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Abstract
Objective To investigate in a cross-sectional study the contributions of altered cerebellar resting-state functional connectivity (FC) to cognitive impairment in Parkinson disease (PD).
Methods We conducted morphometric and resting-state FC-MRI analyses contrasting 81 participants with PD and 43 age-matched healthy controls using rigorous quality assurance measures. To investigate the relationship of cerebellar FC to cognitive status, we compared participants with PD without cognitive impairment (Clinical Dementia Rating [CDR] scale score 0, n = 47) to participants with PD with impaired cognition (CDR score ≥0.5, n = 34). Comprehensive measures of cognition across the 5 cognitive domains were assessed for behavioral correlations.
Results The participants with PD had significantly weaker FC between the vermis and peristriate visual association cortex compared to controls, and the strength of this FC correlated with visuospatial function and global cognition. In contrast, weaker FC between the vermis and dorsolateral prefrontal cortex was found in the cognitively impaired PD group compared to participants with PD without cognitive impairment. This effect correlated with deficits in attention, executive functions, and global cognition. No group differences in cerebellar lobular volumes or regional cortical thickness of the significant cortical clusters were observed.
Conclusion These results demonstrate a correlation between cerebellar vermal FC and cognitive impairment in PD. The absence of significant atrophy in cerebellum or relevant cortical areas suggests that this could be related to local pathophysiology such as neurotransmitter dysfunction.
GLOSSARY
- ANCOVA=
- analysis of covariance;
- BA=
- Brodmann area;
- CDR=
- Clinical Dementia Rating;
- DLPFC=
- dorsolateral prefrontal cortex;
- FC=
- resting-state functional connectivity;
- MCI=
- mild cognitive impairment;
- MDS=
- Movement Disorder Society;
- MMSE=
- Mini-Mental State Examination;
- PD=
- Parkinson disease;
- PD-cog=
- PD with cognitive impairment;
- PD-nl=
- PD without cognitive impairment;
- PIGD=
- postural instability and gait difficulty;
- QA=
- quality assurance;
- RMS=
- root-mean-squared;
- SMC=
- sensorimotor cortex;
- UPDRS-III=
- Unified Parkinson’s Disease Rating Scale motor subscale
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
- Received February 27, 2019.
- Accepted in final form July 19, 2019.
- © 2019 American Academy of Neurology
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