Sako Wataru, Abe Takashi, Matsumoto Yuki, Nakamura Kazumi, Haji Shotaro, Osaki Yusuke, Harada Masafumi, Izumi Yuishin
Department of Neurology, Tokushima University Graduate School of Biomedical Sciences, Tokushima 770-8503, Japan.
Department of Radiology, Tokushima University Graduate School of Biomedical Sciences, Tokushima 770-8503, Japan.
Diagnostics (Basel). 2021 Jun 6;11(6):1042. doi: 10.3390/diagnostics11061042.
Cognitive decline affects the clinical course in patients with Parkinson's disease (PD) and contributes to a poor prognosis. However, little is known about the underlying network-level abnormalities associated with each cognitive domain. We aimed to identify the networks related to each cognitive domain in PD using resting-state functional magnetic resonance imaging (MRI). Forty patients with PD and 15 normal controls were enrolled. All subjects underwent MRI and the Mini-Mental State Examination. Furthermore, the cognitive function of patients with PD was assessed using the Montreal Cognitive Assessment (MoCA). We used independent component analysis of the resting-state functional MRI for functional segmentation, followed by reconstruction to identify each domain-related network, to predict scores in PD using multiple regression models. Six networks were identified, as follows: the visuospatial-executive-domain-related network ( = 0.54, < 0.001), naming-domain-related network ( = 0.39, < 0.001), attention-domain-related network ( = 0.86, < 0.001), language-domain-related network ( = 0.64, < 0.001), abstraction-related network ( = 0.10, < 0.05), and orientation-domain-related network ( = 0.64, < 0.001). Cerebellar lobule VII was involved in the visuospatial-executive-domain-related and attention-domain-related networks. These two domains are involved in the first three listed nonamnestic cognitive impairment in the diagnostic criteria for PD with dementia (PDD). Furthermore, Brodmann area 10 contributed most frequently to each domain-related network. Collectively, these findings suggest that cerebellar lobule VII may play a key role in cognitive impairment in nonamnestic types of PDD.
认知功能衰退会影响帕金森病（PD）患者的临床病程，并导致预后不良。然而，对于与每个认知领域相关的潜在网络层面异常情况，我们知之甚少。我们旨在使用静息态功能磁共振成像（MRI）来识别PD中与每个认知领域相关的网络。招募了40例PD患者和15名正常对照者。所有受试者均接受了MRI检查和简易精神状态检查。此外，使用蒙特利尔认知评估量表（MoCA）对PD患者的认知功能进行评估。我们对静息态功能MRI进行独立成分分析以进行功能分割，随后进行重建以识别每个领域相关网络，并使用多元回归模型预测PD患者的得分。共识别出六个网络，具体如下：视觉空间执行领域相关网络（= 0.54，< 0.001）、命名领域相关网络（= 0.39，< 0.001）、注意力领域相关网络（= 0.86，< 0.001）、语言领域相关网络（= 0.64，< 0.001）、抽象相关网络（= 0.10，< 0.05）和定向领域相关网络（= 0.64，< 0.001）。小脑小叶VII参与了视觉空间执行领域相关和注意力领域相关网络。这两个领域涉及帕金森病痴呆（PDD）诊断标准中列出的前三种非遗忘性认知障碍。此外，布罗德曼区10对每个领域相关网络的贡献最为频繁。总体而言，这些发现表明小脑小叶VII可能在非遗忘型PDD的认知障碍中起关键作用。
