Department of Neurology, University of Ulm, Ulm, Germany.
Brain Connect. 2013;3(3):265-72. doi: 10.1089/brain.2013.0146.
In addition to the skeleto-motor deficits, patients with Parkinson's disease (PD) frequently present with oculomotor dysfunctions such as impaired smooth pursuit and saccadic abnormalities. There is increasing evidence for an impaired cortical function to be responsible for oculomotor deficits that are associated with lack of inhibitory control; however, these pathomechanisms still remain poorly understood. By means of "task-free" resting-state functional magnetic resonance imaging (rs-fMRI), functional connectivity changes in PD within the default mode network (DMN) have been reported. The aim of this study was to investigate whether altered functional connectivity within the DMN was correlated with oculomotor parameter changes in PD. Twelve PD patients and 13 matched healthy controls underwent rs-fMRI at 1.5 T and videooculography (VOG) using Eye-Link-System. Rs-fMRI seed-based region-to-region connectivity analysis was performed, including medial prefrontal cortex (mPFC), medial temporal lobe (MTL), posterior cingulate cortex (PCC), and hippocampal formation (HF); while VOG examination comprised ocular reactive saccades, smooth pursuit, and executive tests. Rs-fMRI analysis demonstrated a decreased region-to-region functional connectivity between mPFC and PCC as well as increased connectivity between bilateral HF in PD compared with controls. In VOG, patients and controls differed in terms of executive tests outcome, smooth pursuit eye movement, and visually guided reactive saccades but not in peak eye velocity. A significant relationship was observed between saccadic accuracy and functional connectivity strengths between MTL and PCC. These results suggest that PD-associated changes of DMN connectivity are correlated with PD-associated saccadic hypometria, in particular in the vertical direction.
除了运动骨骼缺陷外,帕金森病 (PD) 患者还经常出现眼球运动功能障碍,如平滑追踪障碍和眼跳异常。越来越多的证据表明,皮质功能障碍是导致与抑制控制缺乏相关的眼球运动缺陷的原因;然而,这些发病机制仍知之甚少。通过“无任务”静息状态功能磁共振成像 (rs-fMRI),已经报道了帕金森病患者默认模式网络 (DMN) 内的功能连接变化。本研究旨在探讨 DMN 内功能连接的改变是否与帕金森病患者的眼球运动参数变化相关。12 名 PD 患者和 13 名匹配的健康对照者在 1.5T 磁共振成像仪上进行 rs-fMRI 检查,并使用眼动跟踪系统 (Eye-Link-System) 进行视频眼动图 (VOG) 检查。进行了 rs-fMRI 种子区域间连接分析,包括内侧前额叶皮质 (mPFC)、内侧颞叶 (MTL)、后扣带回皮质 (PCC) 和海马结构 (HF);而 VOG 检查包括眼球反应性眼跳、平滑追踪和执行测试。与对照组相比,PD 患者的 mPFC 与 PCC 之间以及双侧 HF 之间的区域间功能连接减少,而双侧 HF 之间的连接增加。在 VOG 中,患者和对照组在执行测试结果、平滑追踪眼球运动和视觉引导的反应性眼跳方面存在差异,但在峰值眼速方面没有差异。眼跳准确性与 MTL 和 PCC 之间功能连接强度之间存在显著相关性。这些结果表明,与 PD 相关的 DMN 连接变化与 PD 相关的眼跳减少有关,特别是在垂直方向。