Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Neurology, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, The Netherlands.
Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Neurology, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, The Netherlands.
Neuroimage Clin. 2020;28:102468. doi: 10.1016/j.nicl.2020.102468. Epub 2020 Oct 15.
Deficits in cognitive functioning are a common yet poorly understood symptom in Parkinson's disease (PD). Recent studies have highlighted the importance of (dynamic) interactions between resting-state networks for cognition, which remains understudied in PD. We investigated how altered (dynamic) functional interactions between brain networks relate to cognitive dysfunction in PD patients. In this fMRI study, 50 PD patients (mean age 65.5 years ± 6.27) on dopaminergic medication were studied cross-sectionally, and of this cohort 31 PD patients were studied longitudinally. MRI imaging and neuropsychological testing was performed at two time points, with a follow-up duration of approximately three years. Functional connectivity within and between seven resting-state networks was calculated (both statically and dynamically) and correlated with four neuropsychological test scores; a combined score of (four) executive tasks, a motor perseveration, memory, and category fluency task. Cognitive dysfunction was determined based on a longitudinal sample of age-matched healthy controls (n = 13). PD patients showed dysfunction on six out of seven cognitive tasks when compared to healthy controls. Severity of executive dysfunction was correlated with higher static and lower dynamic functional connectivity between deep gray matter regions and the frontoparietal network (DGM-FPN). Over time, declining executive function was related to increasing static DGM-FPN connectivity, together with changes of connectivity involving the dorsal attention network (amongst others with the ventral attention network). Static functional connectivity between the ventral and dorsal attention network correlated with motor perseveration. Our findings demonstrate that in PD patients, dysfunctional communication between (i) subcortical, fronto-parietal and attention networks mostly underlies worsening of executive functioning, (ii) attention networks are involved in motor perseveration.
认知功能障碍是帕金森病（PD）中常见但尚未被充分理解的症状。最近的研究强调了静息态网络之间（动态）相互作用对认知的重要性，而这在 PD 中研究较少。我们研究了大脑网络之间改变的（动态）功能相互作用如何与 PD 患者的认知功能障碍相关。在这项 fMRI 研究中，我们对 50 名接受多巴胺能药物治疗的 PD 患者（平均年龄 65.5 岁±6.27 岁）进行了横断面研究，其中 31 名 PD 患者进行了纵向研究。在两个时间点进行 MRI 成像和神经心理学测试，随访时间约为三年。计算了七个静息态网络内和网络间的功能连接（静态和动态），并与四项神经心理学测试分数相关；执行任务（四项）的综合评分、运动持续、记忆和类别流畅性任务。认知功能障碍是基于年龄匹配的健康对照组（n=13）的纵向样本确定的。与健康对照组相比，PD 患者在七个认知任务中的六个任务中表现出功能障碍。执行功能障碍的严重程度与深部灰质区域和额顶网络（DGM-FPN）之间更高的静态和更低的动态功能连接相关。随着时间的推移，执行功能的下降与静态 DGM-FPN 连接的增加有关，同时还与包括背侧注意网络（与腹侧注意网络等）在内的连接变化有关。腹侧和背侧注意网络之间的静态功能连接与运动持续有关。我们的发现表明，在 PD 患者中，（i）皮质下、额顶和注意网络之间的功能障碍交流主要导致执行功能恶化，（ii）注意网络参与运动持续。
