Cumming School of Medicine, Hotchkiss Brain Institute, Calgary, AB, Canada.
Department of Clinical Neurosciences and Department of Radiology, University of Calgary, Calgary, AB, Canada.
Mov Disord. 2019 Jun;34(6):893-902. doi: 10.1002/mds.27674. Epub 2019 Mar 29.
The dual syndrome hypothesis of cognitive impairment in PD suggests that two cognitive profiles exist with distinct pathological mechanisms and a differential risk for further cognitive decline. How these profiles relate to network dysfunction has never been explicitly characterized.
First, to assess intranetwork functional connectivity while considering global connectivity, and second, to relate network connectivity with measures of the dysexecutive and posterior cortical profiles.
Eighty-two subjects with idiopathic PD and 37 age-matched controls underwent resting-state functional MRI and comprehensive neuropsychological assessment. Intranetwork and global connectivity was compared between groups. Measures of the dysexecutive and posterior cortical profiles were related to network connectivity while considering demographic and disease-related covariates.
PD subjects show decreased connectivity within several cortical networks. However, only the sensorimotor network displayed a loss of connectivity independent of the observed decreased global connectivity. The dysexecutive factor was independently related to increased motor severity, less education, and decreased connectivity in the sensorimotor network. The posterior cortical factor was related to increased age, less education, decreased connectivity in the central executive network, as well as increased connectivity in the temporal network.
Our results provide evidence supporting a network-specific process of degeneration in the sensorimotor network which contributes to the dysexecutive cognitive profile. In contrast, connectivity of the temporal and central executive network is related to the posterior cortical profile, representing a distinct network signature of this syndrome. © 2019 International Parkinson and Movement Disorder Society.
认知障碍的 PD 双重综合征假说表明，存在两种认知特征，具有不同的病理机制和进一步认知下降的不同风险。这些特征与网络功能障碍有何关系尚不清楚。
首先，评估内在网络功能连接，同时考虑全局连接，其次，将网络连接与执行功能和皮质后区的指标相关联。
82 名特发性 PD 患者和 37 名年龄匹配的对照组接受静息状态功能磁共振成像和全面神经心理学评估。比较组间内在网络和全局连接。在考虑人口统计学和疾病相关协变量的情况下，将执行功能和皮质后区的指标与网络连接相关联。
PD 患者的几个皮质网络内的连接性降低。然而，只有感觉运动网络显示出与观察到的全局连接降低无关的连接丧失。执行功能因子与运动严重程度增加、教育程度降低和感觉运动网络连接减少独立相关。皮质后区因子与年龄增加、教育程度降低、中央执行网络连接减少以及颞网络连接增加有关。
我们的结果提供了证据支持感觉运动网络中存在特定于网络的退化过程，这有助于执行功能认知特征。相比之下，颞叶和中央执行网络的连接与皮质后区特征有关，代表了这种综合征的独特网络特征。© 2019 国际帕金森病和运动障碍学会。
