs can serve for establishing control cell cultures in studies searching for phenotypes and mechanisms that could potentially be dysregulated in degenerative diseases

Facial Emotion Recognition Impairment in Patients with Parkinson's Disease and Isolated Apathy

Apathy is a frequent feature of Parkinson's disease (PD), usually related with executive dysfunction. However, in a subgroup of PD patients apathy may represent the only or predominant neuropsychiatric feature. To understand the mechanisms underlying apathy in PD, we investigated emotional processing in PD patients with and without apathy and in healthy controls (HC), assessed by a facial emotion recognition task (FERT). We excluded PD patients with cognitive impairment, depression, other affective disturbances and previous surgery for PD. PD patients with apathy scored significantly worse in the FERT, performing worse in fear, anger, and sadness recognition. No differences, however, were found between nonapathetic PD patients and HC. These findings suggest the existence of a disruption of emotional-affective processing in cognitive preserved PD patients with apathy. To identify specific dysfunction of limbic structures in PD, patients with isolated apathy may have therapeutic and prognostic implications

The impact of dopaminergic treatment over cognitive networks in Parkinson's disease : Stemming the tide?

Altres ajuts: Fundació la Marató de TV3/20142910Dopamine-replacing therapies are an effective treatment for the motor aspects of Parkinson's disease. However, its precise effect over the cognitive resting-state networks is not clear; whether dopaminergic treatment normalizes their functional connectivity-as in other networks- and the links with cognitive decline are presently unknown. We recruited 35 nondemented PD patients and 16 age-matched controls. Clinical and neuropsychological assessments were performed at baseline, and conversion to dementia was assessed in a 10 year follow-up. Structural and functional brain imaging were acquired in both the ON and practical OFF conditions. We assessed functional connectivity in both medication states compared to healthy controls, connectivity differences within participants related to the ON/OFF condition, and baseline connectivity of PD participants that converted to dementia compared to those who did not convert. PD participants showed and increased frontoparietal connectivity compared to controls: a pattern of higher connectivity between salience (SN) and default-mode (DMN) networks both in the ON and OFF states. Within PD patients, this higher SN-DMN connectivity characterized the participants in the ON state, while within-DMN connectivity prevailed in the OFF state. Interestingly, participants who converted to dementia also showed higher SN-DMN connectivity in their baseline ON scans compared to nonconverters. To conclude, PD patients showed higher frontoparietal connectivity in cognitive networks compared to healthy controls, irrespective of medication status, but dopaminergic treatment specifically promoted SN-DM hyperconnectivity

Measuring the functional impact of cognitive impairment in Huntington's disease

Acord transformatiu CRUE-CSICBackground: Patients with Huntington's disease (HD) exhibit a variable predominance of cognitive, behavioral and motor symptoms. A specific instrument focusing on the impact of cognitive impairment in HD over functional capacity is lacking. Objective: To address the need for a brief and specifically developed HD questionnaire able to capture functional aspects suspected to be sensitive to cognitive impairment. Methods: We developed and validated the "Huntington's Disease-Cognitive Functional Rating Scale" (HD-CFRS) in 78 symptomatic carriers of the Huntington's disease mutation. We also administered the HD-CFRS to a knowledgeable informant to measure the level of agreement. To explore the association between HD-CFRS scores and participants' cognitive status, we administered objective measures of cognition. Participants were classified as cognitively preserved (HD-NC), as having mild cognitive impairment (HD-MCI), or as having dementia (HD-Dem). Results: The HD-CFRS showed concurrent validity and internal consistency in the three groups. HD carriers and informants in the HD-NC group obtained similar HD-CFRS scores. However, in patients with mild cognitive impairment and dementia, informers reported greater functional impairment than HD participants. The HD-CFRS total score showed strong correlations with measures assessing cognition. Conclusions: These findings support the utility of the HD-CFRS as a brief and reliable instrument to measure functional defects associated with cognitive impairment in HD. We believe this questionnaire could be a useful tool both for clinical practice and research