Wang Jin, Shu Zhilin, Wang Yue, Lu Jiewei, Zhang Xinyuan, Cheng Yuanyuan, Yu Yang, Han Jianda, Zhu Zhizhong, Yu Ningbo, Wu Jialing
Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin, China.
Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China.
Front Neurol. 2025 Feb 19;16:1434733. doi: 10.3389/fneur.2025.1434733. eCollection 2025.
Cognitive decline is common in Parkinson's disease (PD). Reliance on neuropsychological testing alone can lead to delayed identification, and an objective and comprehensive approach is needed in clinical practice. We assessed brain functional connectivity during PD-MCI (mild cognitive impairment) and PD-NC (normal cognition) patients, and healthy controls (HC) completing the Stroop color-word test (SCWT) using functional near-infrared spectroscopy (fNIRS), and explored the predictive value of combining relevant brain function and behavioral information for general cognitive decline in PD.
Nineteen patients with PD-MCI, 21 with PD-NC and 33 age-matched HC were recruited. Group differences in executive performance and prefrontal functional connectivity were analyzed. Receiver operating characteristic analysis was used to measure the value of combining brain functional connectivity with executive and motor function in predicting PD-MCI.
During the color-word incongruent test, PD-MCI patients had significantly lower correct rate than HC and PD-NC patients. Meanwhile, PD-MCI patients exhibited significantly increased regional strength of the left and right prefrontal cortex (RS, RS), and global efficiency than HC, and compared with PD-NC, PD-MCI patients showed significantly higher RS. For PD patients, MMSE score and correct rate during the color-word incongruent test were negatively associated with the RS after adjusting for education level and age. After combined the RS, correct rate and MDS-UPDRS III score, diagnostic sensitivity and specificity of PD-MCI reached 0.737 and 0.810, respectively, with an area under the curve of 0.830.
We proposed a signature combining brain functional connectivity with executive and motor function for general cognitive decline in PD, which could provide new insights into early detection and intervention of this problem.
认知功能衰退在帕金森病(PD)中很常见。仅依靠神经心理学测试可能会导致诊断延迟,临床实践中需要一种客观且全面的方法。我们使用功能近红外光谱技术(fNIRS)评估了帕金森病轻度认知障碍(PD-MCI)患者、帕金森病认知正常(PD-NC)患者以及健康对照(HC)在完成Stroop色词测验(SCWT)时的脑功能连接,并探讨了将相关脑功能和行为信息相结合对帕金森病总体认知衰退的预测价值。
招募了19例PD-MCI患者、21例PD-NC患者和33例年龄匹配的HC。分析了执行功能和前额叶功能连接的组间差异。采用受试者工作特征分析来衡量脑功能连接与执行功能和运动功能相结合在预测PD-MCI中的价值。
在色词不一致测试中,PD-MCI患者的正确率显著低于HC和PD-NC患者。同时,与HC相比,PD-MCI患者左右前额叶皮质的区域强度(RS)和全局效率显著增加,并且与PD-NC相比,PD-MCI患者的RS显著更高。对于帕金森病患者,在调整教育水平和年龄后,简易精神状态检查表(MMSE)评分和色词不一致测试中的正确率与RS呈负相关。结合RS、正确率和帕金森病统一评分量表第三部分(MDS-UPDRS III)评分后,PD-MCI的诊断敏感性和特异性分别达到0.737和0.810,曲线下面积为0.830。
我们提出了一种将脑功能连接与执行功能和运动功能相结合的特征,用于帕金森病总体认知衰退的评估,这可为该问题的早期检测和干预提供新的见解。