Brain Dopaminergic Modulation Associated with Executive Function in Parkinson's Disease
Brain Dopaminergic Modulation Associated with Executive Function in Parkinson's Disease
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DOI：
10.1002/mds.22709
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发表时间：
2009-10-15
影响因子：
8.6
通讯作者：
Allard, Michele
中科院分区：
文献类型：
--
作者：
Farid, Karim;Sibon, Igor;Allard, Michele
包括行动计划在内的执行功能缺陷的逐渐发展是帕金森氏症的众所周知的并发症。前额叶功能障碍，已知参与抑制过程的控制，可以解释帕金森病患者在启动行为或抑制正在进行的行为方面的困难。前额叶皮质强烈的多巴胺能神经支配提出了关于多巴治疗对这种认知损害的假定效果的疑问。在这项研究中，我们使用功能磁共振成像来检测9名接受和不接受左旋多巴治疗的患者以及匹配的对照组在GO/NO-GO任务中多巴治疗对神经活动的功能影响。虽然患者和对照组在GO/NO-GO任务中表现相同，但根据多巴胺能状态的不同，观察到不同的大脑激活模式。停药状态的特点是大脑活动分布更广泛，主要是在双侧尾状核。左旋多巴不能完全恢复正常脑活动，并引起扣带回皮质活动模式的改变，这种改变在停药状态下的吻部和摄取左旋多巴后的尾部更为明显。这些结果支持多巴胺在帕金森病患者的执行功能控制中起关键作用的观点。(C)2009年流动无序协会
The progressive development of deficits in executive functions, including action planning, is a well-known complication of Parkinson's disease. A dysfunction of the prefrontal lobe, which is known to be involved in the control of inhibitory processes, could explain the difficulties in initiating behavior or inhibiting ongoing actions in patients with PD. The strong dopaminergic innervation of the prefrontal cortex raises questions about the putative effects of dopa therapy on this cognitive impairment. In the present study, we used fMRI to examine the functional influence of dopa therapy on neural activity during a go/no-go task in nine patients with and without levodopa treatment and in matched controls. Whereas the patient and control subjects exhibited the same performance during the go/no-go task, different patterns of brain activation were observed depending on the dopaminergic status. The drug-off state was characterized by more widely distributed brain activity, mainly in the bilateral caudate. Levodopa did not fully restore normal brain activation and induced changes in the pattern of cingulate cortex activity, which was more pronounced in the rostral part in the drug-off state and in the caudal part after levodopa intake. These results support the idea of a critical role for dopamine in the control of executive functions in patients with PD. (C) 2009 Movement Disorder Society