Caracterização dos efeitos do extrato de folhas de Swietenia macrophylla em modelo experimental de doença de Parkinson

Estudos prévios indicam que o extrato de folhas de mogno Swietenia macrophylla possui composição química rica em substâncias antioxidantes com efeito neuroprotetor em cultura. Um dos principais mecanismos envolvidos na neurodegeração da Doença de Parkinson (DP) é o estresse oxidativo. Portanto, substâncias antioxidantes são candidatas potenciais para terapias que retardem o processo neurodegenerativo da doença. Este estudo tem por objetivo caracterizar os efeitos do extrato de folhas de mogno frente à degeneração nigroestriatal e alterações comportamentais de camundongos expostos a uma única injeção intraestriatal de 6-OHDA unilateralmente. Foram utilizados camundongos machos, os quais foram submetidos à cirurgia estereotáxica para a injeção de 20 μg de 6-OHDA no estriado esquerdo. Os animais foram subdivididos em 4 grupos, de acordo com a dose de extrato de mogno administrada. O extrato foi aplicado por via intraperitoneal nos 7 primeiros dias após a injeção de 6-OHDA nas doses de 0,0 (controle), 0,5 (G1), 1,0 (G2) e 5,0 mg/kg (G3). O grupo controle (GC) recebeu injeções de salina a 0,9% (veículo). Foi feita análise da ambulação no campo aberto antes, no 7º e no 21º dias e do número de rotações induzidas por apomorfina no 7º e no 21º dias após a cirurgia. Avaliação da neurodegeneração foi realizada através da contagem de neurônios dopaminérgicos TH+ na substância negra por estereologia. Como resultado, encontrou-se diferença estatisticamente significativa no 21º dia, onde os grupos G2 e G3 apresentaram redução no comportamento ambulatório em relação aos grupos G1 e GC; este dois últimos tiveram comportamento ambulatório equivalente entre si. Em relação às rotações induzidas por apomorfina, no 21º dia, o G1 apresentou média de rotações significativamente menor do que os grupos GC, G2 e G3. Na contagem de células, G1 apresentou diminuição na perda dos neurônios dopaminérgicos estatisticamente significativa em relação ao controle. Assim, concluímos que o extrato de mogno na concentração de 0,5 mg/kg promoveu neuroproteção na neurodegeneração do sistema nigroestriatal induzida por 6-OHDA.

Sintomas não motores na doença de Parkinson: modelo de lesão intraestriatal por 6-OHDA em camundongos

A doença de Parkinson (DP) é a segunda doença neurodegenerativa mais comum em idosos, caracterizada pela neurodegeneração de neurônios dopaminérgicos da substância negra (SN), com etiologia não claramente estabelecida, entretanto as causas podem estar associadas a exposição de toxinas ambientais e fatores genéticos. Os processos patológicos envolvidos na DP são disfunção mitocondrial, estresse oxidativo, inflamação e excitotoxicidade. A sintomatologia da DP são alterações motoras, cognitivas e autonômicas. Contudo, poucos estudos analisam os sintomas não-motores da DP, principalmente em modelos animais. Nesse contexto o objetivo deste trabalho foi avaliar sintomas não-motores da DP em modelo animal com lesão provocada pela neurotoxina 6-hidroxidopamina com duas doses diferentes, injetadas bilateralmente no estriado. Para alcançar nossos objetivos realizamos os testes de campo aberto, apomorfina, labirinto aquático de Morris e testes de discriminação olfativa, além de análises histológicas. Nossos resultados mostraram alterações motoras, déficits de memória e aprendizado, associadas a diminuição de células dopaminérgicas na SN, neurônios estriatais e neurônios da região hipocampal CA1. Dessa forma, esse modelo para os sintomas não-motores da DP pode ser utilizado para a compreensão dos mecanismos que envolvem a doença, assim como para avaliar medidas terapêuticas que possam retardar ou interromper a progressão da DP.

