Functional mapping in PD and PSP for sustained phonation and phoneme tasks.
OBJECTIVE
To elucidate the central basis of articulatory speech disorders in Parkinsonian syndromes using functional magnetic resonance imaging (fMRI).


METHODS
Twenty-two patients with Parkinson's disease (PD) and 18 with progressive supranuclear palsy (PSP) were clinically evaluated for speech dysfunction. Functional magnetic resonance imaging (fMRI) was carried out in these patients using sustained phonation and phoneme tasks. Individual and group analysis using SPM2 was done for eight patients with PD, 7 with PSP and 6 healthy controls.


METHODS
Tertiary Medical Teaching Institute.


RESULTS
For sustained phonation paradigm, superior temporal gyrus area was activated in PD patients, and occipital cortex in PSP subjects in comparison to controls. For phoneme paradigm, the patients with PD recruit lingual gyrus obviating the need for more efforts for the task. Also wider areas as well as more clusters were activated in PD patients compared to controls. Lingual gyrus was found to be strongly activated in PSP patients. Reduced activation of the primary areas with recruitment of remote areas was another prominent finding in PSP. Due to excessive motion (>1.5 mm, >1 degrees ) in all the MSA patients, they could not be considered for analysis.


CONCLUSIONS
The failure of the executive fronto-striatal network would lead to increased activation of other areas in PD, but in PSP, there is a widespread cortical dysfunction.
Sachin
S
S
Department of Neurology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110 029, India.
Senthil Kumaran
S
S
Singh
S
S
Goyal
V
V
Shukla
G
G
Mahajan
H
H
Behari
M
M
D000161:Acoustic Stimulation / Q000379:methods; D000328:Adult; D000368:Aged; D001931:Brain Mapping; D002540:Cerebral Cortex / Q000098:blood supply*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000150:complications / Q000473:pathology; D009460:Neurologic Examination; D010100:Oxygen / Q000097:blood; D010300:Parkinson Disease / Q000150:complications / Q000473:pathology*; D010700:Phonetics; D013064:Speech Disorders / Q000209:etiology / Q000473:pathology; D013494:Supranuclear Palsy, Progressive / Q000150:complications / Q000473:pathology*
D010100:Oxygen