Dysfunction of the Default Mode Network in Drug-Naïve Parkinson's Disease with Mild Cognitive Impairments: A Resting-State fMRI Study.
Dysfunction of the Default Mode Network in Drug-Naïve Parkinson's Disease with Mild Cognitive Impairments: A Resting-State fMRI Study.
复制标题
患有轻度认知障碍的初治帕金森病的默认模式网络功能障碍：一项静息态功能磁共振成像研究
DOI：
10.3389/fnagi.2016.00247
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发表时间：
2016
影响因子：
4.8
通讯作者：
Shang H
中科院分区：
文献类型：
--
作者：
Hou Y;Yang J;Luo C;Song W;Ou R;Liu W;Gong Q;Shang H
目的：认知障碍在帕金森病（PD）中很常见，甚至可以发生在早期阶段。默认模式网络（DMN）与认知过程高度相关;然而，DMN连接性的变化是否与轻度认知障碍（MCI）的初治早期PD患者的认知下降相关，在很大程度上仍然未知。本研究采用静息态功能磁共振成像（fMRI）探讨早期药物初治PD伴MCI患者DMN的脑连接。方法：我们招募了32名早期药物初治的PD患者和22名匹配的健康对照（HC）。在PD患者中，14例被归类为MCI（PD-MCI），18例被归类为未受损认知（PD-CU）。通过基于种子的相关性方法评估DMN的功能整合。结果：脑连接分析显示，与HC相比，两个PD亚组的功能连接（FC）均降低。PD-MCI组表现出DMN和一组区域之间的FC显著降低，包括中央前回、颞中回、颞叶、前顶下小叶和额中回。与PD-CU组相比，PD-MCI组在额中回和颞中回的FC显著降低。此外，与HC相比，PD-MCI组DMN内的FC显著降低，主要在海马结构与额下回之间、后扣带回与后顶下小叶之间以及前颞叶与额下回之间的FC。与PD-CU组相比，PD-MCI组DMN内的FC仅在前颞叶和额下回之间显著降低。所有PD患者中，前颞叶与颞中回间的FC降低与注意/工作表现呈正相关，海马结构与额下回间的FC降低与记忆功能呈正相关。结论：我们的研究结果表明，DMN连接的改变是PD-MCI患者的特征。这些发现可能有助于进一步了解PD中MCI的潜在机制。然而，我们的结果是初步的，需要进一步的调查。
Objective: Cognitive impairments are common in Parkinson’s disease (PD) and can even occur in the early stages. The default mode network (DMN) is highly relevant for cognitive processes; however, it remains largely unknown if changes in the DMN connectivity are related to the cognitive decline in drug-naïve early stage PD patients with a mild cognitive impairment (MCI). This study used resting-state functional MRI (fMRI) to explore the brain connectivity of the DMN in early stage drug-naïve PD patients with MCI. Method: We recruited 32 early stage drug-naïve PD patients and 22 matched healthy controls (HC). Among the PD patients, 14 were classified as having MCI (PD-MCI) and 18 were classified as having unimpaired cognition (PD-CU). The functional integration of the DMN was evaluated by a seed-based correlation approach. Results: The brain connectivity analysis revealed reduced functional connectivity (FC) in both PD subgroups compared with HC. The PD-MCI group showed a significant reduction in FC between the DMN and a set of regions, including the precentral gyrus, middle temporal gyrus, insula, anterior inferior parietal lobule and middle frontal gyrus. Compared to the PD-CU group, the PD-MCI group demonstrated a significantly decreased FC in the middle frontal and middle temporal gyri. Additionally, compared to HC, the PD-MCI group had a significantly decreased FC within the DMN, mainly in the FC between the hippocampal formation and inferior frontal gyrus, between the posterior cingulate cortex and posterior inferior parietal lobule, and between the anterior temporal lobe and inferior frontal gyrus. Compared to the PD-CU group, the only significantly decreased FC within the DMN in the PD-MCI group was between the anterior temporal lobe and inferior frontal gyrus. In all PD patients, the decreased FC between anterior temporal lobe and middle temporal gyrus was positively correlated with attention/working performance, and the reduced FC between the hippocampal formation and inferior frontal gyrus was also positively correlated with memory function. Conclusion: Our findings suggest that an altered DMN connectivity characterizes PD-MCI patients. These findings may be helpful for facilitating the further understanding of the potential mechanisms underlying MCI in PD. However, our results are preliminary, and further investigation is needed.