NADPH Oxidase and Neurodegeneration

NADPH oxidase (Nox) is a unique, multi-protein, electron transport system that produces large amounts of superoxide via the reduction of molecular oxygen. Nox-derived reactive oxygen species (ROS) are known to be involved in a variety of physiological processes, including host defense and signal transduction. However, over the past decade, the involvement of (Nox)-dependent oxidative stress in the pathophysiology of several neurodegenerative diseases has been increasingly recognized. ROS produced by Nox proteins contribute to neurodegenerative diseases through distinct mechanisms, such as oxidation of DNA, proteins, lipids, amino acids and metals, in addition to activation of redox-sensitive signaling pathways. In this review, we discuss the recent literature on Nox involvement in neurodegeneration, focusing on Parkinson and Alzheimer diseases.

Different approaches, one target: understanding cellular mechanisms of Parkinson's and Alzheimer's diseases

Neurodegenerative disorders are undoubtedly an increasing problem in the health sciences, given the increase of life expectancy and occasional vicious life style. Despite the fact that the mechanisms of such diseases are far from being completely understood, a large number of studies; that derive from both the basic science and clinical approaches have contributed substantial data in that direction. In this review, it is discussed several frontiers of basic research on Parkinson's and Alzheimer's diseases, in which research groups from three departments of the Institute of Biomedical Sciences of the University of Sao Paulo have been involved in a multidisciplinary effort. The main focus of the review involves the animal models that have been developed to study cellular and molecular aspects of those neurodegenerative diseases, including oxidative stress, insulin signaling and proteomic analyses, among others. We anticipate that this review will help the group determine future directions of joint research in the field and, more importantly, set the level of cooperation we plan to develop in collaboration with colleagues of the Nucleus for Applied Neuroscience Research that are mostly involved with clinical research in the same field.

Microglial cells are involved in the susceptibility of NADPH oxidase knockout mice to 6-hydroxy-dopamine-induced neurodegeneration

We explored the impact of Nox-2 in modulating inflammatory-mediated microglial responses in the 6-hydroxydopamine (6-OHDA)-induced Parkinson’s disease (PD) model. Nox1 and Nox2 gene expression were found to increase in striatum, whereas a marked increase of Nox2 expression was observed in substantia nigra (SN) of wild-type (wt) mice after PD induction. Gp91phox-/- 6-OHDA-lesioned mice exhibited a significant reduction in the apomorphine-induced rotational behavior, when compared to wt mice. Immunolabeling assays indicated that striatal 6-OHDA injections reduced the number of dopaminergic (DA) neurons in the SN of wt mice. In gp91phox-/- 6-OHDA-lesioned mice the DA degeneration was negligible, suggesting an involvement of Nox in 6-OHDA-mediated SN degeneration. Gp91phox-/- 6-OHDA-lesioned mice treated with minocycline, a tetracycline derivative that exerts multiple anti-inflammatory effects, including microglial inhibition, exhibited increased apomorphine-induced rotational behavior and degeneration of DA neurons after 6-OHDA injections. The same treatment also increased TNF-α release and potentiated NF-κB activation in the SN of gp91phox-/--lesioned mice. Our results demonstrate for the first time that inhibition of microglial cells increases the susceptibility of gp91phox-/- 6-OHDA lesioned mice to develop PD. Blockade of microglia leads to NF-κB activation and TNF-α release into the SN of gp91phox-/- 6-OHDA lesioned mice, a likely mechanism whereby gp91phox-/- 6-OHDA lesioned mice may be more susceptible to develop PD after microglial cell inhibition. Nox2 adds an essential level of regulation to signaling pathways underlying the inflammatory response after PD induction

Neuroprotective strategies against neurodegeneration in cellular model systems

In the present study we analyzed new neuroprotective therapeutical strategies in PD (Parkinson’s disease) and AD (Alzheimer’s disease). Current therapeutic strategies for treating PD and AD offer mainly transient symptomatic relief but it is still impossible to block the loss of neuron and then the progression of PD and AD. There is considerable consensus that the increased production and/or aggregation of α- synuclein (α-syn) and β-amyloid peptide (Aβ), plays a central role in the pathogenesis of PD, related synucleinopathies and AD. Therefore, we identified antiamyloidogenic compounds and we tested their effect as neuroprotective drug-like molecules against α-syn and β-amyloid cytotoxicity in PC12. Herein, we show that two nitro-catechol compounds (entacapone and tolcapone) and 5 cathecol-containing compounds (dopamine, pyrogallol, gallic acid, caffeic acid and quercetin) with antioxidant and anti-inflammatory properties, are potent inhibitors of α-syn and β-amyloid oligomerization and fibrillization. Subsequently, we show that the inhibition of α-syn and β-amyloid oligomerization and fibrillization is correlated with the neuroprotection of these compounds against the α-syn and β-amyloid-induced cytotoxicity in PC12. Finally, we focused on the study of the neuroprotective role of microglia and on the possibility that the neuroprotection properties of these cells could be use as therapeutical strategy in PD and AD. Here, we have used an in vitro model to demonstrate neuroprotection of a 48 h-microglial conditioned medium (MCM) towards cerebellar granule neurons (CGNs) challenged with the neurotoxin 6-hydroxydopamine (6-OHDA), which induces a Parkinson-like neurodegeneration, with Aβ42, which induces a Alzheimer-like neurodegeneration, and glutamate, involved in the major neurodegenerative diseases. We show that MCM nearly completely protects CGNs from 6-OHDA neurotoxicity, partially from glutamate excitotoxicity but not from Aβ42 toxin.

