Abstract
BackgroundDepression induces an early onset of Parkinson’s disease (PD), aggravates dyskinesia and cognitive impairment, and accelerates disease progression. However, it is very difficult to identify and diagnose PD with depression (PDD) in the early clinical stage. Few studies have suggested that the changes in neural networks are associated with PDD, while degree centrality (DC) has been documented to be effective in detecting brain network changes.ObjectivesThe objectives of this study are to explore DC changes between patients with PDD and without depression (PDND) and to find the key brain hubs involved with depression in PD patients.MethodsOne hundred and four PD patients and 54 healthy controls (HCs) underwent brain resting-state functional magnetic resonance imaging. The Data Processing and Analysis of Brain Imaging and Resting-State Functional Magnetic Resonance Data Analysis Toolkit were used for processing and statistical analysis. The DC value of each frequency band was calculated. One-way analysis of variance and a two-sample t-test for post hoc comparison were used to compare the differences of the DC values in different frequency bands among PDD, PDND, and healthy control group. Gaussian random field was used for multiple comparison correction. Pearson correlation analysis was performed between each individual’s DC map and clinical indicators.ResultsThe DC value of different brain regions changed in PDD and PDND in different frequency bands. The prefrontal lobe, limbic system, and basal ganglia were the main brain regions involved. PDD patients showed a wider range and more abnormal brain areas in the slow-4 frequency band (0.027–0.073 Hz) compared to the HCs. PDD showed a decreased DC value in the medial frontal gyrus, bilateral cuneus gyrus, right lingual gyrus, bilateral supplementary motor area (SMA), bilateral superior frontal gyrus, and left paracentral lobule, but an increased DC value in the bilateral brainstem, midbrain, bilateral parahippocampal gyrus, cerebellum, left superior temporal gyrus, bilateral insula, left fusiform gyrus, and left caudate nucleus in the traditional frequency band (0.01–0.08 Hz) compared to PDND patients. PDND patients displayed more abnormal functions in the basal ganglia in the slow-4 frequency band.ConclusionThe DC changes in PDD and PDND are frequency dependent and frequency specific. The medial frontal gyrus, SMA, and limbic system may be the key hubs for depression in PD.
Highlights
Parkinson’s disease (PD) is one of the most common neurodegenerative diseases, and its incidence is only second to Alzheimer’s disease (Aaseth et al, 2018)
There were no significant differences between PDD and PDND patients in the course of disease, Hoehn & Yahr (H&Y) classification, and UPDRSIII scores
This study demonstrated that PDD patients exhibited an abnormal degree centrality (DC) value in multiple frequency bands in the prefrontal lobe, limbic system, and basal ganglia; the abnormalities were wider in the slow-4 frequency band, suggesting that slow4 band is more suitable for detecting DC abnormalities in the limbic system
Summary
Parkinson’s disease (PD) is one of the most common neurodegenerative diseases, and its incidence is only second to Alzheimer’s disease (Aaseth et al, 2018). A study by Lee and Gilbert (2016) estimated that the number of PD in China will exceed 5 million in 2020, and over half of all PD patients in the world will be Chinese by 2030. It will be a serious adversity on the health of the elderly and a heavy burden to families and society (Sagna et al, 2014). Parkinson’s disease with depression (PDD) is identified and diagnosed with behavioral observations and neuropsychological measurements, but it is very difficult to obtain an accurate diagnosis in the early clinical stage. Few studies have suggested that the changes in neural networks are associated with PDD, while degree centrality (DC) has been documented to be effective in detecting brain network changes
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