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Structural Brain Correlations of Visuospatial and Visuoperceptual Tests in Parkinson’s Disease
- Anna Isabel Garcia-Diaz, Barbara Segura, Hugo Cesar Baggio, Maria Jose Marti, Francesc Valldeoriola, Yaroslau Compta, Nuria Bargallo, Carme Uribe, Anna Campabadal, Alexandra Abos, Carme Junque
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- Journal:
- Journal of the International Neuropsychological Society / Volume 24 / Issue 1 / January 2018
- Published online by Cambridge University Press:
- 17 July 2017, pp. 33-44
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- Article
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Background: Diagnosis of mild cognitive impairment in Parkinson’s disease (PD) is relevant because it is a marker for evolution to dementia. However, the selection of suitable tests to evaluate separate cognitive domains in mild cognitive impairment related to PD remains an open question. The current work aims to investigate the neuroanatomical correlates of several visuospatial/visuoperceptual tests using the same sample and a multimodal MRI approach. Methods: The study included 36 PD patients and 20 healthy subjects matched for age, sex, and education. The visuospatial/visuoperceptual tests selected were: Pentagon Copying Test (PCT), Judgment of Line Orientation Test (JLOT), Visual Form Discrimination Test (VFDT), Facial Recognition Test (FRT), Symbol Digit Modalities Test (SMDT), and clock copying task (CLOX2). FreeSurfer was used to assess cortical thickness, and tract-based spatial statistics was used for fractional anisotropy analysis. Results: Lower performance in the PCT, JLOT, and SDMT was associated with extensive cortical thickness reductions in lateral parietal and temporal regions. VFDT and CLOX2 did not show this common pattern and correlated with more limited medial occipito-temporal and occipito-parietal regions. Performance in all visuospatial/visuoperceptual tests correlated with fractional anisotropy in the corpus callosum. Conclusions: Our findings show that JLOT, SDMT, and PCT, in addition to differentiating patients from controls, are suitable visuospatial/visuoperceptual tests to reflect cortical thinning in lateral temporo-parietal regions in PD patients. We did not observe the dissociation between dorsal and ventral streams that was expected according to the neuropsychological classification of visuospatial and visuoperceptual tests. (JINS, 2018, 24, 33–44)
Chapter 4 - Paraneoplastic movement disorders
- from Section II - Movement disorders in systemic disease
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- By Francesc Valldeoriola, IDIBAPS-Hospital Clínic, Service of Neurology, University of Barcelona, Barcelona, Spain, Josep Dalmau, Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
- Edited by Werner Poewe, Joseph Jankovic, Baylor College of Medicine, Texas
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- Book:
- Movement Disorders in Neurologic and Systemic Disease
- Published online:
- 05 April 2014
- Print publication:
- 20 February 2014, pp 39-51
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Summary
Introduction
Paraneoplastic neurological syndromes are rare disorders of the central or peripheral nervous system that predominantly occur in patients with cancer, but cannot be ascribed to a direct invasion of the nervous system by the tumor, metastases, or side effects of oncological therapy. They are often associated with immune responses that cross-react with proteins expressed by both by the underlying tumor and neuronal tissue.
Paraneoplastic disorders frequently precede the cancer diagnosis. In these cases, features that suggest a movement disorder is possibly paraneoplastic include a recent, rapid or subacute, clinical onset, the presence of inflammatory changes in the CSF, and the identification of specific antineuronal antibodies in the serum or CSF (Titulaer et al. 2011). Once recognized, prompt identification and treatment of the tumor along with immunotherapy can result in neurological symptom improvement or stabilization.
For many years, the relevance of paraneoplastic etiologies in the field of movement disorders was considered to be low. Opsoclonus-myoclonus was one of the first syndromes recognized as a paraneoplastic movement disorder, but since opsoclonus is readily recognized by most physicians, specialists in movement disorders are rarely consulted for this syndrome. On the other hand, stiff person syndrome and its variants are well-characterized paraneoplastic syndromes in which specialists in movement disorders are frequently involved. Indeed, the differential diagnosis of this syndrome with other clinical disorders such as parkinsonism, rigidity, and dystonia has been an area of interest for clinicians in the last decade. This interest has increased recently with the discovery of a new category of paraneoplastic and autoimmune encephalitis associated with dyskinesias that are likely mediated by neuronal antibodies against cell surface and synaptic proteins. A substantial number of patients with these disorders develop behavioral and psychiatric disturbances in association with prominent motor abnormalities. Paraneoplastic chorea and atypical parkinsonism have also been reported in patients with antineuronal antibodies, and, in general, there have been many case reports in the last few years showing associations between cancer, movement disorders, and neuronal autoimmunity (Baizabal-Carvallo and Jankovic 2012). Different from the traditional approach of describing movement disorders in the context of specific paraneoplastic syndromes or antineuronal antibodies, this chapter reviews the paraneoplastic etiologies following a classification based on the movement disorders (see Table 4.1).