Department of neurology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Neuroradiology. 2020 Jun;62(6):685-692. doi: 10.1007/s00234-020-02378-z. Epub 2020 Feb 17.
Mild cognitive impairment (MCI) in Parkinson's disease (PD) is related to the disrupted connectivity in networks involved in cognition, primarily in the default mode network (DMN). The DMN contains a midline core and two distinct subsystems (dorsal medial prefrontal cortex (DMPFC) and medial temporal lobe (MTL) subsystems).
The strength of functional connectivity (FCS) in intra- and inter-subsystems of DMN and the regional FCS were compared between any two groups from 28 drug-naïve PD patients with MCI (PD-MCI), 19 drug-naïve PD patients with cognitive unimpaired (PD-CU), and 28 age- and sex-matched healthy controls (HCs) by using the nonparametric permutation method (10,000 permutations) with age, sex, and education as covariates and False Discovery Rate (FDR) correction.
For intra-subsystems, the decreased FCS was only detected in the DMPFC subsystem of PD-MCI patients compared with HCs. For inter-subsystems, PD-MCI patients displayed decreased FCS between the posterior cingulate cortex (PCC) and DMPFC subsystem compared with HCs. Furthermore, the temporal parietal junction (TPJ) in the DMPFC subsystem showed decreased regional FCS in the PD-MCI subgroup relative to the HC group. No significant change of FCS was found between PD-MCI and PD-CU patients, and between PD-CU patients and HCs. The sum of FCS values within the DMPFC subsystem and FCS values between the PCC and DMPFC subsystem had a significant power to distinguish PD-MCI patients from PD-CU patients (area under curve (AUC) = 0.703).
The DMPFC subsystem was predominantly disrupted in the PD-MCI subgroup and may have the potential to discriminate PD with MCI.
帕金森病（PD）伴轻度认知障碍（MCI）与认知相关网络（主要为默认模式网络，DMN）连接中断有关。DMN 包含中线核心和两个不同的子系统（背内侧前额叶皮质（DMPFC）和内侧颞叶（MTL）子系统）。
采用非参数置换方法（10000 次置换），以年龄、性别和教育程度为协变量，应用 FDR 校正，比较 28 例未经药物治疗的 PD-MCI 患者、19 例未经药物治疗的认知正常 PD 患者和 28 例年龄和性别匹配的健康对照者（HCs）之间 DMN 内和内-间子系统的功能连接（FCS）强度以及局部 FCS。
对于内-子系统，仅在 PD-MCI 患者的 DMPFC 子系统中发现 FCS 降低，与 HCs 相比。对于间-子系统，与 HCs 相比，PD-MCI 患者 PCC 与 DMPFC 子系统之间的 FCS 降低。此外，DMPFC 子系统中的颞顶联合区（TPJ）在 PD-MCI 亚组中表现出与 HC 组相比局部 FCS 降低。在 PD-MCI 患者和 PD-CU 患者之间，以及在 PD-CU 患者和 HCs 之间，未发现 FCS 有显著变化。DMPFC 子系统内的 FCS 值总和和 PCC 与 DMPFC 子系统之间的 FCS 值具有区分 PD-MCI 患者和 PD-CU 患者的显著能力（曲线下面积（AUC）=0.703）。
DMPFC 子系统在 PD-MCI 亚组中明显受损，可能具有区分伴有 MCI 的 PD 的潜力。
