Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Neurology, First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Parkinsonism Relat Disord. 2023 May;110:105386. doi: 10.1016/j.parkreldis.2023.105386. Epub 2023 Mar 27.
Several studies have identified a relationship between functional brain network disturbance and cognitive decline in people with Parkinson's disease (PwP); however, few studies have explored whether cerebral small vessel disease (CSVD) burden modifies this relationship. This study aimed to investigate the potential moderating effect of CSVD on the relationship between functional brain network disturbance and cognitive decline in PwP.
We prospectively recruited 61 PwP from Beijing Tiantan Hospital between October 2021 to September 2022. The Montreal Cognitive Assessment (MoCA) score was used to assess cognition. CSVD imaging markers were evaluated following the STandards for ReportIng Vascular changes on nEuroimaging instructions, and the CSVD burden score was calculated. The functional connectivity indicator was obtained and calculated using quantitative electroencephalography examination. The moderating effect of CSVD burden on the relationship between functional brain network disturbance and cognitive decline was examined using hierarchical linear regression.
Forty-six of 61 (75.4%) PwP had cognitive impairment. Higher global weighted phase lag index (wPLI) values in beta1 bands were significantly associated with lower adjusted MoCA scores. CSVD burden aggravated the effect of the global wPLI in beta1 bands on adjusted MoCA scores. This effect was reinforced by the high level of CSVD burden.
Higher wPLI indicates a possible pathological activation of functional brain networks that are associated with cognitive decline in PwP, and the high level of CSVD burden aggravates this relationship.
多项研究已经发现帕金森病患者（PwP）的功能性脑网络紊乱与认知能力下降之间存在关系，但很少有研究探讨脑小血管病（CSVD）负担是否会改变这种关系。本研究旨在探讨 CSVD 对 PwP 中功能性脑网络紊乱与认知能力下降之间关系的潜在调节作用。
我们前瞻性地招募了 2021 年 10 月至 2022 年 9 月期间来自北京天坛医院的 61 名 PwP。使用蒙特利尔认知评估（MoCA）评分评估认知能力。按照血管神经影像学报告标准（STandards for ReportIng Vascular changes on nEuroimaging）评估 CSVD 影像学标志物，并计算 CSVD 负担评分。使用定量脑电图检查获得并计算功能性连接指标。使用分层线性回归检验 CSVD 负担对功能性脑网络紊乱与认知能力下降之间关系的调节作用。
61 名 PwP 中有 46 名（75.4%）存在认知障碍。beta1 频段的全局加权相位滞后指数（wPLI）值越高，校正后的 MoCA 评分越低。CSVD 负担加重了 beta1 频段全局 wPLI 对校正后 MoCA 评分的影响。CSVD 负担水平较高会加强这种影响。
较高的 wPLI 表明功能性脑网络可能存在病理性激活，这与 PwP 的认知能力下降有关，而 CSVD 负担水平较高会加重这种关系。
