Functional involvement of central cholinergic circuits and visual hallucinations in Parkinson's disease
Identifieur interne : 000889 ( Main/Exploration ); précédent : 000888; suivant : 000890Functional involvement of central cholinergic circuits and visual hallucinations in Parkinson's disease
Auteurs : Fiore Manganelli [Italie] ; Carmine Vitale [Italie] ; Gabriella Santangelo [Italie] ; Chiara Pisciotta [Italie] ; Rosa Iodice [Italie] ; Autilia Cozzolino [Italie] ; Raffaele Dubbioso [Italie] ; Marina Picillo [Italie] ; Paolo Barone [Italie] ; Lucio Santoro [Italie]Source :
- Brain [ 0006-8950 ] ; 2009-09.
Abstract
Visual hallucinations (VHs) represent a frequent and disturbing complication of Parkinson's disease. Evidence suggests that VH can be related to central cholinergic dysfunction. Short-latency afferent inhibition (SAI) technique gives the opportunity to test an inhibitory cholinergic circuit in the human cerebral motor cortex. This inhibition of motor-evoked potentials can be observed when transcranial magnetic stimulation is delivered with a delay ranging from 2 to 8 ms, after a peripheral nerve afferent input has reached the somatosensory cortex. We applied SAI technique in 10 non-demented patients with Parkinson's disease with VHs, in 12 non-demented patients with Parkinson's disease without VHs (NVH-pts) and in 11 age-matched normal controls. All patients with Parkinson's disease underwent a battery of neuropsychological tests to assess frontal and visuospatial functions, memory and attention. SAI was significantly reduced in patients with VHs compared with controls and patients without VHs. Neuropsychological examination showed a mild cognitive impairment in 16 out of 22 patients with Parkinson's disease. In addition, we found that in our patients with VHs, performance of some tasks evaluating visuospatial functions and attentional/frontal lobe functions was significantly more impaired than in patients without VHs. SAI abnormalities, presence of VH and neuropsychological results strongly support the hypothesis of cholinergic dysfunction in some patients with Parkinson's disease, who will probably develop a dementia. A follow-up study of our patients is required to verify whether SAI abnormalities can predict a future severe cognitive decline. Moreover, SAI can also be very useful to follow-up the efficacy of anti-cholinesterase therapies.
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DOI: 10.1093/brain/awp166
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Evidence suggests that VH can be related to central cholinergic dysfunction. Short-latency afferent inhibition (SAI) technique gives the opportunity to test an inhibitory cholinergic circuit in the human cerebral motor cortex. This inhibition of motor-evoked potentials can be observed when transcranial magnetic stimulation is delivered with a delay ranging from 2 to 8 ms, after a peripheral nerve afferent input has reached the somatosensory cortex. We applied SAI technique in 10 non-demented patients with Parkinson's disease with VHs, in 12 non-demented patients with Parkinson's disease without VHs (NVH-pts) and in 11 age-matched normal controls. All patients with Parkinson's disease underwent a battery of neuropsychological tests to assess frontal and visuospatial functions, memory and attention. SAI was significantly reduced in patients with VHs compared with controls and patients without VHs. Neuropsychological examination showed a mild cognitive impairment in 16 out of 22 patients with Parkinson's disease. In addition, we found that in our patients with VHs, performance of some tasks evaluating visuospatial functions and attentional/frontal lobe functions was significantly more impaired than in patients without VHs. SAI abnormalities, presence of VH and neuropsychological results strongly support the hypothesis of cholinergic dysfunction in some patients with Parkinson's disease, who will probably develop a dementia. A follow-up study of our patients is required to verify whether SAI abnormalities can predict a future severe cognitive decline. Moreover, SAI can also be very useful to follow-up the efficacy of anti-cholinesterase therapies.</div></front></TEI><affiliations><list><country><li>Italie</li></country></list><tree><country name="Italie"><noRegion><name sortKey="Manganelli, Fiore" sort="Manganelli, Fiore" uniqKey="Manganelli F" first="Fiore" last="Manganelli">Fiore Manganelli</name></noRegion><name sortKey="Barone, Paolo" sort="Barone, Paolo" uniqKey="Barone P" first="Paolo" last="Barone">Paolo Barone</name><name sortKey="Cozzolino, Autilia" sort="Cozzolino, Autilia" uniqKey="Cozzolino A" first="Autilia" last="Cozzolino">Autilia Cozzolino</name><name sortKey="Dubbioso, Raffaele" sort="Dubbioso, Raffaele" uniqKey="Dubbioso R" first="Raffaele" last="Dubbioso">Raffaele Dubbioso</name><name sortKey="Iodice, Rosa" sort="Iodice, Rosa" uniqKey="Iodice R" first="Rosa" last="Iodice">Rosa Iodice</name><name sortKey="Manganelli, Fiore" sort="Manganelli, Fiore" uniqKey="Manganelli F" first="Fiore" last="Manganelli">Fiore Manganelli</name><name sortKey="Picillo, Marina" sort="Picillo, Marina" uniqKey="Picillo M" first="Marina" last="Picillo">Marina Picillo</name><name sortKey="Pisciotta, Chiara" sort="Pisciotta, Chiara" uniqKey="Pisciotta C" first="Chiara" last="Pisciotta">Chiara Pisciotta</name><name sortKey="Santangelo, Gabriella" sort="Santangelo, Gabriella" uniqKey="Santangelo G" first="Gabriella" last="Santangelo">Gabriella Santangelo</name><name sortKey="Santangelo, Gabriella" sort="Santangelo, Gabriella" uniqKey="Santangelo G" first="Gabriella" last="Santangelo">Gabriella Santangelo</name><name sortKey="Santangelo, Gabriella" sort="Santangelo, Gabriella" uniqKey="Santangelo G" first="Gabriella" last="Santangelo">Gabriella Santangelo</name><name sortKey="Santangelo, Gabriella" sort="Santangelo, Gabriella" uniqKey="Santangelo G" first="Gabriella" last="Santangelo">Gabriella Santangelo</name><name sortKey="Santoro, Lucio" sort="Santoro, Lucio" uniqKey="Santoro L" first="Lucio" last="Santoro">Lucio Santoro</name><name sortKey="Santoro, Lucio" sort="Santoro, Lucio" uniqKey="Santoro L" first="Lucio" last="Santoro">Lucio Santoro</name><name sortKey="Vitale, Carmine" sort="Vitale, Carmine" uniqKey="Vitale C" first="Carmine" last="Vitale">Carmine Vitale</name><name sortKey="Vitale, Carmine" sort="Vitale, Carmine" uniqKey="Vitale C" first="Carmine" last="Vitale">Carmine Vitale</name><name sortKey="Vitale, Carmine" sort="Vitale, Carmine" uniqKey="Vitale C" first="Carmine" last="Vitale">Carmine Vitale</name><name sortKey="Vitale, Carmine" sort="Vitale, Carmine" uniqKey="Vitale C" first="Carmine" last="Vitale">Carmine Vitale</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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