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Front. Neurosci. | doi: 10.3389/fnins.2018.00972

Asymmetric dopaminergic degeneration and attentional resources in Parkinson’s disease.

Paola Ortelli1,  Davide Ferrazzoli1*, Marianna Zarucchi1, Roberto Maestri2 and  Giuseppe Frazzitta1
  • 1Ospedale Moriggia Pelascini, Italy
  • 2IRCCS Istituti Clinici Scientifici Maugeri (ICS Maugeri), Italy

Background: Attention is crucial to voluntary perform actions in Parkinson’s disease (PD), allowing patients to bypass the impaired habitual motor control. The asymmetrical degeneration of the dopaminergic system could affect the attentional functions.
Objective: To investigate the relationship between the asymmetric dopaminergic degeneration and the attentional resources in Parkinsonian patients with right-side (RPD) and left-side (LPD) motor symptoms predominance.
Methods: 50 RPD, 50 LPD and 34 healthy controls underwent visual (V), auditory (A) and multiple choices (MC) reaction time (RTs) tasks. For PD patients, these tasks were performed before and after a 4-week intensive, motor-cognitive rehabilitation treatment (MIRT). The effectiveness of treatment was evaluated assessing Unified Parkinson’s disease Rating Scale (UPDRS) III and Timed-up and Go Test (TUG).
Results: RTs did not differ between PD patients and healthy controls. Before MIRT, no differences between LPD and RPD patients were observed in RTs (p=0.20), UPDRS III (p=0,60) and TUG (p=0,38). No differences in dopaminergic medication were found between groups (p=0.44 and p=0.66 before and after MIRT, respectively). After MIRT, LPD patients showed a significant reduction in MC RTs (p=0.05), V RTs (p=0.02) and MC-V RTs. A significant association between changes in RTs and improvements in UPDRS III and TUG was observed in LPD patients.
Conclusions: attention does not differ among RPD patients, LPD patients and healthy controls. Only LPD patients improved their performances on attentional tasks after MIRT. We argue that the increased early susceptibility of the left nigrostriatal system to degeneration affects differently the cognitive modifiability and the neuroplastic potential. Our results could provide insight into new therapeutic approaches, highlighting the importance to design different treatments for RPD patients and LPD patients.

Keywords: Parkinson’s disease, Attention, dopamine-related asymmetry, neuroplasticity, Rehabilitation

Received: 26 Aug 2018; Accepted: 04 Dec 2018.

Edited by:

Antonio Oliviero, Fundación del Hospital Nacional de Parapléjicos, Spain

Reviewed by:

Michele Dileone, Neurology; Advaced Neuro-rehabilitation Unit; Los Madroños Hospital, Spain
Nuria López Ariztegui, Hospital Virgen de la Salud, Spain  

Copyright: © 2018 Ortelli, Ferrazzoli, Zarucchi, Maestri and Frazzitta. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: MD. Davide Ferrazzoli, Ospedale Moriggia Pelascini, Gravedona ed Uniti, Italy, davideferrazzoli@gmail.com