背景:冷漠是帕金森病(PD)的常见神经精神表现,但是神经网络机制仍然难以捉摸。我们旨在研究患有冷漠的PD中脑结构网络的拓扑改变。
方法:在本研究中,总共有47名麻痹性PD(aPD)患者,37例非交感神经性PD(naPD)患者,和40名健康对照(HCs)入组。扩散张量成像(DTI)与图论方法相结合,用于探索由PD中的冷漠引起的WM结构网络拓扑特性的变化。进行了协方差的单向分析和事后分析,以探索三组之间的差异。确定相关性以检查Starkstein冷漠量表(AS)得分与三组之间显着不同的网络指标之间的关系。
结果:aPD和naPD患者均保持小世界拓扑结构。然而,与NAPD患者相比,APD患者在全球范围内表现出增加的聚集系数(Cp),在区域一级,APD表现出节点属性下降,主要在右背外侧前额叶皮质(DLPFC),右尾状核(CAU),右边的海马,和右顶叶上回.Further,合并的PD患者中,AS评分与右侧DLPFC(r=-0.254,p=0.020)和右侧CAU(r=-0.357,p=0.001)的程度中心性呈负相关。
结论:研究结果表明,PD中的冷漠表现出相对优化的大脑结构网络的全局拓扑特性,并破坏了区域网络的拓扑组织,特别涉及额纹状体边缘回路。异常脑区拓扑特性的改变可用于了解aPD患者神经网络的病理生理学机制。
BACKGROUND: Apathy is a common neuropsychiatric manifestations in Parkinson\'s disease (PD), but neural network mechanisms still remain elusive. We aim to investigate the topological alteration of the brain structural network in PD with apathy.
METHODS: In the present study, a total of 47 apathetic PD (aPD) patients, 37 non-apathetic PD (naPD) patients, and 40 healthy controls (HCs) were enrolled. Diffusion tensor imaging (DTI) in conjunction with graph-theoretic approaches were used to explore the alterations of topological properties of the WM structural network arising from apathy in PD. One-way analysis of covariance and post hoc analyses were performed to explore differences among the three groups. Correlations were ascertained to examine relationships between the Starkstein Apathy Scale (AS) scores and significantly different network metrics among the three groups.
RESULTS: Both aPD and naPD patients remained small-world topology. However, compared with the naPD patients, aPD patients showed increased clustering coefficient (Cp) at the global level. At the regional level, aPD exhibited decreased nodal properties, mainly in the right dorsolateral prefrontal cortex (DLPFC), the right caudate nucleus (CAU), the right hippocampus, and the right superior parietal gyrus. Further, AS scores were negatively correlated with degree centrality of the right DLPFC (r = -0.254, p = 0.020) and the right CAU ( r = -0.357, p = 0.001) in the pooled patients with PD.
CONCLUSIONS: The findings suggested that apathy in PD presented relatively optimized global topological properties of the brain structural network and disrupted topological organization of the regional network, particularly involving the fronto-striatal-limbic circuits. The altered topological properties of abnormal brain regions might be used to understand the physiopathologic mechanism of the neural network in aPD patients.