Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China; Department of Neurology, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, China.
Department of Neurology, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, China.
J Affect Disord. 2020 Sep 1;274:792-798. doi: 10.1016/j.jad.2020.05.145. Epub 2020 May 30.
Apathy is a prevalent and debilitating neuropsychiatric syndrome in Parkinson's disease (PD). However, its neural mechanisms are still unclear.
Forty-six de novo, drug-naïve, non-demented PD patients without depressive or anxious symptoms, of whom 26 were apathetic (PD-A) and 20 were not (PD-NA) according to the Apathy Scale (AS), and 23 matched healthy control (HC) subjects were enrolled in this study. The regional homogeneity (ReHo) approach based on resting-state functional MRI on a 3-T MR system was used to investigate apathy related local brain activity.
Compared with both patients with PD-NA and HC subjects, patients with PD-A showed significantly lower ReHo values in the dorsal anterior cingulate cortex (ACC) and right caudate. Both the PD-A and PD-NA groups also demonstrated lower ReHo values in the right putamen compared to the HC group. Further correlation analyses revealed that AS scores were negatively correlated with the ReHo values in the dorsal ACC and right caudate in the pooled patients with PD.
The present results are preliminary due to the small sample size in the study.
This study used ReHo for the first time to characterize "pure" apathy related regional spontaneous brain function within the frontostriatal circuits in PD. Our findings suggest that abnormal brain activity in the dorsal ACC and caudate may involve the pathological mechanisms of apathy in PD.
淡漠是帕金森病（PD）中一种普遍且使人虚弱的神经精神综合征。然而，其神经机制仍不清楚。
本研究纳入了 46 例初诊、未经药物治疗、无抑郁或焦虑症状的非痴呆 PD 患者，根据淡漠量表（AS），其中 26 例为淡漠型 PD（PD-A），20 例为非淡漠型 PD（PD-NA），23 例匹配的健康对照（HC）受试者也参与了本研究。采用基于 3-T MR 系统的静息态功能磁共振的局部一致性（ReHo）方法来研究与淡漠相关的局部脑活动。
与 PD-NA 患者和 HC 受试者相比，PD-A 患者的背侧前扣带皮层（ACC）和右侧尾状核的 ReHo 值明显较低。与 HC 组相比，PD-A 组和 PD-NA 组的右侧壳核的 ReHo 值也较低。进一步的相关分析显示，在汇总的 PD 患者中，AS 评分与背侧 ACC 和右侧尾状核的 ReHo 值呈负相关。
由于研究中样本量较小，目前的结果是初步的。
本研究首次使用 ReHo 来描述 PD 患者额纹状体回路中“纯”淡漠相关的局部自发脑功能。我们的研究结果表明，背侧 ACC 和尾状核的异常脑活动可能涉及 PD 淡漠的病理机制。
