Tian Bingjie, Chen Qing, Zou Min, Xu Xin, Liang Yuqi, Liu Yiyan, Hou Miaomiao, Zhao Jiahao, Liu Zhenguo, Jiang Liping
School of Nursing, Shanghai Jiao Tong University, Shanghai, China.
Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Glob Health Med. 2024 Apr 30;6(2):132-140. doi: 10.35772/ghm.2023.01043.
This study aimed to explore the brain network characteristics in elderly patients with Parkinson's disease (PD) with depressive symptoms. Thirty elderly PD patients with depressive symptoms (PD-D) and 26 matched PD patients without depressive symptoms (PD-NOD) were recruited based on HAMD-24 with a cut-off of 7. The resting-state functional connectivity (RSFC) was conducted by 53-channel functional near-infrared spectroscopy (fNIRS). There were no statistically significant differences in MMSE scores, disease duration, Hoehn-Yahr stage, daily levodopa equivalent dose, and MDS-UPDRS III between the two groups. However, compared to the PD-NOD group, the PD-D group showed significantly higher MDS-UPDRS II, HAMA-14, and HAMD-24. The interhemispheric FC strength and the FC strength between the left dorsolateral prefrontal cortex (DLPFC-L) and the left frontal polar area (FPA-L) was significantly lower in the PD-D group (FDR < 0.05). As for graph theoretic metrics, the PD-D group had significantly lower degree centrality (aDc) and node efficiency (aNe) in the DLPFC-L and the FPA-L (FDR, < 0.05), as well as decreased global efficiency (aEg). Pearson correlation analysis indicated moderate negative correlations between HAMD-24 scores and the interhemispheric FC strength, FC between DLPFC-L and FPA-L, aEg, aDc in FPA-L, aNe in DLPFC-L and FPA-L. In conclusion, PD-D patients show decreased integration and efficiency in their brain networks. Furthermore, RSFC between DLPFC-L and FPA-L regions is negatively correlated with depressive symptoms. These findings propose that targeting DLPFC-L and FPA-L regions non-invasive brain stimulation may be a potential intervention for alleviating depressive symptoms in elderly PD patients.
本研究旨在探讨伴有抑郁症状的老年帕金森病(PD)患者的脑网络特征。基于汉密尔顿抑郁量表(HAMD-24)评分≥7,招募了30例伴有抑郁症状的老年PD患者(PD-D组)和26例年龄匹配的无抑郁症状的PD患者(PD-NOD组)。采用53通道功能近红外光谱技术(fNIRS)进行静息态功能连接(RSFC)检测。两组患者的简易精神状态检查表(MMSE)评分、病程、Hoehn-Yahr分期、每日左旋多巴等效剂量及统一帕金森病评定量表第三部分(MDS-UPDRS III)评分差异均无统计学意义。然而,与PD-NOD组相比,PD-D组的MDS-UPDRS第二部分、汉密尔顿焦虑量表(HAMA-14)及HAMD-24评分显著更高。PD-D组的半球间功能连接强度以及左侧背外侧前额叶皮质(DLPFC-L)与左侧额极区(FPA-L)之间的功能连接强度显著降低(错误发现率校正后P<0.05)。在图论指标方面,PD-D组在DLPFC-L和FPA-L区域的度中心性(aDc)和节点效率(aNe)显著降低(错误发现率校正后P<0.05),全局效率(aEg)也降低。Pearson相关分析表明,HAMD-24评分与半球间功能连接强度、DLPFC-L与FPA-L之间的功能连接、aEg、FPA-L区域的aDc、DLPFC-L和FPA-L区域的aNe呈中度负相关。总之,PD-D患者脑网络的整合性和效率降低。此外,DLPFC-L与FPA-L区域之间的RSFC与抑郁症状呈负相关。这些发现提示,针对DLPFC-L和FPA-L区域进行无创脑刺激可能是缓解老年PD患者抑郁症状的一种潜在干预措施。
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