Abnormal activity in the precuneus during time perception in Parkinson’s disease: An fMRI study

Background Parkinson's disease (PD) patients are deficient in time estimation. This deficit improves after dopamine (DA) treatment and it has been associated with decreased internal timekeeper speed, disruption of executive function and memory retrieval dysfunction. Methodology/Findings The aim of the present study was to explore the neurophysiologic correlates of this deficit. We performed functional magnetic resonance imaging on twelve PD patients while they were performing a time reproduction task (TRT). The TRT consisted of an encoding phase (during which visual stimuli of durations from 5s to 16.6s, varied at 8 levels were presented) and a reproduction phase (during which interval durations were reproduced by a button pressing). Patients were scanned twice, once while on their DA medication (ON condition) and once after medication withdrawal (OFF condition). Differences in Blood-Oxygenation-Level-Dependent (BOLD) signal in ON and OFF conditions were evaluated. The time course of activation in the brain areas with different BOLD signal was plotted. There were no significant differences in the behavioral results, but a trend toward overestimation of intervals ≤11.9s and underestimation of intervals ≥14.1s in the OFF condition (p<0.088). During the reproduction phase, higher activation in the precuneus was found in the ON condition (p<0.05 corrected). Time course was plotted separately for long (≥14.1s) and short (≤11.9s) intervals. Results showed that there was a significant difference only in long intervals, when activity gradually decreased in the OFF, but remained stable in the ON condition. This difference in precuneus activation was not found during random button presses in a control task. Conclusions/Significance Our results show that differences in precuneus activation during retrieval of a remembered duration may underlie some aspects of time perception deficit in PD patients. We suggest that DA medication may allow compensatory activation in the precuneus, which results in a more accurate retrieval of remembered interval duration

Improving brain imaging in Parkinson's disease by accounting for simultaneous motor output

Parkinson's disease leads to a variety of movement impairments. While studying the disease with fMRI, the main motivation for the research becomes one of its major obstacles: the motor output is unpredictable. Therefore it is troublesome to access, inside the scanner, performances of motor tasks and reliably relate them to brain measurements. We proposed to overcome this by expanding the patients’ number and restricting statistical criteria from a previous study which used a glove with non-magnetic sensors during scanning. Our results revealed basal ganglia not observed in the previous study confirming the usefulness of the device in fMRI studies

Different brain areas require different analysis models: fMRI observations in Parkinson’s disease

Foreseeing how specific brain areas respond in time to a stimulus can be a prerequisite for a successfully conceived fMRI experiment. We demonstrate that in medicated Parkinson’s disease patients, putamen's activation peaks around the onset of tapping but does not persist throughout the tapping block, whereas sustained activation is observed in the motor cortex. Consequently, in the widely used tapping paradigm “On vs. Off L-DOPA”, the drug effect remains undetected if statistical analysis apply a block design instead of an event-related one. Ignoring this information can lead to fallacious conclusions which suggests using different models to investigate different brain regions

Improving fMRI in Parkinson's disease by accounting for realistic motor output

In Parkinson's disease (PD), the motor loop functioning and the patients’ motor output are unpredictable, due to brain compensatory mechanisms initiated up to decades before diagnosis. Consequently, the accuracy of motor tasks during fMRI is impeded, and deviations of the movement performance affect results. Kinematic modeling based on simultaneous measurements with MR-compatible gloves has been previously proposed as means to address this problem and outperform conventional boxcar modeling (Standard). Here, we adopted this approach in a larger cohort along with conservative statistics employing family-wise error (FWE) correction at the voxel level (p< 0.05) to be less prone to produce false positives

Mutational profiling of kinases in glioblastoma

Background: Glioblastoma is a highly malignant brain tumor for which no cure is available. To identify new therapeutic targets, we performed a mutation analysis of kinase genes in glioblastoma.Methods: Database mining and a literature search identified 76 kinases that have been found to be mutated at least twice in multiple cancer types before. Among those we selected 34 kinase genes for mutation analysis. We also included IDH1, IDH2, PTEN, TP53 and NRAS, genes that are known to be mutated at considerable frequencies in glioblastoma. In total, 174 exons of 39 genes in 113 glioblastoma samples from 109 patients and 16 high-grade glioma (HGG) cell lines were sequenced. Results: Our mutation analysis led to the identification of 148 non-synonymous somatic mutations, of which 25 have not been reported before in glioblastoma. Somatic mutations were found in TP53, PTEN, IDH1, PIK3CA, EGFR, BRAF, EPHA3, NRAS, TGFBR2, FLT3 and RPS6KC1. Mapping the mutated genes into known signaling pathways revealed that the large majority of them plays a central role in the PI3K-AKT pathway. Conclusions: The knowledge that at least 50% of glioblastoma tumors display mutational activation of the PI3K-AKT pathway should offer new opportunities for the rational development of therapeutic approaches for glioblastomas. However, due to the development of resistance mechanisms, kinase inhibition studies targeting the PI3K-AKT pathway for relapsing glioblastoma have mostly failed thus far. Other therapies should be investigated, targeting early events in gliomagenesis that involve both kinases and non-kinases

Does early resection of presumed low-grade glioma improve survival? A clinical perspective

Early resection is standard of care for presumed low-grade gliomas. This is based on studies including only tumors that were post-surgically confirmed as low-grade glioma. Unfortunately this does not represent the clinicians’ situation wherein he/she has to deal with a lesion on MRI that is suspect for low-grade glioma (i.e. without prior knowledge on the histological diagnosis). We therefore aimed to determine the optimal initial strategy for patients with a lesion suspect for low-grade glioma, but not histologically proven yet. We retrospectively identified 150 patients with a resectable presumed low-grade-glioma and who were otherwise in good clinical condition. In this cohort we compared overall survival between three types of initital treatment strategy: a wait-and-scan approach (n = 38), early resection (n = 83), or biopsy for histopathological verification (n = 29). In multivariate analysis, no difference was observed in overall survival for early resection compared to wait-and-scan: hazard ratio of 0.92 (95% CI 0.43–2.01; p = 0.85). However, biopsy strategy showed a shorter overall survival compared to wait-and-scan: hazard ratio