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Parkinson’s Disease as a Disconnection Syndrome

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Abstract

Parkinson’s disease (PD) is a major neurodegenerative disorder that is usually considered in terms of midbrain and basal ganglia dysfunction. Regarding PD instead as a disconnection syndrome may prove beneficial to understanding aspects of cognition, perception, and other neuropsychological domains in the disease. PD is usually of unilateral onset, providing evidence of intrahemispheric dissociations and an imbalance in the usual relative strengths of the right and left hemispheres. Hence, in order to appreciate the neuropsychology of PD, it is important to apply to this disease our understanding of hemispheric lateralization effects and within-hemisphere circuitry from brainstem to higher-order association cortex. The focus of this review is on the relevance of PD-related disconnections among subcortical and cortical structures to cognition, perception, emotion, and associated brainstem-based domains such as sleep and mood disturbance. Besides providing information on disease characteristics, regarding PD as a disconnection syndrome allows us to more completely understand normal brain-behavior relations in general.

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Acknowledgements

I am grateful to my colleagues who collaborated on the experiments described here and who discussed and critiqued earlier versions of this review, including Melissa Amick, Sanford Auerbach, Justin Centi, Uraina Clark, Sigurros Davidsdottir, Mirella Diaz-Santos, Raymon Durso, Georgio Ganis, Erica Harris, Tom Laudate, Alison Lee, Patrick McNamara, Ivy Miller, Sandy Neargarder, Haline Schendan, Daniel Seichepine, Karina Stavitsky, Robert Wagenaar, and Daniel Young. Chelsea Toner provided technical assistance in the preparation of the manuscript. This work was conducted with the support of the National Institute of Neurological Disorders and Stroke (1 R01 NS050446-01).

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    Alice Cronin-Golomb

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Cronin-Golomb, A. Parkinson’s Disease as a Disconnection Syndrome. Neuropsychol Rev 20, 191–208 (2010). https://doi.org/10.1007/s11065-010-9128-8

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