Dan Xiao-Juan, Wang Yu-Wei, Sun Jun-Yan, Gao Lin-Lin, Chen Xiao, Yang Xue-Ying, Xu Er-He, Ma Jing-Hong, Yan Chao-Gan, Wu Tao, Chan Piu
Department of Neurology, Xuanwu Hospital of Capital Medical University, 100053, Beijing, China.
Key Laboratory on Neurodegenerative Disorders of Ministry of Education, Key Laboratory on Parkinson's Disease of Beijing, 100053, Beijing, China.
NPJ Parkinsons Dis. 2024 Jan 3;10(1):5. doi: 10.1038/s41531-023-00617-7.
REM sleep behavior disorder (RBD) symptoms in Parkinson's disease (PD) suggest both a clinically and pathologically malignant subtype. However, whether RBD symptoms are associated with alterations in the organization of whole-brain intrinsic functional networks in PD, especially at early disease stages, remains unclear. Here we use resting-state functional MRI, coupled with graph-theoretical approaches and network-based statistics analyses, and validated with large-scale network analyses, to characterize functional brain networks and their relationship with clinical measures in early PD patients with probable RBD (PD+pRBD), early PD patients without probable RBD (PD-pRBD) and healthy controls. Thirty-six PD+pRBD, 57 PD-pRBD and 71 healthy controls were included in the final analyses. The PD+pRBD group demonstrated decreased global efficiency (t = -2.036, P = 0.0432) compared to PD-pRBD, and decreased network efficiency, as well as comprehensively disrupted nodal efficiency and whole-brain networks (all eight networks, but especially in the sensorimotor, default mode and visual networks) compared to healthy controls. The PD-pRBD group showed decreased nodal degree in right ventral frontal cortex and more affected edges in the frontoparietal and ventral attention networks compared to healthy controls. Furthermore, the assortativity coefficient was negatively correlated with Montreal cognitive assessment scores in the PD+pRBD group (r = -0.365, P = 0.026, d = 0.154). The observation of altered whole-brain functional networks and its correlation with cognitive function in PD+pRBD suggest reorganization of the intrinsic functional connectivity to maintain the brain function in the early stage of the disease. Future longitudinal studies following these alterations along disease progression are warranted.
帕金森病(PD)中的快速眼动睡眠行为障碍(RBD)症状提示存在一种临床和病理上均为恶性的亚型。然而,RBD症状是否与PD患者全脑内在功能网络组织的改变相关,尤其是在疾病早期阶段,仍不清楚。在此,我们使用静息态功能磁共振成像,结合图论方法和基于网络的统计分析,并通过大规模网络分析进行验证,以表征早期可能患有RBD的PD患者(PD + pRBD)、早期可能未患有RBD的PD患者(PD - pRBD)和健康对照者的脑功能网络及其与临床指标的关系。最终分析纳入了36例PD + pRBD患者、57例PD - pRBD患者和71名健康对照者。与PD - pRBD相比,PD + pRBD组的全局效率降低(t = -2.036,P = 0.0432),与健康对照相比,网络效率降低,节点效率和全脑网络全面受损(所有八个网络,但特别是感觉运动、默认模式和视觉网络)。与健康对照相比,PD - pRBD组右侧腹侧额叶皮质的节点度降低,额顶叶和腹侧注意网络中的受影响边更多。此外,PD + pRBD组的聚类系数与蒙特利尔认知评估得分呈负相关(r = -0.365,P = 0.026,d = 0.154)。PD + pRBD中全脑功能网络改变及其与认知功能的相关性观察结果表明,在疾病早期阶段内在功能连接发生了重组以维持脑功能。有必要对这些改变随疾病进展进行未来的纵向研究。