Objectives The aim of the study was to evaluate the effects of freezing of gait (FOG) on static and dynamic balance.Methods Twenty patients with Parkinson's disease with and without FOG [PD+FOG (68,6±6,39 years) and PD-FOG group (70,6±4,57 years)] and 10 healthy individuals (68,4±4,92 years) with similar demographic characteristics were included in the study. Balance was compared between the three groups. Balance was evaluated with clinical tests Limits of stability (LoS) and body sway were measured using the E-LINK FP3 Force Plate and the Korebalance Balance Evaluation System, which measure the balance in static and dynamic conditions. Center of pressure (COP) change and average sway velocity were evaluated with the Zebris RehaWalk system.Results Total and subscale scores of the Unified Parkinson's Disease Rating Scale were significantly higher in the PD+FOG group (p<0.05). The balance test results for both groups were similar (p>0.05). The PD+FOG group performed worse on the computerized static balance tests, the COP analysis, and the dynamic balance total score than the other two groups (p<0.05). The PD+FOG group had significantly greater sustained weight deviation than the healthy controls (p<0.05). Patients with Parkinson's disease had a lower LoS in the posterior direction than healthy controls (p<0.05).Discussion FOG affects the dynamic balance more negatively than the static balance. In addition, FOG reduces LoS in the posterior direction and increases body sway in the anterior-posterior direction, which can lead to falls.Keywords Center of pressure, Freezing of gait, Limits of stability, Parkinson's disease, Postural Balance.
Objective: Our aim was to investigate the relation between unilateral hippocampal and/or nigral alpha-synucleinopathy and cognitive dysfunction, anxiety and anhedonia.Materials and Methods: Female Sprague-Dawley rats were stereotactically injected adeno-associated viruses carrying alpha-synuclein (α-syn) into unilateral dentate gyrus (DG), substantia nigra (SN) or both SN + DG.The animals were tested for motor functions and memory, spatial learning, anxiety and hedony.Levels of α-syn and synaptophysin were evaluated by Western blot (WB) analysis.Results: In apomorphine-induced rotation test, a mild motor dysfunction was found in SN-α-syn group compared to control.DG-α-syn group showed memory impairment in novel object recognition test.All the α-syn injected groups spent more time to find the platform compared to controls in Morris water maze but this difference did not reach statistical significance.DG-α-syn group consumed more sucrose solution in sucrose consumption test and spent more time on the open arm in elevated plus maze, while the opposite was observed in SN-α-syn group compared to controls.We showed α-syn protein expression in the injected areas of all α-syn groups by WB and immunohistochemical staining.In WB analysis, both hippocampal and striatal synaptophysin expression levels were lower in the α-syn groups compared to controls.Conclusion: Parkinson's disease (PD) is characterized by both motor and non-motor symptoms (NMS).However, an animal model recapitulating NMS with the background of dopaminergic denervation is still lacking.This model may help to investigate hippocampal α-syn pathology correlated especially with cognitive dysfunction and other NMS of PD.
In addressing our recent report of HTRA2 p.G399S as the gene and mutation responsible for essential tremor and subsequent Parkinson disease in a large kindred (1), Tzoulis et al. (2) screened this mutation in patients with Parkinson disease, essential tremor, tremulous cervical dystonia, and nontremulous cervical dystonia patients, and did not find a significant difference in carrier frequency compared with the general population. Their observation replicates our experience, in that in the kindred of our study, HTRA2 p.G399S was responsible for essential tremor and, among homozygotes, for Parkinson disease, but as we reported, this allele was not responsible for essential tremor in other families from the same population.
Measurement of functional connectivity (FC) of neural networks such as the default-mode network (DMN) by resting-state functional magnetic resonance imaging (Rest-fMRI) can be a potential tool in early diagnosis of Alzheimer's disease (AD). Several studies showed that FC of more posterior parts of the DMN such as posterior cingulate cortex (PCC) and the medial temporal lobes preferentially diminished in AD. Here, we studied FC of ventral and dorsal parts of PCC and other DMN structures separately since anatomical and functional connections of the components of PCC are different. Rest-fMRI and 3D T1-weighted structural images of fifteen patients with mild to moderate AD and 10 age-matched healthy controls were obtained in a 3.0 T scanner (Trio, Tim, Siemens, Germany) along with detailed neuropsychological evaluation. Following preprocessing of the data using SPM8 and normalization to the Atlas of MNI, we performed independent component analysis on FSL and obtained group maps for AD and healthy controls. Analysis of FC of low-frequency BOLD fluctuations was carried out with the “conn” toolbox. We examined connectivity patterns separately for seven different seed regions-of-interest (ROIs) of 6mm-radius in expected DMN nodes. Correlation coefficient images between PCC/subunits and DMN nodes were z-transformed, with one-sample t-test examining within group connectivity (voxelwise threshold of p<005). MMSE scores of AD and controls were 18.1 ± 8.6 and 27.5 ± 2.4, respectively (p<0.05). Neuropsychological test scores of episodic memory, semantic memory, executive and visuospatial functions were worse in AD (p<0.05). FC maps of DMN derived from PCC in AD and controls are shown in figure. In AD group, we found diminished FC of ventral PCC and the both medial temporal lobes; and the absence of FC of dorsal PCC and medial temporal lobes. In contrast, connectivity of dorsal PCC and inferior parietal lobules, and ventral PCC and medial prefrontal cortex increased. Functional connectivity of PCC and the both medial temporal lobes are decreased in AD patients. In contrast, connectivity of PCC and inferior parietal lobules are increased.
Several medical and surgical procedures have been presented for treatment of dystonia. Thalamotomy, pallidotomy, and campotomy are some of the surgical choices. This study presents a patient with dystonia who underwent a cervical dorsal root entry zone (DREZ) operation after thalamotomy and campotomy. A 23-year-old man who was resistant to medical treatment presented with left hemidystonia. Thalamotomy and campotomy were performed. The patient remarkably benefited from the procedure but dystonic complaints in his left arm continued. A cervical DREZ operation was performed 5 years after the first operation and the dystonic complaints decreased after the surgery. This article presents a new aspect for the treatment of dystonia. Based on the outcomes of the treatment, DREZ operation may be suggested as an alternative surgical treatment for patients with segmental dystonia located in the extremities.
Objective: Motor freezing in Parkinson's Disease (PD) causes loss of balance, gait disturbances and falls due to the sudden occurrence of movement at an unexpected moment. Therefore, the aim of our study is to evaluate balance and gait in Parkinson's patients with motor freezing. Materials and Methods: 10 PD patients with motor freezing, 10 PD patients without motor freezing and 10 healthy individuals with similar age and gender were included in the study.. Demographic characteristics of the individuals were recorded. Tandem Stance Test for static balance assessment; Computed Dynamic Posturography (CDP) and Timed Up and Go Test were used for dynamic balance assessment. The gait was evaluated with the GaitRite electronic walkway and 10 m walking test. Results: A significant difference was found between the groups in terms of static and dynamic balance and walking tests (p
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