Department of Radiology, University of Michigan, Ann Arbor, MI 48105, USA.
Neurology Service and GRECC, Veterans Administration Ann Arbor Healthcare System, Ann Arbor, MI 48105, USA.
Aging (Albany NY). 2023 Oct 27;15(20):10817-10820. doi: 10.18632/aging.205209.
Decreased cholinergic binding within the recently identified centro-cingulate brain network robustly has been shown to robustly correlate with the severity of cognitive impairment in Parkinson disease (PD). This network with key hubs within the cingulum, operculum and peri-central cortical regions also correlates with elements of parkinsonian motor impairments, including postural instability and gait difficulties, such as falls or freezing. MRI neuroimaging studies have shown that the anterior midcingulate cortex is a key node for cognitive aspects of movement generation, i.e., intentional motor control. Recent evidence also suggests a novel aspect of organization of primary motor cortex, describing "effector" regions for fine movement control intercalated with interlinked "inter-effector" regions devoted to whole-body control. A distinguishing feature of inter-effector regions is tight linkage to the cingular and opercular regions. Such inter-effector regions have been proposed to be part of a greater somato-cognitive action network necessary for integration of goals and movement. Recent evidence also points to vulnerabilities of cholinergic nerve terminals in the centro-cingulate network in older non-PD adults. These features of normal aging underscore that cortical cholinergic terminal losses in age-associated neurodegenerative disorders are likely not exclusively the result of disease-specific etiologies but also related to otherwise normal aging. Practical implications of this overlap are that addressing disease-specific and general aging etiologies involved in neurodegeneration, may be of benefit in age-associated neurodegenerative disorders where significant cholinergic systems degeneration is present.
在最近确定的中央扣带脑网络中，胆碱能结合的减少与帕金森病（PD）认知障碍的严重程度呈显著相关。该网络的关键枢纽位于扣带、脑岛和皮质区域，也与帕金森运动障碍的一些元素相关，包括姿势不稳和步态困难，如跌倒或冻结。MRI 神经影像学研究表明，前扣带皮质是运动生成认知方面的关键节点，即意向性运动控制。最近的证据还表明，初级运动皮层的组织有一个新的方面，描述了用于精细运动控制的“效应器”区域与专门用于全身控制的互联“效应器”区域交错。效应器区域的一个区别特征是与扣带和脑岛区域的紧密联系。这些效应器区域被认为是更大的躯体认知运动网络的一部分，对于目标和运动的整合是必要的。最近的证据还指出，在老年非 PD 成年人中，中央扣带网络中的胆碱能神经末梢易受损害。这些正常衰老的特征强调，与年龄相关的神经退行性疾病中皮质胆碱能末梢的丧失可能不仅是疾病特异性病因的结果，而且还与正常衰老有关。这种重叠的实际意义是，解决神经退行性疾病中涉及疾病特异性和一般衰老病因的问题，可能对存在显著胆碱能系统退化的与年龄相关的神经退行性疾病有益。
