Jean Louis Bourriez

Movement related desynchronisation pattern preceding voluntary movement in untreated Parkinson's disease.

OBJECTIVE--To study planning of movement in Parkinsons disease. METHODS--The spatiotemporal pattern of movement related desynchronisation (MRD) preceding a self paced voluntary wrist flexion was compared between two groups of 10 untreated right and left hemiparkinsonian patients receiving no treatment and 10 control subjects. The MRD was computed in the 9 to 11 Hz frequency band from 11 source derivations covering the frontocentral, central, and parietocentral areas, during two successive left and right experimental conditions. RESULTS--In the two patient groups the desynchronisation appeared over the primary sensorimotor area contralateral to the affected side with a shorter latency (750 ms before movement onset for the right hemiparkinsonian group and 875 ms for the left hemiparkinsonian group) than in the control group (1750 ms), only when the movements were performed with the akinetic hand. For the non-affected hand, the same latency as in the control group was noted (1750 ms). CONCLUSION--The delay of appearance of MRD in Parkinsons disease confirmed that the programming of movement is affected, thus partially explaining akinesia.

Disturbance of sensory filtering in dementia with Lewy bodies: comparison with Parkinson’s disease dementia and Alzheimer’s disease

Introduction: Prepulse inhibition (PPI) is considered to mirror an organism’s ability to filter out irrelevant sensory or cognitive information. The disruption of PPI has never been studied in individuals suffering from dementia with Lewy bodies (DLB). As attention deficits largely contribute to cognitive impairment in DLB, an investigation with a PPI paradigm is useful for differential diagnosis of DLB versus Alzheimer’s disease (AD) and Parkinson’s disease dementia (PDD). Objective and methods: PPI of the N1/P2 component of auditory evoked potentials was used to investigate the early stages of attention selectivity in 10 DLB, 10 AD, and 10 PDD patients, as well as in 10 healthy controls. The PPI paradigm consisted of the presentation of sound pulses (40 ms, 115 dB) preceded by a prepulse (40 ms, 80 dB). Sound stimuli were presented in a total of 80 trials in a pseudo-random order. Results: Non-parametric analyses of variance revealed a significant group effect on the 120 ms lead interval. Retrospective analyses revealed that PPI was significantly reduced in DLB compared to healthy controls and AD. In the PDD group, the disturbance was of intermediate intensity. Conclusion: The present study revealed a severe disturbance of PPI in DLB patients. The DLB patients displayed a specific disruption profile in terms of magnitude as well as time course.

P300 component of the event-related potentials (ERP) during an attention task: effects of age, stimulus modality and event probability

The effects of age, stimulus modality and event probability on event-related potentials (ERP) were studied in 12 young and 12 elderly healthy subjects. The ERP were recorded from 15 electrodes referred to linked ears. Results showed that both amplitude and latency of the P300 component are affected by aging. Study of the latency of the earlier ERP components in the two age groups revealed that the P300 delay was not imputable to a delay of the earlier components. P300 amplitude and latency were also affected by event probability and stimulus modality: infrequent stimulus involved higher and later P300, but this effect was more pronounced in the young than in the old group; higher and later P300 were also recorded during the visual task compared to the auditory. Topographical repartition of the brain wave revealed a predominance of the central sites (Fz, Cz, Pz). The findings are discussed in relation to the sensitivity of the ERP assessment procedures in age related modifications of information processing.

Event-Related Desynchronization (ERD) patterns during verbal memory tasks: effect of age

Event-related desynchronization (ERD) was studied in 10 young (mean age = 19.1) and 10 older (mean age = 62.8) subjects during a verbal recognition task. The attention load of the task varied according to the difficulty of discriminating between targets and distractors. EEG recorded from 29 electrodes was used to compute ERD from 14 source derivations in 125 ms intervals. Thereafter, it was displayed as spatiotemporal maps. The results show that attention influences the characteristics of EEG desynchronization. In young subjects, ERD is more pronounced and more widespread when the attentional load is high. In the elderly, differences between the two attention conditions are less marked. ANOVA reveals main effects of attention and time. The significant attention x time x age group interaction confirms the presence of different brain activation patterns in the two age groups in relation to attention load.

Chronic bilateral pallidal stimulation and levodopa do not improve gait in the same way in Parkinson's disease: a study using a video motion analysis system.

