Resting state functional connectivity of the striatum in Parkinson's disease
Resting state functional connectivity of the striatum in Parkinson's disease
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DOI：
10.1093/brain/aws281
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发表时间：
2012-12-01
期刊：
影响因子：
14.5
通讯作者：
Snyder, Abraham Z.
中科院分区：
文献类型：
--
作者：
Hacker, Carl D.;Perlmutter, Joel S.;Snyder, Abraham Z.
帕金森氏病的病理生理学的经典记载强调了多巴胺能骨纹状体神经元的变性，随之而来的是皮质 - 纹状体丘脑环路的功能障碍。相比之下，验尸研究表明，帕金森氏病（路易神经突和路易体）的病理变化首先出现在较低的脑干中，随后进展到神经肌的更胸部。黑质和组织学的观点并非不兼容，但它们确实强调了不同的解剖结构。为了解决哪些大脑结构在功能上受到帕金森氏病影响最大的问题，我们进行了一项静止的功能磁共振成像研究，该研究的重点是纹状体功能连通性。我们将13例患有晚期帕金森氏病的患者与19岁年龄匹配的对照组患者进行了对比，该方法使用了仔细注意的方法，以最大程度地减少扫描过程中头部运动的影响。帕金森氏病组中的主要发现与丘脑，中脑，庞斯和小脑显着较低。这一结果增强了脑干在帕金森氏病的病理生理学中的重要性。在大脑皮层的感觉运动和视觉区域以及上乳房回旋中也观察到了局部变化的功能连通性。在帕金森氏病和控制受试者的两名患者中，对与脑干的纹状体功能连通性进行分级（后壳>前壳>尾状），以对应于帕金森氏病的纹状体多巴胺能损失的梯度。我们假设这种梯度为帕金森氏病的发病机理提供了线索。
Classical accounts of the pathophysiology of Parkinson's disease have emphasized degeneration of dopaminergic nigrostriatal neurons with consequent dysfunction of cortico-striatal-thalamic loops. In contrast, post-mortem studies indicate that pathological changes in Parkinson's disease (Lewy neurites and Lewy bodies) first appear primarily in the lower brainstem with subsequent progression to more rostral parts of the neuraxis. The nigrostriatal and histological perspectives are not incompatible, but they do emphasize different anatomical structures. To address the question of which brain structures are functionally most affected by Parkinson's disease, we performed a resting-state functional magnetic resonance imaging study focused on striatal functional connectivity. We contrasted 13 patients with advanced Parkinson's disease versus 19 age-matched control subjects, using methodology incorporating scrupulous attention to minimizing the effects of head motion during scanning. The principal finding in the Parkinson's disease group was markedly lower striatal correlations with thalamus, midbrain, pons and cerebellum. This result reinforces the importance of the brainstem in the pathophysiology of Parkinson's disease. Focally altered functional connectivity also was observed in sensori-motor and visual areas of the cerebral cortex, as well the supramarginal gyrus. Striatal functional connectivity with the brainstem was graded (posterior putamen > anterior putamen > caudate), in both patients with Parkinson's disease and control subjects, in a manner that corresponds to well-documented gradient of striatal dopaminergic function loss in Parkinson's disease. We hypothesize that this gradient provides a clue to the pathogenesis of Parkinson's disease.