帕金森病大脑网络中的功能重新映射:具有临床相关性的临床前神经影像学视角。
Functional remapping in networks of the Parkinsonian brain: A preclinical neuroimaging perspective with clinical correlates.
作者信息
Wang Zhuo, Jakowec Michael W, Petzinger Giselle M, Holschneider Daniel P
机构信息
Department of Psychiatry and Behavioral Sciences, University of Southern California, 1975 Zonal Avenue, KAM 400, MC9037, Los Angeles, CA 90089-9037, United States of America.
Graduate Program in Neurosciences, University of Southern California, Los Angeles, California, United States of America.
出版信息
Transl Neurosci. 2025 Jun 14;16(1):20250374. doi: 10.1515/tnsci-2025-0374. eCollection 2025 Jan 1.
Parkinson's disease (PD) is increasingly understood as a neurodegenerative condition whose pathology extends beyond the direct and indirect basal ganglia pathways. Clinically, patients are all too painfully aware of dysfunction not only of motor circuits but also of somatosensory, autonomic, cognitive, and emotional systems. Functional neuroimaging studies have begun to document a functional reorganization in the PD brain across a wide number of networks. In particular, the cerebellar-thalamocortical, as well as the fronto-striatal circuit, have been shown to undergo functional reorganization. In this narrative review, citing preclinical as well as clinical neuroimaging studies, our objective is to highlight trends and discuss the relevance of cerebral adaptive changes. It remains clear that not all changes contribute to the normalization of functions. Parsing differences between functional "compensation," "silencing," or "maladaptation" in neural circuits is important. A necessary next step in neurorehabilitation is the question of whether compensatory cerebral changes can be enhanced. In this regard, physical exercise remains of interest, given that in patients, exercise may allow some degree of symptom improvement and possibly slow the course of the disease. Future interventions may wish to integrate neuroimaging findings as potential targets to support neuroplastic changes.
帕金森病(PD)越来越被认为是一种神经退行性疾病,其病理学不仅局限于直接和间接的基底神经节通路。临床上,患者痛苦地意识到不仅运动回路功能失调,而且体感、自主神经、认知和情感系统也存在功能障碍。功能神经影像学研究已开始记录帕金森病大脑中多个网络的功能重组。特别是,小脑 - 丘脑 - 皮质以及额叶 - 纹状体回路已被证明发生了功能重组。在这篇叙述性综述中,引用临床前和临床神经影像学研究,我们的目的是突出趋势并讨论大脑适应性变化的相关性。很明显,并非所有变化都有助于功能正常化。区分神经回路中功能性“补偿”“沉默”或“适应不良”之间的差异很重要。神经康复的下一个必要步骤是能否增强代偿性大脑变化的问题。在这方面,体育锻炼仍然值得关注,因为在患者中,锻炼可能会使症状得到一定程度的改善,并可能减缓疾病进程。未来的干预措施可能希望将神经影像学研究结果作为潜在靶点,以支持神经可塑性变化。