Li Hongwei, Shao Xiali, Jia Jia, Wang Bingyi, Wang Jian, Liu Kai, Chen Jinhan, Chen Zhensen, Jin Lirong, Wang He
Institute of Science and Technology for Brain-inspired Intelligence, Fudan University, Shanghai, China.
Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.
Neuroimage Clin. 2025 Jul 3;48:103836. doi: 10.1016/j.nicl.2025.103836.
Vascular risk factors are increasingly implicated in Parkinson's disease (PD), but the role of altered cerebrovascular dysfunction in early-stage PD remains unclear. Here, we investigated resting-state cerebrovascular reactivity (RS-CVR), cerebral blood flow (CBF), arterial morphological changes, and corresponding alterations in functional connectivity density (FCD) in de novo PD patients with different cognitive status.
25 de novo PD patients with mild cognitive impairment (PD-MCI), 34 with normal cognition (PD-NC), and 48 healthy controls (HCs) underwent neuropsychological assessments and multimodal MRI. CBF derived from arterial spin labeling, RS-CVR and FCD generated from resting-state functional MRI and the arterial morphology extracted from the magnitude images of multi-echo gradient echo.
RS-CVR significantly decreased in PD patients, particularly in the left occipital gyrus and posterior cerebral artery (PCA) territories. Long-range FCD was reduced in the left inferior occipital gyrus in both PD-NC and PD-MCI compared to HCs (p = 0.005, p < 0.001). In PD-MCI, negative correlations between Stroop Color-Word Test time and RS-CVR in the distal right PCA (r = -0.71, pFDR = 0.030) and middle left PCA (r = -0.66, pFDR = 0.044) were observed. A significant correlation was found between decreased long-range FCD in the left inferior occipital gyrus and poorer Trail Making Test Part B performance (r = -0.63, pFDR = 0.029) in the PD-MCI. No significant differences in CBF, but significant dilation of the left PCA and compensatory CBF increases in the corresponding territory in PD-MCI were found (r = 0.57, pFDR = 0.023).
Microvascular dysfunction, rather than perfusion defects, might underlie early-stage of the de novo PD, especially in the patients with PD-MCI.
血管危险因素与帕金森病（PD）的关联日益密切，但脑血管功能障碍改变在早期PD中的作用仍不明确。在此，我们研究了不同认知状态的初发PD患者的静息态脑血管反应性（RS-CVR）、脑血流量（CBF）、动脉形态变化以及功能连接密度（FCD）的相应改变。
25例轻度认知障碍的初发PD患者（PD-MCI）、34例认知正常的患者（PD-NC）和48例健康对照者（HCs）接受了神经心理学评估和多模态磁共振成像。通过动脉自旋标记获得CBF，从静息态功能磁共振成像生成RS-CVR和FCD，并从多回波梯度回波的幅度图像中提取动脉形态。
PD患者的RS-CVR显著降低，尤其是在左侧枕叶和大脑后动脉（PCA）区域。与HCs相比，PD-NC和PD-MCI患者左侧枕下回的长程FCD均降低（p = 0.005，p < 0.001）。在PD-MCI患者中，观察到右侧PCA远端（r = -0.71，pFDR = 0.030）和左侧PCA中部（r = -0.66，pFDR = 0.044）的Stroop色词测验时间与RS-CVR之间存在负相关。在PD-MCI患者中，左侧枕下回长程FCD降低与较差的连线测验B表现之间存在显著相关性（r = -0.63，pFDR = 0.029）。CBF无显著差异，但在PD-MCI患者中发现左侧PCA显著扩张，且相应区域的CBF出现代偿性增加（r = 0.57，pFDR = 0.023）。
微血管功能障碍而非灌注缺陷可能是初发PD早期的基础，尤其是在PD-MCI患者中。