Der Einfluss von Apolipoprotein E auf die zellulären Mechanismen der Alzheimer Erkrankung

Die massive Bildung und Ablagerung von aggregiertem Amyloid Beta-Peptid im Gehirn wird allgemein als zentrales Ereignis im Rahmen des Neurodegenerationsprozesses der Alzheimer Demenz betrachtet. Als einer der ursächlichen Risikofaktoren gilt das Vorliegen des ε4-Allels des Apolipoprotein E. Die Alzheimer´sche Krankheit ist dabei in sehr vielfältige Weise mit Apolipoprotein E verknüpft. ApoE begünstigt isoformenabhängig Aβ-Ablagerungen, ApoE-Fragmente kommen im Gehirn und der Cerebrospinalflüssigkeit von Alzheimer Patienten vor und ApoE ist darüber hinaus als Cholesterintransportprotein über den zellulären Cholesterinstoffwechsel mit der Amyloidbildung verknüpft. Mit Hilfe einer Doppeltransfektion von ApoE und ADAM10 in HEK-Zellen und durch Studien mit Inhibitoren der ADAM-Familie an HepG-2-Zellen wurde in vitro gezeigt, dass ApoE nicht durch α-Sekretasen der ADAM-Familie gespalten wird. Weiterhin konnte bewiesen werden, dass ApoE in Astrogliomazellen keinen Einfluss auf die APP-Prozessierung ausübt. Durch in vitro Modulation des Cholesteringehaltes an Astrogliomazellen mit MβCD und seine Cholesterin-Komplexverbindungen ist gezeigt worden, dass die ApoE-Sekretion durch abnehmenden Cholesteringehalt gesenkt wird. Indem Statine alleine oder in Kombination mit Isoprenylierungssubstraten eingesetzt wurden ist der Beweis erbracht worden, dass Statine in vitro die ApoE-Sekretionsinhibition alleine durch Hemmung der Cholesterinbiosynthese bewirken. Bestätigt wurde dies weiterhin durch Experimente mit Isoprenylierungsinhibitoren. Aus dem Wirkmechanismus von Statinen auf die ApoE-Sekretionssenkung leitet sich womöglich der für bestimmte Statine berichtete neuroprotektive Effekt bei Morbus Alzheimer in retrospektiven Humanstudien ab, der sich durch reine Cholesterinsenkung nicht erklären lässt. Im Zusammenhang mit der Cholesterinhomöostase und dem gesteigerten 24(S)-Hydroxycholesterinspiegel bei Morbus Alzheimer, haben die Ergebnisse gezeigt, dass 24(S)-Hydroxycholesterin [24(S)-OH-chol] zur ApoE-Sekretions- und Expressionssteigerung führt. In dieser Arbeit konnte erstmals der Nachweis erbracht werden, dass der stimulatorische Effekt von 24(S)-OH-Chol durch gleichzeitige Lovastatingabe reduziert werden kann. Dies stellt einen möglichen Ansatz im Kampf gegen die Alzheimer Demenz dar. Weiterführend müssen diese Ergebnisse noch in vivo beispielsweise durch Versuche an ApoE-transgenen Mäusen bestätigt werden. Darüber hinaus könnte nach einer Statintherapie der ApoE-Gehalt in humaner, cerebrospinaler Flüssigkeit ermittelt werden.

