Abstract

Impulsivity is a neuropsychiatric feature of Parkinson’s disease (PD). We investigated the pathophysiology of impulsivity in PD using resting-state functional magnetic resonance imaging (rs-fMRI). We investigated 45 patients with idiopathic PD and 21 healthy controls. Based on Barratt Impulsiveness Scale (BIS-11) score, PD patients were classified as higher (PD-HI) or lower impulsivity (PD-LI). Functional connectivity (FC) between various large-scale brain networks were analysed using the CONN toolbox. FC between the right frontoparietal network (FPN) and medial visual network (MVN) was significantly higher in PD-HI patients than PD-LI patients (false discovery rate [FDR]-adjusted p = 0.0315). FC between the right FPN and MVN had a significant positive correlation with total BIS-11 score (FDR-adjusted p = 0.010) and the attentional impulsivity (FDR-adjusted p = 0.046) and non-planning impulsivity subscale scores (FDR-adjusted p = 0.018). On the other hand, motor impulsivity subscale score had a significant negative correlation with the FC between the default-mode and salience networks (right supramarginal gyrus, FDR-adjusted p = 0.018; anterior cingulate cortex, FDR-adjusted p = 0.027); this trend was observed in healthy controls. The attentional and non-planning impulsivity, regarded as ‘cognitive’ impulsivity, may be associated with dysfunction in integration of perceptual information and flexible cognitive control in PD.

Highlights

  • Impulsivity is a neuropsychiatric feature of Parkinson’s disease (PD)

  • To test our hypothesis that the impulsivity in PD is related to alterations in large-scale networks such as the default-mode network (DMN), salience network (SN) and frontoparietal network (FPN), we examined Functional connectivity (FC) changes in various large-scale networks between PD patients grouped according to impulsivity using fully automated whole-brain FC analysis

  • There were no significant differences between the PD patients and healthy controls (HCs) with respect to age, gender and education

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Summary

Introduction

Impulsivity is a neuropsychiatric feature of Parkinson’s disease (PD). We investigated the pathophysiology of impulsivity in PD using resting-state functional magnetic resonance imaging (rs-fMRI). FC between the right FPN and MVN had a significant positive correlation with total BIS-11 score (FDR-adjusted p = 0.010) and the attentional impulsivity (FDR-adjusted p = 0.046) and non-planning impulsivity subscale scores (FDR-adjusted p = 0.018). The attentional and non-planning impulsivity, regarded as ‘cognitive’ impulsivity, may be associated with dysfunction in integration of perceptual information and flexible cognitive control in PD. Patients with PD suffer from various non-motor symptoms, among which impulse control disorders (ICDs) are a common neuropsychiatric symptom. To assess the multifaceted constructs of impulsivity, various methods have been developed, including Barratt Impulsiveness Scale 11th version (BIS-11), Stop Signal Reaction Time (SSRT), 5-choice serial reaction time task, Hayling test, go/no-go task and Iowa gambling task. It has been pointed out that the HI of PD is caused by different pathophysiologies of motor impulsivity and cognitive i­mpulsivity[24], but few studies have investigated them individually

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