帕金森病患者生活质量相关的神经网络。
Neural networks associated with quality of life in patients with Parkinson's disease.
机构信息
Department of Neurology, Osaka University Graduate School of Medicine, Osaka, Japan.
Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan; Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.
出版信息
Parkinsonism Relat Disord. 2021 Aug;89:6-12. doi: 10.1016/j.parkreldis.2021.06.007. Epub 2021 Jun 17.
INTRODUCTION
The neural underpinnings of health-related quality of life in Parkinson's disease remain unclear. This study was conducted to unravel which motor and non-motor symptoms in Parkinson's disease influence health-related quality of life and reveal neural networks most likely linked to it.
METHODS
Comprehensive clinical assessments were conducted for 247 Parkinson's disease patients and image analyses were performed for 181 patients. Clinical scores commonly used to assess various symptoms related to health-related quality of life were investigated. Factor and resting-state functional magnetic resonance imaging analyses were reviewed to reveal health-related quality of life-associated brain networks.
RESULTS
The Spearman's rank correlation coefficient for the Parkinson's disease Questionnaire-39 summary index was high in the Activities-specific Balance Confidence Scale, Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale part 2, Freezing of Gait Questionnaire, and Self-reported Autonomic Symptoms in Parkinson's disease. Multiple regression and Random Forest regression analyses indicated that health-related quality of life-associated factors were Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale part 1, Depression Rating Scales, and the above-mentioned scales. The resting-state functional magnetic resonance imaging analysis revealed decreased functional connectivity between the anterior cingulate cortex and right temporo-parietal junction as health-related quality of life worsened.
CONCLUSION
Fear of falling, daily living activities, gait freezing, and autonomic dysfunction have notable effects on health-related quality of life in Parkinson's disease. Brain networks consisting of the anterior cingulate cortex and temporo-parietal junction may be associated with the emotion-related and social factors of health-related quality of life in Parkinson's disease.
简介
帕金森病患者健康相关生活质量的神经基础仍不清楚。本研究旨在阐明帕金森病的哪些运动和非运动症状影响健康相关生活质量，并揭示与之最相关的神经网络。
方法
对 247 例帕金森病患者进行了全面的临床评估，对 181 例患者进行了图像分析。研究了常用于评估与健康相关生活质量相关的各种症状的临床评分。进行因子和静息态功能磁共振成像分析，以揭示与健康相关生活质量相关的大脑网络。
结果
帕金森病问卷 39 综合指数的斯皮尔曼等级相关系数在特定活动平衡信心量表、运动障碍协会赞助的统一帕金森病评定量表第 2 部分修订版、冻结步态问卷和帕金森病自主症状自我报告中较高。多元回归和随机森林回归分析表明，与健康相关的生活质量相关因素为运动障碍协会赞助的统一帕金森病评定量表第 1 部分、抑郁评定量表以及上述量表。静息态功能磁共振成像分析显示，随着健康相关生活质量的恶化，前扣带皮层和右侧颞顶联合区之间的功能连接减少。
结论
对帕金森病患者来说，害怕跌倒、日常生活活动、步态冻结和自主功能障碍对健康相关生活质量有显著影响。由前扣带皮层和颞顶联合区组成的大脑网络可能与帕金森病健康相关生活质量的情绪相关和社会因素有关。
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