Department of Neurology, Maastricht University Medical Centre, P.O. Box 5800, 6202, AZ, Maastricht, the Netherlands.
Department of Psychiatry, Maastricht University Medical Centre, P.O. Box 5800, 6202, AZ, Maastricht, the Netherlands; Department of Neuropsychology, Maastricht University Medical Centre, P.O. Box 5800, 6202, AZ, Maastricht, the Netherlands.
Parkinsonism Relat Disord. 2019 May;62:16-27. doi: 10.1016/j.parkreldis.2018.12.016. Epub 2018 Dec 17.
Cognitive impairment is a common non-motor symptom in Parkinson's disease. So far, the underlying pathophysiology remains unclear. Several alterations in functional network connectivity have been described in Parkinson's disease patients with cognitive impairment which are probably the result of the heterogenous pathophysiology underlying this cognitive decline, including dopaminergic and cholinergic deficits. Accordingly, the reported resting-state connectivity patterns vary greatly among studies.
To evaluate the localization and magnitude of functional connectivity patterns in resting-state brain networks in Parkinson's disease patients with cognitive impairment by pooling data from available studies.
We searched PubMed, the Cochrane Library, MEDLINE, Embase and PsycINFO to identify functional MRI studies in Parkinson's disease patients with cognitive impairment. A voxel-based meta-analysis combined with quality statistics was performed, using the anisotropic effect-size version of the signed differential mapping method.
Seventeen studies with cognitively impaired Parkinson's disease patients were included consisting of 222 Parkinson's disease patients with mild cognitive impairment, 68 patients with Parkinson's disease dementia, 289 cognitively unimpaired Parkinson's disease patients and 353 healthy controls. Parkinson's disease patients with cognitive impairment predominantly showed a reduced connectivity in specific brain regions that are part of the default mode network.
Cognitive impairment in Parkinson's disease is associated with reduced connectivity in networks relevant to cognition, most prominently the default mode network. Specific alterations in functional connectivity may contribute to cognitive decline in Parkinson patients and may be a promising future biomarker.
认知障碍是帕金森病的常见非运动症状。迄今为止，其潜在的病理生理学机制仍不清楚。一些帕金森病伴认知障碍患者的功能网络连接改变已经被描述，这些改变可能是导致这种认知下降的异质性病理生理学的结果，包括多巴胺能和胆碱能缺陷。因此，报告的静息状态连接模式在不同的研究中差异很大。
通过汇总现有研究的数据，评估帕金森病伴认知障碍患者静息状态大脑网络中功能连接模式的定位和幅度。
我们检索了 PubMed、Cochrane 图书馆、MEDLINE、Embase 和 PsycINFO，以确定帕金森病伴认知障碍患者的功能磁共振成像研究。使用各向异性效应大小的符号差异映射方法，进行基于体素的荟萃分析和质量统计。
纳入了 17 项认知障碍帕金森病患者的研究，共包括 222 例轻度认知障碍帕金森病患者、68 例帕金森病痴呆患者、289 例认知正常帕金森病患者和 353 名健康对照者。帕金森病伴认知障碍患者主要表现为特定脑区的连接减少，这些脑区是默认模式网络的一部分。
帕金森病患者的认知障碍与与认知相关的网络连接减少有关，尤其是默认模式网络。功能连接的特定改变可能导致帕金森病患者的认知下降，并且可能是一个有前途的未来生物标志物。
