Yang Jihyun, Pourzinal Dana, McMahon Katie L, Byrne Gerard J, Copland David A, O'Sullivan John D, Dissanayaka Nadeeka N
UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, QLD, 4029, Australia.
School of Clinical Sciences, Queensland University of Technology, QLD, 4000, Australia.
Parkinsonism Relat Disord. 2021 Apr;85:17-22. doi: 10.1016/j.parkreldis.2021.02.009. Epub 2021 Feb 22.
Deficits in attentional processing observed in Parkinson's disease (PD) patients with mild cognitive impairment (MCI) increase risk of PD dementia. However, the neural basis of these attentional deficits are presently unknown. The present study aimed to explore the neural correlates of attention dysfunction in PD-MCI using the Attention Network Test (ANT) and functional Magnetic Resonance Imaging (fMRI).
Fifteen (15) PD-MCI patients, 26 PD patients without MCI (PD-NC) and 22 healthy controls (HC) were scanned (3T Siemens PRISMA) whilst performing the ANT. Reaction time, accuracy and fMRI BOLD activation were compared between groups for the three attentional task components of 1) alerting, 2) orienting, and 3) executive control.
PD-MCI patients showed an overall slower reaction time compared to PD-NC and HC, and showed less interference of reaction time in the orienting effect than HC. fMRI data demonstrated greater activation in the bilateral cerebellum crus 1 during the alerting attention condition in both PD-MCI and PD-NC compared to HC. However, activation was supressed in the left postcentral gyrus in PD-MCI compared to PD-NC and HC.
Alterations in the alerting attention functional network despite intact task performance in PD-MCI suggests that functional brain changes may precede cognitive changes in the attention domain. Furthermore, increased activation in the cerebellum may reflect an attentional compensatory mechanism unique to the PD pathology. Taken together, the findings suggest that PD has a complex effect on attentional ability that can, at least in part, be elucidated using functional neuroimaging.
在患有轻度认知障碍（MCI）的帕金森病（PD）患者中观察到的注意力加工缺陷会增加患PD痴呆症的风险。然而，目前尚不清楚这些注意力缺陷的神经基础。本研究旨在使用注意力网络测试（ANT）和功能磁共振成像（fMRI）探索PD-MCI中注意力功能障碍的神经关联。
15名PD-MCI患者、26名无MCI的PD患者（PD-NC）和22名健康对照者（HC）在进行ANT时接受扫描（3T西门子PRISMA）。比较了三组在以下三个注意力任务成分上的反应时间、准确性和fMRI血氧水平依赖（BOLD）激活：1）警觉，2）定向，3）执行控制。
与PD-NC和HC相比，PD-MCI患者的总体反应时间较慢，并且在定向效应中反应时间受到的干扰比HC少。fMRI数据显示，与HC相比，在警觉注意力条件下，PD-MCI和PD-NC患者双侧小脑脚1的激活程度更高。然而，与PD-NC和HC相比，PD-MCI患者左侧中央后回的激活受到抑制。
尽管PD-MCI患者的任务表现完好，但警觉注意力功能网络发生了改变，这表明大脑功能变化可能先于注意力领域的认知变化。此外，小脑激活增加可能反映了PD病理特有的注意力补偿机制。综上所述，研究结果表明PD对注意力能力有复杂的影响，至少部分可以通过功能神经影像学来阐明。
