Brain Structural and Functional Connectivity in Parkinson's Disease With Freezing of Gait
Brain Structural and Functional Connectivity in Parkinson's Disease With Freezing of Gait
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DOI：
10.1002/hbm.22994
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发表时间：
2015-12-01
影响因子：
4.8
通讯作者：
Filippi, Massimo
中科院分区：
文献类型：
--
作者：
Canu, Elisa;Agosta, Federica;Filippi, Massimo
目的：使用多模态方法评估帕金森病和步态冻结（PD-FoG）患者的脑结构通路和静息状态（RS）功能连接异常。研究方法：应用3.0T磁共振扫描仪对22例PD-FoG患者和35例正常对照者进行T1加权、扩散张量（DT）和RS功能MRI（fMRI）检查。患者接受了临床、运动和神经心理学评估。灰质（GM）体积和白色物质（WM）的损害分别使用基于体素的形态测量和基于束的空间统计进行评估。采用纤维束成像研究了脚桥脑束（PPT）。RS功能磁共振成像数据进行了分析，使用无模型的方法调查的主要感觉运动和认知脑网络。采用多元回归模型评估结构、功能和临床/认知变量之间的关系。在一个独立的样本中重复GM和WM结构异常的分析，该样本包括28名PD-FoG患者，25名没有FoG的PD患者和30名在1.5 T扫描仪上进行MRI扫描的健康对照。结果：与对照组相比，PD-FoG病例中未发现GM萎缩。PD-FoG患者表现出PPT、胼胝体、皮质脊髓束、扣带回、上级纵束的WM损伤，以及双侧初级运动、运动前区、前额叶、眶额和顶下皮质下方的WM损伤。在PD-FoG中，右侧PTT损伤与更严重的疾病严重程度相关。对独立PD样本的分析显示，PD-FoG患者与对照组的结果相似，PD-FoG患者与PD非FoG患者相比，胼胝体和右顶叶WM的白质损伤相似。RS功能磁共振成像分析表明，PD-FoG与减少的功能连接的初级运动皮层和辅助运动区双边的感觉运动网络，额顶叶区的默认模式网络，枕叶皮层的视觉联想网络。结论：这项研究表明，PD中的FoG可能是运动和运动外（认知）神经系统之间结构和功能整合不良的结果。(C)2015 Wiley Periodicals，Inc.
Objective: To use a multimodal approach to assess brain structural pathways and resting state (RS) functional connectivity abnormalities in patients with Parkinson's disease and freezing of gait (PD-FoG). Methods: T1-weighted, diffusion tensor (DT) MRI and RS functional MRI (fMRI) were obtained from 22 PD-FoG patients and 35 controls on a 3.0 T MR scanner. Patients underwent clinical, motor, and neuropsychological evaluations. Gray matter (GM) volumes and white matter (WM) damage were assessed using voxel based morphometry and tract-based spatial statistics, respectively. The pedunculopontine tract (PPT) was studied using tractography. RS fMRI data were analyzed using a model free approach investigating the main sensorimotor and cognitive brain networks. Multiple regression models were performed to assess the relationships between structural, functional, and clinical/cognitive variables. Analysis of GM and WM structural abnormalities was replicated in an independent sample including 28 PD-FoG patients, 25 PD patients without FoG, and 30 healthy controls who performed MRI scans on a 1.5 T scanner. Results: Compared with controls, no GM atrophy was found in PD-FoG cases. PD-FoG patients showed WM damage of the PPT, corpus callosum, corticospinal tract, cingulum, superior longitudinal fasciculus, and WM underneath the primary motor, premotor, prefrontal, orbitofrontal, and inferior parietal cortices, bilaterally. In PD-FoG, right PTT damage was associated with a greater disease severity. Analysis on the independent PD sample showed similar findings in PD-FoG patients relative to controls as well as WM damage of the genu and body of the corpus callosum and right parietal WM in PD-FoG relative to PD no-FoG patients. RS fMRI analysis showed that PD-FoG is associated with a decreased functional connectivity of the primary motor cortex and supplementary motor area bilaterally in the sensorimotor network, frontoparietal regions in the default mode network, and occipital cortex in the visual associative network. Conclusions: This study suggests that FoG in PD can be the result of a poor structural and functional integration between motor and extramotor (cognitive) neural systems. (C) 2015 Wiley Periodicals, Inc.