Acute Modulation of Brain Connectivity in Parkinson Disease after Automatic Mechanical Peripheral Stimulation: A Pilot Study

Abstract

ObjectiveThe present study shows the results of a double-blind sham-controlled pilot trial to test whether measurable stimulus-specific functional connectivity changes exist after Automatic Mechanical Peripheral Stimulation (AMPS) in patients with idiopathic Parkinson Disease.MethodsEleven patients (6 women and 5 men) with idiopathic Parkinson Disease underwent brain fMRI immediately before and after sham or effective AMPS. Resting state Functional Connectivity (RSFC) was assessed using the seed-ROI based analysis. Seed ROIs were positioned on basal ganglia, on primary sensory-motor cortices, on the supplementary motor areas and on the cerebellum. Individual differences for pre- and post-effective AMPS and pre- and post-sham condition were obtained and first entered in respective one-sample t-test analyses, to evaluate the mean effect of condition.ResultsEffective AMPS, but not sham stimulation, induced increase of RSFC of the sensory motor cortex, nucleus striatum and cerebellum. Secondly, individual differences for both conditions were entered into paired group t-test analysis to rule out sub-threshold effects of sham stimulation, which showed stronger connectivity of the striatum nucleus with the right lateral occipital cortex and the cuneal cortex (max Z score 3.12) and with the right anterior temporal lobe (max Z score 3.42) and of the cerebellum with the right lateral occipital cortex and the right cerebellar cortex (max Z score 3.79).ConclusionsOur results suggest that effective AMPS acutely increases RSFC of brain regions involved in visuo-spatial and sensory-motor integration.Classification of EvidenceThis study provides Class II evidence that automatic mechanical peripheral stimulation is effective in modulating brain functional connectivity of patients with Parkinson Disease at rest.Trial RegistrationClinical Trials.gov NCT01815281

Absence of dentate nucleus resting‐state functional connectivity changes in nonneurological patients with gadolinium‐related hyperintensity on T1‐weighted images

“…In this study, the field strength of 1.5 T, the repetition time of 4 seconds, and the number of frames ( n = 120) might have affected the temporal contrast‐to‐noise. However, rsfMRI changes have been detected under similar conditions in psychiatric and neurological diseases . Moreover, age could have an impact on fMRI, considering that DN signal on T 2 *‐weighted EPI images is age‐related.…”

“…However, rsfMRI changes have been detected under similar conditions in psychiatric and neurological diseases. 42,50 Moreover, age could have an impact on fMRI, considering that DN signal on T 2 *weighted EPI images is age-related. However, recent data from Ngo et al 51 show that age-related differences in BOLD signal are expected to be small for an fMRI study at 3 T and, based on the relationship between magnetic susceptibility and B 0 , are even smaller for an fMRI study at 1.5 T. It also should be considered that, even at low tissue concentrations, we cannot exclude that the presence of gadolinium as a paramagnetic metal ion in the brain might directly affect the signal in EPI-BOLD imaging; any effect would in any case be expected on amplitude of signal rather than temporal coupling.…”

“…Registration from high‐resolution structural to standard space was then further refined using FNIRT nonlinear registration . RSFC analysis was carried out using a seed‐ROI‐based approach . Based on previous evidence of gadolinium retention in human DN and cerebellum cortex, we explored functional connectivity of the cerebellum (as on the MNI Structural Atlas), as previously reported .…”

“…42 Based on previous evidence of gadolinium retention in human DN and cerebellum cortex, 12,13 we explored functional connectivity of the cerebellum (as on the MNI Structural Atlas), as previously reported. 42 DN ROIs were obtained as follows: 1) T 1 hyperintense nuclei were manually segmented on 3D-MPRAGE T 1 -weighted volumes of each patient using MRIcro software (http://www.cabiatl.com/mricro/mricro/mricro.html); 2) 3D-MPRAGE T 1 volumes were standardized and binary masks were created; 3) a group probability map of the bilateral DN was generated; 4) the resulting map was thresholded to show voxels that were shared by at least 60% of the patients; and 5) the thresholded probability map was then binarized and used as the seed ROI for DN in the common functional space of patients and controls. A neuroradiologist (C.C.Q., 15 years of experience) visually inspected the chosen ROIs in order to validate anatomical correspondence (Online Fig.…”

Beneficial Effect of Foot Plantar Stimulation in Gait Parameters in Individuals with Parkinson’s Disease

“…In such studies, results were compared with age-matched control groups in order to identify differences in gait pattern between PD patients and healthy subjects. The aim of the study was to stimulate foot plantar through the application of customized 3D-printed insoles that present two blunted cones ( Figure 2) in similar plantar area feet analyzed in other reports [31]. This ensures usability, preserves adherence, and avoids discomfort or stigma.…”