Franziska Maier1, Kim L Williamson2, Masoud Tahmasian3, Luisa Rochhausen2, Anna L Ellereit2, George P Prigatano4, Lutz Kracht5, Chris C Tang6, Damian M Herz7, Gereon R Fink8, Lars Timmermann2, Carsten Eggers2. 1. Department of Neurology, University Hospital of Cologne, Germany. Electronic address: franziska.maier@uk-koeln.de. 2. Department of Neurology, University Hospital of Cologne, Germany. 3. Department of Neurology, University Hospital of Cologne, Germany; Department of Nuclear Medicine, University Hospital Cologne, Cologne, Germany; National Brain Mapping Center, Shahid Beheshti University, General and Medical Campus, Tehran, Iran. 4. Department of Clinical Neuropsychology, Barrow Neurological Institute, St. Joseph's Hospital & Medical Center, Phoenix, AZ, USA. 5. Department of Nuclear Medicine, University Hospital Cologne, Cologne, Germany; Max-Planck Institute for Metabolism Research, Cologne, Germany. 6. Center for Neurosciences, The Feinstein Institute for Medical Research, Manhasset, NY, USA. 7. Medical Research Council Brain Network Dynamics Unit at the University of Oxford, Oxford, United Kingdom; Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom. 8. Department of Neurology, University Hospital of Cologne, Germany; Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM3), Research Center Juelich, Germany.
Abstract
INTRODUCTION: Anosognosia or impaired self-awareness of motor symptoms (ISAm) has been rarely investigated in Parkinson's disease (PD). We here studied the relationship between ISAm during periods with and without dopaminergic medication (ON- and OFF-state), and clinical, neuropsychological, and neuroimaging data to further elucidate behavioural aspects and the neurobiological underpinnings of ISAm. METHODS: Thirty-one right-handed, non-demented, non-depressed PD patients were included. ISAm was evaluated using a recently developed scale that assesses awareness of dyskinesia, resting tremor, and bradykinesia. The test was applied during both ON- and OFF-states. Multiple correlation analyses between ISAm and behavioural data were conducted. In addition, imaging of glucose metabolism using 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) was performed to investigate the neural basis of ISAm. A multiple regression approach was applied to investigate metabolism alterations related to ISAm. RESULTS: In the OFF-state, higher ISAm was associated with left-sided disease onset, older age, and shorter disease duration. Concerning FDG-PET data, there was a significant negative correlation between higher OFF-state ISAm and decreased glucose metabolism in the right inferior frontal gyrus (IFG). In the ON-state, ISAm was not significantly correlated with clinical or behavioural data. However, there was a significant correlation between higher ISAm and an increased metabolism in the bilateral medial frontal gyrus, left IFG, right superior frontal gyrus and right precentral gyrus. CONCLUSION: The results support the role of the right hemisphere in awareness of motor symptoms in the OFF-state. In the ON-state, dopaminergic medication and dyskinesia influence ISAm and relate to metabolism changes in bilateral frontal regions.
INTRODUCTION: Anosognosia or impaired self-awareness of motor symptoms (ISAm) has been rarely investigated in Parkinson's disease (PD). We here studied the relationship between ISAm during periods with and without dopaminergic medication (ON- and OFF-state), and clinical, neuropsychological, and neuroimaging data to further elucidate behavioural aspects and the neurobiological underpinnings of ISAm. METHODS: Thirty-one right-handed, non-demented, non-depressed PDpatients were included. ISAm was evaluated using a recently developed scale that assesses awareness of dyskinesia, resting tremor, and bradykinesia. The test was applied during both ON- and OFF-states. Multiple correlation analyses between ISAm and behavioural data were conducted. In addition, imaging of glucose metabolism using 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) was performed to investigate the neural basis of ISAm. A multiple regression approach was applied to investigate metabolism alterations related to ISAm. RESULTS: In the OFF-state, higher ISAm was associated with left-sided disease onset, older age, and shorter disease duration. Concerning FDG-PET data, there was a significant negative correlation between higher OFF-state ISAm and decreased glucose metabolism in the right inferior frontal gyrus (IFG). In the ON-state, ISAm was not significantly correlated with clinical or behavioural data. However, there was a significant correlation between higher ISAm and an increased metabolism in the bilateral medial frontal gyrus, left IFG, right superior frontal gyrus and right precentral gyrus. CONCLUSION: The results support the role of the right hemisphere in awareness of motor symptoms in the OFF-state. In the ON-state, dopaminergic medication and dyskinesia influence ISAm and relate to metabolism changes in bilateral frontal regions.
Authors: Diana Tordesillas-Gutierrez; Rosa Ayesa-Arriola; Manuel Delgado-Alvarado; Jennifer L Robinson; Javier Lopez-Morinigo; Jesus Pujol; M Encarnación Dominguez-Ballesteros; Anthony S David; Benedicto Crespo-Facorro Journal: PLoS One Date: 2018-06-01 Impact factor: 3.240
Authors: Sara Palermo; Leonardo Lopiano; Rosalba Morese; Maurizio Zibetti; Alberto Romagnolo; Mario Stanziano; Mario Giorgio Rizzone; Giuliano Carlo Geminiani; Maria Consuelo Valentini; Martina Amanzio Journal: Front Psychol Date: 2018-09-20