Background And Objective: Cognitive impairment and dementia as well as affective disorders are common and debilitating syndromes that develop in people with Parkinson's disease (PwPD). The authors summarized recommendations for the 2023 updated German guidelines on "Parkinson's disease" from the German Neurological Society (DGN), focusing on the diagnosis and treatment of these disorders.
Methods: The recommendations were based on literature reviews, other relevant guidelines, and expert opinions.
J Neurol
August 2024
Background: Cognitive reserve (CR) is considered a protective factor for cognitive function and may explain interindividual differences of cognitive performance given similar levels of neurodegeneration, e.g., in Alzheimer´s disease.
View Article and Find Full Text PDFBackground: Spreading depolarization describes a near-complete electrical discharge with altered local cerebral blood flow. It is described in association with acute and chronic diseases like hemorrhagic stroke or migraine. Moyamoya vasculopathy is a chronic, progressive cerebrovascular disorder leading to cerebral hypoperfusion, hemodynamically insufficient basal collateralization, and increased cortical microvascularization.
View Article and Find Full Text PDFAdaptive control has been studied in Parkinson's disease mainly in the context of proactive control and with mixed results. We compared reactive- and proactive control in 30 participants with Parkinson's disease to 30 age matched healthy control participants. The electroencephalographic activity of the participants was recorded over 128 channels while they performed a numerical Stroop task, in which we controlled for confounding stimulus-response learning.
View Article and Find Full Text PDFDopamine exerts antinociceptive effects on pain in PD at cortical and spinal levels, whereas only cortical effects have been described for DBS, so far. By assessing the nociceptive flexion reflex (NFR) threshold at medication on, and DBS ON and OFF in two patients, we showed that DBS additionally decreases spinal nociception.
View Article and Find Full Text PDFBackground: Cognitive decline is a major factor for the deterioration of the quality of life in patients suffering from Parkinson's disease (PD). Recently, it was reported that cognitive training (CT) in PD patients with mild cognitive impairment (PD-MCI) led to an increase of physical activity (PA) accompanied by improved executive function (EF). Moreover, PA has been shown to alter positively brain function and cognitive abilities in PD.
View Article and Find Full Text PDFIntroduction: Cognitive impairment in Parkinson's disease (PD), especially in patients with mild cognitive impairment (PD-MCI), coincides with less physical activity. Cognitive trainings (CT) have been found to promote laboratory environment-based movement. Knowledge about their effect in natural home-based environment, reflecting everyday function, is sparse.
View Article and Find Full Text PDFStroke-induced lesions at different locations in the brain can affect various aspects of binaural hearing, including spatial perception. Previous studies found impairments in binaural hearing, especially in patients with temporal lobe tumors or lesions, but also resulting from lesions all along the auditory pathway from brainstem nuclei up to the auditory cortex. Currently, structural magnetic resonance imaging (MRI) is used in the clinical treatment routine of stroke patients.
View Article and Find Full Text PDFIntroduction: In acute ischemic stroke, progressive impairment of cerebral autoregulation (CA) is frequent and associated with unfavorable outcomes. Easy assessment of cerebral blood flow and CA in stroke units bedside tools like near-infrared spectroscopy (NIRS) might improve early detection of CA deterioration. This study aimed to assess dynamic CA with multichannel CW-NIRS in acute ischemic stroke (AIS) patients compared to agematched healthy controls.
View Article and Find Full Text PDFWalking on natural terrain while performing a dual-task, such as typing on a smartphone is a common behavior. Since dual-tasking and terrain change gait characteristics, it is of interest to understand how altered gait is reflected by changes in gait-associated neural signatures. A study was performed with 64-channel electroencephalography (EEG) of healthy volunteers, which was recorded while they walked over uneven and even terrain outdoors with and without performing a concurrent task (self-paced button pressing with both thumbs).
View Article and Find Full Text PDFBackground: Cervical dystonia (CD) is characterized by involuntary contractions of the cervical muscles. Data on long-term effectiveness of deep brain stimulation (DBS) are rare. The aim of this study was to evaluate the longitudinal ten years treatment efficacy of DBS in the globus pallidus internus (GPI).
View Article and Find Full Text PDFElectric and magnetic stimulation of the human brain can be used to excite or inhibit neurons. Numerous methods have been designed over the years for this purpose with various advantages and disadvantages that are the topic of this review. Deep brain stimulation (DBS) is the most direct and focal application of electric impulses to brain tissue.
View Article and Find Full Text PDFHypersexuality in medicated patients with PD is caused by an increased influence of motivational drive areas and a decreased influence of inhibitory control areas due to dopaminergic medication. In this pilot study, we test a newly developed paradigm investigating the influence of dopaminergic medication on brain activation elicited by sexual pictures with and without inhibitory contextual framing. Twenty PD patients with and without hypersexuality were examined with fMRI either OFF or ON standardized dopaminergic medication.
View Article and Find Full Text PDFSpeech production relies on the interplay of different brain regions. Healthy aging leads to complex changes in speech processing and production. Here, we investigated how the whole-brain functional connectivity of healthy elderly individuals differs from that of young individuals.
View Article and Find Full Text PDFIntroduction: Objective of this study was to examine if the Interlocking Finger Test (ILFT) is a suitable bedside screening test for visuospatial functions and/or dementia in Parkinson's disease (PD) patients aiming to facilitate the diagnosis of a dementia syndrome associated with posterior cortical and temporal lobe dysfunction according to the dual syndrome hypothesis (frontostriatal vs. posterior cortical cognitive impairment).
Methods: Forty-seven PD patients were assessed with the ILFT and an extensive cognitive test battery.
Compared to functional magnetic resonance imaging (fMRI), functional near infrared spectroscopy (fNIRS) has several advantages that make it particularly interesting for neurofeedback (NFB). A pre-requisite for NFB applications is that with fNIRS, signals from the brain region of interest can be measured. This study focused on the supplementary motor area (SMA).
View Article and Find Full Text PDF