Jiang Li, Zhuo Jiachen, Furman Andrew, Fishman Paul S, Gullapalli Rao
Department of Diagnostic Radiology & Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, United States.
Center for Advanced Imaging Research (CAIR), University of Maryland School of Medicine, Baltimore, MD, United States.
Front Neurosci. 2023 Jun 22;17:1113889. doi: 10.3389/fnins.2023.1113889. eCollection 2023.
Parkinson's Disease (PD) is a progressive neurodegenerative disorder affecting both motor and cognitive function. Previous neuroimaging studies have reported altered functional connectivity (FC) in distributed functional networks. However, most neuroimaging studies focused on patients at an advanced stage and with antiparkinsonian medication. This study aims to conduct a cross-sectional study on cerebellar FC changes in early-stage drug-naïve PD patients and its association with motor and cognitive function.
Twenty-nine early-stage drug-naïve PD patients and 20 healthy controls (HCs) with resting-state fMRI data and motor UPDRS and neuropsychological cognitive data were extracted from the Parkinson's Progression Markers Initiative (PPMI) archives. We used seed-based resting-state fMRI (rs-fMRI) FC analysis and the cerebellar seeds were defined based on the hierarchical parcellation of the cerebellum (AAL atlas) and its topological function mapping (motor cerebellum and non-motor cerebellum).
The early stage drug-naïve PD patients had significant differences in cerebellar FC when compared with HCs. Our findings include: (1) Increased intra-cerebellar FC within motor cerebellum, (2) increase motor cerebellar FC in inferior temporal gyrus and lateral occipital gyrus within ventral visual pathway and decreased motor-cerebellar FC in cuneus and dorsal posterior precuneus within dorsal visual pathway, (3) increased non-motor cerebellar FC in attention, language, and visual cortical networks, (4) increased vermal FC in somatomotor cortical network, and (5) decreased non-motor and vermal FC within brainstem, thalamus and hippocampus. Enhanced FC within motor cerebellum is positively associated with the MDS-UPDRS motor score and enhanced non-motor FC and vermal FC is negatively associated with cognitive function test scores of SDM and SFT.
These findings provide support for the involvement of cerebellum at an early stage and prior to clinical presentation of non-motor features of the disease in PD patients.
帕金森病（PD）是一种影响运动和认知功能的进行性神经退行性疾病。先前的神经影像学研究报告了分布式功能网络中功能连接（FC）的改变。然而，大多数神经影像学研究集中在晚期且正在服用抗帕金森药物的患者身上。本研究旨在对早期未服用药物的PD患者的小脑FC变化及其与运动和认知功能的关系进行横断面研究。
从帕金森病进展标志物倡议（PPMI）档案中提取了29例早期未服用药物的PD患者和20名健康对照（HCs）的静息态功能磁共振成像（fMRI）数据、运动统一帕金森病评定量表（UPDRS）和神经心理学认知数据。我们使用基于种子点的静息态fMRI（rs-fMRI）FC分析，小脑种子点基于小脑的分层分割（AAL图谱）及其拓扑功能映射（运动小脑和非运动小脑）来定义。
与HCs相比，早期未服用药物的PD患者在小脑FC方面存在显著差异。我们的研究结果包括：（1）运动小脑中脑内FC增加；（2）腹侧视觉通路中下颞叶和枕外侧回的运动小脑FC增加，背侧视觉通路中楔叶和背侧后楔前叶的运动小脑FC减少；（3）注意力、语言和视觉皮层网络中非运动小脑FC增加；（4）躯体运动皮层网络中蚓部FC增加；（5）脑干、丘脑和海马体内非运动和蚓部FC减少。运动小脑中增强的FC与MDS-UPDRS运动评分呈正相关，增强的非运动FC和蚓部FC与SDM和SFT的认知功能测试评分呈负相关。
这些发现为PD患者在疾病非运动特征临床表现之前小脑在早期阶段的参与提供了支持。
