novel cholinergic patterns
Nicolaas I. Bohnen (Author), Uroš Marušič (Author), Stiven Roytman (Author), Rebecca Paalanen (Author), Fotini Michalakis (Author), Taylor Brown (Author), Peter J. H. Scott (Author), Giulia Carli (Author), Roger Albin (Author), Prabesh Kanel (Author)

Abstract

The cholinergic system has been implicated in postural deficits, in particular falls, in Parkinson’s disease. Falls and freezing of gait typically occur during dynamic and challenging balance and gait conditions, such as when initiating gait, experiencing postural perturbations, or making turns. However, the precise cholinergic neural substrate underlying dynamic postural and gait changes remains poorly understood. The aim of this study was to investigate whether brain vesicular acetylcholine transporter binding, as measured with [18F]-fluoroethoxybenzovesamicolbinding PET, correlates with dynamic gait and balance impairments in 125 patients with Parkinson’s disease (mean age 66.89±7.71 years) using the abbreviated Balance Evaluation Systems Test total and its four functional domain sub-scores (anticipatory postural control, reactive postural control, dynamic gait, and sensory integration). Whole brain false discoverycorrected (P < 0.05) correlations for total abbreviated Balance Evaluation Systems Test scores included the following bilateral or asymmetric hemispheric regions: gyrus rectus, orbitofrontal cortex, anterior part of the dorsomedial prefrontal cortex, dorsolateral prefrontal cortex, cingulum, frontotemporal opercula, insula, fimbria, right temporal pole, mesiotemporal, parietal and visual cortices, caudate nucleus, lateral and medial geniculate bodies, thalamus, lingual gyrus, cerebellar hemisphere lobule VI, left cerebellar crus I, superior cerebellar peduncles, flocculus, and nodulus. No significant correlations were found for the putamen or anteroventral putamen. The four domain-specific sub-scores demonstrated overlapping cholinergic topography in the metathalamus, fimbria, thalamus proper, and prefrontal cortices but also showed distinct topographic variations. For example, reactive postural control functions involved the right flocculus but not the upper brainstem regions. The anterior cingulum associated with reactive postural control whereas the posterior cingulum correlated with anticipatory control. The spatial extent of associated cholinergic system changes were least for dynamic gait and sensory orientation functional domains compared to the anticipatory and reactive postural control functions. We conclude that specific aspects of dynamic balance and gait deficits in Parkinson’s disease associate with overlapping but also distinct patterns of cerebral cholinergic system changes in numerous brain regions. Our study also presents novel evidence of cholinergic topography involved in dynamic balance and gait in Parkinson’s disease that have not been typically associated with mobility disturbances, such as the right anterior temporal pole, right anterior part of the dorsomedial prefrontal cortex, gyrus rectus, fimbria, lingual gyrus, flocculus, nodulus and right cerebellar hemisphere lobules VI and left crus I.

Keywords

Parkinson’s disease;dynamic balance;cholinergic;PET;

Data

Language: English
Year of publishing:
Typology: 1.01 - Original Scientific Article
Organization: UP - University of Primorska
UDC: 616.858
COBISS: 205843203 Link will open in a new window
ISSN: 2632-1297
Views: 298
Downloads: 511
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Other data

Secondary language: Slovenian
Secondary keywords: Parkinsonova bolezen;dinamično ravnotežje;holinergični sistem;PET;
Source comment: Nasl. z nasl. zaslona; Opis vira z dne 30.8.2024;
Pages: str. 1-16
Volume: ǂVol. ǂ6
Issue: ǂiss. ǂ5, [article no.] fcae286
Chronology: 2024
DOI: 10.1093/braincomms/fcae286
ID: 24862762