Bezdicek Ondrej, Ballarini Tommaso, Albrecht Franziska, Libon David J, Lamar Melissa, Růžička Filip, Roth Jan, Hurlstone Mark J, Mueller Karsten, Schroeter Matthias L, Jech Robert
Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, General University Hospital, Charles University, Prague, Czech Republic.
Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
J Neuropsychol. 2021 Mar;15(1):88-111. doi: 10.1111/jnp.12208. Epub 2020 May 11.
We sought to determine if Parkinson's disease (PD) with mild cognitive impairment (MCI) is associated with a greater SERIAL-ORDER (mental manipulation) than ANY-ORDER (auditory span, storage) deficit in working memory (WM). We investigated WM combining neuropsychological measures with the study of brain functional connectivity. A cohort of 160 patients with idiopathic PD, classified as PD-MCI (n = 87) or PD with normal cognition (PD-NC; n = 73), and 70 matched healthy controls were studied. Verbal WM was assessed with the Backward Digit Span Task (BDT; Lamar et al., 2007, Neuropsychologia, 45, 245), measuring SERIAL-ORDER and ANY-ORDER recall. Resting-state MRI data were collected for 15 PD-MCI, 15 PD-NC and 30 controls. Hypothesis-driven seed-based functional connectivity of the dorsolateral prefrontal cortex (DLPFC) was compared between the three groups and correlated with BDT performance. We found the main effect of the test (impairment in SERIAL ORDER > ANY ORDER) and group ((NC = PD-NC) > PD-MCI) in BDT performance that was even more pronounced in SERIAL ORDER when controlling for ANY ORDER variability but not vice versa. Furthermore, PD-MCI compared to other groups were characterized by the functional disconnection between the bilateral DLPFC and the cerebellum. In functional correlations, DLPFC connectivity was positively related to both SERIAL- and ANY-ORDER performance. In conclusion, PD-MCI patients evidenced greater SERIAL-ORDER (manipulation and cognitive control) than ANY-ORDER (storage) working memory impairment than PD-NC and controls with a disrupted DLPFC resting-state connectivity that was also related to the verbal WM performance.
我们试图确定伴有轻度认知障碍（MCI）的帕金森病（PD）患者在工作记忆（WM）方面，序列顺序（心理操作）缺陷是否比任意顺序（听觉广度、存储）缺陷更明显。我们结合神经心理学测量和脑功能连接研究来调查工作记忆。研究了160名特发性PD患者，分为PD-MCI组（n = 87）或认知正常的PD组（PD-NC；n = 73），以及70名匹配的健康对照者。使用倒背数字广度任务（BDT；Lamar等人，2007年，《神经心理学》，45卷，245页）评估言语工作记忆，测量序列顺序和任意顺序回忆。收集了15名PD-MCI患者、15名PD-NC患者和30名对照者的静息态MRI数据。比较了三组之间基于假设驱动的背外侧前额叶皮层（DLPFC）种子功能连接，并将其与BDT表现相关联。我们发现测试的主要效应（序列顺序损伤>任意顺序损伤）和组间效应（（NC = PD-NC）> PD-MCI）在BDT表现中，在控制任意顺序变异性时，序列顺序效应更明显，反之则不然。此外，与其他组相比，PD-MCI的特征是双侧DLPFC与小脑之间功能断开。在功能相关性方面，DLPFC连接与序列顺序和任意顺序表现均呈正相关。总之，与PD-NC患者和对照组相比，PD-MCI患者表现出更明显的序列顺序（操作和认知控制）而非任意顺序（存储）工作记忆损伤，其DLPFC静息态连接中断，这也与言语工作记忆表现相关。
