Abstract
Lesions of the cerebellum lead to motor and non-motor deficits by influencing cerebral cortex activity via cerebello-cortical circuits. It remains unknown whether the cerebello-cortical “disconnection” underlies motor and non-motor impairments both in the parkinsonian variant of multiple system atrophy (MSA-P) and Parkinson’s disease (PD). In this study, we investigated both the functional and effective connectivity of the cerebello-cortical circuits from resting-state functional magnetic resonance imaging (rs-fMRI) data of three groups (26 MSA-P patients, 31 PD patients, and 30 controls). Correlation analysis was performed between the causal connectivity and clinical scores. PD patients showed a weakened cerebellar dentate nucleus (DN) functional coupling in the posterior cingulate cortex (PCC) and inferior parietal lobe compared with MSA-P or controls. MSA-P patients exhibited significantly enhanced effective connectivity from the DN to PCC compared with PD patients or controls, as well as declined causal connectivity from the left precentral gyrus to right DN compared with the controls, and this value is significantly correlated with the motor symptom scores. Our findings demonstrated a crucial role for the cerebello-cortical networks in both MSA-P and PD patients in addition to striatal-thalamo-cortical (STC) networks and indicated that different patterns of cerebello-cortical loop degeneration are involved in the development of the diseases.
Highlights
The parkinsonian variant of multiple system atrophy (MSA-P) is a neurodegenerative disorder that is clinically difficult to differentiate from idiopathic Parkinson’s disease (PD), especially in the early stages of the diseases (Wenning et al, 2000; Kim et al, 2016)
MSA-P patients were evaluated by the Unified Multiple System Atrophy Rating Scale (UMSARS), which was conducive to classification
There were no significant differences in age, gender, education level, Mini-Mental State Examination (MMSE), and Montreal Cognitive Assessment (MoCA) scores among the three groups
Summary
The parkinsonian variant of multiple system atrophy (MSA-P) is a neurodegenerative disorder that is clinically difficult to differentiate from idiopathic Parkinson’s disease (PD), especially in the early stages of the diseases (Wenning et al, 2000; Kim et al, 2016). Inchoate differentiation between MSA-P and PD has significant therapeutic and rehabilitative implications. Altered Connectivity of Cerebello-Cortical Circuits (Dickson, 2012). Functional brain imaging had been proved to be of some value for the differential diagnosis of parkinsonism. Liu et al (2013) described that the dopamine deficits in striatal subregions impair the function of striatal-thalamo-cortical (STC) networks involved in motor, cognitive and emotional processing (Braak and Braak, 2000) For instance, disclosed decreased striatal presynaptic uptake, binding, glucose metabolism, and post-synaptic binding in both MSA-P and PD (Ghaemi et al, 2002; Bohnen et al, 2006), especially the reduced post-synaptic binding in MSA-P. Liu et al (2013) described that the dopamine deficits in striatal subregions impair the function of striatal-thalamo-cortical (STC) networks involved in motor, cognitive and emotional processing (Braak and Braak, 2000)
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