Rosskopf Johannes, Gorges Martin, Müller Hans-Peter, Lulé Dorothée, Uttner Ingo, Ludolph Albert C, Pinkhardt Elmar, Juengling Freimut D, Kassubek Jan
Department of Neurology, University of Ulm, Ulm, Germany.
Department of Nuclear Medicine, Claraspital Basel, Basel, Switzerland.
Mov Disord. 2017 Jul;32(7):1006-1015. doi: 10.1002/mds.27039. Epub 2017 May 22.
The topography of functional network changes in progressive supranuclear palsy can be mapped by intrinsic functional connectivity MRI. The objective of this study was to study functional connectivity and its clinical and behavioral correlates in dedicated networks comprising the cognition-related default mode and the motor and midbrain functional networks in patients with PSP.
Whole-brain-based "resting-state" functional MRI and high-resolution T1-weighted magnetic resonance imaging data together with neuropsychological and video-oculographic data from 34 PSP patients (22 with Richardson subtype and 12 with parkinsonian subtype) and 35 matched healthy controls were subjected to network-based functional connectivity and voxel-based morphometry analysis.
After correction for global patterns of brain atrophy, the group comparison between PSP patients and controls revealed significantly decreased functional connectivity (P < 0.05, corrected) in the prefrontal cortex, which was significantly correlated with cognitive performance (P = 0.006). Of note, midbrain network connectivity in PSP patients showed increased connectivity with the thalamus, on the one hand, whereas, on the other hand, lower functional connectivity within the midbrain was significantly correlated with vertical gaze impairment, as quantified by video-oculography (P = 0.004). PSP Richardson subtype showed significantly increased functional motor network connectivity with the medial prefrontal gyrus.
PSP-associated neurodegeneration was attributed to both decreased and increased functional connectivity. Decreasing functional connectivity was associated with worse behavioral performance (ie, dementia severity and gaze palsy), whereas the pattern of increased functional connectivity may be a potential adaptive mechanism. © 2017 International Parkinson and Movement Disorder Society.
进行性核上性麻痹中功能网络变化的地形图可通过内在功能连接MRI绘制。本研究的目的是研究进行性核上性麻痹患者中包括认知相关默认模式以及运动和中脑功能网络在内的特定网络中的功能连接及其临床和行为相关性。
对34例进行性核上性麻痹患者（22例为理查森亚型，12例为帕金森亚型）和35名匹配的健康对照者的全脑“静息态”功能MRI和高分辨率T1加权磁共振成像数据，以及神经心理学和视频眼动图数据进行基于网络的功能连接和基于体素的形态学分析。
在校正脑萎缩的整体模式后，进行性核上性麻痹患者与对照组之间的组间比较显示前额叶皮质的功能连接显著降低（P < 0.05，校正后），这与认知表现显著相关（P = 0.006）。值得注意的是，进行性核上性麻痹患者的中脑网络连接一方面显示与丘脑的连接增加，而另一方面，中脑内较低的功能连接与视频眼动图量化的垂直凝视障碍显著相关（P = 0.004）。进行性核上性麻痹理查森亚型显示与内侧前额叶回的功能运动网络连接显著增加。
进行性核上性麻痹相关的神经退行性变归因于功能连接的降低和增加。功能连接降低与更差的行为表现（即痴呆严重程度和凝视麻痹）相关，而功能连接增加的模式可能是一种潜在的适应性机制。©2017国际帕金森和运动障碍协会。
