The emerging postural instability phenotype in idiopathic Parkinson disease.

Identification of individuals at high risk for rapid progression of motor and cognitive signs in Parkinson disease (PD) is clinically significant. Postural instability and gait dysfunction (PIGD) are associated with greater motor and cognitive deterioration. We examined the relationship between baseline clinical factors and the development of postural instability using 5-year longitudinal de-novo idiopathic data (n = 301) from the Parkinson's Progressive Markers Initiative (PPMI).

A longitudinal neurite and free water imaging study in patients with a schizophrenia spectrum disorder.

Diffusion tensor imaging (DTI) studies show widespread white matter abnormalities in schizophrenia, but it is difficult to directly relate these parameters to biological processes. Neurite orientation dispersion and density imaging (NODDI) is geared toward biophysical characterization of white matter microstructure, but only few studies have leveraged this technique to study white matter alterations. We recruited 42 schizophrenia patients (30 antipsychotic-naïve and 12 currently untreated) and 42 matched controls in this prospective study.

Micro- and Macrostructural White Matter Integrity in Never-Treated and Currently Unmedicated Patients With Schizophrenia and Effects of Short-Term Antipsychotic Treatment.

Background: Schizophrenia is associated with progressive white matter changes, but it is unclear whether antipsychotic medications contribute to these. Our objective was to characterize effects of short-term treatment with risperidone on white matter diffusion indices.

Methods: We recruited 42 patients with schizophrenia (30 never treated and 12 currently untreated) and 42 matched healthy control subjects in this prospective case-control neuroimaging study.

High-Intensity Exercise Acutely Increases Substantia Nigra and Prefrontal Brain Activity in Parkinson's Disease.

BACKGROUND Pathologic alterations in resting-state brain activity patterns exist among individuals with Parkinson's disease (PD). Since physical exercise alters resting-state brain activity in non-PD populations and improves PD symptoms, we assessed the acute effect of exercise on resting-state brain activity in exercise-trained individuals with PD. MATERIAL AND METHODS Resting-state functional magnetic resonance imaging (fMRI) was collected twice for 17 PD participants at the conclusion of an exercise intervention.

Parkinson's disease-related network topographies characterized with resting state functional MRI.

Spatial covariance mapping can be used to identify and measure the activity of disease-related functional brain networks. While this approach has been widely used in the analysis of cerebral blood flow and metabolic PET scans, it is not clear whether it can be reliably applied to resting state functional MRI (rs-fMRI) data. In this study, we present a novel method based on independent component analysis (ICA) to characterize specific network topographies associated with Parkinson's disease (PD).

Allocentric But Not Egocentric Pseudoneglect of Peripersonal Space.

Background And Objective: Healthy adults often deviate leftward on line bisection tasks (allocentric pseudoneglect) but rightward on body part bisection tasks (egocentric pseudoneglect). People visually estimate distance in peripersonal space by comparing the distance to the length of a body part such as an arm's length (an egocentric reference) or using standard units of distance such as inches (an allocentric reference). Our objective was to learn whether people have pseudoneglect when estimating distances in peripersonal space using egocentric versus allocentric reference frames.

Ventral tegmental area/midbrain functional connectivity and response to antipsychotic medication in schizophrenia.

Medication management in schizophrenia is a lengthy process, as the lack of clinical response can only be confirmed after at least 4 weeks of antipsychotic treatment at a therapeutic dose. Thus, there is a clear need for the discovery of biomarkers that have the potential to accelerate the management of treatment. Using resting-state functional MRI, we examined the functional connectivity of the ventral tegmental area (VTA), the origin of the mesocorticolimbic dopamine projections, in 21 healthy controls and 21 unmedicated patients with schizophrenia at baseline (pre-treatment) and after 1 week of treatment with the antipsychotic drug risperidone (1-week post-treatment).

Hypometric allocentric and egocentric distance estimates in Parkinson disease.

Objective And Background: Persons with Parkinson disease (PD) show hypometric movements and make hypometric estimates of imagined actions. These deficits may be related to misestimates of the length of body parts. Our objective was to learn whether patients with PD are impaired in their estimations of their arm's length and standard units of distance.

Anxiety and depression severity are related to right but not left onset Parkinson's disease duration.

Depression and anxiety have both been associated with relative left frontal hypoactivation and the motor symptoms of Parkinson's disease typically begin in a lateral or asymmetrical fashion. Hence, PD patients with right hemibody onset may experience heightened depression and anxiety. However, research is mixed regarding whether right or left hemibody onset PD is associated with elevated levels of depression and anxiety.

Influence of left versus right hemibody onset Parkinson's disease on cardiovascular control.

Whereas the left hemisphere is involved in regulating the parasympathetic nervous system, the right hemisphere regulates the sympathetic. Given the asymmetrical onset of motor symptoms and neuropathology in PD, differences in cardiovascular functions might be expected between PD patients with left hemibody onset (LHO) versus right hemibody onset (RHO). A total of 66 PD patients served as participants, including 31 LHO patients and 35 RHO PD patients.

Verbal and visuospatial memory in lateral onset Parkinson disease: time is of the essence.

Objective: This investigation sought to study immediate and delayed verbal and visuospatial recall in Parkinson disease (PD) patients with left hemibody (LHO) and right hemibody (RHO) onset of motor symptoms and to examine the role of mental processing speed in recall of this information.

Background: Research is mixed regarding material specific memory impairments in LHO and RHO PD. However, earlier research has not used a factorial approach in investigating material specific memory in LHO and RHO PD.

Anxiety affects working memory only in left hemibody onset Parkinson disease patients.

