Wang Qingguang, He Wei, Liu Dinghua, Han Bojun, Jiang Qitao, Niu Jiali, Ding Yunlong
Department of Neurology, The Affiliated Jiangyin People's Hospital of Southeast University Medical College, Jiangyin, People's Republic of China.
Department of Physical Medicine and Rehabilitation, The Affiliated Jiangyin People's Hospital of Southeast University Medical College, Jiangyin, People's Republic of China.
Int J Gen Med. 2021 Jun 17;14:2623-2630. doi: 10.2147/IJGM.S300422. eCollection 2021.
To explore the alteration of pattens of anatomical and functional connectivity (FC) of posterior cingulate cortex (PCC) in Parkinson's disease (PD) patients with cognitive dysfunction and the relationship between the connection strengths and cognitive state.
We prospectively enrolled 20 PD patients with mild cognitive impairment (PD-MCI), 13 PD patients with normal cognition (PD-NC) and 13 healthy controls (HCs). By collecting, preprocessing and FC analyzing resting-state functional magnetic resonance imaging (rs-fMRI) data, we extracted default mode network (DMN) patterns, compared the differences in DMN between the three groups and the analyzed the correlation between FC value with the commonly used neuropsychological testing.
The PD-MCI showed significant worse performances in general cognition, and PD-NC and HCs showed comparable performances of cognitive function. Cognitive-related differences in DMN were detected in the bilateral precuneus (BPcu). Compared with the HCs, PD-NC and PD-MCI showed significantly decreased FC within BPcu (both P < 0.001). For PD-MCI, the rho of the Fisher's Z-transformed FC (zFC) value within BPcu with the TMTA, DSST and CFT-20min were 0.50, 0.66 and 0.47, respectively. For PD-NC, the rho of the zFC value within BPcu with the MMSE was 0.58.
BPcu was the cognitive-related region in DMN. As cognition declines, FC within BPcu weakens. For PD-MCI, the higher the FC values within BPcu were likely to be related to the better the performances of TMTA, DSST and CFT-20 min DR, which needs to be further confirmed by large-sample studies.
探讨帕金森病（PD）认知功能障碍患者后扣带回皮质（PCC）解剖和功能连接（FC）模式的改变以及连接强度与认知状态之间的关系。
我们前瞻性纳入了20例轻度认知障碍的PD患者（PD-MCI）、13例认知正常的PD患者（PD-NC）和13名健康对照者（HCs）。通过收集、预处理静息态功能磁共振成像（rs-fMRI）数据并进行FC分析，我们提取了默认模式网络（DMN）模式，比较了三组之间DMN的差异，并分析了FC值与常用神经心理学测试之间的相关性。
PD-MCI在一般认知方面表现明显更差，而PD-NC和HCs在认知功能方面表现相当。在双侧楔前叶（BPcu）检测到DMN中与认知相关的差异。与HCs相比，PD-NC和PD-MCI在BPcu内的FC显著降低（均P<0.001）。对于PD-MCI，BPcu内Fisher's Z变换FC（zFC）值与语言流畅性测试（TMTA）、数字符号替换测验（DSST）和20分钟持续操作测试（CFT-20min）的相关系数分别为0.50、0.66和0.47。对于PD-NC，BPcu内zFC值与简易精神状态检查表（MMSE）的相关系数为0.58。
BPcu是DMN中与认知相关的区域。随着认知功能下降，BPcu内的FC减弱。对于PD-MCI，BPcu内FC值越高，可能与TMTA、DSST和CFT-20min延迟回忆测试的表现越好相关，这需要通过大样本研究进一步证实。
