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Multimodal neuroimaging to characterize symptom-specific networks in movement disorders
npj Parkinson's Disease ( IF 6.7 ) Pub Date : 2024-08-14 , DOI: 10.1038/s41531-024-00774-3
Elizabeth G Ellis 1, 2 , Garance M Meyer 3 , Valtteri Kaasinen 4, 5 , Daniel T Corp 1, 2 , Nicola Pavese 6, 7 , Martin M Reich 8 , Juho Joutsa 1, 4, 5
Affiliation  

Movement disorders, such as Parkinson’s disease, essential tremor, and dystonia, are characterized by their predominant motor symptoms, yet diseases causing abnormal movement also encompass several other symptoms, including non-motor symptoms. Here we review recent advances from studies of brain lesions, neuroimaging, and neuromodulation that provide converging evidence on symptom-specific brain networks in movement disorders. Although movement disorders have traditionally been conceptualized as disorders of the basal ganglia, cumulative data from brain lesions causing parkinsonism, tremor and dystonia have now demonstrated that this view is incomplete. Several recent studies have shown that lesions causing a given movement disorder occur in heterogeneous brain locations, but disrupt common brain networks, which appear to be specific to each motor phenotype. In addition, findings from structural and functional neuroimaging in movement disorders have demonstrated that brain abnormalities extend far beyond the brain networks associated with the motor symptoms. In fact, neuroimaging findings in each movement disorder are strongly influenced by the constellation of patients’ symptoms that also seem to map to specific networks rather than individual anatomical structures or single neurotransmitters. Finally, observations from deep brain stimulation have demonstrated that clinical changes, including both symptom improvement and side effects, are dependent on the modulation of large-scale networks instead of purely local effects of the neuromodulation. Combined, this multimodal evidence suggests that symptoms in movement disorders arise from distinct brain networks, encouraging multimodal imaging studies to better characterize the underlying symptom-specific mechanisms and individually tailor treatment approaches.



中文翻译:


多模态神经影像学表征运动障碍症状特异性网络



运动障碍,如帕金森病、特发性震颤和肌张力障碍,其主要特征是运动症状,但引起异常运动的疾病还包括其他几种症状,包括非运动症状。在这里,我们回顾了脑损伤、神经影像学和神经调节研究的最新进展,这些研究为运动障碍中症状特异性的大脑网络提供了一致的证据。尽管运动障碍传统上被概念化为基底神经节疾病,但引起帕金森症、震颤和肌张力障碍的脑损伤的累积数据现在证明这种观点是不完整的。最近的几项研究表明,引起特定运动障碍的病变发生在不同的大脑位置,但会破坏常见的大脑网络,而这些网络似乎是针对每种运动表型的。此外,运动障碍的结构和功能神经影像学研究结果表明,大脑异常远远超出了与运动症状相关的大脑网络。事实上,每种运动障碍的神经影像学结果都受到患者症状群的强烈影响,这些症状似乎也映射到特定的网络,而不是个体的解剖结构或单一的神经递质。最后,深部脑刺激的观察结果表明,包括症状改善和副作用在内的临床变化取决于大规模网络的调节,而不是纯粹的神经调节的局部效应。 综合起来,这种多模态证据表明运动障碍的症状源于不同的大脑网络,鼓励多模态成像研究更好地描述潜在的症状特异性机制并单独定制治疗方法。

更新日期:2024-08-15
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