Gan Caiting, Zhang Heng, Sun Huimin, Cao Xingyue, Wang Lina, Zhang Kezhong, Yuan Yongsheng
Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Jiangsu Key Laboratory of Neurodegeneration, Nanjing Medical University, Nanjing, China.
Front Aging Neurosci. 2024 Apr 25;16:1364402. doi: 10.3389/fnagi.2024.1364402. eCollection 2024.
Impulse control disorders (ICDs) refer to the common neuropsychiatric complication of Parkinson's disease (PD). The white matter (WM) topological organization and its impact on brain networks remain to be established.
A total of 17 PD patients with ICD (PD-ICD), 17 without ICD (PD-NICD), and 18 healthy controls (HCs) were recruited. Graph theoretic analyses and Granger causality analyses were combined to investigate WM topological organization and the directional connection patterns of key regions.
Compared to PD-NICD, ICD patients showed abnormal global properties, including decreased shortest path length (Lp) and increased global efficiency (Eg). Locally, the ICD group manifested abnormal nodal topological parameters predominantly in the left middle cingulate gyrus (MCG) and left superior cerebellum. Decreased directional connectivity from the left MCG to the right medial superior frontal gyrus was observed in the PD-ICD group. ICD severity was significantly correlated with Lp and Eg.
Our findings reflected that ICD patients had excessively optimized WM topological organization, abnormally strengthened nodal structure connections within the reward network, and aberrant causal connectivity in specific cortical- limbic circuits. We hypothesized that the aberrant reward and motor inhibition circuit could play a crucial role in the emergence of ICDs.
冲动控制障碍（ICD）是帕金森病（PD）常见的神经精神并发症。白质（WM）拓扑组织及其对脑网络的影响尚待确定。
共招募了17例患有ICD的PD患者（PD-ICD）、17例无ICD的PD患者（PD-NICD）和18名健康对照者（HC）。结合图论分析和格兰杰因果分析来研究WM拓扑组织以及关键区域的定向连接模式。
与PD-NICD相比，ICD患者表现出异常的全局属性，包括最短路径长度（Lp）降低和全局效率（Eg）增加。在局部，ICD组主要在左侧扣带回中部（MCG）和左侧小脑上部表现出异常的节点拓扑参数。在PD-ICD组中观察到从左侧MCG到右侧额上回内侧的定向连接减少。ICD严重程度与Lp和Eg显著相关。
我们的研究结果表明，ICD患者的WM拓扑组织过度优化，奖励网络内的节点结构连接异常增强，特定皮质-边缘回路中的因果连接异常。我们推测，异常的奖励和运动抑制回路可能在ICD的发生中起关键作用。
