Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, No. 264, Guangzhou Road, Gulou District, Nanjing, Jiangsu 210029, China; Department of Neurology, Lianyungang Hospital of Traditional Chinese Medicine, No. 160, Chaoyang Middle Road, Haizhou District, Lianyungang, Jiangsu 222000, China.
Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, No. 264, Guangzhou Road, Gulou District, Nanjing, Jiangsu 210029, China.
Neuroscience. 2022 May 21;491:13-22. doi: 10.1016/j.neuroscience.2022.03.032. Epub 2022 Mar 28.
Although various studies have reported a high prevalence of depression among Parkinson's disease (PD) patients, the pathophysiological mechanism of depression in PD (DPD) is still unclear. The core region of the reward network, the ventral striatum (VS), is critical in the occurrence and development of DPD. This study aimed to explore the altered functional connectivity (FC) of VS subregions in DPD. We recruited 20 DPD patients, 37 non-depressed PD (NDPD) patients, and 41 healthy controls (HC) matched in age, gender, and years of education. The patients' diagnosis with PD was de-novo. We then used resting-state functional magnetic resonance imaging to detect the FC differences of VS subregions among these groups. The FC between the left ventral caudate (vCa_L) and the left middle occipital gyrus (MOG.L) was significantly increased in DPD than in NDPD patients or HC. Compared with HC, NDPD patients exhibited significantly increased FCs between bilateral ventromedial putamen and the left paracentral lobule, the right ventromedial putamen (vmPu_R), and the right precentral gyrus, the vmPu_R, and the left precuneus. Besides, a significant negative correlation was found between the FC values of the vCa_L with the MOG.L and the HAMD-17 scores in the DPD group. The hyperconnectivity between vCa_L and the MOG.L might be viewed as a compensatory mechanism for depression in the early stage of PD. This study provides new insight into the neural mechanism of depression in the early stage of PD and contributes to explore the potential neuroimaging markers for DPD.
虽然多项研究报道帕金森病 (PD) 患者中抑郁的发病率很高,但 PD 伴发抑郁(DPD)的病理生理学机制仍不清楚。奖励网络的核心区域,腹侧纹状体(VS),在 DPD 的发生和发展中起着关键作用。本研究旨在探讨 DPD 患者 VS 亚区功能连接(FC)的改变。我们招募了 20 名 DPD 患者、37 名非抑郁性 PD(NDPD)患者和 41 名年龄、性别和受教育年限相匹配的健康对照者(HC)。这些患者的 PD 诊断为首发。然后,我们使用静息态功能磁共振成像来检测这些组之间 VS 亚区的 FC 差异。与 NDPD 患者或 HC 相比,DPD 患者左腹侧尾状核(vCa_L)与左中枕叶(MOG.L)之间的 FC 显著增加。与 HC 相比,NDPD 患者双侧腹内侧苍白球与左旁中央小叶、右侧腹内侧苍白球(vmPu_R)与右侧中央前回、vmPu_R 与左侧楔前叶之间的 FC 显著增加。此外,DPD 组 vCa_L 与 MOG.L 的 FC 值与 HAMD-17 评分呈显著负相关。vCa_L 与 MOG.L 之间的过度连接可能被视为 PD 早期抑郁的代偿机制。这项研究为 PD 早期抑郁的神经机制提供了新的见解,并有助于探索 DPD 的潜在神经影像学标志物。