Department of Research, National Neuroscience Institute, Singapore; Department of Neurology, National Neuroscience Institute, Singapore.
Department of Research, National Neuroscience Institute, Singapore; Department of Neurology, National Neuroscience Institute, Singapore.
Parkinsonism Relat Disord. 2017 Dec;45:21-27. doi: 10.1016/j.parkreldis.2017.09.019. Epub 2017 Sep 21.
Although the clinical signs of prodromal Parkinson's disease (PD) have been identified, little is known about the neural features of the prodromal phase of PD (proPD). The aim of this study was to examine the structural network alterations from healthy aging to proPD and to early PD.
181 non-demented and non-depressed participants comprising 55 healthy controls (HCs), 20 proPDs, and 106 de novo PD patients (dPDs) were included in the study and underwent clinical assessment and diffusion tensor imaging scanning. Graph-theoretical analysis and network-based statistics, with age and gender as nuisance covariates, were used.
Compared with HCs and dPDs, proPD patients showed significantly elevated small-worldness and clustering coefficient (Ps < 0.01) and greater local connectivity between regions relating to motor, olfactory and sleep functions (Ps < 0.05). Although dPDs and HCs did not differ on all graph-theoretic metrics, dPD patients showed decreased connectivity within the prefrontal regions and between the left temporal and occipital lobes (P < 0.05). The connectivity strength between these regions significantly distinguished between diagnostic groups. Connectivity between bilateral SMAs was correlated with UPSIT in HCs and with UPDRS-III in dPDs. Connectivity between the right SMA and putamen was correlated RBDSQ in proPDs.
Increased network efficiency and connectivity of proPDs and decreased local connectivity of dPDs might suggest the emergence and dissipation of neural compensation in the prodromal phase and in early PD, respectively. Nonetheless, longitudinal studies are needed to follow up the long-term structural network changes of proPD patients.
虽然前驱帕金森病（PD）的临床征象已经确定，但前驱期 PD（proPD）的神经特征知之甚少。本研究旨在探讨从健康衰老到前驱期 PD 和早期 PD 的结构网络改变。
纳入了 181 名非痴呆和非抑郁的参与者，包括 55 名健康对照者（HCs）、20 名前驱 PD 患者和 106 名新发 PD 患者（dPDs），并进行了临床评估和弥散张量成像扫描。使用了基于图论的分析和网络统计方法，以年龄和性别为混杂因素。
与 HCs 和 dPDs 相比，前驱 PD 患者的小世界特性和聚类系数显著升高（P < 0.01），与运动、嗅觉和睡眠功能相关的区域之间的局部连接性增强（P < 0.05）。尽管 dPDs 和 HCs 在所有图论指标上均无差异，但 dPDs 患者的前额叶区域内和左颞叶与枕叶之间的连接性降低（P < 0.05）。这些区域之间的连接强度可显著区分诊断组。双侧 SMA 之间的连接性与 HCs 的 UPSIT 相关，与 dPDs 的 UPDRS-III 相关。右侧 SMA 与壳核之间的连接性与前驱 PD 患者的 RBDSQ 相关。
前驱 PD 患者的网络效率和连接性增加，dPD 患者的局部连接性降低，这可能分别提示前驱期和早期 PD 中神经代偿的出现和消散。然而，需要进行纵向研究来随访前驱 PD 患者的长期结构网络变化。
