de Schipper Laura J, van der Grond Jeroen, Marinus Johan, Henselmans Johanna M L, van Hilten Jacobus J
Department of Neurology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands.
Department of Radiology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands.
Neuroimage Clin. 2017 Jun 9;15:587-593. doi: 10.1016/j.nicl.2017.05.012. eCollection 2017.
In Parkinson's disease (PD), the relation between cortical brain atrophy on MRI and clinical progression is not straightforward. Determination of changes in structural covariance networks - patterns of covariance in grey matter density - has shown to be a valuable technique to detect subtle grey matter variations. We evaluated how structural network integrity in PD is related to clinical data.
3 Tesla MRI was performed in 159 PD patients. We used nine standardized structural covariance networks identified in 370 healthy subjects as a template in the analysis of the PD data. Clinical assessment comprised motor features (Movement Disorder Society-Unified Parkinson's Disease Rating Scale; MDS-UPDRS motor scale) and predominantly non-dopaminergic features (SEverity of Non-dopaminergic Symptoms in Parkinson's Disease; SENS-PD scale: postural instability and gait difficulty, psychotic symptoms, excessive daytime sleepiness, autonomic dysfunction, cognitive impairment and depressive symptoms). Voxel-based analyses were performed within networks significantly associated with PD.
The anterior and posterior cingulate network showed decreased integrity, associated with the SENS-PD score, p = 0.001 (β = - 0.265, η = 0.070) and p = 0.001 (β = - 0.264, η = 0.074), respectively. Of the components of the SENS-PD score, cognitive impairment and excessive daytime sleepiness were associated with atrophy within both networks.
We identified loss of integrity and atrophy in the anterior and posterior cingulate networks in PD patients. Abnormalities of both networks were associated with predominantly non-dopaminergic features, specifically cognition and excessive daytime sleepiness. Our findings suggest that (components of) the cingulate networks display a specific vulnerability to the pathobiology of PD and may operate as interfaces between networks involved in cognition and alertness.
在帕金森病（PD）中，MRI上脑皮质萎缩与临床进展之间的关系并不简单。结构协方差网络变化的测定——灰质密度协方差模式——已被证明是检测细微灰质变化的一项有价值的技术。我们评估了PD患者的结构网络完整性与临床数据之间的关系。
对159例PD患者进行了3特斯拉MRI检查。我们将在370名健康受试者中确定的9个标准化结构协方差网络作为模板来分析PD数据。临床评估包括运动特征（运动障碍协会统一帕金森病评定量表；MDS-UPDRS运动量表）和主要的非多巴胺能特征（帕金森病非多巴胺能症状严重程度；SENS-PD量表：姿势不稳和步态困难、精神症状、日间过度嗜睡、自主神经功能障碍、认知障碍和抑郁症状）。在与PD显著相关的网络内进行基于体素的分析。
前扣带回和后扣带回网络的完整性降低，分别与SENS-PD评分相关，p = 0.001（β = -0.265，η = 0.070）和p = 0.001（β = -0.264，η = 0.074）。在SENS-PD评分的各个组成部分中，认知障碍和日间过度嗜睡与两个网络内的萎缩相关。
我们发现PD患者前扣带回和后扣带回网络的完整性丧失和萎缩。两个网络的异常均与主要的非多巴胺能特征相关，特别是认知和日间过度嗜睡。我们的研究结果表明，扣带回网络（的组成部分）对PD的病理生物学表现出特定的易损性，并且可能作为参与认知和警觉的网络之间的接口。
