Resting-state functional connectivity of the striatum in early-stage Parkinson's disease: Cognitive decline and motor symptomatology.
Resting-state functional connectivity of the striatum in early-stage Parkinson's disease: Cognitive decline and motor symptomatology.
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DOI：
10.1002/hbm.23056
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发表时间：
2016-02
影响因子：
4.8
通讯作者：
Leung HC
中科院分区：
文献类型：
--
作者：
Manza P;Zhang S;Li CS;Leung HC
帕金森氏病是一种神经退行性疾病，其特征是纹状体中的多巴胺能功能改变以及一系列认知和运动障碍。神经成像研究一再表明，有症状的帕金森氏病患者和健康对照组在纹状体的激活和功能连接模式上存在差异。然而，早期帕金森氏症患者的认知和运动症状的存在和严重程度似乎有很大的不同。为了探讨这种异质性的神经基础，我们研究了62例早期帕金森病患者(女性21例，新药23例，年龄39-77岁，停药后平均UPDRS运动评分=18.56，平均H&Y分期=1.66)尾状核和壳核亚区的静息状态功能连接模式与认知和运动障碍的关系。我们还探索了纹状体连通性的变化与一年来症状学变化的关系。主要有两个发现。首先，较高的运动缺陷等级与前壳核和包括黑质在内的中脑之间的耦合较弱有关。有趣的是，这些区域之间的功能连通性的急剧下降与一年中运动功能的更大下降有关。其次，认知功能的下降，特别是在记忆和视觉空间领域，与背侧尾状核和嘴前扣带回皮质之间更强的耦合有关。在控制了年龄、药物、性别和教育后，这些发现仍然显著。总而言之，我们的发现表明，认知衰退和运动障碍都与纹状体亚区功能连接的不同模式有关。
Parkinson’s disease is a neurodegenerative disorder characterized by changes to dopaminergic function in the striatum and a range of cognitive and motor deficits. Neuroimaging studies have repeatedly shown differences in activation and functional connectivity patterns of the striatum between symptomatic individuals with Parkinson’s disease and healthy controls. However, the presence and severity of cognitive and motor symptoms seem to differ dramatically among individuals with Parkinson’s disease at the early-stages. To investigate the neural basis of such heterogeneity, we examined the resting state functional connectivity patterns of caudate and putamen subdivisions in relation to cognitive and motor impairments among 62 early-stage individuals with Parkinson’s disease (21 females, 23 drug naive, ages 39–77 years, average UPDRS motor scores off medication = 18.56, average H&Y stage = 1.66). We also explored how changes in striatal connectivity relate to changes in symptomatology over a year. There are two main findings. First, higher motor deficit rating was associated with weaker coupling between anterior putamen and midbrain including substantia nigra. Intriguingly, steeper declines in functional connectivity between these regions were associated with greater declines in motor function over the course of 1 year. Second, decline in cognitive function, particularly in the memory and visuospatial domains, was associated with stronger coupling between the dorsal caudate and the rostral anterior cingulate cortex. These findings remained significant after controlling for age, medication, gender, and education. In sum, our findings suggest that cognitive decline and motor deficit are each associated with a differentiable pattern of functional connectivity of striatal subregions.