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特定频段皮质连接的改变与早期帕金森病及其临床相关性。

Band-Specific Altered Cortical Connectivity in Early Parkinson's Disease and its Clinical Correlates.

机构信息

Parkinson Centre, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.

Parkinson and Movement Disorders Unit, Study Centre on Neurodegeneration (CESNE), Department of Neuroscience, University of Padova, Padua, Italy.

出版信息

Mov Disord. 2023 Dec;38(12):2197-2208. doi: 10.1002/mds.29615. Epub 2023 Oct 20.

Abstract

BACKGROUND

Functional connectivity (FC) has shown promising results in assessing the pathophysiology and identifying early biomarkers of neurodegenerative disorders, such as Parkinson's disease (PD).

OBJECTIVES

In this study, we aimed to assess possible resting-state FC abnormalities in early-stage PD patients using high-density electroencephalography (EEG) and to detect their clinical relationship with motor and non-motor PD symptoms.

METHODS

We enrolled 26 early-stage levodopa naïve PD patients and a group of 20 healthy controls (HC). Data were recorded with 64-channels EEG system and a source-reconstruction method was used to identify brain-region activity. FC was calculated using the weighted phase-lag index in θ, α, and β bands. Additionally, we quantified the unbalancing between β and lower frequencies through a novel index (β-functional ratio [FR]). Statistical analysis was conducted using a network-based statistical approach.

RESULTS

PD patients showed hypoconnected networks in θ and α band, involving prefrontal-limbic-temporal and frontoparietal areas, respectively, and a hyperconnected network in the β frequency band, involving sensorimotor-frontal areas. The θ FC network was negatively related to Non-Motor Symptoms Scale scores and α FC to the Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale part III gait subscore, whereas β FC and β-FR network were positively linked to the bradykinesia subscore. Changes in θ FC and β-FR showed substantial reliability and high accuracy, precision, sensitivity, and specificity in discriminating PD and HC.

CONCLUSIONS

Frequency-specific FC changes in PD likely reflect the dysfunction of distinct cortical networks, which occur from the early stage of the disease. These abnormalities are involved in the pathophysiology of specific motor and non-motor PD symptoms, including gait, bradykinesia, mood, and cognition. © 2023 International Parkinson and Movement Disorder Society.

摘要

背景

功能连接(FC)已在评估神经退行性疾病(如帕金森病(PD))的病理生理学和识别早期生物标志物方面显示出良好的效果。

目的

本研究旨在使用高密度脑电图(EEG)评估早期 PD 患者的静息状态 FC 异常,并检测其与运动和非运动 PD 症状的临床关系。

方法

我们招募了 26 名初诊、未经左旋多巴治疗的 PD 患者和 20 名健康对照者(HC)。数据由 64 通道 EEG 系统记录,使用源重建方法识别脑区活动。使用加权相位滞后指数在θ、α和β频段计算 FC。此外,我们通过一种新的指数(β功能比[FR])量化了β和较低频率之间的不平衡。使用基于网络的统计方法进行统计分析。

结果

PD 患者在θ和α频段表现出连接不足的网络,分别涉及额-边缘-颞叶和额顶叶区域,在β频段表现出连接过度的网络,涉及感觉运动-额区。θ FC 网络与非运动症状量表评分呈负相关,α FC 与运动障碍协会赞助的统一帕金森病评定量表第 3 部分步态亚评分呈负相关,而β FC 和β-FR 网络与运动迟缓亚评分呈正相关。θ FC 和β-FR 的变化在区分 PD 和 HC 方面具有较高的可靠性和准确性、精密度、灵敏度和特异性。

结论

PD 中特定频率的 FC 变化可能反映了不同皮质网络的功能障碍,这些变化发生在疾病的早期阶段。这些异常与特定的运动和非运动 PD 症状的病理生理学有关,包括步态、运动迟缓、情绪和认知。

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