Characterizing the interaction between neural attention and somato-motor systems in non-demented patients with Parkinson's disease

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Parkinson’s disease (PD) is a progressive neurodegenerative disorder that presents a looming economic and societal challenge in the United States and worldwide. Despite being primarily a disorder of the motor system (i.e., the brain systems controlling movement), patients with PD are also known to exhibit profound deficits in attention, which is our ability to direct brain resources towards important aspects of the environment. Importantly, these issues are not isolated from one another, as attentional issues are robustly linked to risk of falls in patients with PD, which are the most common reason for hospitalization and major injury in this population. Indeed, attention-based therapies have been developed for patients with PD and have been moderately successful, but a great deal of variability exists in patient outcomes. This variability is largely due to the lack of specific neurophysiological and cognitive targets of these therapies, so a better understanding of the brain systems being affected is essential to improving patient outcomes. The current project aims to identify and quantify the brain- basis of attentional impairments in patients with PD, as well as the neurophysiology underlying the interactions between these deficient attentional sub-systems and somato-motor systems. The primary goal of this research will be to provide novel targets for enhanced clinical interventions, such as brain stimulation and attention-training therapies. A secondary goal of this project is to provide a data-driven framework for the assessment of attention- training in the brains of patients with PD, and the impact of this training on the brain circuits that control movement (i.e., somato-motor networks). To reach these goals, a series of innovative cognitive neuroscience experiments will be utilized, combined with advanced brain imaging techniques. These data will be collected using expansive data repositories available in Montreal (the Quebec Parkinson Network and the Montreal Neurological Institute Clinical Biological Imaging and Genetic Repository) and analyzed using a number of highly innovative signal processing techniques developed by Professor Sylvain Baillet in his state-of-the-art software housed in his laboratory at McGill University (Brainstorm; > 23,000 users worldwide). These studies which will allow for novel investigations of the role of dynamic brain activity patterns between and within attention and somato-motor networks in patients with PD. This will provide new targets for attention- training and brain stimulation therapies, while also enhancing our understanding of the neurobiological aberrations that contribute to PD. The aim of my research project is to understand (1) which attentional neural sub-systems are being preferentially affected by PD, and (2) how these attentional sub-systems interact with established PD-related somato-motor system aberrations. These findings will then provide key metrics for the assessment of treatment efficacy, as well as targets for therapeutic intervention. With the prevalence of PD rising both nationally and worldwide, concrete targets for intervention are desperately needed to minimize the impact of this debilitating disorder, both on the personal level for those affected, and broadly on a socio-economic scale.