Acute Modulation of Brain Connectivity in Parkinson Disease after Automatic Mechanical Peripheral Stimulation: A Pilot Study

Carlo Cosimo Quattrocchi, Maria Francesca de Pandis, Claudia Piervincenzi, Manuela Galli, Jean Marc Melgari, Gaetano Salomone, Patrizio Sale, Carlo Augusto Mallio, Filippo Carducci, Fabrizio Stocchi, Carlo Cosimo Quattrocchi, Maria Francesca de Pandis, Claudia Piervincenzi, Manuela Galli, Jean Marc Melgari, Gaetano Salomone, Patrizio Sale, Carlo Augusto Mallio, Filippo Carducci, Fabrizio Stocchi

Abstract

Objective: The present study shows the results of a double-blind sham-controlled pilot trial to test whether measurable stimulus-specific functional connectivity changes exist after Automatic Mechanical Peripheral Stimulation (AMPS) in patients with idiopathic Parkinson Disease.

Methods: Eleven patients (6 women and 5 men) with idiopathic Parkinson Disease underwent brain fMRI immediately before and after sham or effective AMPS. Resting state Functional Connectivity (RSFC) was assessed using the seed-ROI based analysis. Seed ROIs were positioned on basal ganglia, on primary sensory-motor cortices, on the supplementary motor areas and on the cerebellum. Individual differences for pre- and post-effective AMPS and pre- and post-sham condition were obtained and first entered in respective one-sample t-test analyses, to evaluate the mean effect of condition.

Results: Effective AMPS, but not sham stimulation, induced increase of RSFC of the sensory motor cortex, nucleus striatum and cerebellum. Secondly, individual differences for both conditions were entered into paired group t-test analysis to rule out sub-threshold effects of sham stimulation, which showed stronger connectivity of the striatum nucleus with the right lateral occipital cortex and the cuneal cortex (max Z score 3.12) and with the right anterior temporal lobe (max Z score 3.42) and of the cerebellum with the right lateral occipital cortex and the right cerebellar cortex (max Z score 3.79).

Conclusions: Our results suggest that effective AMPS acutely increases RSFC of brain regions involved in visuo-spatial and sensory-motor integration.

Classification of evidence: This study provides Class II evidence that automatic mechanical peripheral stimulation is effective in modulating brain functional connectivity of patients with Parkinson Disease at rest.

Trial registration: Clinical Trials.gov NCT01815281.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1. Flowchart of the experimental protocol…
Fig 1. Flowchart of the experimental protocol of the pilot interventional study as approved by the local ethical committee.
Fig 2. The device used for the…
Fig 2. The device used for the AMPS treatment (a), the sites of feet stimulation (b), the effective AMPS (c), and the sham stimulation (d).
Fig 3. Z-statistic images showing clusters of…
Fig 3. Z-statistic images showing clusters of significantly increased RSFC (p
Seed regions of interest are red-coloured in the panels on the left. MNI coordinates (x, y, z) of the maximal Z-scores are presented in Table 2. Coronal and axial views follow the neurological convention.
Fig 4. Z-statistic images showing clusters of…
Fig 4. Z-statistic images showing clusters of significantly increased RSFC (p
Seed regions of interest are red-coloured in the panels on the left. MNI coordinates (x, y, z) of the maximal Z-scores are presented in Table 3. Coronal and axial views follow the neurological convention.
Fig 5. Z-statistic images showing clusters of…
Fig 5. Z-statistic images showing clusters of significantly increased RSFC (p
Coronal and axial views follow the neurological convention.

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