Melanopsin Retinal Ganglion Cells: relevance to circadian rhythms and sleep in neurodegeneration

In this PhD thesis 3 projects were addressed focusing on the melanopsin retinal ganglion cells (mRGCs) system and its relevance for circadian rhythms and sleep in neurodegeneration. The first project was aimed at completing the characterization of mRGCs system in hereditary optic neuropathies (LHON and DOA). We confirmed that mRGCs are relatively spared also in post-mortem retinal specimens of a DOA case and pupillometric evaluation of LHON patients showed preservation of the pupillary light reflex, with attenuated responses compared to controls. Cell studies failed to indicate a protective role exerted by melanopsin itself. The second project was aimed at characterizing the possible occurrence of optic neuropathy and rest-activity circadian rhythm dysfunction in Alzheimer (AD) and Parkinson disease (PD), as well as, at histological level, the possible involvement of mRGCs in AD. OCT studies demonstrated a subclinical optic neuropathy in both AD and PD patients, with a different pattern involving the superior and nasal quadrants in AD and the temporal quadrant in PD. Actigraphic studies demonstrated a tendency towards an increased intradaily variability (IV) and reduced relative amplitude (RA) of rest-activity circadian rhythm in AD and a significant increased IV a reduced RA in PD. Immunohistochemical analysis of post-mortem retinal specimens and optic nerve cross-sections of neuropathologically confirmed AD cases demonstrated a significant loss of mRGCs and a nearly significant loss of axons in AD compared to controls. The mRGCs were affected in AD independently from age and magnitude of axonal loss. Overall these results suggest a role of the mRGCs system in the pathogenesis of circadian dysfunction in AD. The third project was aimed at evaluating the possible association between a single nucleotide polymorphism of the OPN4 gene and chronotype or SAD, failing to find any significant association with chronotype, but showing a non-significant increment of TT genotype in SAD.

Untersuchung neuer hochwirksamer neuroprotektiver Antioxidantien in experimentellen Modellen der Parkinsonschen Krankheit

