METHODS: 108 PD patients with continuum of cognitive decline (PD-NC = 46, PD-MCI = 43, PDD = 19) and 34 healthy controls (HCs) underwent resting-state functional MRI and neuropsychological tests. Independent component analysis (ICA) and graph theory analyses (GTA) were employed to explore RSN connection changes. Additionally, stage-dependent differential impact of network communication on cognitive performance were examined using sparse varying coefficient modeling.
RESULTS: Compared to HCs, the dorsal attention network (DAN) and dorsal sensorimotor network (dSMN) were central networks with decreased connections in PD-NC and PD-MCI stage, while the lateral visual network (LVN) emerged as a central network in patients with dementia. Additionally, connectivity of the cerebellum network (CBN) increased in the PD-NC and PD-MCI stages. GTA demonstrated decreased nodal metrics for DAN and dSMN, coupled with an increase for CBN. Moreover, the degree centrality (DC) values of DAN and dSMN exhibited a stage-dependent differential impact on cognitive performance across the continuum of cognitive decline.
CONCLUSIONS: Our findings suggest that across the progression of cognitive impairment, the LVN gradually transitions into a core node with reduced connectivity, while the enhancement of connections in CBN diminishes. Furthermore, the non-linear relationship between the DC values of RSNs and cognitive decline indicates the potential for tailored interventions targeting specific stages.
方法:108名持续认知功能下降的PD患者(PD-NC=46,PD-MCI=43,PDD=19)和34名健康对照(HC)接受了静息状态功能MRI和神经心理学测试。采用独立成分分析(ICA)和图论分析(GTA)来探索RSN连接变化。此外,使用稀疏变系数模型研究了网络通信对认知表现的阶段依赖差异影响。
结果:与HC相比,背侧注意网络(DAN)和背侧感觉运动网络(dSMN)是PD-NC和PD-MCI阶段连接减少的中心网络,而侧视视觉网络(LVN)则成为痴呆患者的中心网络。此外,小脑网络(CBN)的连通性在PD-NC和PD-MCI阶段增加。GTA显示DAN和dSMN的节点指标下降,加上CBN的增加。此外,DAN和dSMN的度中心性(DC)值在认知衰退的连续性中对认知表现表现出阶段依赖性的差异影响.
结论:我们的研究结果表明,随着认知障碍的进展,LVN逐渐过渡到连通性降低的核心节点,而CBN中连接的增强减弱。此外,RSN的DC值与认知下降之间的非线性关系表明针对特定阶段的量身定制干预措施的潜力。