Resting-State Frontostriatal Functional Connectivity in Parkinson's Disease-Related Apathy
Resting-State Frontostriatal Functional Connectivity in Parkinson's Disease-Related Apathy
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DOI：
10.1002/mds.26137
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发表时间：
2015-04-15
影响因子：
8.6
通讯作者：
Junque, Carme
中科院分区：
文献类型：
--
作者：
Cesar Baggio, Hugo;Segura, Barbara;Junque, Carme
帕金森病（PD）中最常见的神经精神症状之一是冷漠，影响23%至70%的患者，被认为与额纹状体多巴胺缺乏有关。在目前的研究中，我们在大量PD受试者和健康对照中评估了与冷漠存在相关的功能静息状态额纹状体连通性和结构变化，同时控制了共病抑郁症和认知能力下降的存在。31名健康对照（HC）和62名年龄、性别和教育程度相匹配的PD患者接受静息状态功能磁共振成像（MRI）检查。用冷漠量表（AS）评估冷漠症状。测量焦虑情绪症状的11贝克抑郁量表- ii项目以及相关的神经心理学分数被用作连通性分析中的妨害因素。对额叶（边缘、执行区、吻侧运动区和尾侧运动区）、纹状体（边缘、执行区、感觉运动区）和丘脑之间的功能连通性进行体素分析。采用皮质下体积/形状分析和额-皮质下体素形态测量来评估相关的结构变化。25例PD患者被分类为冷漠（as bbbb13）。与HC和非麻木的PD患者相比，麻木的PD患者表现出功能连接减少，主要发生在左侧回路，主要涉及边缘纹状体和额叶区域。同样，冷漠的严重程度与这些回路的连通性呈负相关。在结构分析中没有发现显著的影响。我们的研究结果表明，PD中冷漠的存在与额纹状体回路的功能连接减少有关，主要发生在左半球，主要涉及其边缘成分。(c) 2015年国际帕金森和运动障碍学会
One of the most common neuropsychiatric symptoms in Parkinson's disease (PD) is apathy, affecting between 23% and 70% of patients and thought to be related to frontostriatal dopamine deficits. In the current study, we assessed functional resting-state frontostriatal connectivity and structural changes associated with the presence of apathy in a large sample of PD subjects and healthy controls, while controlling for the presence of comorbid depression and cognitive decline. Thirty-one healthy controls (HC) and 62 age-, sex-, and education-matched PD patients underwent resting-state functional magnetic resonance imaging (MRI). Apathy symptoms were evaluated with the Apathy Scale (AS). The 11 Beck Depression Inventory-II items that measure dysphoric mood symptoms as well as relevant neuropsychological scores were used as nuisance factors in connectivity analyses. Voxel-wise analyses of functional connectivity between frontal lobes (limbic, executive, rostral motor, and caudal motor regions), striata (limbic, executive, sensorimotor regions), and thalami were performed. Subcortical volumetry/shape analysis and fronto-subcortical voxel-based morphometry were performed to assess associated structural changes. Twenty-five PD patients were classified as apathetic (AS>13). Apathetic PD patients showed functional connectivity reductions compared with HC and with non-apathetic patients, mainly in left-sided circuits, and predominantly involving limbic striatal and frontal territories. Similarly, severity of apathy negatively correlated with connectivity in these circuits. No significant effects were found in structural analyses. Our results indicate that the presence of apathy in PD is associated with functional connectivity reductions in frontostriatal circuits, predominating in the left hemisphere and mainly involving its limbic components. (c) 2015 International Parkinson and Movement Disorder Society