Department of Neurology, Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, No. 106 Zhongshan Er Road, Guangzhou, Guangdong Province, 510080, China.
Department of Neurology, Tongji Medical College, The Central Hospital of Wuhan, Huazhong University of Science and Technology, Wuhan, 430014, China.
Brain Imaging Behav. 2024 Jun;18(3):646-661. doi: 10.1007/s11682-024-00862-1. Epub 2024 Feb 10.
To investigate brain network centrality and connectivity alterations in different Parkinson's disease (PD) clinical subtypes using resting-state functional magnetic resonance imaging (RS-fMRI), and to explore the correlation between baseline connectivity changes and the clinical progression. Ninety-two PD patients were enrolled at baseline, alongside 38 age- and sex-matched healthy controls. Of these, 85 PD patients underwent longitudinal assessments with a mean of 2.75 ± 0.59 years. Two-step cluster analysis integrating comprehensive motor and non-motor manifestations was performed to define PD subtypes. Degree centrality (DC) and secondary seed-based functional connectivity (FC) were applied to identify brain network centrality and connectivity changes among groups. Regression analysis was used to explore the correlation between baseline connectivity changes and clinical progression. Cluster analysis identified two main PD subtypes: mild PD and moderate PD. Two different subtypes within the mild PD were further identified: mild motor-predominant PD and mild-diffuse PD. Accordingly, the disrupted DC and seed-based FC in the left inferior frontal orbital gyrus and left superior occipital gyrus were severe in moderate PD. The DC and seed-based FC alterations in the right gyrus rectus and right postcentral gyrus were more severe in mild-diffuse PD than in mild motor-predominant PD. Moreover, disrupted DC were associated with clinical manifestations at baseline in patients with PD and predicted motor aspects progression over time. Our study suggested that brain network centrality and connectivity changes were different among PD subtypes. RS-fMRI holds promise to provide an objective assessment of subtype-related connectivity changes and predict disease progression in PD.
为了使用静息态功能磁共振成像（RS-fMRI）研究不同帕金森病（PD）临床亚型的脑网络中心性和连通性改变，并探讨基线连通性变化与临床进展的相关性，我们招募了 92 名 PD 患者和 38 名年龄和性别匹配的健康对照者作为研究对象。其中，85 名 PD 患者进行了平均 2.75±0.59 年的纵向评估。采用两步聚类分析整合全面的运动和非运动表现来定义 PD 亚型。应用度中心度（DC）和基于种子的功能连通性（FC）来识别组间脑网络中心性和连通性变化。回归分析用于探讨基线连通性变化与临床进展的相关性。聚类分析确定了两种主要的 PD 亚型：轻度 PD 和中度 PD。在轻度 PD 中进一步确定了两种不同的亚型：轻度运动占优势的 PD 和轻度弥漫性 PD。因此，中度 PD 患者左额下回眶部和左顶叶上回的 DC 和基于种子的 FC 破坏更严重。轻度弥漫性 PD 患者右侧直回和右侧中央后回的 DC 和基于种子的 FC 改变比轻度运动占优势的 PD 患者更严重。此外，PD 患者的 DC 中断与基线时的临床表现相关，并可预测运动方面随时间的进展。我们的研究表明，PD 亚型之间的脑网络中心性和连通性变化不同。RS-fMRI 有望提供一种客观的评估方法，用于评估与亚型相关的连通性变化，并预测 PD 的疾病进展。
