Le colliculus supérieur dans la maladie de Parkinson : un biomarqueur possible ?

Some visuo-motor impairments observed in the early stages of Parkinson’s disease (PD) might be related to a dysfunction of a subcortical structure connected to the basal ganglia, the superior colliculus (SC). The aim of this PhD thesis was to explore the functional state of the SC in newly diagnosed (de novo) PD patients before and after dopaminergic treatment intake, in order to evaluate the potential value of the SC functioning as a biomarker. To do this, we developed a functional Magnetic Resonance Imaging (fMRI) experimental protocol, which successfully imaged the SC and also the lateral geniculate nucleus (LGN) and primary visual area V1 functional activity and modulate their activity by using visual stimuli with low luminance contrast levels (<10%). Additionally, we estimated the perceptual response to contrast by using a psychophysical task. We tested in a first time this experimental protocol on healthy subjects with varying age in order to evaluate the effect of normal aging on the functioning of these regions of interest (ROIs) and to distinguish the effects related to age from those potentially related to the pathology (Study 1). A significant progressive decrease of the BOLD amplitude with age was observed in the LGN and V1. These data were consistent with the response functions obtained with the psychophysical task. These results indicate a significant luminance contrast sensitivity decline with age of both the magnocellular and parvocellular pathways. In a second time, we tested our protocol on de novo PD patients before and after the introduction of the first dopaminergic treatment in order to assess the effects of PD and treatment on the ROIs functioning (Study 2). Our results highlighted an early alteration of the contrast processing for the SC and LGN in PD patients, with no normalization after dopaminergic treatment introduction. These findings indicate a functional deficit of the SC and LGN that appears early in the disease course, in line with our effective connectivity analyses. These results could favor the identification of deficits linked to sensory dysfunction of these structures as well as the development of paraclinical and clinical tests involving this system for an early diagnosis of the disease.Certains troubles visuo-moteurs observés dès le stade précoce de la maladie de Parkinson (MP) pourraient être liés à une altération du fonctionnement d’une structure sous-corticale reliée aux ganglions de la base, le colliculus supérieur (CS). L’objectif de cette thèse a été d’explorer l’état fonctionnel du CS chez le patient parkinsonien nouvellement diagnostiqué (de novo) avant et après instauration du traitement dopaminergique, afin d’évaluer son potentiel de biomarqueur. Pour cela, un paradigme expérimental d’Imagerie par Résonance Magnétique fonctionnelle (IRMf) a été développé, permettant d’imager avec succès l’activité fonctionnelle du CS et également du corps genouillé latéral (CGL) et de l’aire visuelle primaire V1 et de moduler leur activité via l’emploi de stimulation visuelle jouant sur de très faibles niveaux de contraste (