Pourzinal Dana, Yang Jihyun, McMahon Katie L, Copland David A, Mitchell Leander, O'Sullivan John D, Byrne Gerard J, Dissanayaka Nadeeka N
Faculty of Medicine, The University of Queensland Centre for Clinical Research, Herston, Australia.
School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Australia.
Brain Behav. 2024 Mar;14(3):e3454. doi: 10.1002/brb3.3454.
Frontal and posterior-cortical cognitive subtypes in Parkinson's disease (PD) present with executive/attention and memory/visuospatial deficits, respectively. As the posterior-cortical subtype is predicted to progress rapidly toward dementia, the present study aimed to explore biological markers of this group using resting-state functional magnetic resonance imaging (rs-fMRI).
K-means cluster analysis delineated subtypes (cognitively intact, frontal, posterior-cortical, and globally impaired) among 85 people with PD. A subset of PD participants (N = 42) and 20 healthy controls (HCs) underwent rs-fMRI. Connectivity of bilateral hippocampi with regions of interest was compared between posterior-cortical, cognitively intact, and HC participants using seed-based analysis, controlling for age. Exploratory correlations were performed between areas of interest from the group analysis and a series of cognitive tests.
The posterior-cortical subtype (N = 19) showed weaker connectivity between the left hippocampus and right anterior temporal fusiform cortex compared to the cognitively intact (N = 11) group, p-false discovery rate (FDR) = .01, and weaker connectivity between bilateral hippocampi and most fusiform regions compared to HCs (N = 20). No differences were found between HCs and cognitively intact PD. Exploratory analyses revealed strongest associations between connectivity of the right anterior temporal fusiform cortex and left hippocampus with category fluency (p-FDR = .01).
Results suggest that weakened connectivity between the hippocampus and fusiform region is a unique characteristic of posterior-cortical cognitive deficits in PD. Further exploration of hippocampal and fusiform functional integrity as a marker of cognitive decline in PD is warranted.
帕金森病（PD）的额叶和后皮质认知亚型分别表现为执行/注意力和记忆/视觉空间缺陷。由于后皮质亚型预计会迅速发展为痴呆，本研究旨在使用静息态功能磁共振成像（rs-fMRI）探索该组的生物学标志物。
K均值聚类分析在85名帕金森病患者中划分出亚型（认知正常、额叶、后皮质和整体受损）。一部分帕金森病参与者（N = 42）和20名健康对照者（HC）接受了rs-fMRI检查。使用基于种子点的分析方法，在控制年龄的情况下，比较后皮质、认知正常和健康对照参与者双侧海马与感兴趣区域之间的连接性。在组分析的感兴趣区域和一系列认知测试之间进行探索性相关性分析。
与认知正常组（N = 11）相比，后皮质亚型（N = 19）的左海马与右前颞梭状回皮质之间的连接较弱，错误发现率（FDR）校正P值 = 0.01，与健康对照者（N = 20）相比，双侧海马与大多数梭状回区域之间的连接也较弱。健康对照者和认知正常的帕金森病患者之间未发现差异。探索性分析显示，右前颞梭状回皮质与左海马之间的连接性与类别流畅性之间的关联最强（FDR校正P值 = 0.01）。
结果表明，海马与梭状回区域之间连接减弱是帕金森病后皮质认知缺陷的一个独特特征。有必要进一步探索海马和梭状回的功能完整性作为帕金森病认知衰退的标志物。
