Zhu Yongyun, Yang Baiyuan, Zhou Chuanbin, Gao Chao, Hu Yanfei, Yin Wei Fang, Yin Kangfu, Zhu Yangfan, Jiang Guoliang, Ren Hui, Pang Ailan, Yang Xinglong
Department of Geriatric Neurology, First Affiliated Hospital of Kunming Medical University, 650032, Kunming, Yunnan Province, P.R. China.
Department of Neurology, Seventh People's Hospital of Chengdu, 690041, Chengdu, Sichuan Province, P.R. China.
Brain Imaging Behav. 2022 Dec;16(6):2586-2600. doi: 10.1007/s11682-022-00714-w. Epub 2022 Aug 31.
We aimed to perform a combined analysis of cortical thickness and functional connectivity to explore their association with cognitive impairment in Parkinson's disease (PD). A total of 53 PD and 15 healthy control subjects were enrolled. PD patients were divided into PD with normal cognition (PD-NC, n = 25), PD with mild cognitive impairment (PD-MCI, n = 11), and PD with dementia (PDD, n = 17). In some analyses, the PD-MCI and PDD groups were aggregated to represent "PD patients with cognitive impairment". Cognitive status was assessed with the Mini-Mental State Examination (MMSE). Anatomical magnetic resonance imaging and resting-state functional connectivity analysis were performed in all subjects. First, surface-based morphometry measurements of cortical thickness and voxels with cortical thickness reduction were detected. Then, regions showing reduced thickness were analyzed for changes in resting-state functional connectivity in PD involving cognitive impairment. Our results showed that, compared with PD-NC, patients with cognitive impairment showed decreased cortical thickness in the left superior temporal, left lingual, right insula, and right fusiform regions. PD-MCI patients showed these alterations in the right lingual region. Widespread cortical thinning was detected in PDD subjects, including the left superior temporal, left fusiform, right insula, and right fusiform areas. We found that cortical thinning in the left superior temporal, left fusiform, and right temporal pole regions positively correlated with MMSE score. In the resting-state functional connectivity analysis, we found a decrease in functional connectivity between the cortical atrophic brain areas mentioned above and cognition-related brain networks, as well as an increase in functional connectivity between those region and the cerebellum. Alterations in cortical thickness may result in a dysfunction of resting-state functional connectivity, contributing to cognitive decline in patients with PD. However, it is more probable that the relation between structure and FC would be bidirectional,and needs more research to explore in PD cognitve decline.
我们旨在对皮质厚度和功能连接性进行联合分析，以探讨它们与帕金森病（PD）认知障碍的关联。共纳入了53例PD患者和15名健康对照者。PD患者被分为认知正常的PD（PD-NC，n = 25）、轻度认知障碍的PD（PD-MCI，n = 11）和痴呆的PD（PDD，n = 17）。在一些分析中，将PD-MCI和PDD组合并以代表“有认知障碍的PD患者”。使用简易精神状态检查表（MMSE）评估认知状态。对所有受试者进行了解剖磁共振成像和静息态功能连接性分析。首先，进行基于表面的皮质厚度形态测量，并检测皮质厚度减少的体素。然后，分析厚度减少的区域在涉及认知障碍的PD患者静息态功能连接性方面的变化。我们的结果显示，与PD-NC相比，有认知障碍的患者在左侧颞上回、左侧舌回、右侧岛叶和右侧梭状回区域的皮质厚度降低。PD-MCI患者在右侧舌回区域出现这些改变。在PDD受试者中检测到广泛的皮质变薄，包括左侧颞上回、左侧梭状回、右侧岛叶和右侧梭状回区域。我们发现左侧颞上回、左侧梭状回和右侧颞极区域的皮质变薄与MMSE评分呈正相关。在静息态功能连接性分析中，我们发现上述皮质萎缩脑区与认知相关脑网络之间的功能连接性降低，以及这些区域与小脑之间的功能连接性增加。皮质厚度的改变可能导致静息态功能连接性障碍，从而导致PD患者的认知衰退。然而，结构与功能连接性之间的关系更可能是双向的，在PD认知衰退方面需要更多研究来探索。
