OBJECTIVE In a substantial portion of patients with drug-induced parkinsonism (DIP), parkinsonism may persist for long periods after discontinuation of offending drugs, suggesting subtle underlying neurodegeneration. We hypothesized that patients with DIP have impaired functional connectivity (FC) of brain networks, which may determine the reversibility of parkinsonism. METHODS In this case-control study, we consecutively recruited 60 patients with DIP and 32 healthy controls. We used independent component analysis and dual regression of functional magnetic resonance imaging data to identify seven resting-state networks and compared FC of the networks between the DIP and control groups. Among regions where the two groups showed a significant difference in the FC with sensorimotor network, we compared the FC between patients who had completely recovered (n = 21) and those who had partially recovered (n = 39) within 3 months of cessation of the offending drugs. RESULTS Patients with DIP had decreased FC between the sensorimotor network and widespread brain regions, when compared to healthy controls. FC in the prefrontal regions was negatively correlated with parkinsonian motor score. Patients who partially recovered had a significantly lower FC in the prefrontal and cerebellar regions than those who recovered completely, providing a useful predictor of recovery status. CONCLUSIONS Patients with DIP had decreased FC of the sensorimotor network, which correlated with the severity of parkinsonism and predicted the recovery status after cessation of offending drugs. Impaired FC of the sensorimotor network can be used as a biomarker to evaluate the severity and prognosis of DIP.

中文翻译：

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感觉运动网络的功能连接性受损可预测药物诱发的帕金森病的恢复。

目的在绝大部分药物诱发的帕金森病（DIP）患者中，帕金森病在停用违规药物后可能会持续很长时间，这表明潜在的潜在神经变性很微妙。我们假设DIP患者的大脑网络功能连接（FC）受损，这可能决定了帕金森氏病的可逆性。方法在本病例对照研究中，我们连续招募了60名DIP患者和32名健康对照。我们使用功能磁共振成像数据的独立成分分析和双重回归来识别七个静止状态网络，并比较了DIP组和对照组之间的网络FC。在两组之间，感觉运动神经网络FC的差异显着，我们比较了在违规药物停用后3个月内完全康复（n = 21）和部分康复（n = 39）的患者的FC。结果与健康对照组相比，DIP患者的感觉运动网络和广泛的大脑区域之间的FC降低。前额叶区域的FC与帕金森氏运动评分呈负相关。与完全康复的患者相比，部分康复的患者前额区和小脑区域的FC显着降低，这是康复状态的有用预测指标。结论DIP患者的感觉运动网络FC降低，这与帕金森氏症的严重程度相关，并预测了违规药物停止后的恢复状态。