Chen Yubing, Guo Zhiying, Wang Yajie, Yin Hangxing, Zhang Shugang, Liu Weiguo
Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.
Front Neurol. 2023 May 17;14:1102927. doi: 10.3389/fneur.2023.1102927. eCollection 2023.
The thalamus is an integrative hub of motor circuits in Parkinson's disease (PD). This study aimed to investigate the alterations of structure and functional connectivity (FC) of the thalamic subregions in the tremor-dominant (TD) subtype and the postural instability and gait difficulty (PIGD) subtype in PD.
A total of 59 drug-naïve patients (24 TD and 35 PIGD) and 37 healthy controls were recruited. The volumes of the thalamus and the thalamic subregions were calculated using FreeSurfer. Functional connectivity (FC) analysis of the resting-state functional MRI (rsfMRI) was conducted on the thalamic subregions. Finally, the altered structure and FC were used for correlation analysis with clinical motor scores and for further motor subtypes differentiation.
The volumes of the left posterior parietal thalamus (PPtha) in TD patients were significantly lower than those of PIGD patients. Compared with PIGD patients, TD patients exhibited higher FC between the thalamic subregions, the left middle temporal gyrus (MTG), the right dorsolateral superior frontal gyrus (SFGdl), the left middle occipital gyrus (MOG), and the right superior temporal gyrus (STG). Compared with HCs, TD patients showed higher FC between the thalamic subregions and the right SFGdl, as well as the left MOG. Compared with HCs, PIGD patients showed lower FC between the thalamic subregions and the left MTG. In addition, the altered FC was closely related to clinical symptoms and performed high-discriminative power in differentiating the motor subtypes.
Increased FC between the thalamic subregions and the sensory cortices in TD patients may indicate a better compensatory capacity for impairment of sensory information integration than that in PIGD patients. The altered FC between the thalamus and the MTG was a potential biomarker for the distinction of the PD motor subtypes.
丘脑是帕金森病（PD）运动回路的一个整合枢纽。本研究旨在调查PD中震颤为主型（TD）和姿势不稳及步态障碍型（PIGD）丘脑亚区域的结构和功能连接（FC）变化。
共招募了59例未服用过药物的患者（24例TD和35例PIGD）以及37名健康对照者。使用FreeSurfer计算丘脑及丘脑亚区域的体积。对丘脑亚区域进行静息态功能磁共振成像（rsfMRI）的功能连接（FC）分析。最后，将改变的结构和FC与临床运动评分进行相关分析，并用于进一步的运动亚型区分。
TD患者左侧后顶叶丘脑（PPtha）的体积显著低于PIGD患者。与PIGD患者相比，TD患者丘脑亚区域、左侧颞中回（MTG）、右侧背外侧额上回（SFGdl）、左侧枕中回（MOG）和右侧颞上回（STG）之间的FC更高。与健康对照者相比，TD患者丘脑亚区域与右侧SFGdl以及左侧MOG之间的FC更高。与健康对照者相比，PIGD患者丘脑亚区域与左侧MTG之间的FC更低。此外，改变的FC与临床症状密切相关，并且在区分运动亚型方面具有较高的鉴别力。
TD患者丘脑亚区域与感觉皮层之间FC的增加可能表明其对感觉信息整合受损的代偿能力优于PIGD患者。丘脑与MTG之间FC的改变是区分PD运动亚型的潜在生物标志物。
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