Disruption of the default mode network and its intrinsic functional connectivity underlies minor hallucinations in Parkinson's disease
Disruption of the default mode network and its intrinsic functional connectivity underlies minor hallucinations in Parkinson's disease
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DOI：
10.1002/mds.27557
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发表时间：
2019-01-01
影响因子：
8.6
通讯作者：
Kulisevsky, Jaime
中科院分区：
文献类型：
--
作者：
Bejr-Kasem, Helena;Pagonabarraga, Javier;Kulisevsky, Jaime
背景轻度幻觉和结构良好的幻觉被认为是与帕金森病相关的精神病谱的严重连续体。虽然它们的时间关系在很大程度上是未知的，但这两种形式的幻觉的脑萎缩的空间模式部分重叠，表明它们具有相似的病理生理过程。功能连接研究表明，参与感知和注意力的功能网络的中断可能与结构良好的幻觉的出现有关。然而，缺乏对孤立性轻微幻觉患者的功能神经成像研究。本研究的目的是探索轻微幻觉背后的结构和功能变化。方法我们使用多模式结构(基于灰质体积体素的形态测量)和功能(种子到全脑静息状态的功能MRI)神经成像研究对18例轻度幻觉患者和14例无轻度幻觉的患者进行了比较。结果与先前描述的结构良好的帕金森病幻觉的结构变化一致，轻度幻觉患者表现出灰质萎缩，在视觉操作处理区域和默认模式网络的核心区域具有显著的体素方向差异。功能连接性改变包括默认模式网络内的连接性改变，与任务积极网络的负相关性降低，以及默认模式网络的后部区域和视觉加工区域之间的异常连接。这些变化与注意网络假说相一致。结论虽然还需要进行纵向研究来评估轻微幻觉作为进展为良好结构幻觉的早期临床生物标志物的潜在作用，但目前的研究结果表明，这两种现象具有相似的结构和功能相关性。(C)2018国际帕金森病和运动障碍协会
BackgroundMinor hallucinations and well-structured hallucinations are considered in the severity continuum of the psychotic spectrum associated with Parkinson's disease. Although their chronological relationship is largely unknown, the spatial patterns of brain atrophy in these 2 forms of hallucinations partially overlap, suggesting they share similar pathophysiological processes. Functional connectivity studies show that disruption of functional networks involved in perception and attention could be relevant in the emergence of well-structured hallucinations. However, functional neuroimaging studies in patients with isolated minor hallucinations are lacking. The objectives of this study were to explore the structural and functional changes underlying minor hallucinations.MethodsWe compared patients with (n=18) and without (n=14) minor hallucinations using a multimodal structural (gray-matter volume voxel-based morphometry) and functional (seed-to-whole-brain resting-state functional MRI) neuroimaging study.ResultsCoincident with previously described structural changes in well-structured hallucinations in Parkinson's disease, patients with minor hallucinations exhibited gray-matter atrophy with significant voxel-wise differences in visuoperceptual processing areas and core regions of the default mode network. Functional connectivity changes consisted of altered connectivity within the default mode network, reduced negative correlation with task-positive network, and aberrant connectivity between posterior regions of the default mode network and visual-processing areas. These changes are in accordance with the attentional networks hypothesis proposed for well-structured hallucinations.ConclusionsAlthough longitudinal studies are needed to assess the potential role of minor hallucinations as an early clinical biomarker of progression to well-structured hallucinations, the present findings show that the 2 phenomena share similar structural and functional brain correlates. (c) 2018 International Parkinson and Movement Disorder Society