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在非痴呆帕金森病患者中,认知缺陷的不同表现与不同的静息态网络紊乱有关。

Distinct manifestation of cognitive deficits associate with different resting-state network disruptions in non-demented patients with Parkinson's disease.

机构信息

Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan.

Brain and Mind Research Center, Nagoya University, Showa-ku, Nagoya, 466-8550, Japan.

出版信息

J Neurol. 2018 Mar;265(3):688-700. doi: 10.1007/s00415-018-8755-5. Epub 2018 Feb 1.

Abstract

Cognitive deficits in Parkinson's disease (PD) are heterogeneous entities, but a relationship between the heterogeneity of cognitive deficits and resting-state network (RSN) changes remains elusive. In this study, we examined five sub-domain scores according to Addenbrooke's Cognitive Examination-Revised (ACE-R) for the cognitive evaluation and classification of 72 non-demented patients with PD. Twenty-eight patients were classified as PD with normal cognition (PD-NC). The remaining 44 were subdivided into the following 2 groups using a hierarchical cluster analysis: 20 with a predominant decrease in memory (PD with amnestic cognitive deficits: PD-A) and 24 with good memory who exhibited a decrease in other sub-domains (PD with non-amnestic cognitive deficits: PD-NA). We used an independent component analysis of RS-fMRI data to investigate the inter-group differences of RSN. Compared to the controls, the PD-A showed lower FC within the ventral default mode network (vDMN) and the visuospatial network. On the other hand, the PD-NA showed lower FC within the visual networks and the cerebellum-brainstem network. Significant differences in the FC within the vDMN and cerebellum-brainstem network were observed between the PD-A and PD-NA, which provided a good discrimination between PD-A and PD-NA using a support vector machine. Distinct patterns of cognitive deficits correspond to different RSN changes.

摘要

帕金森病(PD)的认知缺陷是异质的实体,但认知缺陷的异质性与静息态网络(RSN)变化之间的关系仍不清楚。在这项研究中,我们根据 Addenbrooke 认知评估修订版(ACE-R)检查了五个子域分数,用于对 72 名非痴呆 PD 患者进行认知评估和分类。28 名患者被归类为 PD 伴正常认知(PD-NC)。其余 44 名患者使用层次聚类分析进一步分为以下 2 组:20 名以记忆减退为主(PD 伴遗忘性认知缺陷:PD-A),24 名记忆良好但其他子域减退(PD 伴非遗忘性认知缺陷:PD-NA)。我们使用 RS-fMRI 数据的独立成分分析来研究 RSN 的组间差异。与对照组相比,PD-A 在腹侧默认模式网络(vDMN)和视觉空间网络内的 FC 较低。另一方面,PD-NA 在视觉网络和小脑脑干网络内的 FC 较低。在 vDMN 和小脑脑干网络内的 FC 存在显著差异,PD-A 和 PD-NA 之间存在差异,这为使用支持向量机对 PD-A 和 PD-NA 进行良好区分提供了依据。不同的认知缺陷模式对应于不同的 RSN 变化。

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