School of Mechatronical Engineering, Beijing Institute of Technology, Beijing, China.
Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China.
Hum Brain Mapp. 2024 Mar;45(4):e26647. doi: 10.1002/hbm.26647.
Parkinson's disease (PD) patients exhibit deficits in primary sensorimotor and higher-order executive functions. The gradient reflects the functional spectrum in sensorimotor-associated areas of the brain. We aimed to determine whether the gradient is disrupted in PD patients and how this disruption is associated with treatment outcome. Seventy-six patients (mean age, 59.2 ± 12.4 years [standard deviation], 44 women) and 34 controls participants (mean age, 58.1 ± 10.0 years [standard deviation], 19 women) were evaluated. We explored functional and structural gradients in PD patients and control participants. Patients were followed during 2 weeks of multidisciplinary intensive rehabilitation therapy (MIRT). The Unified Parkinson's Disease Rating Scale Part III (UPDRS-III) was administered to patients before and after treatment. We investigated PD-related alterations in the principal functional and structural gradients. We further used a support vector machine (SVM) and correlation analysis to assess the classification ability and treatment outcomes related to PD gradient alterations, respectively. The gradients showed significant differences between patients and control participants, mainly in somatosensory and visual networks involved in primary function, and higher-level association networks (dorsal attentional network (DAN) and default mode network (DMN)) related to motor control and execution. On the basis of the combined functional and structural gradient features of these networks, the SVM achieved an accuracy of 91.2% in discriminating patients from control participants. Treatment reduced the gradient difference. The altered gradient exhibited a significant correlation with motor improvement and was mainly distributed across the visual network, DAN and DMN. This study revealed damage to gradients in the brain characterized by sensorimotor and executive control deficits in PD patients. The application of gradient features to neurological disorders could lead to the development of potential diagnostic and treatment markers for PD.
帕金森病（PD）患者表现出初级感觉运动和高级执行功能的缺陷。这种梯度反映了大脑感觉运动相关区域的功能谱。我们旨在确定这种梯度在 PD 患者中是否受到干扰，以及这种干扰与治疗结果如何相关。
我们评估了 76 名患者（平均年龄 59.2±12.4 岁[标准差]，44 名女性）和 34 名对照组参与者（平均年龄 58.1±10.0 岁[标准差]，19 名女性）。我们探索了 PD 患者和对照组参与者的功能和结构梯度。患者在 2 周的多学科强化康复治疗（MIRT）期间接受了随访。在治疗前后，我们使用统一帕金森病评定量表第三部分（UPDRS-III）对患者进行了评估。我们研究了 PD 相关的主要功能和结构梯度的改变。我们进一步使用支持向量机（SVM）和相关分析来分别评估与 PD 梯度改变相关的分类能力和治疗结果。
梯度在患者和对照组参与者之间显示出显著差异，主要在初级功能涉及的感觉运动和视觉网络，以及与运动控制和执行相关的更高水平的关联网络（背侧注意网络（DAN）和默认模式网络（DMN））。基于这些网络的功能和结构梯度特征的组合，SVM 在区分患者和对照组参与者方面达到了 91.2%的准确性。治疗减少了梯度差异。改变的梯度与运动改善显著相关，主要分布在视觉网络、DAN 和 DMN 中。
这项研究揭示了 PD 患者大脑梯度的损伤，其特征是感觉运动和执行控制缺陷。梯度特征在神经疾病中的应用可能会为 PD 开发潜在的诊断和治疗标志物。
