帕金森病的自上而下控制和运动网络动力学。
Dynamics of Top-Down Control and Motor Networks in Parkinson's Disease.
机构信息
Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA.
Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
出版信息
Mov Disord. 2021 Apr;36(4):916-926. doi: 10.1002/mds.28461. Epub 2021 Jan 6.
BACKGROUND
Motor symptoms in Parkinson's disease (PD) patients might be related to high-level task-control deficits. We aimed at investigating the dynamics between sensorimotor network and top-down control networks (frontal-parietal, cingulo-opercular, and cerebellar) in PD and at determining the effects of levodopa on the dynamics of these networks.
METHODS
We investigated dynamic functional connectivity (dFC), during resting state functional magnetic resonance imaging, between sensorimotor network and top-down control networks in 36 PD patients (OFF medication, PD-OFF) and 36 healthy volunteers. We further assessed the effect of medication on dFC in18 PD patients who were also scanned ON medication.
RESULTS
The dFC analyses identified three discrete states: State I (35.68%) characterized by connections between the cerebellum and sensorimotor network, State II (34.17%) with connections between the sensorimotor and frontal-parietal network, and State III (30.15%) with connection between the sensorimotor and cingulo-opercular network. PD patients have significantly fewer occurrences and overall spent less time (shorter dwell time) in State II compared to healthy controls. After levodopa intake, dwell time improved toward normal. The change in dwell time before and after taking levodopa was negatively related to the respective changes in Unified Parkinson's Disease Rating Scale, Part III. PD-OFF showed significantly decreased connectivity between sensorimotor and control networks and increased connectivity within control networks. These changes were partially improved after levodopa intake.
CONCLUSIONS
Dopamine depletion in PD is associated with abnormalities in temporal and spatial properties between cognitive control and sensorimotor network, possibly contributing to clinical deficits. Levodopa partially restores the network function toward the values observed in healthy volunteers. © 2021 International Parkinson and Movement Disorder Society.
背景
帕金森病（PD）患者的运动症状可能与高级任务控制缺陷有关。我们旨在研究 PD 患者感觉运动网络与自上而下控制网络（额顶叶、扣带回顶叶和小脑）之间的动态关系，并确定左旋多巴对这些网络动态的影响。
方法
我们在 36 名 PD 患者（未服药，PD-OFF）和 36 名健康志愿者的静息状态功能磁共振成像中研究了感觉运动网络与自上而下控制网络之间的动态功能连接（dFC）。我们还进一步评估了 18 名 PD 患者在服药时（ON 药物）对 dFC 的影响。
结果
dFC 分析确定了三种离散状态：状态 I（35.68%）以小脑与感觉运动网络之间的连接为特征，状态 II（34.17%）以感觉运动与额顶叶网络之间的连接为特征，状态 III（30.15%）以感觉运动与扣带顶叶网络之间的连接为特征。与健康对照组相比，PD 患者状态 II 的发生次数明显减少，总时间（停留时间更短）减少。服用左旋多巴后，停留时间有所改善。服用左旋多巴前后停留时间的变化与统一帕金森病评定量表第三部分的相应变化呈负相关。PD-OFF 显示感觉运动和控制网络之间的连接明显减少，控制网络内的连接增加。这些变化在服用左旋多巴后部分得到改善。
结论
PD 中的多巴胺耗竭与认知控制和感觉运动网络之间的时空特性异常有关，可能导致临床缺陷。左旋多巴部分恢复了网络功能，使其接近健康志愿者的观察值。© 2021 国际帕金森病和运动障碍学会。
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