Beyond Dopamine: GABA, Glutamate, and the Axial Symptoms of Parkinson Disease
Introduction: The axial symptoms of Parkinson disease (PD) include difficulties with balance, posture, speech, swallowing, and locomotion with freezing of gait, as well as axial rigidity. These axial symptoms impact negatively on quality of life for many patients, yet remain poorly understood. Dopam...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2018-09-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fneur.2018.00806/full |
| _version_ | 1818420474085900288 |
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| author | Ruth L. O'Gorman Tuura Christian R. Baumann Heide Baumann-Vogel |
| author_facet | Ruth L. O'Gorman Tuura Christian R. Baumann Heide Baumann-Vogel |
| author_sort | Ruth L. O'Gorman Tuura |
| collection | DOAJ |
| description | Introduction: The axial symptoms of Parkinson disease (PD) include difficulties with balance, posture, speech, swallowing, and locomotion with freezing of gait, as well as axial rigidity. These axial symptoms impact negatively on quality of life for many patients, yet remain poorly understood. Dopaminergic treatments typically have little effect on the axial symptoms of PD, suggesting that disruptions in other neurotransmitter systems beyond the dopamine system may underlie these symptoms. The purpose of the present study was to examine the relationship between the axial symptoms of PD and GABA and glutamate levels quantified with magnetic resonance spectroscopy.Methods: The participant group included 20 patients with PD and 17 healthy control participants. Water-scaled GABA and Glx (glutamate + glutamine) concentrations were derived from GABA-edited MEGA-PRESS spectra acquired from the left basal ganglia and prefrontal cortex, and additional water-scaled Glx concentrations were acquired from standard PRESS spectra acquired from the pons. Spectra were analyzed with LCModel. The axial symptoms of PD were evaluated from subscales of the Unified Parkinson's Disease rating scale (MDS-UPDRS).Results: PD patients demonstrated significantly higher GABA levels in the basal ganglia, which correlated with the degree of gait disturbance. Basal ganglia Glx levels and prefrontal GABA and Glx levels did not differ significantly between patient and control groups, but within the PD group prefrontal Glx levels correlated negatively with difficulties turning in bed. Results from an exploratory subgroup analysis indicate that the associations between GABA, Glx, and axial symptoms scores are typically more prominent in akinetic-rigid patients than in tremor-dominant patients.Conclusion: Alterations in GABAergic and glutamatergic neurotransmission may contribute to some of the axial symptoms of PD. |
| first_indexed | 2024-12-14T12:55:02Z |
| format | Article |
| id | doaj.art-3a51ed98042144578574f59f3ddc913d |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-14T12:55:02Z |
| publishDate | 2018-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-3a51ed98042144578574f59f3ddc913d2022-12-21T23:00:35ZengFrontiers Media S.A.Frontiers in Neurology1664-22952018-09-01910.3389/fneur.2018.00806397277Beyond Dopamine: GABA, Glutamate, and the Axial Symptoms of Parkinson DiseaseRuth L. O'Gorman Tuura0Christian R. Baumann1Heide Baumann-Vogel2Center for MR Research, University Children's Hospital Zurich, Zurich, SwitzerlandDepartment of Neurology, University Hospital Zurich, Zurich, SwitzerlandDepartment of Neurology, University Hospital Zurich, Zurich, SwitzerlandIntroduction: The axial symptoms of Parkinson disease (PD) include difficulties with balance, posture, speech, swallowing, and locomotion with freezing of gait, as well as axial rigidity. These axial symptoms impact negatively on quality of life for many patients, yet remain poorly understood. Dopaminergic treatments typically have little effect on the axial symptoms of PD, suggesting that disruptions in other neurotransmitter systems beyond the dopamine system may underlie these symptoms. The purpose of the present study was to examine the relationship between the axial symptoms of PD and GABA and glutamate levels quantified with magnetic resonance spectroscopy.Methods: The participant group included 20 patients with PD and 17 healthy control participants. Water-scaled GABA and Glx (glutamate + glutamine) concentrations were derived from GABA-edited MEGA-PRESS spectra acquired from the left basal ganglia and prefrontal cortex, and additional water-scaled Glx concentrations were acquired from standard PRESS spectra acquired from the pons. Spectra were analyzed with LCModel. The axial symptoms of PD were evaluated from subscales of the Unified Parkinson's Disease rating scale (MDS-UPDRS).Results: PD patients demonstrated significantly higher GABA levels in the basal ganglia, which correlated with the degree of gait disturbance. Basal ganglia Glx levels and prefrontal GABA and Glx levels did not differ significantly between patient and control groups, but within the PD group prefrontal Glx levels correlated negatively with difficulties turning in bed. Results from an exploratory subgroup analysis indicate that the associations between GABA, Glx, and axial symptoms scores are typically more prominent in akinetic-rigid patients than in tremor-dominant patients.Conclusion: Alterations in GABAergic and glutamatergic neurotransmission may contribute to some of the axial symptoms of PD.https://www.frontiersin.org/article/10.3389/fneur.2018.00806/fullParkinson diseasemagnetic resonance spectroscopyGABAglutamatebasal gangliaprefrontal cortex |
| spellingShingle | Ruth L. O'Gorman Tuura Christian R. Baumann Heide Baumann-Vogel Beyond Dopamine: GABA, Glutamate, and the Axial Symptoms of Parkinson Disease Frontiers in Neurology Parkinson disease magnetic resonance spectroscopy GABA glutamate basal ganglia prefrontal cortex |
| title | Beyond Dopamine: GABA, Glutamate, and the Axial Symptoms of Parkinson Disease |
| title_full | Beyond Dopamine: GABA, Glutamate, and the Axial Symptoms of Parkinson Disease |
| title_fullStr | Beyond Dopamine: GABA, Glutamate, and the Axial Symptoms of Parkinson Disease |
| title_full_unstemmed | Beyond Dopamine: GABA, Glutamate, and the Axial Symptoms of Parkinson Disease |
| title_short | Beyond Dopamine: GABA, Glutamate, and the Axial Symptoms of Parkinson Disease |
| title_sort | beyond dopamine gaba glutamate and the axial symptoms of parkinson disease |
| topic | Parkinson disease magnetic resonance spectroscopy GABA glutamate basal ganglia prefrontal cortex |
| url | https://www.frontiersin.org/article/10.3389/fneur.2018.00806/full |
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