Different functional connectivity modes of the right fronto-insular cortex in akinetic-rigid and tremor-dominant Parkins
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ORIGINAL ARTICLE
Different functional connectivity modes of the right fronto-insular cortex in akinetic-rigid and tremor-dominant Parkinson’s disease Juan Wang 1 & Yalian Shen 1 & Juan Peng 2 & Anran Wang 2 & Xiaolin Wu 1 & Xiaocui Chen 1 & Jinjin Liu 1 & Min Wei 1 & Dezhi Zou 1 & Yu Han 1 & Oumei Cheng 1 Received: 1 August 2020 / Accepted: 16 November 2020 # Fondazione Società Italiana di Neurologia 2020
Abstract Background Patients with akinetic-rigid Parkinson’s disease (AR-PD) are more prone to cognitive decline and depressive symptoms than tremor-dominant PD (TD-PD) patients. The right fronto-insular cortex (rFIC), as a key node of salience network, plays a critical role in the switching between central executive network and default mode network. In this study, we explored the functional connectivity mode of rFIC with triple-brain networks, namely default mode network, salience network, and central executive network, in two motor subtypes of PD. Methods We recruited 44 PD patients (including the TD-PD group and AR-PD group) and 18 age-matched healthy controls (HCs). We performed functional connectivity (FC) analysis of resting-state functional MRI. Results Compared with TD-PD, decreased FC were found in the right insular cortex and bilateral anterior cingulate gyrus in ARPD. Compared with HCs, decreased FC in the bilateral insula, the anterior cingulate gyrus, the precentral gyrus, and the right medial frontal gyrus were found; therein, the FC value of rFIC-precentral gyrus was positively correlated with the Unified Parkinson’s Disease Rating Scale-II score in AR-PD (p = 0.0482, r = 0.4162). While TD-PD showed decreased FC in the left insula as well as bilateral anterior cingulate gyrus when compared with HCs, and the FC value of the rFIC-left insula was positively correlated with its Hamilton Depression Rating Scale score (p = 0.02, r = 0.50). Conclusion The functional connectivity mode of rFIC in AR-PD differed from that in TD-PD. The decreased rFIC FC with the other nodes of salience network might be a potential indicator for AR-PD patients prone to develop cognitive decline and depressive symptoms. Keywords Akinetic-rigid Parkinson’s disease . Tremor-dominant Parkinson's disease . Right fronto-insular cortex . Salience network . Functional connectivity . Depressive symptom . Cognitive deficit
Introduction Parkinson’s disease (PD) is characterized by motor and nonmotor symptoms. Motor symptoms include bradykinesia, rigidity, resting tremors, and postural instability. Non-motor
Juan Wang, Yalian Shen, and Juan Peng contributed equally to this work. * Oumei Cheng [email protected]; [email protected] 1
Department of Neurology, The First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, China
2
Department of Radiology, The First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, China
symptoms such as depression, dementia, and sleep disorder are also common. Due to the clinical outcome heterogeneity, PD are usually divided into tremor-dominant PD (TD-PD) a
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