Abstract Chronic bilateral internal globus pallidus (GPi) stimulation allows control of levodopa induced dyskinesias (LID) and motor symptoms in severe Parkinsons disease (PD). The effect on gait has not been clearly established. Different results have been reported, mostly consisting of clinical data. The aim of this study was to evaluate, by means of a video motion analysis system (optoelectronic VICON system), the influence of bilateral GPi stimulation on gait in PD.Five patients underwent bilateral GPi stimulation. The preoperative and postoperative (3 months after surgery) clinical gait disturbances (items 29 and 30 of the motor UPDRS), as well as spatial and temporal gait measurements (namely cadence, velocity, stride and step times, single and double limb support times, stride and step lengths) were analysed in off condition (the patient had received no treatment for 12 hours or merely the lowest dose of levodopa allowing him to walk for the gait analysis) and in the on drug condition (after administration of 200 mg of levodopa). The gait analysis was performed with the VICON system.In off condition, there was a statistically significant improvement after surgery for UPDRS III and gait (clinically assessed). In on drug condition, there was a significant improvement for LID whereas UPDRS III and clinical assessment of gait were unchanged.The VICON system also showed that surgery improved gait especially in off condition, but also in on drug condition.Our method allowed exact quantification of the influence of surgery on gait characteristics. As compared with levodopa treatment, the effect of stimulation seems to be different. Indeed, the results suggest only limited effects of pallidal stimulation on the control of stride length and rather point to compensatory additional mechanisms.

Anticipatory postural adjustments associated with arm movement in Parkinson’s disease: a biomechanical analysis

Objective: To study anticipatory postural adjustments (APAs) in Parkinson’s disease (PD) via a biomechanical analysis, including vertical torque (Tz). Methods: Ten patients with PD (in the “off-drug” condition) and 10 age matched controls were included. While standing on a force platform, the subject performed a right shoulder flexion in order to grasp a handle in front of him/her, under three conditions (all at maximal velocity): movement triggered by a sound signal and loaded/non-loaded, self-paced movement. The anteroposterior coordinates of the centre of pressure (COP) and Tz were calculated. Results: A group effect was observed for Tz and COP in patients with PD (compared with controls): the maximal velocity peak appeared later and the amplitude of the COP backward displacement and the area of the positive phase of Tz were lower, whereas the duration of the positive phase of Tz was greater. Interaction analysis showed that the area of Tz was especially affected in the triggered condition and the loaded, self-paced condition. The onset of the COP backward displacement was delayed in the triggered condition. Conclusion: Our biomechanical analysis revealed that patients with PD do indeed perform APAs prior to unilateral arm movement, although there were some abnormalities. The reduced APA magnitude appears to correspond to a strategy for not endangering postural balance.

Gait abnormalities induced by acquired bilateral pallidal lesions: a motion analysis study.

BackgroundBilateral pallidal lesions induce a range of cognitive and motor disorders, principally a parkinsonian syndrome in which severe disturbances of gait and gait initiation are frequently reported. However, the precise clinical features of these disorders (and the role of the pallidum therein) remain to be established.ObjectivesThe goal of this study was to characterise gait and gait initiation disorders within the context of a parkinsonian syndrome in patients with acquired, bilateral, pallidal lesions (PAL patients), to compare these disorders to those seen in Parkinson’s disease (PD), and to assess the corresponding physiopathological implications.Patients and methodsBy using a video motion analysis system (VICON), we studied gait kinematic parameters in two patients presenting with bilateral, pallidal lesions. Kinematic and kinetic parameters were also determined during gait initiation. The two patients were compared with a group of 17 PD patients and to 20 healthy controls.ResultsIn both PAL and PD patients, kinematic parameters (gait and gait initiation) and kinetic parameters (gait initiation) were similarly impaired, evidenced by akinesia (difficulty in initiating gait characterized by impairment of anticipatory postural adjustments). Hypokinesia and bradykinesia (respectively reduced stride length and reduced speed during gait) were also noted.ConclusionThe gait and gait initiation disorders seen in cases of bilateral pallidal lesions (namely akinesia, hypokinesia and bradykinesia) are similar to those observed in PD. Subject to confirmation in more extensive studies, we hypothesize that bipallidal patients may present higher level gait disorders,with potential mediation by cognitive impairment.

A 15-day course of donepezil modulates spectral EEG dynamics related to target auditory stimuli in young, healthy adult volunteers

OBJECTIVEnTo identify possible electroencephalographic (EEG) markers of donepezils effect on cortical activity in young, healthy adult volunteers at the group level.nnnMETHODSnThirty subjects were administered a daily dose of either 5mg donepezil or placebo for 15days in a double-blind, randomized, cross-over trial. The electroencephalogram during an auditory oddball paradigm was recorded from 58 scalp electrodes. Current source density (CSD) transformations were applied to EEG epochs. The event-related potential (ERP), inter-trial coherence (ITC: the phase consistency of the EEG spectrum) and event-related spectral perturbation (ERSP: the EEG power spectrum relative to the baseline) were calculated for the target (oddball) stimuli.nnnRESULTSnThe donepezil and placebo conditions differed in terms of the changes in delta/theta/alpha/beta ITC and ERSP in various regions of the scalp (especially the frontal electrodes) but not in terms of latency and amplitude of the P300-ERP component.nnnCONCLUSIONnOur results suggest that ITC and ERSP analyses can provide EEG markers of donepezils effects in young, healthy, adult volunteers at a group level.nnnSIGNIFICANCEnNovel EEG markers could be useful to assess the therapeutic potential of drug candidates in Alzheimers disease in healthy volunteers prior to the initiation of Phase II/III clinical studies in patients.