Seok Jong Chung1, Youn Jung Bae1, Suhnyoung Jun1, Han Soo Yoo1, Seung Woo Kim1, Yang Hyun Lee2, Young H Sohn1, Seung-Koo Lee2, Joon-Kyung Seong2, Phil Hyu Lee2. 1. From the Department of Neurology (S.J.C., H.S.Y., S.W.K., Y.H.L., Y.H.S., and P.H.L.), Department of Radiology (S.-K.L.), and Severance Biomedical Science Institute (P.H.L.), Yonsei University College of Medicine; Department of Biomedical Engineering (Y.J.B., J.-K.S.), Korea University; and Department of Psychology (S.J.) and Integrative Neurocognitive Functional Imaging Center (S.J.), Yonsei University, Seoul, South Korea. 2. From the Department of Neurology (S.J.C., H.S.Y., S.W.K., Y.H.L., Y.H.S., and P.H.L.), Department of Radiology (S.-K.L.), and Severance Biomedical Science Institute (P.H.L.), Yonsei University College of Medicine; Department of Biomedical Engineering (Y.J.B., J.-K.S.), Korea University; and Department of Psychology (S.J.) and Integrative Neurocognitive Functional Imaging Center (S.J.), Yonsei University, Seoul, South Korea. phlee@yuhs.ac jkseong@korea.ac.kr.
Abstract
OBJECTIVE: To investigate whether the presence of autonomic dysfunction is associated with white matter and functional connectivities and the level of cognitive performance in patients with de novo Parkinson disease (PD). METHODS: Seventy-five patients with de novo PD underwent a comprehensive autonomic function test and were classified into 2 groups according to the Composite Autonomic Severity Score (CASS; 30 with moderate to severe autonomic dysfunction [CASS 4-10, PD-AUT+] and 45 without significant autonomic dysfunction [CASS 0-3, PD-AUT-]). Network-based statistics and a graph theoretical analysis were performed to assess the interregional white matter connectivity using diffusion tensor imaging. We also performed analyses of resting-state functional connectivity and compared cognitive performance between the 2 groups. RESULTS: There were no significant differences in demographic characteristics and vascular risk factors between the PD-AUT+ and PD-AUT- groups. The PD-AUT+ group showed poorer cognitive performance on frontal/executive function than the PD-AUT- group. The PD-AUT+ group exhibited severely disrupted white matter connectivity in both fronto-subcortical and posterior cortical regions, which was well correlated with the severity of autonomic dysfunction assessed by the CASS. In addition, functional connectivity within the executive control network and dorsal attention network negatively correlated with the CASS. CONCLUSIONS: Our results suggest that autonomic dysfunction is associated with disrupted white matter and functional brain connectivity as well as cognitive impairment in de novo patients with PD.
OBJECTIVE: To investigate whether the presence of autonomic dysfunction is associated with white matter and functional connectivities and the level of cognitive performance in patients with de novo Parkinson disease (PD). METHODS: Seventy-five patients with de novo PD underwent a comprehensive autonomic function test and were classified into 2 groups according to the Composite Autonomic Severity Score (CASS; 30 with moderate to severe autonomic dysfunction [CASS 4-10, PD-AUT+] and 45 without significant autonomic dysfunction [CASS 0-3, PD-AUT-]). Network-based statistics and a graph theoretical analysis were performed to assess the interregional white matter connectivity using diffusion tensor imaging. We also performed analyses of resting-state functional connectivity and compared cognitive performance between the 2 groups. RESULTS: There were no significant differences in demographic characteristics and vascular risk factors between the PD-AUT+ and PD-AUT- groups. The PD-AUT+ group showed poorer cognitive performance on frontal/executive function than the PD-AUT- group. The PD-AUT+ group exhibited severely disrupted white matter connectivity in both fronto-subcortical and posterior cortical regions, which was well correlated with the severity of autonomic dysfunction assessed by the CASS. In addition, functional connectivity within the executive control network and dorsal attention network negatively correlated with the CASS. CONCLUSIONS: Our results suggest that autonomic dysfunction is associated with disrupted white matter and functional brain connectivity as well as cognitive impairment in de novo patients with PD.
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