Department of Neurology, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8521, Japan.
Department of Rehabilitation Medicine, Nara Prefecture General Medical Center, Nara, Japan.
J Neural Transm (Vienna). 2023 Dec;130(12):1537-1545. doi: 10.1007/s00702-023-02688-5. Epub 2023 Aug 23.
The mechanisms underlying motor fluctuations in patients with Parkinson's disease (PD) are currently unclear. Regional brain stimulation reported the changing of motor symptoms, but the correlation with functional connectivity (FC) in the brain network is not fully understood. Hence, our study aimed to explore the relationship between motor symptom severity and FC using resting-state functional magnetic resonance imaging (rsfMRI) in the "on" and "off" states of PD. In 26 patients with sporadic PD, FC was assessed using rsfMRI, and clinical severity was analyzed using the motor part of the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS Part III) in the on and off states. Correlations between FC values and MDS-UPDRS Part III scores were assessed using Pearson's correlation coefficient. The correlation between FC and motor symptoms differed in the on and off states. FC between the ipsilateral precentral gyrus (PreCG) and globus pallidus (GP) correlated with the total MDS-UPDRS Part III scores and those for bradykinesia/rigidity in the off state. Lateralization analysis indicated that FC between the PreCG and GP correlated with the contralateral total MDS-UPDRS Part III scores and those for bradykinesia/rigidity in the off state. Aberrant FC in cortico-striatal circuits correlated with the severity of motor symptoms in PD. Cortico-striatal hyperconnectivity, particularly in motor pathways involving PreCG and GP, is related to motor impairments in PD. These findings may facilitate our understanding of the mechanisms underlying motor symptoms in PD and aid in developing treatment strategies such as brain stimulation for motor impairment.
帕金森病（PD）患者运动波动的机制目前尚不清楚。区域脑刺激报告了运动症状的变化，但与大脑网络中的功能连接（FC）的相关性尚不完全清楚。因此，我们的研究旨在使用 PD 的“开”和“关”状态下的静息态功能磁共振成像（rsfMRI）来探索运动症状严重程度与 FC 之间的关系。在 26 名散发性 PD 患者中，使用 rsfMRI 评估 FC，使用运动障碍协会统一帕金森病评定量表（MDS-UPDRS 第三部分）在开和关状态下分析临床严重程度。使用 Pearson 相关系数评估 FC 值与 MDS-UPDRS 第三部分评分之间的相关性。FC 与运动症状之间的相关性在开和关状态下不同。同侧中央前回（PreCG）与苍白球（GP）之间的 FC 与总 MDS-UPDRS 第三部分评分以及关闭状态下的运动迟缓/僵硬相关。偏侧化分析表明，PreCG 和 GP 之间的 FC 与关闭状态下的对侧总 MDS-UPDRS 第三部分评分以及运动迟缓/僵硬相关。皮质纹状体回路中的异常 FC 与 PD 中运动症状的严重程度相关。皮质纹状体的过度连接，特别是涉及 PreCG 和 GP 的运动通路，与 PD 中的运动障碍有关。这些发现可能有助于我们理解 PD 中运动症状的机制，并有助于开发治疗策略，如脑刺激治疗运动障碍。
