Abstract
Objective The aim of this work was to investigate whether there are differences in the executive control network (ECN) between patients with Parkinson's disease (PD) before and after deep brain stimulation (DBS) surgery and to explore how deep brain stimulation (DBS) surgery affects ECN connectivity in patients with PD. Methods Resting-state magnetic resonance imaging (MRI) data were obtained from 23 patients with Parkinson's disease preoperatively (pre-PD) and postoperatively (post-PD) and 14 normal controls (CN). The right dorsolateral prefrontal cortex (DLPFC) was used as the seed region of interest (ROI) to study the characteristics of the functional connectivity of the ECN in these subjects. Results There were differences in the ECN among PD patients before and after surgery and between the CN. Compared with the CN group, the pre-PD patients showed significantly reduced functional connectivity (FC) between the DLPFC and the left inferior frontal gyrus, left precuneus, left cerebellum posterior lobe, right middle frontal gyrus, right inferior parietal gyrus, right posterior central gyrus, right precuneus, and right inferior frontal gyrus. Compared to the CN group, the post-PD patients showed significantly reduced FC between the DLPFC and left inferior frontal gyrus, left precuneus, left cerebellum posterior lobe, right middle frontal gyrus, right inferior frontal gyrus, and right parietal lobule. There is no difference in the ECN between the pre-PD patients and the post-PD patients. Conclusions The FC of ECN in PD patients was different from that in normal controls, but the FC of the ECN in patients with PD may not be altered by DBS. This suggests that the ECN may be considered an imaging biomarker for the identification of PD but may not be a good imaging biomarker for the evaluation of DBS efficacy.
Highlights
Parkinson’s disease (PD) is a common neurodegenerative disease in middle and older age adults, second in incidence to Alzheimer’s disease [1]. e incidence of the disease increases with age, typically developing between the age of 55 and 65 [2, 3]
PD presents with both motor symptoms and nonmotor symptoms, of which motor symptoms mainly manifest as quiescent tremors, slow movements, myotonia, and postural balance disorders, while nonmotor symptoms mainly manifest as cognitive impairment, emotional disorders, sleep disorders, and autonomic nervous dysfunction
executive function (EF) impairment has been found in newly diagnosed PD patients and negatively impacts their ability to participate in the activities of daily living and their quality of life [9,10,11]
Summary
Parkinson’s disease (PD) is a common neurodegenerative disease in middle and older age adults, second in incidence to Alzheimer’s disease [1]. e incidence of the disease increases with age, typically developing between the age of 55 and 65 [2, 3]. Patients with PDrelated executive dysfunction may have difficulty in controlling and regulating their behavior or performing tasks that require attention and complex thinking. Postoperative symptoms can be controlled by adjusting the stimulation parameters Jahanshahi and his team found that DBS of patients’ subthalamic nuclei (STN-DBS) effectively improved the motor function and the EF of PD [13]. E ECN is often used to study the functional mechanism of EF changes in patients [17, 18], and several research teams have found a close correlation between EF changes and the executive control network [18,19,20,21,22]. To study whether the ECN of PD patients is different from that of normal people and whether DBS changes the functional connectivity (FC) of PD patients’ ECN, we selected the seed-based FC on resting-state fMRI to investigate differences in functional connectivity of the brain networks between pre-PD, post-PD, and CN patients and further analyze how DBS improved the symptoms of PD patients from the perspective of brain functional network connectivity
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