Objective: This investigation sought to examine the potential moderating influence of heightened anxiety on working memory in Parkinson disease (PD) patients. Further, we wanted to determine whether this moderating influence of anxiety differentially affects PD patients with left hemibody (LBH) versus right hemibody (RHB) onset of motor symptoms.

Background: Research has examined the neurocognitive effects of depression in PD.

Conceptual hypometria? An evaluation of conceptual mapping of space in Parkinson's disease.

When interacting with objects in their environment, patients with Parkinson's disease (PD) often make hypometric movements (e.g., micrographia).

Attentional grasp in Parkinson disease.

Background: Patients with Parkinson disease (PD) have deficits in the neurotransmitter systems important for the normal allocation of attention. We sought to examine how the presence of PD influences the spatial allocation of reactive (bottom-up) and volitional (top-down) attention.

Methods: To assess the spatial allocation of attention, we used the line bisection task.

Pilot safety and feasibility study of treadmill aerobic exercise in Parkinson disease with gait impairment.

This pilot study evaluated the safety and feasibility of a 3-month progressive treadmill aerobic exercise (TM-AEX) program for persons with Parkinson disease with gait impairment. Eight subjects underwent a treadmill stress test to determine eligibility. Of these subjects, three were referred for further cardiac evaluation and five were enrolled.

Spatial emotional akinesia in Parkinson disease.

Background/objectives: Patients with Parkinson disease (PD) exhibit motor and frontal-executive dysfunction and often seem to be emotionally apathetic. We investigated whether PD patients have alterations in their emotional reactivity and how this might impact their proximal (avoidance) versus distal (approach) allocation of attention-intention.

Methods: Nine participants with PD and 9 normal controls were asked to judge the valence (pleasant-positive vs.

Greater motor improvement in right hemibody Parkinson's patients after dopaminergic medications.

Due to motor and neuropathological asymmetries, Parkinson's disease (PD) patients with right hemibody onset (RHO) of symptoms may experience greater benefit from dopaminergic enhancing medications, relative to patients with left hemibody onset (LHO). We investigated this possibility by measuring UPDRS scores of 20 PD patients with LHO and 13 patients with RHO, both prior and subsequent to taking dopaminergic enhancing medications. Following treatment, the motor score from the UPDRS improved for both groups of patients.

Daily ambulatory activity levels in idiopathic Parkinson disease.

Patients with Parkinson disease (PD) may have decreased physical activity due to motor deficits. We recently validated the reliability of step activity monitors (SAMs) to accurately count steps in PD, and we wished to use them to evaluate the impact of disease severity on home activity levels in PD. Twenty-six subjects with PD (Hoehn and Yahr disease stage 2-4) were recruited to participate in a study of activity levels over 48 hours.

Psychogenic camptocormia.

Camptocormia describes a severe forward-flexion at the waist. Originally used in reference to a conversion disorder seen in military personel (Souques and Rosanoff-Saloff, Rev Neurol 1915, 22, 937; Rosen and Frymoyer, Spine 1985, 10, 325; Miller and Forbes, Br J Psychiatry 1990, 157, 765; Perez-Sales, Arch Phys Med Rehabil 1990, 71, 1078; Sinel and Eisenberg, Rev Rhum Mal Osteoartic 1992, 59, 169; Miller and Forbes, Mil Med 1990, 155, 561; Belgrano and Giordano, Rev Neurol 1947, 79, 25-35), the term has been adapted to describe severely flexed postures observed in Parkinson disease (Djaldetti et al., Mov Disord 1999, 14, 443), other basal ganglia disorders (Nieves et al.

The four As associated with pathological Parkinson disease gamblers: anxiety, anger, age, and agonists.

Several studies have related pathological gambling in PD to dopamine agonist therapy. A mail-in survey was sent to PD patients seen at the University of Florida Movement Disorders Center to determine gambling frequency and behavior, and any lifestyle or environmental factors associated with compulsive gambling in PD. 462 surveys were sent and 127 completed surveys were returned, of which ten were from patients who met criteria for compulsive gambling.

Induction of tyrosine hydroxylase expression by the transcription factor Pitx3.

Transcription factors are fate determining regulatory factors in dopaminergic neuronal development and differentiation. Among them, Nurr1 is the most extensively studied, but the importance of Pitx3 has recently been appreciated. Over-expression of both factors has been utilized to enhance the dopaminergic differentiation of stem cells for transplantation into models of Parkinson's disease.

Laterality, region, and type of motor dysfunction correlate with cognitive impairment in Parkinson's disease.

We studied the relationship between two screening cognitive measures and off motor Unified Parkinson's Disease Rating Scale (UPDRS) scores in 108 Parkinson's disease patients. Multiple regressions were conducted to examine the UPDRS subscores' unique contributions to cognitive function. When including bradykinesia, rigidity, and postural/gait instability subscores, only bradykinesia predicted Mini Mental Status Examination (MMSE), normalized beta = -0.

Lessons learned in deep brain stimulation for movement and neuropsychiatric disorders.

The introduction of deep brain stimulation (DBS) as a treatment for medication-refractory essential tremor in the late 1980s revealed, for the first time, that "chronically" implanted brain hardware had the potential to modulate neurologic function with surprisingly low morbidity. Over time, the therapeutic promise of DBS has become evident in Parkinson's disease and dystonia. In some experienced centers, complex tremor disorders, such as posttraumatic Holmes tremor and the tremor of multiple sclerosis, are being increasingly targeted.

Camptocormia in a patient with multiple system atrophy.

The term "camptocormia" describes a severe forward-flexed posture. Although initially used to describe a conversion disorder, early authors also recognized organic camptocormia occurring in old age, or "camptocormie senile," as well as traumatic and arthritic camptocormia. More recently, camptocormia has been described in patients with Parkinson's disease and in an individual with parkinsonism.