Frailty is a geriatric syndrome defined by coexistence of unintentional weight loss, low physical reserve or activity and is associated with adverse health events. Neuroimaging studies reported structural white matter changes in frail patients. In the current study, we hypothesized that clinical frailty is associated also with functional changes in motion-related cortical areas, i. e. (pre-)supplementary motor areas (SMA, pre-SMA). We expected that observed functional changes are related to motor-cognitive test performance. We studied a clinical sample of 143 cognitively healthy patients ≥65 years presenting for elective surgery, enrolled in the BioCog prospective multicentric cohort study on postoperative cognitive disorders. Participants underwent preoperative resting-state fMRI, motor-cognitive testing and assessment of Fried's modified frailty criteria. We analyzed functional connectivity associations with frailty and motor-cognitive test performance. Clinically robust patients (N=60) showed higher connectivity in the SMA network compared to frail (N=13) and pre-frail (N=70) patients. No changes were found in the pre-SMA network. SMA connectivity correlated with motor speed (Trail-Making-Test A) and manual dexterity (Grooved Pegboard Test). Our results suggest that diminished functional connectivity of the SMA is an early correlate of functional decline in the elderly. The SMA may serve as a potential treatment target in frailty.

中文翻译：

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辅助运动网络的功能连通性与弗里德的老年人脆弱性评分得到改善。

身体虚弱是一种由无意识的体重减轻，身体储备不足或活动不足并存的老年性综合症，并与不良健康事件相关。神经影像学研究报道了脆弱患者的结构性白质变化。在当前的研究中，我们假设临床虚弱还与运动相关的皮质区域（即补充运动前区域（SMA，SMA前））的功能变化有关。我们期望观察到的功能变化与运动认知测试性能有关。我们研究了143例年龄≥65岁的认知健康患者的临床样本，这些患者需要进行择期手术，并参加了有关术后认知障碍的BioCog前瞻性多中心队列研究。参与者进行了术前静息状态功能磁共振成像，运动认知测试和Fried'评估 修改后的脆弱标准。我们分析了功能连接的关联与虚弱和运动认知测试性能。与体弱（N = 13）和体弱前（N = 70）的患者相比，临床上健壮的患者（N = 60）在SMA网络中显示出更高的连通性。在SMA前网络中未发现任何变化。SMA连接性与电机速度（Trail-Making-Test A）和手动灵活性（Grooved Pegboard Test）相关。我们的结果表明，SMA的功能连通性降低是老年人功能下降的早期相关因素。SMA可能是脆弱的潜在治疗目标。与体弱（N = 13）和体弱前（N = 70）的患者相比，临床上健壮的患者（N = 60）在SMA网络中显示出更高的连通性。在SMA前网络中未发现任何变化。SMA连接性与电机速度（Trail-Making-Test A）和手动灵活性（Grooved Pegboard Test）相关。我们的结果表明，SMA的功能连通性降低是老年人功能下降的早期相关因素。SMA可能是脆弱的潜在治疗目标。与体弱（N = 13）和体弱前（N = 70）的患者相比，临床上健壮的患者（N = 60）在SMA网络中显示出更高的连通性。在SMA前网络中未发现任何变化。SMA连接性与电机速度（Trail-Making-Test A）和手动灵活性（Grooved Pegboard Test）相关。我们的结果表明，SMA的功能连通性降低是老年人功能下降的早期相关因素。SMA可能是脆弱的潜在治疗目标。