Guo Weina, Jin Wei, Li Na, Gao Junshu, Wang Jiuxue, Chang Yajun, Yin Kuochang, Chen Yingmin, Zhang Shuqian, Wang Tianjun
Department of Graduate School of Hebei North University, Zhangjiakou, China; Department of Neurology, Hebei General Hospital, Shijiazhuang, China.
Department of Neurology, Hebei General Hospital, Shijiazhuang, China.
Neurosci Lett. 2021 Mar 16;747:135672. doi: 10.1016/j.neulet.2021.135672. Epub 2021 Jan 27.
This study aimed to investigate the differences in regional homogeneity (ReHo) values in patients with Parkinson's disease (PD) with cognitive impairment (PD-CI) and thus explore the neuropathological mechanism of PD-CI.
Resting-state functional magnetic resonance imaging scans were obtained from 36 patients with PD and 20 healthy controls (HCs) in this study. The PD group comprised 20 patients with PD-CI and 16 patients with PD with normal cognitive function (PD-NC). The data were analyzed using ReHo analysis to observe the changes in brain activity in patients with PD-CI and PD-NC. Statistical comparison was performed using covariance analysis and post hoc t tests.
The patients in the PD-CI group were older than those in the PD-NC and HC groups. Compared with the HC group, the PD-CI group showed that the ReHo value decreased in the right supplementary motor area, left lingual gyrus, left thalamus, and left precuneus, but increased in the left fusiform gyrus. Compared with the HC group, the PD-NC group showed that the ReHo value decreased in the right cerebellum_6, but increased in the left inferior temporal gyrus, left orbital inferior frontal gyrus, and left precentral gyrus. Compared with the PD-NC group, the PD-CI group showed that the ReHo value decreased in the right precuneus, left triangular inferior frontal gyrus, left middle frontal gyrus, right opercular inferior frontal gyrus, left orbital inferior frontal gyrus, left supramarginal gyrus, left angular gyrus, left inferior temporal gyrus, and right cerebelum_7b, but increased in the left precentral gyrus and left fusiform gyrus.
Age was a risk factor for cognitive decline in patients with PD. The ReHo value in the default mode network (DMN) was closely related to PD cognitive function, and the DMN was affected before CI and continuously deteriorated with disease progression. The disorder of visual conduction pathway was involved in CI in patients with PD, but these patients could recruit cognitive resources by improving visual-spatial ability. The cognitive function in such patients was related to the dopaminergic, cholinergic, and noradrenergic systems. The information transmission efficiency of the cerebellum-thalamus-cortex loop was reduced and involved in the cognitive decline process in patients with PD.
本研究旨在调查伴认知障碍的帕金森病（PD）患者的局部一致性（ReHo）值差异，从而探究PD伴认知障碍（PD-CI）的神经病理机制。
本研究对36例PD患者和20名健康对照者（HCs）进行静息态功能磁共振成像扫描。PD组包括20例PD-CI患者和16例认知功能正常的PD患者（PD-NC）。采用ReHo分析对数据进行分析，以观察PD-CI和PD-NC患者脑活动的变化。使用协方差分析和事后t检验进行统计学比较。
PD-CI组患者的年龄大于PD-NC组和HC组患者。与HC组相比，PD-CI组显示右侧辅助运动区、左侧舌回、左侧丘脑和左侧楔前叶的ReHo值降低，但左侧梭状回的ReHo值升高。与HC组相比，PD-NC组显示右侧小脑_6的ReHo值降低，但左侧颞下回、左侧眶额下回和左侧中央前回的ReHo值升高。与PD-NC组相比，PD-CI组显示右侧楔前叶、左侧额下回三角部、左侧额中回、右侧额下回岛盖部、左侧眶额下回、左侧缘上回、左侧角回、左侧颞下回和右侧小脑_7b的ReHo值降低，但左侧中央前回和左侧梭状回的ReHo值升高。
年龄是PD患者认知功能下降的危险因素。默认模式网络（DMN）中的ReHo值与PD认知功能密切相关，DMN在认知障碍之前就受到影响，并随着疾病进展持续恶化。视觉传导通路紊乱参与了PD患者的认知障碍，但这些患者可通过提高视觉空间能力来调动认知资源。此类患者的认知功能与多巴胺能、胆碱能和去甲肾上腺素能系统有关。小脑-丘脑-皮质环路的信息传递效率降低，并参与了PD患者的认知下降过程。