Bei der Parkinsonschen Krankheit kommt es zu einer selektiven Degeneration der dopaminergen Neurone in der Substantia nigra pars compacta. Die Rolle des oxidativen Stresses in der Pathogenese dieser Erkrankung konnte an post mortem Untersuchungen der Parkinson-Patienten, wie auch an zahlreichen in vitro und in vivo Modellen bestätigt werden. Die Anwendung von Antioxidantien wurde als therapeutische Strategie der Parkinsonschen Krankheit vorgeschlagen. In dieser Hinsicht wurden bereits antioxidative Substanzen in klinischen Studien evaluiert. Klinische Studien mit Antioxidantien haben jedoch bislang nur wenig überzeugende Ergebnisse erbracht, mit Ausnahme des Einsatzes des Ubichinons (Coenzym Q). Eine kritische Analyse der klinischen Studien lässt zusammenfassen, dass auf Seiten der verwendeten Antioxidantien noch massiver Optimierungsbedarf besteht. Für einen erfolgreichen therapeutischen Einsatz von Antioxidantien bei dieser Krankheit sind folgende Eigenschaften der Substanzen von höchster Bedeutung: i) maximale neuroprotektive Aktivität bei geringen Dosen; ii) geringe Nebenwirkungen; iii) eine hohe Blut-Hirn-Schrankengängigkeit.In dieser Arbeit wurde das neuroprotektive Potential von drei Bisarylimin-basierten antioxidativen Strukturen (Phenothiazin, Iminostilben und Phenoxazin) in in vitro und in vivo Parkinson-Modellsystemen evaluiert. Beide experimentellen Modelle basieren auf der Wirkung der mitochondrialen Komplex I Inhibitoren 1-Methyl-4-Phenylpyridin (MPP+) und Rotenon, welche pathophysiologische Charakteristika der Parkinsonschen Krankheit reproduzieren. Unsere in vitro Untersuchungen an primären Neuronen des Mittelhirns und der klonalen SH-SY5Y-Neuroblastomazelllinie konnten zeigen, dass die Komplex I Inhibition krankheitsspezifische zelluläre Merkmale induziert, wie die Abnahme der antioxidativen Verteidigungskapazität und Verlust des mitochondrialen Membranpotentials. Zusätzlich kommt es in primären Neuronen des Mittelhirns zur selektiven Degeneration dopaminerger Neurone, welche in der Parkinsonschen Erkrankung besonders betroffen sind. Ko-Inkubation der in vitro Modelle mit Phenothiazin, Iminostilben und Phenoxazin in niedrigen Konzentrationen (50 nM) halten die pathologischen Prozesse fast vollständig auf. In vivo Untersuchungen am MPP+- und Rotenon-basierten Caenorhabditis elegans (C. elegans) Modell bestätigen das neuroprotektive Potential der Bisarylimine. Hierfür wurde eine transgene C. elegans Linie mithilfe einer dopaminerg spezifischen DsRed2- (Variante des rot fluoreszierenden Proteins von Discosoma sp.)-Expression und pan-neuronaler CFP- (cyan fluoreszierendes Protein)-Expression zur Visualisierung der dopaminergen Neuronenpopulation in Kontrast zum Gesamtnervensystem erstellt. Behandlung des C. elegans mit MPP+ und Rotenon im larvalen und adulten Stadium führt zu einer selektiven Degeneration dopaminerger Neurone, sowie zum Entwicklungsarrest der larvalen Population. Die dopaminerge Neurodegeneration, wie auch weitere phänotypische Merkmale des C. elegans Modells, können durch Phenothiazin, Iminostilben und Phenoxazin in niedrigen Konzentrationen (500 nM) komplett verhindert werden. Ein systemischer Vergleich aromatischer Bisarylimine mit bekannten, gut charakterisierten Antioxidantien, wie α-Tocopherol (Vitamin E), Epigallocatechingallat und β-Catechin, zeigt, dass effektive Konzentrationen für Phenothiazin, Iminostilben und Phenoxazin um Zehnerpotenzen niedriger liegen im Vergleich zu natürlichen Antioxidantien. Der Wirkungsmechanismus der Bisarylimine konnte in biochemischen und in vitro Analysen, sowie in Verhaltensuntersuchungen an C. elegans von der Wirkungsweise strukturell ähnlicher, neuroleptisch wirkender Phenothiazin-Derivate differenziert werden. Die Analyse des dopaminerg-gesteuerten Verhaltens (Beweglichkeit) in C. elegans konnte verdeutlichen, dass antioxidative und Dopaminrezeptor-bindende Eigenschaften der Bisaryliminstrukturen sich gegenseitig ausschließen. Diese qualitativen Merkmale unterscheiden Bisarylimine fundamental von klinisch angewandten Neuroleptika (Phenothiazin-Derivate), welche als Dopaminrezeptor-Antagonisten zur Behandlung psychischer Erkrankungen klinisch eingesetzt werden.Aromatische Bisarylimine (Phenothiazin, Iminostilben und Phenoxazin) besitzen günstige strukturelle Eigenschaften zur antioxidativ-basierter Neuroprotektion. Durch die Anwesenheit der antioxidativ wirkenden, nicht-substituierten Iminogruppe unterscheiden sich Bisarylimine grundlegend von neuroleptisch-wirkenden Phenothiazin-Derivaten. Wichtige strukturelle Voraussetzungen eines erfolgreichen antioxidativen Neuropharmakons, wie eine hohe Radikalisierbarkeit, die stabile Radikalform und der lipophile Charakter des aromatischen Ringsystems, werden in der Bisaryliminstruktur erfüllt. Antioxidative Bisarylimine könnten in der Therapie der Parkinsonschen Krankheit als eine effektive neuroprotektiv-therapeutische Strategie weiter entwickelt werden.

Retinal thickness in Parkinson's disease

BACKGROUND: Visual symptoms are common in Parkinson's disease with studies consistently demonstrating reductions in visual acuity, contrast sensitivity, colour and motion perception as well as alterations in electroretinogram latencies and amplitudes. Optical coherence tomography can examine retinal structure non-invasively and retinal thinning has been suggested as a potential biomarker for neurodegeneration in Parkinson's disease. Our aim was to examine the retinal thickness of a cohort of Parkinson's disease subjects (and age-matched controls) to establish the practical utility of optical coherence tomography in a representative older Parkinson's disease group. METHODS: Fifty-one established Parkinson's disease subjects and 25 healthy controls were subjected to ophthalmological assessment and optical coherence tomography (Zeiss Stratus 3000™) of macular thickness and volume and retinal nerve fibre thickness around the optic nerve head. Twenty four percent of control and 20% of Parkinson's disease subjects were excluded from final analysis due to co-morbid ocular pathology. Further data was excluded either due to poor tolerability of optical coherence tomography or poor quality scans. RESULTS: Despite a reduction in both visual acuity and contrast sensitivity in the residual evaluable Parkinson's disease cohort, we did not detect any differences between the two study groups for any measures of retinal thickness, in contrast to previously published work. CONCLUSIONS: In addition to technical problems inherent in the evaluation, the lack of difference between Parkinson's disease and healthy control subjects suggests longitudinal studies, employing newer techniques, will be required to define the role of optical coherence tomography as a potential diagnostic biomarker.

