4.5 Article

Distinct neural circuits are associated with subclinical neuropsychiatric symptoms in Parkinson's disease

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ELSEVIER
DOI: 10.1016/j.jns.2021.117365

关键词

Magnetic resonance imaging; Resting-state; Functional connectivity; Parkinson?s disease; Nonmotor symptoms

资金

  1. National Center for Advancing Translational Science, a component of the National Institutes of Health [UL1TR001863, KL2TR001862]
  2. National Institute of Neurological Disorders and Stroke [K23NS099478]

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This study found that subclinical neuropsychiatric symptoms in Parkinson's disease patients are associated with abnormal functional connectivity of distinct neural circuits, even at an early stage of the disease. Understanding these neural correlates may help in early interventions to prevent the onset of clinical symptoms.
Background: Parkinson?s disease (PD) can present with neuropsychiatric symptoms (here, anxiety, depression, and apathy) at any stage of the disease. We investigated the neural correlates of subclinical neuropsychiatric symptoms in relation to motor and cognitive symptoms in a high-functioning PD cohort. Methods: Brain morphometry of the cognitively intact, early-stage (Hoehn & Yahr 2) PD group (n = 48) was compared to matched controls (n = 37). Whole-brain, pairwise, resting-state functional connectivity measures were correlated with neuropsychiatric symptom, motor exam, and global cognitive scores of the PD group. Results: Factor analysis of highly collinear anxiety, depression, and apathy scores revealed a single principal component (i.e., composite neuropsychiatric symptom score) explaining 71.6% of variance. There was no collinearity between the neuropsychiatric, motor, and cognitive scores. Compared to controls, PD group showed only subcortical changes including amygdala and nucleus accumbens atrophy, and greater pallidal volume. Reduced functional connectivity in the limbic cortical-striatal circuits and increased functional connectivity between the cerebellum and occipito-temporal regions were associated with a more impaired neuropsychiatric profile. This functional connectivity pattern was distinct from those associated with motor deficits and global cognitive functioning. The individual components of the neuropsychiatric symptoms also exhibited unique connectivity patterns. Limitations: Patients were scanned in ?on-medication? state only and a control group with similar neuropsychiatric symptoms was not included. Conclusion: Abnormal functional connectivity of distinct neural circuits is present even at the subclinical stage of neuropsychiatric symptoms in PD. Neuropsychiatric phenotyping is important and may facilitate early interventions to ?reorganize? these circuits and delay/prevent clinical symptom onset.

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