My research compared healthy participants who are at an increased risk for the future development of Parkinson’s disease based on their genetic status (G2019S LRRK2, GBA), using both structural and functional imaging.

A recurrent finding was the utilization of compensatory mechanisms in the carrier groups in order to perform tasks to the same degree as non-carriers.

Neural Assessment of 'at risk' subjects for the future development of Parkinson disease

In conclusion, while at risk mutation carriers function as well as non carriers on these fMRI tasks, they recruit and utilize different cerebral mechanisms including wider cortical activations and higher functional connectivity. These can be regarded as compensatory and should be a target for further research in order to prolong the non-manifesting state.

DR. AVNER THALER (MD, PhD) 

Dr. Thaler is currently a movement disorders fellow at the Tel-Aviv Medical Center. He graduated from the Sackler School of Medicine, Tel-Aviv University, in 2008. He completed his PhD in 2014, which focused on imaging genetically based "at risk" subjects for the future development of Parkinson's disease, and finished his residency in neurology at the Tel-Aviv Medical Center in 2015. Dr. Thaler currently combines clinical work in the field of movement disorders with imaging research.

1. Thaler et al. Neurology, 2012

1. Thaler et al. Neurology, 2012

Recurrent finding was the utilization of compensatory mechanisms in the carrier groups in order to perform tasks to the same degree as non-carriers. Specifically, results from a computerized cognitive assessment battery found that non-manifesting G2019S carriers showed lower executive functions compared to non-carriers.

2. Thaler et al. Neurology, 2012

2. Thaler et al. Neurology, 2012

Differential Stroop effect and reaction times were also found between the two groups on the computerized program.

3. Thaler et al. Cotrex, 2014

3. Thaler et al. Cotrex, 2014

The fMRI results during the Stroop task found 3 regions that demonstrated higher activations among carriers when performing the task equally well as non-carriers.

4. Thaler et al. Cotrex, 2014

4. Thaler et al. Cotrex, 2014

Stronger functional connectivity was seen among carriers, from the IPL and precuneus to regions of both the dorsal and the ventral attention network.

5. Bregman et al. 2014

5. Bregman et al. 2014

Differential activation patterns seen among GBA, LRRK2 and controls during the Stroop task indicate that non-manifesting GBA carriers recruit both frontal and posterior cortex to perform the Stroop task as well as controls and LRRK2 carriers.

6.

6.

A motor imagery analysis indicated that non-manifesting G2019S carriers have reduced bilateral caudate activations and increased left dorsal premotor activation compared to controls, with increased connectivity in carriers to parietal regions while performing the task.

7.

7.

An event related fMRI gambling task found increased bilateral caudate and right motor cortex activity as well as reduced left midbrain activity among non-manifesting G2019S carriers while pressing the response button.