Nonmotor disturbances in Parkinson's disease

Nonmotor disturbances (NMDs) affect most patients with Parkinson's disease (PD) and often have a profound impact on their quality of life. NMDs such as depression, anxiety, fatigue, REM sleep behavior disorder, constipation, delayed gastric emptying, altered olfaction and pain can precede the onset of motor symptoms. Other NMDs, including hallucinations, dementia, excessive daytime sleepiness, insomnia, orthostatic hypotension and bladder disturbances, typically appear later in the course of PD. For most NMDs of PD, nondopaminergic and non-nigrostriatal mechanisms (e.g. neurodegeneration of other transmitter systems in the cortex and brainstem, side effects of medications, genetic and psychosocial factors) are considered more relevant than the 'classical' dopaminergic-nigrostriatal dysfunction. The recognition of NMDs requires a high degree of clinical suspicion, the use of specific questionnaires and ancillary tests. Pharmacological and nonpharmacological approaches can be effective, but for most forms of treatment of NMDs, the scientific evidence is limited.

Comparative aromatic hydroxylation and N-demethylation of MPTP neurotoxin and its analogs, N-methylated beta-carboline and isoquinoline alkaloids, by human cytochrome P450 2D6

1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) neurotoxin is a chemical inducer of Parkinson's disease (PD) whereas N-methylated beta-carbolines and isoquinolines are naturally occurring analogues of MPTP involved in PD. This research has studied the oxidation of MPTP by human CYP2D6 (CYP2D6*1 and CYP2D6*10 allelic variants) as well as by a mixture of cytochrome P450s-resembling HLM, and the products generated compared with those afforded by human monoamine oxidase (MAO-B). MPTP was efficiently oxidized by CYP2D6 to two main products: MPTP-OH (p-hydroxylation) and PTP (N-demethylation), with turnover numbers of 10.09 min-1 and Km of 79.36+/-3 microM (formation of MPTP-OH) and 18.95 min-1 and Km 69.6+/-2.2 microM (PTP). Small amounts of dehydrogenated toxins MPDP+ and MPP+ were also detected. CYP2D6 competed with MAO-B for the oxidation of MPTP. MPTP oxidation by MAO-B to MPDP+ and MPP+ toxins (bioactivation) was up to 3-fold higher than CYP2D6 detoxification to PTP and MPTP-OH. Several N-methylated beta-carbolines and isoquinolines were screened for N-demethylation (detoxification) that was not significantly catalyzed by CYP2D6 or the P450s mixture. In contrast, various beta-carbolines were efficiently hydroxylated to hydroxy-beta-carbolines by CYP2D6. Thus, N(2)-methyl-1,2,3,4-tetrahydro-beta-carboline (a close MPTP analog) was highly hydroxylated to 6-hydroxy-N(2)-methyl-1,2,3,4-tetrahydro-beta-carboline and a corresponding 7-hydroxy-derivative. Thus, CYP2D6 could participate in the bioactivation and/or detoxification of these neuroactive compounds by an active hydroxylation pathway. The CYP2D6*1 enzymatic variant exhibited much higher metabolism of both MPTP and N(2)-methyl-1,2,3,4-tetrahydro-beta-carboline than the CYP2D6*10 variant, highlighting the importance of CYP2D6 polymorphism in the oxidation of these toxins. Altogether, these results suggest that CYP2D6 can play an important role in the metabolic outcome of both MPTP and beta-carbolines.

