Veréb Dániel, Kovács Márton Attila, Antal Szabolcs, Kocsis Krisztián, Szabó Nikoletta, Kincses Bálint, Bozsik Bence, Faragó Péter, Tóth Eszter, Király András, Klivényi Péter, Zádori Dénes, Kincses Zsigmond Tamás
Department of Radiology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.
Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.
Front Neurol. 2022 Aug 9;13:927481. doi: 10.3389/fneur.2022.927481. eCollection 2022.
Visual dysfunction is a recognized early symptom of Parkinson's disease (PD) that partly scales motor symptoms, yet its background is heterogeneous. With additional deficits in visuospatial attention, the two systems are hard to disentangle and it is not known whether impaired functional connectivity in the visual cortex is translative in nature or disrupted attentional modulation also contributes. In this study, we investigate functional connectivity modulation during a visuospatial attention task in patients with PD. In total, 15 PD and 16 age-matched healthy controls performed a visuospatial attention task while undergoing fMRI, in addition to a resting-state fMRI scan. Tensorial independent component analysis was used to investigate task-related network activity patterns. Independently, an atlas-based connectivity modulation analysis was performed using the task potency method. Spearman's rank correlation was calculated between task-related network expression, connectivity modulation, and clinical characteristics. Task-related networks including mostly visual, parietal, and prefrontal cortices were expressed to a significantly lesser degree in patients with PD ( < 0.027). Resting-state functional connectivity did not differ between the healthy and diseased cohorts. Connectivity between the precuneus and ventromedial prefrontal cortex was modulated to a higher degree in patients with PD ( < 0.004), while connections between the posterior parietal cortex and primary visual cortex, and also the superior frontal gyrus and opercular cortex were modulated to a lesser degree ( < 0.001 and < 0.011). Task-related network expression and superior frontal gyrus-opercular cortex connectivity modulation were significantly associated with UPDRSIII motor scores and the Hoehn-Yahr stages ( = -0.72, < 0.006 and = -0.90, < 0.001; = -0.68, < 0.01 and = -0.71, < 0.007). Task-related networks function differently in patients with PD in association with motor symptoms, whereas impaired modulation of visual and default-mode network connectivity was not correlated with motor function.
视觉功能障碍是帕金森病（PD）公认的早期症状，它在一定程度上与运动症状相关，但其背后的机制具有异质性。由于存在视觉空间注意力方面的额外缺陷，这两个系统难以区分，并且尚不清楚视觉皮层中功能连接受损是本质上的转换问题还是注意力调制的破坏也起到了作用。在本研究中，我们调查了PD患者在视觉空间注意力任务期间的功能连接调制情况。总共15名PD患者和16名年龄匹配的健康对照在进行功能磁共振成像（fMRI）时执行了视觉空间注意力任务，此外还进行了静息态fMRI扫描。使用张量独立成分分析来研究与任务相关的网络活动模式。另外，使用任务效能方法进行了基于图谱的连接调制分析。计算了与任务相关的网络表达、连接调制和临床特征之间的斯皮尔曼等级相关性。包括主要视觉、顶叶和前额叶皮层在内的与任务相关的网络在PD患者中的表达程度明显较低（<0.027）。健康组和患病组之间的静息态功能连接没有差异。PD患者楔前叶与腹内侧前额叶皮层之间的连接调制程度更高（<0.004），而后顶叶皮层与初级视觉皮层之间以及额上回与岛盖皮层之间的连接调制程度较低（<0.001和<0.011）。与任务相关的网络表达和额上回 - 岛盖皮层连接调制与统一帕金森病评定量表第三部分（UPDRSIII）运动评分和 Hoehn - Yahr 分期显著相关（= -0.72，<0.006 和 = -0.90，<0.001；= -0.68，<0.01 和 = -0.71，<0.007）。与运动症状相关的情况下，PD患者中与任务相关的网络功能不同，而视觉和默认模式网络连接的调制受损与运动功能无关。
