Impulsivity Relates to Relative Preservation of Mesolimbic Connectivity in Patients with Parkinson Disease.
Impulsivity Relates to Relative Preservation of Mesolimbic Connectivity in Patients with Parkinson Disease.
复制标题
冲动与帕金森病患者中脑边缘连接的相对保留有关。
DOI：
10.1016/j.nicl.2020.102259
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Pouratian,Nader
中科院分区：
文献类型：
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作者：
Sparks,Hiro;Riskin-Jones,Hannah;Price,Collin;DiCesare,Jasmine;Bari,Ausaf;Hashoush,Nadia;Pouratian,Nader
帕金森病（PD）病理、多巴胺替代疗法（DRT）和冲动控制障碍（ICD）发展之间的关系尚不完全清楚。考虑到PD患者的感觉运动-外侧黑质（SN）选择性退行性变，我们假设DRT背景下边缘-内侧黑质的相对保留驱动了近期有严重冲动史的PD患者的冲动、寻求奖励行为。方法从连续接受术前深部脑刺激（DBS）计划扫描（包括3T结构MRI和64方向弥散张量成像（DTI））的PD患者名单中选择冲动组和对照组。利用先前识别的黑质（SN）亚段网络连通性特征来开发分类目标，使用概率束状图进行基于分裂半球目标的SN分割。比较了SN与边缘、联合和运动网络目标之间的相对亚段体积和连通性强度。结果近期有严重冲动性病史的PD患者SN与边缘网络目标之间的连通性高于运动网络和联合网络目标（P = 0.0075）。我们没有观察到各组间相对体积亚段的差异。首先，我们的研究结果表明，细粒度、图谱衍生的分类靶标可用于PD，以包裹和分类功能不同的SN亚段，并明显保留了先前报道的边缘-内侧SN、联合-腹侧SN和感觉运动-外侧SN的地形方向。我们认为，相对的，而不是绝对的，在sn相关的多巴胺能网络退化与PD的冲动性表型有关。
IntroductionThe relationship between Parkinson Disease (PD) pathology, dopamine replacement therapy (DRT), and impulse control disorder (ICD) development is still incompletely understood. Given the sensorimotor-lateral substantia nigra (SN) selective degeneration associated with PD, we posit that a relative sparing of the limbic-medial SN in the context of DRT drives impulsive, reward-seeking behavior in PD patients with recent history of severe impulsivity.MethodsImpulsive and control participants were selected from a consecutive list of PD patients receiving pre-operative deep brain stimulation (DBS) planning scans including 3T structural MRI and 64 direction diffusion tensor imaging (DTI). Using previously identified substantia nigra (SN) subsegment network connectivity profiles to develop classification targets, split-hemisphere target-based SN segmentation with probabilistic tractography was performed. The relative subsegment volumes and strength of connectivity between the SN and the limbic, associative, and motor network targets were compared.ResultsOur results show that there is greater probability of connectivity between the SN and limbic network targets relative to motor and associative network targets in PD patients with recent history of severe impulsivity as compared to PD patients without impulsivity (P = 0.0075). We did not observe relative volumetric subsegment differences across groups.ConclusionFirstly, our results suggest that fine-grained, atlas-derived classification targets may be used in PD to parcellate and classify functionally distinct subsegments of the SN, with the apparent preservation of previously reported topographical limbic-medial SN, associative-ventral SN, and sensorimotor-lateral SN orientation. We suggest that relative, as opposed to absolute, degeneration amongst SN-associated dopaminergic networks relates to the impulsivity phenotype in PD.