Choi Euna, Han Ji Won, Suh Seung Wan, Bae Jong Bin, Han Ji Hyun, Lee Subin, Kim Sang Eun, Kim Ki Woong
Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, South Korea.
Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea.
Front Neurol. 2022 Aug 8;13:847935. doi: 10.3389/fneur.2022.847935. eCollection 2022.
Although dementia with Lewy bodies (DLB) have Parkinsonism in common with Parkinson's disease (PD) or PD dementia (PDD), they have different neuropathologies that underlie Parkinsonism. Altered brain functional connectivity that may correspond to neuropathology has been reported in PD while never been studied in DLB. To identify the characteristic brain connectivity of Parkinsonism in DLB, we compared the resting state metabolic connectivity in striato-thalamo-cortical (STC) circuit, nigrostriatal pathway, and cerebello-thalamo-cortical motor (CTC) circuit in 27 patients with drug-naïve DLB and 27 age- and sex-matched normal controls using 18F-fluoro-2-deoxyglucose PET. We derived 118 regions of interest using the Automated Anatomical Labeling templates and the Wake Forest University Pick-Atlas. We applied the sparse inverse covariance estimation method to construct the metabolic connectivity matrix. Patients with DLB, with or without Parkinsonism, showed lower inter-regional connectivity between the areas included in the STC circuit (motor cortex-striatum, midbrain-striatum, striatum-globus pallidus, and globus pallidus-thalamus) than the controls. DLB patients with Parkinsonism showed less reduced inter-regional connectivity between the midbrain and the striatum than those without Parkinsonism, and higher inter-regional connectivity between the areas included in the CTC circuit (motor cortex-pons, pons-cerebellum, and cerebellum-thalamus) than those without Parkinsonism and the controls. The resting state metabolic connectivity in the STC circuit may be reduced in DLB. In DLB with Parkinsonism, the CTC circuit and the nigrostriatal pathway may be activated to mitigate Parkinsonism. This difference in the brain connectivity may be a candidate biomarker for differentiating DLB from PD or PDD.
尽管路易体痴呆（DLB）与帕金森病（PD）或帕金森病痴呆（PDD）都有帕金森综合征，但它们导致帕金森综合征的神经病理学不同。据报道，PD存在与神经病理学相对应的大脑功能连接改变，而DLB从未有过相关研究。为了确定DLB中帕金森综合征的特征性脑连接，我们使用18F-氟代脱氧葡萄糖PET比较了27例未用药的DLB患者和27例年龄及性别匹配的正常对照者在纹状体-丘脑-皮质（STC）回路、黑质纹状体通路和小脑-丘脑-皮质运动（CTC）回路中的静息态代谢连接。我们使用自动解剖标记模板和维克森林大学拾取图谱得出118个感兴趣区域。我们应用稀疏逆协方差估计方法构建代谢连接矩阵。有或无帕金森综合征的DLB患者在STC回路（运动皮质-纹状体、中脑-纹状体、纹状体-苍白球和苍白球-丘脑）所包含区域之间的区域间连接性低于对照组。有帕金森综合征的DLB患者中脑与纹状体之间的区域间连接性降低程度低于无帕金森综合征的患者，且在CTC回路（运动皮质-脑桥、脑桥-小脑和小脑-丘脑）所包含区域之间的区域间连接性高于无帕金森综合征的患者及对照组。DLB中STC回路的静息态代谢连接可能降低。在有帕金森综合征的DLB中，CTC回路和黑质纹状体通路可能被激活以减轻帕金森综合征。这种脑连接的差异可能是区分DLB与PD或PDD的候选生物标志物。
