Department of Radiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
AJNR Am J Neuroradiol. 2011 Nov-Dec;32(10):1969-74. doi: 10.3174/ajnr.A2672. Epub 2011 Oct 13.
Deficits in tactile perception are common in patients with PD. However, the neural mechanisms have not been previously reported in the early stages. This study aims to investigate how the brain activity and connectivity changed under tactile perception at early Parkinsonian state by using functional MR imaging.
Twenty-one patients with early PD and 22 age- and sex-matched controls were recruited and scanned under a passive tactile stimulation task. Within-group and between-group activation maps were acquired, and regions of interest were defined according to the group-comparison result. This was followed by a functional connectivity analysis based on the graph theory.
We found that in the PD group, bilateral sensorimotor cortex was hypoactive during the task, whereas the hyperactive regions were mainly in bilateral prefrontal cortex, bilateral cerebellum, and contralateral striatum. There was a significant decrease of total connectivity degree in ipsilateral SMA in PD, which was negatively correlated with the Unified Parkinson's Disease Rating Scale score. Furthermore, the connection strengths among the areas of prefrontal cortex, striatum, and cerebellum were increased.
This study illustrated that early PD was associated with not only altered brain activation but also changed functional connectivity in tactile perception. The most significant impairment was in SMA, whereas striato-prefrontal and cerebello-prefrontal loops may play a compensatory role in early PD tactile function.
触觉感知缺陷在 PD 患者中很常见。然而,其在早期阶段的神经机制尚未有报道。本研究旨在通过功能磁共振成像研究早期帕金森病患者触觉感知时大脑活动和连接的变化。
招募了 21 名早期 PD 患者和 22 名年龄和性别匹配的对照组,并在被动触觉刺激任务下进行扫描。获取了组内和组间的激活图,并根据组间比较结果定义了感兴趣区域。然后基于图论进行了功能连接分析。
我们发现,在 PD 组中,双侧感觉运动皮层在任务中活动不足,而过度活跃的区域主要在双侧前额叶皮层、双侧小脑和对侧纹状体。PD 患者同侧 SMA 的总连接度显著降低,与统一帕金森病评定量表评分呈负相关。此外,前额叶皮层、纹状体和小脑之间的连接强度增加。
本研究表明,早期 PD 不仅与大脑激活改变有关,而且与触觉感知的功能连接改变有关。最明显的损伤是在 SMA,而纹状体-前额叶和小脑-前额叶回路可能在早期 PD 的触觉功能中起代偿作用。