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Functional evaluation of central cholinergic circuits in patients with Parkinson’s disease and REM sleep behavior disorder: a TMS study

  • Neurology and Preclinical Neurological Studies - Original Article
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Abstract

Central cholinergic dysfunction has been reported in patients with Parkinsonʼs disease (PD) and hallucinations by evaluating short latency afferent inhibition (SAI), a transcranial magnetic stimulation protocol which gives the possibility to test an inhibitory cholinergic circuit in the human brain. REM sleep behavior disorder (RBD) was also found to be associated with cognitive impairment in PD patients. The objective of the study was to assess the cholinergic function, as measured by SAI, in PD patients with RBD (PD-RBD) and PD patients without RBD (PD-nRBD). We applied the SAI technique in 10 PD-RBD patients, in 13 PD-nRBD patients and in 15 age-matched normal controls. All PD patients and control subjects also underwent a comprehensive battery of neuropsychological tests. Mean SAI was significantly reduced in PD-RBD patients when compared with PD-nRBD patients and controls. Neuropsychological examination showed mild cognitive impairment in 9 out of the 10 PD-RBD patients, and in 5 out of the 13 PD-nRBD. SAI values correlated positively with neuropsychological tests measuring episodic verbal memory, executive functions, visuoconstructional and visuoperceptual abilities. Similar to that previously reported in the idiopathic form of RBD, SAI abnormalities suggest a cholinergic dysfunction in PD patients who develop cognitive impairment, and present findings indicate that RBD is an important determinant of MCI in PD.

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Authors and Affiliations

  1. Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria

    Raffaele Nardone, Alexander Kunz, Martin Seidl, Eugen Trinka & Stefan Golaszewski

  2. Department of Neurology, Franz Tappeiner Hospital, Merano, Via Rossini, 5, 39012, Meran/o, BZ, Italy

    Raffaele Nardone, Francesco Brigo & Frediano Tezzon

  3. Neuroscience Institute, Christian Doppler Klinik, Salzburg, Austria

    Jürgen Bergmann

  4. Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, Verona, Italy

    Francesco Brigo

  5. Department of Physiology, Medical University of Graz, Graz, Austria

    Monica Christova

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  1. Raffaele Nardone
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  2. Jürgen Bergmann
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  3. Francesco Brigo
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  4. Monica Christova
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  5. Alexander Kunz
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  9. Stefan Golaszewski
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Correspondence to Raffaele Nardone.

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Nardone, R., Bergmann, J., Brigo, F. et al. Functional evaluation of central cholinergic circuits in patients with Parkinson’s disease and REM sleep behavior disorder: a TMS study. J Neural Transm 120, 413–422 (2013). https://doi.org/10.1007/s00702-012-0888-6

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  • DOI: https://doi.org/10.1007/s00702-012-0888-6

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