BACKGROUND Mild behavioral impairment (MBI) is a syndrome characterized by later life onset, sustained neuropsychiatric symptoms as a marker of dementia risk. In Parkinson's disease (PD), MBI has been associated with worse cognitive abilities and increased cortical atrophy. However, the circuit level correlates of MBI have not been investigated in this population. Our objective was to investigate the relationship between MBI and corticostriatal connectivity in PD patients. This emphasis on corticostriatal connectivity was due to the significant role of these circuits in neuropsychiatric and cognitive symptoms across disease conditions. METHODS Seventy-four non-demented patients with PD were administered the MBI-checklist, and classified as having high MBI (PD-MBI; n = 21) or low MBI scores (PD-noMBI; n = 53). Corticostriatal connectivity was assessed with both an atlas and seed-based analysis. The atlas analysis consisted of calculating the average connectivity between the striatal network and the default mode (DMN), central executive (CEN), and saliency networks (SAN). Structural measurements of cortical thickness and volume were also assessed. PD-MBI and PD-noMBI patients were compared, along with a group of age matched healthy control subjects (HC; n = 28). Subsequently, a seed analysis assessed the relationship of MBI scores with the connectivity of twelve seeds within the striatum while controlling for cognitive ability. A complementary analysis assessed the relationship between striatal connectivity and cognition, while controlling for MBI-C. RESULTS PD-MBI demonstrated decreased connectivity between the striatum and both the DMN and SAN compared to PD-noMBI and HC. The decreased connectivity between the striatum and the SAN was explained partly by increased atrophy within the SAN in PD-MBI. The seed analysis revealed a relationship between higher MBI scores and lower connectivity of the left caudate head to the dorsal anterior cingulate cortex and left middle frontal gyrus. Higher MBI-C scores were also related to decreased connectivity of the right caudate head with the anterior cingulate cortex, precuneus, and left supramarginal gyrus, as well as increased connectivity to the left hippocampus and right cerebellar hemisphere. Caudate-precuneus connectivity was independently associated with both global behavioural and cognitive scores. CONCLUSION These results suggest PD-MBI is associated with altered corticostriatal connectivity, particularly between the head of the caudate and cortical regions associated with the DMN and SAN. In particular, caudate-precuneus connectivity is associated with both global behavioral and cognitive symptoms in PD.

中文翻译：

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帕金森氏病的轻度行为障碍与皮质骨皮质连接性改变有关。

背景技术轻度行为障碍（MBI）是一种以迟发性生活，持续的神经精神症状为特征的痴呆症候群。在帕金森氏病（PD）中，MBI与认知能力下降和皮质萎缩增加有关。但是，尚未在此人群中研究MBI的电路级相关性。我们的目的是研究PD患者的MBI与皮层连接性之间的关系。强调皮质前庭连接性是由于这些回路在跨疾病状况的神经精神病学和认知症状中的重要作用。方法对74例非痴呆的PD患者进行MBI检查表检查，并将其分类为具有高MBI（PD-MBI； n = 21）或低MBI评分（PD-noMBI； n = 53）。使用图集和基于种子的分析评估了皮质口连接性。地图集分析包括计算纹状体网络与默认模式（DMN），中央执行器（CEN）和显着网络（SAN）之间的平均连通性。还评估了皮质厚度和体积的结构测量。比较了PD-MBI和PD-noMBI患者，以及一组年龄匹配的健康对照受试者（HC； n = 28）。随后，种子分析评估了MBI分数与纹状体内十二个种子的连通性之间的关系，同时控制了认知能力。补充分析评估了纹状体连通性和认知之间的关系，同时控制了MBI-C。结果与PD-noMBI和HC相比，PD-MBI证实纹状体与DMN和SAN之间的连通性降低。纹状体与SAN之间的连通性下降的部分原因是PD-MBI中SAN内萎缩的增加。种子分析显示，较高的MBI评分与左尾状头与背侧扣带回皮层和左中额回之间的连通性较低之间具有相关性。较高的MBI-C分数还与右尾状头与前扣带回皮层，前突神经和左上指回回的连接性降低以及与左海马和右小脑半球的连接性增加有关。尾-胎前连接与整体行为和认知评分均独立相关。结论这些结果表明，PD-MBI与皮质皮质连接性的改变有关，尤其是在与DMN和SAN相关的尾状头和皮质区域之间。特别是，尾状核与神经元的连通性与PD中的整体行为和认知症状均相关。