Aberrant corticospinal tract characteristics in prodromal PD: A diffusion tensor imaging study.

Introduction: Parkinson's disease (PD) is typically diagnosed when motor symptoms first occur. However, PD-related non-motor symptoms may appear several years before diagnosis. REM sleep behaviour disorder (RBD) and olfactory deficits (hyposmia) are risk factors, but they are not specific for predicting progression towards PD. Other PD-related markers, for example brain imaging markers, may help to identify preclinical PD in hyposmic RBD patients. Studies have reported abnormal structural characteristics in the corticospinal tract (CST) of PD patients, but it is unclear whether hyposmic RBD patients have similar abnormalities that may help to predict PD in these individuals. This study examined whether CST abnormalities may be a potential marker of PD risk by using diffusion tensor imaging (DTI) measures. Methods: Twenty hyposmic RBD patients, 31 PD patients, and 29 healthy controls (HCs) were studied. DTI data were collected on a 1.5 T MRI scanner and CST characteristics (FA, MD, AD, and RD) were evaluated using probabilistic tractography (with seed regions in the bilateral primary motor cortex and mediolateral cerebral peduncles). Olfactory function was assessed with the University of Pennsylvania Smell Identification Test (UPSIT). Results: Hyposmic RBD patients showed significantly higher mean diffusivity (MD) values of the right CST compared to HCs but did not differ from PD patients. PD patients showed a trend of higher MD values compared to HCs. Conclusions: Altered diffusivity in the CST seems to be associated with RBD. The combination of RBD, hyposmia, and CST alterations may be related to later development of PD with comorbid RBD.

Diffusion tensor imaging and olfactory identification testing in early-stage Parkinson's disease.

Evidence from imaging, clinical studies, and pathology suggests that Parkinson's disease is preceded by a prodromal stage that predates clinical diagnosis by several years but there is no established method for detecting this stage. Olfactory impairment, which is common in Parkinson's disease and often predates clinical diagnosis, may be a useful biomarker for early Parkinson's. Evidence is emerging that diffusion imaging parameters might be altered in olfactory tract and substantia nigra in the early stages of clinical Parkinson's disease, possibly reflecting pathological changes. However, no study has examined olfaction and diffusion imaging in olfactory tract and substantia nigra in the same group of patients. The present study compared newly diagnosed Parkinson's disease patients with a matched control group using both olfactory testing and diffusion tensor imaging of the substantia nigra and anterior olfactory structures. Fourteen patients with stage 1-2 Hoehn & Yahr Parkinson's disease were matched to a control group by age and sex. All subjects then completed the University of Pennsylvania Smell Identification Test, as well as a series of MRI scans designed to examine diffusion characteristics of the olfactory tract and the substantia nigra. Olfactory testing revealed significant impairment in the patient group. Diffusion tensor imaging revealed significant group differences in both the substantia nigra and anterior olfactory region, with fractional anisotropy of the olfactory region clearly distinguishing the Parkinson's subjects from controls. This study suggests that there may be value in combining behavioral (olfaction) and MRI testing to identify early Parkinson's disease. Since loss of olfaction often precedes the motor symptoms in Parkinson's disease, the important question raised is "will the combination of olfactory testing and MRI (DTI) testing identify pre-motor Parkinson's disease?"

Visuomotor representation decay: influence on motor systems.

The contribution of ventral stream information to the variability of movement has been the focus of much attention, and has provided numerous researchers with conflicting results. These results have been obtained through the use of discrete pointing movements, and as such, do not offer any explanation regarding how ventral stream information contributes to movement variability over time. The present study examined the contribution of ventral stream information to movement variability in three tasks: Hand-only movement, eye-only movement, and an eye-hand coordinated task. Participants performed a continuous reciprocal tapping task to two point-of-light targets for 10 s. The targets were visible for the first 5 s, at which point vision of the targets was removed. Movement variability was similar in all conditions for the initial 5-s interval. The no-vision condition (final 5 s) can be summarized as follows: ventral stream information contributed to an initial significant increase in variability across motor systems, though the different motor systems were able to preserve ventral information integrity differently. The results of these studies can be attributed to the behavioral and cortical networks that underlie the saccadic and manual motor systems.

Decay in visuomotor representations during manual aiming.

The time course of the decay of spatial representations used for planning and controlling manual aiming has not been established. The authors' purpose in the present investigation was to generate a psychometric function for memory-guided reaching movements. Eight university-aged students performed a reciprocal tapping task for 10 s. Participants could see the targets for 5 s; then, vision of the targets was occluded. The present findings provide mixed support for 2 prominent theories concerning memory representations. Variability increased concurrently with the removal of vision of the targets, supporting the real-time hypothesis. However, a brief plateau in the curve was apparent for approximately 2 s after vision was removed, consistent with the use of a highly accurate representation for action.