Visual exploration in Parkinson's disease and Parkinson's disease dementia

Parkinson's disease, typically thought of as a movement disorder, is increasingly recognized as causing cognitive impairment and dementia. Eye movement abnormalities are also described, including impairment of rapid eye movements (saccades) and the fixations interspersed between them. Such movements are under the influence of cortical and subcortical networks commonly targeted by the neurodegeneration seen in Parkinson's disease and, as such, may provide a marker for cognitive decline. This study examined the error rates and visual exploration strategies of subjects with Parkinson's disease, with and without cognitive impairment, whilst performing a battery of visuo-cognitive tasks. Error rates were significantly higher in those Parkinson's disease groups with either mild cognitive impairment (P = 0.001) or dementia (P < 0.001), than in cognitively normal subjects with Parkinson's disease. When compared with cognitively normal subjects with Parkinson's disease, exploration strategy, as measured by a number of eye tracking variables, was least efficient in the dementia group but was also affected in those subjects with Parkinson's disease with mild cognitive impairment. When compared with control subjects and cognitively normal subjects with Parkinson's disease, saccade amplitudes were significantly reduced in the groups with mild cognitive impairment or dementia. Fixation duration was longer in all Parkinson's disease groups compared with healthy control subjects but was longest for cognitively impaired Parkinson's disease groups. The strongest predictor of average fixation duration was disease severity. Analysing only data from the most complex task, with the highest error rates, both cognitive impairment and disease severity contributed to a predictive model for fixation duration [F(2,76) = 12.52, P ≤ 0.001], but medication dose did not (r = 0.18, n = 78, P = 0.098, not significant). This study highlights the potential use of exploration strategy measures as a marker of cognitive decline in Parkinson's disease and reveals the efficiency by which fixations and saccades are deployed in the build-up to a cognitive response, rather than merely focusing on the outcome itself. The prolongation of fixation duration, present to a small but significant degree even in cognitively normal subjects with Parkinson's disease, suggests a disease-specific impact on the networks directing visual exploration, although the study also highlights the multi-factorial nature of changes in exploration and the significant impact of cognitive decline on efficiency of visual search.

Quantitative diffusion tensor imaging detects dopaminergic neuronal degeneration in a murine model of Parkinson's disease.

Early diagnosis of Parkinson's disease (PD) is required to improve therapeutic responses. Indeed, a clinical diagnosis of resting tremor, rigidity, movement and postural deficiencies usually reflect >50% loss of the nigrostriatal system in disease. In a step to address this, quantitative diffusion tensor magnetic resonance imaging (DTI) was used to assess nigrostriatal degeneration in the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) intoxication model of dopaminergic nigral degeneration. We now demonstrate increased average diffusion (p<0.005) and decreased fractional anisotropy (p<0.03) in the substantia nigra (SN) of 5- to 7-day MPTP-treated animals when compared to saline controls. Transverse diffusivity demonstrated the most significant differences (p < or = 0.002) and correlated with the numbers of SN dopaminergic neurons (r=-0.75, p=0.012). No differences were found in the striatum, corpus callosum, cerebral cortex, or ventricles. These results demonstrate that DTI may be used as a surrogate biomarker of nigral dopaminergic neuronal degeneration.

Do executive dysfunction and freezing of gait in Parkinson's disease share the same neuroanatomical correlates?

Current hypotheses postulate a relationship between executive dysfunction and freezing of gait (FOG) in Parkinson's disease (PD). Hitherto, most evidence comes from entirely clinical approaches, while knowledge about this relationship on the morphological level is sparse. The aim of this study was therefore to assess the overlap of gray matter atrophy associated with FOG and executive dysfunction in PD. We included 18 PD patients with FOG and 20 without FOG in our analysis. A voxel-based morphometry approach was used to reveal voxel clusters in the gray matter which were associated with FOG and executive dysfunction as measured by the Frontal Assessment Battery, respectively. Conjunction analysis was applied to detect overlaps of the associated patterns. FOG correlated with different cortical clusters in the frontal and parietal lobes, whereas those associated with the FAB scores were, although widespread, widely confined to the frontal lobe. Conjunction analysis revealed a significant cluster of gray matter loss in the right dorsolateral prefrontal cortex. We could show that the patterns of neurodegeneration associated with FOG and executive dysfunction (as measured by the FAB) share atrophic changes in the same cortical areas. However, there is also a considerable number of cortical areas where neurodegenerative changes are only unique for either sign. Particularly, the involvement of parietal lobe areas seems to be more specific for FOG.