Xing Fengbo, Feng Jingjing, Lv Lingling, Liu Jiaqiu, Chen Xin, Sun Jinmei, Hu Panpan, Wang Kai
Department of Neurology, The First Affiliated Hospital of Anhui Medical University Hefei 230000, Anhui, China.
Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders Hefei 230032, Anhui, China.
Am J Transl Res. 2024 Jun 15;16(6):2423-2434. doi: 10.62347/GTVB7800. eCollection 2024.
Tremor-dominant (TD) and postural instability/gait difficulty (PIGD) are common subtypes of Parkinson's disease, each with distinct clinical manifestations and prognoses. The neural mechanisms underlying these subtypes remain unclear. This study aimed to investigate the altered connectivity of the frontal cortex and supplementary motor area (SMA) in different types of Parkinson's disease.
Data of 173 participants, including 41 TD patients, 65 PIGD patients, and 67 healthy controls, were retrospectively analyzed. All subjects underwent resting-state functional magnetic resonance imaging (rs-fMRI) and clinical assessments. Differences in amplitude of low frequency fluctuation (ALFF), voxel-wise functional connectivity (FC), and functional network connectivity (FNC) among the three groups were compared, followed by partial correlation analysis.
Compared to healthy controls, the left dorsolateral superior frontal gyrus (DLSFG) ALFF was significantly increased in both PIGD and TD patients. The FC between the left DLSFG and the left SMA, as well as between the left paracentral lobule and the right DLSFG, was significantly decreased. Similarly, the FNC between the visual network and the auditory network was reduced. Compared to TD patients, PIGD patients showed a significantly higher ALFF in the left DLSFG and a notably reduced FC between the left DLSFG and left SMA. Additionally, the FC of the left DLSFG-SMA was inversely correlated with the PIGD score exclusively in PIGD patients. The FNC of the visual-auditory network was inversely associated with the tremor score only in TD patients.
Decreases in the left DLSFG-SMA connectivity may be a key feature of the PIGD subtype, while reduced VN-AUD connectivity may characterize the TD subtype.
震颤为主型（TD）和姿势不稳/步态障碍型（PIGD）是帕金森病的常见亚型，各有独特的临床表现和预后。这些亚型背后的神经机制仍不清楚。本研究旨在调查不同类型帕金森病中额叶皮质和辅助运动区（SMA）的连接性改变。
回顾性分析了173名参与者的数据，包括41名TD患者、65名PIGD患者和67名健康对照者。所有受试者均接受静息态功能磁共振成像（rs-fMRI）和临床评估。比较了三组之间低频振幅波动（ALFF）、体素功能连接（FC）和功能网络连接（FNC）的差异，随后进行偏相关分析。
与健康对照者相比，PIGD和TD患者的左侧背外侧额上回（DLSFG）的ALFF均显著增加。左侧DLSFG与左侧SMA之间以及左侧中央旁小叶与右侧DLSFG之间的FC显著降低。同样，视觉网络与听觉网络之间的FNC也降低。与TD患者相比，PIGD患者左侧DLSFG的ALFF显著更高，左侧DLSFG与左侧SMA之间的FC显著降低。此外，仅在PIGD患者中，左侧DLSFG-SMA的FC与PIGD评分呈负相关。仅在TD患者中，视觉-听觉网络的FNC与震颤评分呈负相关。
左侧DLSFG-SMA连接性降低可能是PIGD亚型的关键特征，而视觉-听觉网络连接性降低可能是TD亚型的特征。
