Behavioural and neuroimaging correlates of impaired self-awareness of hypo- and hyperkinesia in Parkinson's disease
Behavioural and neuroimaging correlates of impaired self-awareness of hypo- and hyperkinesia in Parkinson's disease
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DOI：
10.1016/j.cortex.2016.05.019
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发表时间：
2016-09-01
期刊：
影响因子：
3.6
通讯作者：
Eggers, Carsten
中科院分区：
文献类型：
--
作者：
Maier, Franziska;Williamson, Kim L.;Eggers, Carsten
引言：病感失认症或运动症状自我意识受损（ISAm）在帕金森病（PD）中很少被研究。在这里，我们研究了ISAm之间的关系，期间与多巴胺能药物（ON-和OFF-状态），临床，神经心理学和神经影像学数据，以进一步阐明行为方面和神经生物学基础的ISAm.Methods：31右撇子，非痴呆，非抑郁症PD患者。ISAm使用最近开发的量表进行评估，该量表评估运动障碍、静息震颤和运动迟缓的意识。在ON和OFF状态下进行测试。进行了ISAM和行为数据之间的多重相关分析。此外，使用18 F-氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）的葡萄糖代谢成像进行调查ISAm的神经基础。多元回归方法被应用到调查代谢改变相关ISAm.Results：在关闭状态下，较高的ISAm与左侧发病，年龄较大，病程较短。关于FDG-PET数据，在右额下回（IFG）中，较高的OFF状态ISAm与葡萄糖代谢降低之间存在显著的负相关性。在ON状态下，ISAm与临床或行为数据无显著相关性。然而，有较高的ISAm和代谢增加的双边额内侧回，左IFG，右上级额上回和右中央前gyrus.Conclusion：结果支持的作用，右半球在运动症状的认识在OFF状态。在ON状态下，多巴胺能药物和运动障碍影响ISAm，并与双侧额叶区域的代谢变化有关。(C)2016爱思唯尔有限公司版权所有
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. (C) 2016 Elsevier Ltd. All rights reserved.