Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.
MRI Research Center, University of Campania "Luigi Vanvitelli", Naples, Italy.
Mov Disord. 2021 Jan;36(1):96-105. doi: 10.1002/mds.28372. Epub 2020 Nov 10.
Anxiety symptoms are common in Parkinson's disease (PD). A link between anxiety and cognitive impairment in PD has been demonstrated.
Using resting-state functional magnetic resonance imaging, we investigated intrinsic brain network connectivity correlates of anxiety symptoms in a cohort of drug-naive, cognitively unimpaired patients with PD.
The intrinsic functional brain connectivity of 25 drug-naive, cognitively unimpaired PD patients with anxiety, 25 without anxiety, and 20 matched healthy controls was compared. All patients underwent a detailed behavioral and neuropsychological evaluation. Anxiety presence and severity were assessed using the Parkinson's Disease Anxiety Scale. Single-subject and group-level independent component analyses were used to investigate functional connectivity differences within and between the major resting-state networks.
Decreased connectivity within the default-mode and sensorimotor networks (SMN), increased connectivity within the executive-control network (ECN), and divergent connectivity measures within salience and frontoparietal networks (SN and FPN) were detected in PD patients with anxiety compared with those without anxiety. Moreover, patients with anxiety showed a disrupted inter-network connectivity between SN and SMN, ECN, and FPN. Anxiety severity was correlated with functional abnormalities within these networks.
Our findings demonstrated that an abnormal intrinsic connectivity within and between the most reported large-scale networks may represent a potential neural correlate of anxiety symptoms in drug-naive PD patients even in the absence of clinically relevant cognitive impairment. We hypothesize that these specific cognitive and limbic network architecture changes may represent a potential biomarker of treatment response in clinical trials. © 2020 International Parkinson and Movement Disorder Society.
焦虑症状在帕金森病（PD）中很常见。已经证明 PD 中的焦虑与认知障碍之间存在关联。
使用静息态功能磁共振成像，我们研究了一组未经药物治疗、认知无障碍的 PD 患者的焦虑症状与内在脑网络连接的相关性。
比较了 25 名未经药物治疗、认知无障碍且伴有焦虑的 PD 患者、25 名无焦虑的 PD 患者和 20 名匹配的健康对照者的内在功能脑连接。所有患者均接受了详细的行为和神经心理学评估。使用帕金森病焦虑量表评估焦虑的存在和严重程度。采用单个体和组水平的独立成分分析来研究主要静息态网络内和网络间的功能连接差异。
与无焦虑的 PD 患者相比，有焦虑的 PD 患者的默认模式和感觉运动网络（SMN）内连接减少，执行控制网络（ECN）内连接增加，以及突显和额顶网络（SN 和 FPN）内连接不同。此外，有焦虑的患者表现出 SN 和 SMN、ECN 和 FPN 之间的网络间连接中断。焦虑严重程度与这些网络内的功能异常相关。
我们的发现表明，在未经药物治疗的 PD 患者中，即使没有明显的认知障碍，内在连接的异常也可能代表焦虑症状的潜在神经相关性。我们假设这些特定的认知和边缘网络结构变化可能代表临床试验中治疗反应的潜在生物标志物。
