Differential functional connectivity of insular subdivisions in de novo Parkinson’s disease with mild cognitive impairment

Chenxi Pan,Jianxia Xu,Yuqian Li,Guanjie Hu,Chen Xue,Li Zhang,Yong Chen,Lanting Li,Yu Sun,Jingru Ren,Wenbing Zhang,Weiguo Liu,Miao Yu,Jiu Chen,Xiao Hu

doi:10.1007/s11682-021-00471-2

Abstract

The insula, consisting of functionally diverse subdivisions, plays a significant role in Parkinson's disease (PD)-related cognitive disorders. However, the functional connectivity (FC) patterns of insular subdivisions in PD remain unclear. Our aim is to investigate the changes in FC patterns of insular subdivisions and their relationships with cognitive domains. Three groups of participants were recruited in this study, including PD patients with mild cognitive impairment (PD-MCI, n = 25), PD patients with normal cognition (PD-NC, n = 13), and healthy controls (HCs, n = 17). Resting-state functional magnetic resonance imaging (rs-fMRI) was used to investigate the FC in insular subdivisions of the three groups. Moreover, all participants underwent a neuropsychological battery to assess cognition so that the relationship between altered FC and cognitive performance could be elucidated. Compared with the PD-NC group, the PD-MCI group exhibited increased FC between the left dorsal anterior insular (dAI) and the right superior parietal gyrus (SPG), and altered FC was negatively correlated with memory and executive function. Compared with the HC group, the PD-MCI group showed significantly increased FC between the right dAI and the right median cingulate and paracingulate gyri (DCG), and altered FC was positively related to attention/working memory, visuospatial function, and language. Our findings highlighted the different abnormal FC patterns of insular subdivisions in PD patients with different cognitive abilities. Furthermore, dysfunction of the dAI may partly contribute to the decline in executive function and memory in early drug-naïve PD patients.

Highlights

Parkinson’s disease (PD) has been defined on the basis of specific motor features (Postuma et al, 2015)
There were no significant differences in sex, years of education, disease duration, Hoehn and Yahr (H-Y) stage, UPDRSIII, NMSQ, Hamilton Anxiety Scale (HAMA), Hamilton Depression Rating Scale (HAMD), and MMSE score between the PD-mild cognitive impairment (MCI) and PD with normal cognition (PD-NC) groups
We found that abnormal functional connectivity (FC) of bilateral dorsal anterior insular (dAI) was related to cognition, proving the dorsal anterior insula is more involved in human cognition than the ventral anterior and posterior networks (Chang, Yarkoni, Khaw, & Sanfey, 2013; Kurth et al, 2010; Touroutoglou et al, 2012)

Summary

Introduction

Parkinson’s disease (PD) has been defined on the basis of specific motor features (Postuma et al, 2015). Nonmotor symptoms, such as cognitive dysfunction, autonomic dysfunction, and sleep disorders, contribute to the entire course of PD and even appear to precede motor symptoms (Schapira, Chaudhuri, & Jenner, 2017). With the progression of PD, nonmotor symptoms, such as cognitive impairment, are the main determinants of quality of life (Schapira et al, 2017; Svenningsson, Westman, Ballard, & Aarsland, 2012). PD-MCI is a stage of clinical cognitive impairment between PD with normal cognition (PD-NC) and PD dementia (PDD) (Caviness et al, 2007). Early diagnosis and progression tracking of PD-MCI and its biological markers would be crucial for clinicians identify the patient’s status and make corresponding decisions

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