Neurodegeneration, Neuroprotection, and Disease-Oriented NeuroscienceResearch PaperDifferential involvement of striato- and cerebello-thalamo-cortical pathways in tremor- and akinetic/rigid-predominant Parkinson's disease
Research highlights
▶PDAR and PDT subjects show more activity in STC and CTC circuits compared to controls. ▶PDT subjects show significant changes from controls in contralateral STC and CTC. ▶PDAR subjects only show significance in contralateral CTC compared to controls. ▶Comparing PDT and PDAR subjects shows significant differences in ipsilateral STC and CTC.
Section snippets
Subjects
Seventeen PD subjects (nine PDT and eight PDAR) were recruited for this study from a tertiary movement disorders clinic (see Table 1 for demographic information). Each PD subject was diagnosed by a movement disorders specialist (XH) based on previously published criteria (Gibb and Lees, 1988). Twelve PD subjects (six PDAR and six PDT) had right side predominant symptoms. Most subjects were early in their disease course (see Table 1), with a mean (±SD) disease duration for PDAR subjects of
Demographic data
Although PDT subjects appeared on average to be slightly older than control and PDAR subjects, there were no significant differences in age among the groups (Table 1). For PD subtypes, there were no significant differences in disease duration, total UPRDS, or Hoehn and Yahr scores. PDAR subjects had a higher LED compared to PDT subjects. As expected, the two subtypes showed significant differences in the tremor/AR ratio (Table 1).
PDAR versus control subjects
In all ROIs comprising the bilateral STC and CTC circuits, PDAR
Discussion
In doing the first fMRI study that has compared control, PDAR, and PDT subjects, we have shown that there is differential involvement of STC and CTC pathways for the two different PD clinical presentations (or subtypes). The results indicate first, that PDAR and PDT subjects both display overall increased recruitment of STC and CTC neurocircuitry compared to controls during this internally guided motor task. Second, the pattern of the recruitment of STC and CTC circuits was different for PDAR
Acknowledgments
We thank all those who participated in the study and support of the UNC MRI center. This work was supported in part by NIH grants AG21491 (XH), NS060722 (XH, MML, and GD), and the UNC GCRC (RR00046).
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Present address: Biostatistics Center, Kurume University, Kurume 830-0011, Japan.