Functional connectivity and cognitive decline over 3 years in Parkinson disease
Functional connectivity and cognitive decline over 3 years in Parkinson disease
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DOI：
10.1212/wnl.0000000000001020
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发表时间：
2014-11-25
期刊：
影响因子：
9.9
通讯作者：
Berendse, Henk W.
中科院分区：
文献类型：
--
作者：
Dubbelink, Kim T. E. Olde;Schoonheim, Menno M.;Berendse, Henk W.
目的：探讨帕金森病（PD）患者3年内全脑静息态fMRI功能连接变化与认知功能下降的关系。方法：对55例PD患者（平均年龄65.8岁，SD 6.37;平均病程9.24年，SD 3.96）和15例对照组（平均年龄64.4岁，SD 8.65）进行静息态fMRI扫描。我们首先进行了整体（即，1个全脑平均值）以及区域（即，对于所有感兴趣的单独区域）功能连接性分析，其中我们对受试者组进行了横截面比较。经过3年的随访期，36例PD患者和12名对照进行了重新扫描，研究功能连接的变化随着时间的推移，并与功能连接的变化恶化的认知和运动功能的PD samples.Results：在横断面分析，我们发现广泛的休息状态功能连接的PD患者相比，对照组。2个时间点之间的后续比较显示，PD患者的功能连接进一步降低，与衰老效应无关。这些功能连接的变化是最突出的后部的大脑和相关的疾病进展的临床措施，特别是认知能力下降的时间。结论：在PD的功能磁共振成像研究，我们证明了一个渐进性的损失的休息状态的功能连接超过3年的多个大脑区域，特别是在后部的大脑。与认知能力下降的强相关性支持了功能连接性降低在认知能力下降和PD痴呆发展中的病理生理作用。
Objective:To evaluate fMRI whole-brain resting-state functional connectivity changes in relation to cognitive decline in Parkinson disease (PD) over a 3-year period.Methods:Resting-state fMRI scans were acquired in 55 patients with PD (mean age 65.8 years, SD 6.37; average disease duration 9.24 years, SD 3.96) and 15 matched controls (mean age 64.4 years, SD 8.65). We first performed overall (i.e., 1 whole-brain mean) as well as regional (i.e., for all individual regions of interest) functional connectivity analyses, in which we compared subject groups cross-sectionally. After a 3-year follow-up period, 36 patients with PD and 12 controls were rescanned to study functional connectivity changes over time and correlate the changes in functional connectivity with deteriorating cognitive and motor function in the PD sample.Results:In the cross-sectional analysis, we found widespread decreases of resting-state functional connectivity in patients with PD in comparison to controls. Subsequent comparison between the 2 timepoints revealed that patients with PD displayed further decreases in functional connectivity independent of aging effects. These functional connectivity changes were most prominent for posterior parts of the brain and correlated across time with clinical measures of disease progression, especially cognitive decline.Conclusions:In this fMRI study in PD, we demonstrated a progressive loss of resting-state functional connectivity over a period of 3 years for multiple brain regions, especially in posterior parts of the brain. The strong correlation with decreasing cognitive performance supports the pathophysiologic role of reduced functional connectivity in cognitive decline and the development of dementia in PD.