Wang Haiyang, Liang Zhanhua, Yan Zhongrui, Liu Yiming
Medical Integration and Practice Center, Cheeloo College of Medicine, Shandong University, 250012 Jinan, Shandong, China.
Department of Neurology, Jining No. 1 People's Hospital, Shandong First Medical University, 272000 Jining, Shandong, China.
J Integr Neurosci. 2025 May 22;24(5):36989. doi: 10.31083/JIN36989.
Executive function (EF) impairment is a recognized common cognitive deficit in early-onset Parkinson's disease (EOPD), profoundly impacting patient autonomy and quality of life. While EF-related cognitive decline has been extensively studied in late-onset Parkinson's disease (LOPD), research on EOPD remains limited. Addressing this gap, this study uniquely employed functional near-infrared spectroscopy (fNIRS), a technique well-adapted for assessing patients with motor challenges, to explore EF-related neural mechanisms in EOPD patients with mild cognitive impairment.
This study included 30 patients with PD, classified into distinct cognitive profiles based on comprehensive assessments of their cognitive function. To assess functional changes in the prefrontal cortex (PFC) we administered a verbal fluency test to evaluate EF during task performance. In the resting state, we recorded neural activity and analyzed the amplitude of low-frequency fluctuations (ALFF) to assess spontaneous brain activity.
During executive tasks, patients with EF-dominant impairment (EOPD-EL) showed increased activation in the dorsolateral prefrontal cortex (DLPFC) and medial prefrontal cortex (mPFC), indicating disrupted balance between the executive and default mode networks. Resting-state analysis revealed reduced spontaneous activity in the ventrolateral prefrontal cortex (VLPFC), suggesting impaired regulatory efficiency in these regions. These findings support the dual syndrome hypothesis in EOPD, with EF dysfunction as a primary deficit that may lead to secondary cognitive challenges.
This study underscores the central role of PFC dysfunction in EOPD-related EF impairment, identifying abnormalities in the DLPFC, mPFC, and VLPFC as key contributors to cognitive decline. These results lay the groundwork for early detection of EF deficits and inform targeted interventions to mitigate cognitive decline in EOPD.
执行功能（EF）障碍是早发性帕金森病（EOPD）中一种公认的常见认知缺陷，对患者的自主性和生活质量有深远影响。虽然与EF相关的认知衰退在晚发性帕金森病（LOPD）中已得到广泛研究，但对EOPD的研究仍然有限。为填补这一空白，本研究独特地采用了功能近红外光谱（fNIRS）技术，该技术非常适合评估有运动障碍的患者，以探索轻度认知障碍的EOPD患者中与EF相关的神经机制。
本研究纳入了30名帕金森病患者，根据对其认知功能的全面评估将他们分为不同的认知特征组。为了评估前额叶皮质（PFC）的功能变化，我们在任务执行期间进行了语言流畅性测试以评估EF。在静息状态下，我们记录神经活动并分析低频波动幅度（ALFF）以评估自发脑活动。
在执行任务期间，以EF为主导受损的患者（EOPD-EL）在背外侧前额叶皮质（DLPFC）和内侧前额叶皮质（mPFC）表现出激活增加，表明执行网络和默认模式网络之间的平衡被破坏。静息状态分析显示腹外侧前额叶皮质（VLPFC）的自发活动减少，表示这些区域的调节效率受损。这些发现支持EOPD中的双综合征假说，即EF功能障碍是可能导致继发性认知挑战的主要缺陷。
本研究强调了PFC功能障碍在EOPD相关EF损害中的核心作用，确定DLPFC、mPFC和VLPFC中的异常是认知衰退的关键因素。这些结果为早期检测EF缺陷奠定了基础，并为减轻EOPD认知衰退的靶向干预提供了依据。
