Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea.
Department of Neurology, Yongin Severance Hospital, Yonsei University Health System, Yongin, South Korea.
Mov Disord. 2020 Apr;35(4):577-586. doi: 10.1002/mds.28012. Epub 2020 Feb 24.
The severity of motor symptoms in Parkinson's disease (PD) does not always correlate with the degree of nigral dopaminergic neuronal loss. Individuals with greater motor reserve may have milder motor signs than their striatal dopamine loss. In this study, we explored the functional brain network associated with motor reserve in early-stage PD.
We analyzed 134 patients with de novo PD who underwent dopamine transporter scans and resting-state functional magnetic resonance imaging. We estimated individual motor reserve based on initial motor deficits and striatal dopamine depletion using a residual model. We applied network-based statistic analysis to identify the functional brain network associated with the measure of motor reserve (ie, motor reserve network). We also assessed the effect of motor reserve network connectivity strength on the longitudinal increase in levodopa-equivalent dose during the 2-year follow-up period.
Network-based statistic analysis identified the motor reserve network composed of the basal ganglia, inferior frontal cortex, insula, and cerebellar vermis at a primary threshold of P value 0.001. Patients with an increased degree of functional connectivity within the motor reserve network had greater motor reserve. There was a significant interaction between the motor reserve network strength and time in the linear mixed model, indicating that higher motor reserve network strength was associated with slower longitudinal increase in levodopa-equivalent dose.
The present study revealed the functional brain network associated with motor reserve in patients with early-stage PD. Functional connections within the motor reserve network are associated with the individual's capacity to cope with PD-related pathologies. © 2020 International Parkinson and Movement Disorder Society.
帕金森病（PD）的运动症状严重程度并不总是与黑质多巴胺能神经元丧失的程度相关。具有较大运动储备的个体可能比其纹状体多巴胺丧失具有更轻微的运动迹象。在这项研究中，我们探索了与早期 PD 中的运动储备相关的功能性大脑网络。
我们分析了 134 名患有新诊断的 PD 的患者，他们接受了多巴胺转运蛋白扫描和静息状态功能磁共振成像。我们使用残差模型根据初始运动缺陷和纹状体多巴胺耗竭来估计个体运动储备。我们应用基于网络的统计分析来识别与运动储备测量相关的功能性大脑网络（即运动储备网络）。我们还评估了运动储备网络连通性强度对 2 年随访期间左旋多巴等效剂量的纵向增加的影响。
基于网络的统计分析确定了由基底节，额下回，岛叶和小脑蚓部组成的运动储备网络，其初级阈值 P 值为 0.001。在运动储备网络内功能连接程度增加的患者具有更大的运动储备。在线性混合模型中，运动储备网络强度与时间之间存在显著的相互作用，表明较高的运动储备网络强度与左旋多巴等效剂量的纵向增加较慢相关。
本研究揭示了与早期 PD 患者运动储备相关的功能性大脑网络。运动储备网络内的功能连接与个体应对 PD 相关病理学的能力有关。
