Marlieke Scholten1, Rathinaswamy B Govindan2, Christoph Braun3, Bastiaan R Bloem4, Christian Plewnia5, Rejko Krüger6, Alireza Gharabaghi7, Daniel Weiss8. 1. Department of Neurodegenerative Diseases and Hertie Institute for Clinical Brain Research (HIH), University of Tuebingen, Tuebingen, Germany; German Centre of Neurodegenerative Diseases (DZNE), University of Tuebingen, Tuebingen, Germany; Centre for Integrative Neuroscience (CIN), University of Tuebingen, Tuebingen, Germany; Graduate School of Neural & Behavioral Sciences, International Max Planck Research School, University of Tuebingen, Tuebingen, Germany. Electronic address: marlieke.scholten@uni-tuebingen.de. 2. Division of Fetal and Transitional Medicine, Children's National Medical Center, Washington, DC, USA. 3. Centre for Integrative Neuroscience (CIN), University of Tuebingen, Tuebingen, Germany; MEG Center, University of Tuebingen, Tuebingen, Germany; CIMeC, Center of Mind/Brain Sciences, University of Trento, Italy. 4. Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behavior, Department of Neurology, Nijmegen, The Netherlands. 5. Department of Psychiatry and Psychotherapy, University of Tuebingen, Tuebingen, Germany. 6. Department of Neurodegenerative Diseases and Hertie Institute for Clinical Brain Research (HIH), University of Tuebingen, Tuebingen, Germany; German Centre of Neurodegenerative Diseases (DZNE), University of Tuebingen, Tuebingen, Germany; Centre for Integrative Neuroscience (CIN), University of Tuebingen, Tuebingen, Germany; Clinical and Experimental Neuroscience, Luxembourg Center for Systems Biomedicine (LCSB), University of Luxembourg and Centre Hospitalier de Luxembourg (CHL), Luxembourg. 7. Centre for Integrative Neuroscience (CIN), University of Tuebingen, Tuebingen, Germany; Division of Functional and Restorative Neurosurgery, Department of Neurosurgery, University of Tuebingen, Tuebingen, Germany. 8. Department of Neurodegenerative Diseases and Hertie Institute for Clinical Brain Research (HIH), University of Tuebingen, Tuebingen, Germany; German Centre of Neurodegenerative Diseases (DZNE), University of Tuebingen, Tuebingen, Germany; Centre for Integrative Neuroscience (CIN), University of Tuebingen, Tuebingen, Germany. Electronic address: daniel.weiss@uni-tuebingen.de.
Abstract
OBJECTIVE: Freezing behavior is an unmet symptom in Parkinson's disease (PD), which reflects its complex pathophysiology. Freezing behavior can emerge when attentional capacity is reduced, i.e. under dual task interference. In this study, we characterized the cortical network signatures underlying the susceptibility to freezing during continuous finger tapping. METHODS: Fourteen PD patients with STN-DBS and thirteen age- and gender-matched healthy controls performed continuous tapping with the index finger as single motor task and during dual tasking. Synchronized EEG and mechanogram of the finger tapping were recorded. Subsequently, we analyzed cortical activity and cortico-cortical phase synchronization. We correlated these spectral measures with the biomechanically confirmed numbers of freezing episodes during finger tapping. RESULTS: During dual tasking compared to the single motor task, PD patients showed an increase of cortico-cortical phase synchronization over the left prefrontal area from 13 to 30Hz. This correlated with increased occurrence of freezing episodes. Interestingly, PD patients lacked the increase of prefrontal cortico-cortical synchronization from 4 to 7Hz during dual tasking as observed in healthy controls. CONCLUSION: Dual task interference led to an increase of left prefrontal beta band synchronization (13-30Hz) in PD and this increment predicted the number of freezing episodes. This increment may underscore the relevance of prefrontal executive dysfunction in freezing susceptibility. SIGNIFICANCE: These findings enhance our understanding of the pathological network mechanisms behind increased susceptibility to freezing behavior.
OBJECTIVE: Freezing behavior is an unmet symptom in Parkinson's disease (PD), which reflects its complex pathophysiology. Freezing behavior can emerge when attentional capacity is reduced, i.e. under dual task interference. In this study, we characterized the cortical network signatures underlying the susceptibility to freezing during continuous finger tapping. METHODS: Fourteen PDpatients with STN-DBS and thirteen age- and gender-matched healthy controls performed continuous tapping with the index finger as single motor task and during dual tasking. Synchronized EEG and mechanogram of the finger tapping were recorded. Subsequently, we analyzed cortical activity and cortico-cortical phase synchronization. We correlated these spectral measures with the biomechanically confirmed numbers of freezing episodes during finger tapping. RESULTS: During dual tasking compared to the single motor task, PDpatients showed an increase of cortico-cortical phase synchronization over the left prefrontal area from 13 to 30Hz. This correlated with increased occurrence of freezing episodes. Interestingly, PDpatients lacked the increase of prefrontal cortico-cortical synchronization from 4 to 7Hz during dual tasking as observed in healthy controls. CONCLUSION: Dual task interference led to an increase of left prefrontal beta band synchronization (13-30Hz) in PD and this increment predicted the number of freezing episodes. This increment may underscore the relevance of prefrontal executive dysfunction in freezing susceptibility. SIGNIFICANCE: These findings enhance our understanding of the pathological network mechanisms behind increased susceptibility to freezing behavior.
Authors: Daniel Weiss; Anna Schoellmann; Michael D Fox; Nicolaas I Bohnen; Stewart A Factor; Alice Nieuwboer; Mark Hallett; Simon J G Lewis Journal: Brain Date: 2020-01-01 Impact factor: 13.501
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Authors: Petra Fischer; Chiung Chu Chen; Ya-Ju Chang; Chien-Hung Yeh; Alek Pogosyan; Damian M Herz; Binith Cheeran; Alexander L Green; Tipu Z Aziz; Jonathan Hyam; Simon Little; Thomas Foltynie; Patricia Limousin; Ludvic Zrinzo; Harutomo Hasegawa; Michael Samuel; Keyoumars Ashkan; Peter Brown; Huiling Tan Journal: J Neurosci Date: 2018-05-14 Impact factor: 6.167