Abstract
Parkinson's disease (PD) is manifested by motor impairment, which may impede the ability to accurately perform motor tasks during functional magnetic resonance imaging (fMRI). Both temporal and amplitude deviations of movement performance affect the blood oxygenation level-dependent (BOLD) response. We present a general approach for assessing PD patients' movement control employing simultaneously recorded fMRI time series and behavioral data of the patients' kinematics using MR-compatible gloves. Twelve male patients with advanced PD were examined with fMRI at 1.5T during epoch-based visually paced finger tapping. MR-compatible gloves were utilized online to quantify motor outcome in two conditions with or without dopaminergic medication. Modeling of individual-level brain activity included (i) a predictor consisting of a condition-specific, constant-amplitude boxcar function convolved with the canonical hemodynamic response function (HRF) as commonly used in fMRI statistics (standard model), or (ii) a custom-made predictor computed from glove time series convolved with the HRF (kinematic model). Factorial statistics yielded a parametric map for each modeling technique, showing the medication effect on the group level. Patients showed bilateral response to levodopa in putamen and globus pallidus during the motor experiment. Interestingly, kinematic modeling produced significantly higher activation in terms of both the extent and amplitude of activity. Our results appear to account for movement performance in fMRI motor experiments with PD and increase sensitivity in detecting brain response to levodopa. We strongly advocate quantitatively controlling for motor performance to reach more reliable and robust analyses in fMRI with PD patients.
Highlights
Parkinson’s disease (PD) is a progressive neurodegenerative disorder causing basal ganglia (BG) dysfunction [1]
Analysis of lateralized hemibody Unified PD Rating Scale (UPDRS)-III scores in the OFF condition showed non-significant left/right asymmetry suggesting that patients with main involvement of the right or left hemispheres were represented in our study
Our results provide clear evidence of increasing sensitivity in detecting brain activity in PD patients using functional magnetic resonance imaging (fMRI) analyses considering on-line quantification of their motor outcome, compared to generic fMRI statistics
Summary
Parkinson’s disease (PD) is a progressive neurodegenerative disorder causing basal ganglia (BG) dysfunction [1]. It is characterized by a large number of motor and non-motor deficits, which significantly contribute to reduced quality of life. Used blockdesign paradigms primarily utilize the upper limbs, in particular, various hand and finger movement sequences, to investigate the neural basis of PD patients’ motor performance. Prevalent tasks in investigating the brain motor circuitry in PD are sequential finger movements, which are part of the widely used Unified PD Rating Scale (UPDRS) [10] This clinical scoring system rates the symptomatic severity of the disease. It is accessible and suitable for providing a direct comparison between subjects or use in longitudinal studies
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