Brain Advance Access originally published online on April 5, 2007
Brain 2007 130(7):1847-1860; doi:10.1093/brain/awm034
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Slowing of oscillatory brain activity is a stable characteristic of Parkinson's disease without dementia
1Institute for Clinical and Experimental Neurosciences, Department of Neurology, VU University Medical Center, 2Department of Clinical Neuropsychology, VU University and 3Institute for Clinical and Experimental Neurosciences, Department of Clinical Neurophysiology, VU University Medical Center, Amsterdam, The Netherlands
Correspondence to: D. Stoffers, Department of Neurology, VU University Medical Center, P.O. box 7057, 1007 MB, Amsterdam, The Netherlands E-mail: d.stoffers{at}vumc.nl
Extensive changes in resting-state oscillatory brain activity have recently been demonstrated using magnetoencephalography (MEG) in moderately advanced, non-demented Parkinson's disease patients relative to age-matched controls. The aim of the present study was to determine the onset and evolution of these changes over the disease course and their relationship with clinical parameters. In addition, we evaluated the effects of dopaminomimetics on resting-state oscillatory brain activity in levodopa-treated patients. MEG background oscillatory activity was studied in a group of 70 Parkinson's disease patients with varying disease duration and severity (including 18 de novo patients) as well as in 21 controls that were age-matched to the de novo patients. Whole head 151-channel MEG recordings were obtained in an eyes-closed resting-state condition. Levodopa-treated patients (N = 37) were examined both in a practically defined ‘OFF’ as well as in the ‘ON’ state. Relative spectral power was calculated for delta, theta, low alpha, high alpha, beta and gamma frequency bands and averaged for 10 cortical regions of interest (ROIs). Additionally, extensive clinical and neuropsychological testing was performed in all subjects. De novo Parkinson's disease patients showed widespread slowing of background MEG activity relative to controls. Changes included a widespread increase in theta and low alpha power, as well as a loss of beta power over all but the frontal ROIs and a loss of gamma power over all but the right occipital ROI. Neuropsychological assessment revealed abnormal perseveration in de novo patients, which was associated with increased low alpha power in centroparietal ROIs. In the whole group of Parkinson's disease patients, longer disease duration was associated with reduced low alpha power in the right temporal and right occipital ROI, but not with any other spectral power measure. No association was found between spectral power and disease stage, disease severity or dose of dopaminomimetics. In patients on levodopa therapy, a change from the ‘OFF’ to the ‘ON’ state was associated with decreases in right frontal theta, left occipital beta and left temporal gamma power and an increase in right parietal gamma power. Widespread slowing of oscillatory brain activity is a characteristic of non-demented Parkinson's disease patients from the earliest clinical stages onwards that is (largely) independent of disease duration, stage and severity and hardly influenced by dopaminomimetic treatment. Some early cognitive deficits in Parkinson's disease appear to be associated with increased low alpha power. We postulate a role for hypofunctional non-dopaminergic ascending neurotransmitter systems in spectral power changes in non-demented Parkinson's disease patients.
Key Words: Parkinson's disease; magnetoencephalography (MEG); resting-state; oscillations; spectral analysis
Abbreviations: EEG, Electroencephalography; MEG, Magnetoencephalography
Received October 4, 2006. Revised February 1, 2007. Accepted February 12, 2007.