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Impulsivity Relates to Relative Preservation of Mesolimbic Connectivity in Patients with Parkinson Disease.
NeuroImage: Clinical ( IF 4.2 ) Pub Date : 2020-04-22 , DOI: 10.1016/j.nicl.2020.102259
Hiro Sparks 1 , Hannah Riskin-Jones 1 , Collin Price 2 , Jasmine DiCesare 1 , Ausaf Bari 1 , Nadia Hashoush 1 , Nader Pouratian 1
Affiliation  

INTRODUCTION The relationship between Parkinson Disease (PD) pathology, dopamine replacement therapy (DRT), and impulse control disorder (ICD) development is still incompletely understood. Given the sensorimotor-lateral substantia nigra (SN) selective degeneration associated with PD, we posit that a relative sparing of the limbic-medial SN in the context of DRT drives impulsive, reward-seeking behavior in PD patients with recent history of severe impulsivity. METHODS Impulsive and control participants were selected from a consecutive list of PD patients receiving pre-operative deep brain stimulation (DBS) planning scans including 3T structural MRI and 64 direction diffusion tensor imaging (DTI). Using previously identified substantia nigra (SN) subsegment network connectivity profiles to develop classification targets, split-hemisphere target-based SN segmentation with probabilistic tractography was performed. The relative subsegment volumes and strength of connectivity between the SN and the limbic, associative, and motor network targets were compared. RESULTS Our results show that there is greater probability of connectivity between the SN and limbic network targets relative to motor and associative network targets in PD patients with recent history of severe impulsivity as compared to PD patients without impulsivity (P = 0.0075). We did not observe relative volumetric subsegment differences across groups. CONCLUSION Firstly, our results suggest that fine-grained, atlas-derived classification targets may be used in PD to parcellate and classify functionally distinct subsegments of the SN, with the apparent preservation of previously reported topographical limbic-medial SN, associative-ventral SN, and sensorimotor-lateral SN orientation. We suggest that relative, as opposed to absolute, degeneration amongst SN-associated dopaminergic networks relates to the impulsivity phenotype in PD.

中文翻译:

冲动与帕金森病患者中边缘边缘连通性的相对保存有关。

引言帕金森病(PD)病理学,多巴胺替代疗法(DRT)和冲动控制障碍(ICD)发展之间的关系仍然不完全清楚。考虑到与PD相关的感觉运动性外侧黑质(SN)选择性变性,我们假设在DRT的背景下,相对中度的边缘内侧SN会驱动最近有严重冲动病史的PD患者的冲动,寻求奖励行为。方法从连续接受手术前深部脑刺激(DBS)计划扫描(包括3T结构MRI和64方向扩散张量成像(DTI))的PD患者名单中选择冲动和对照参与者。使用先前确定的黑质(SN)细分网络连接配置文件来制定分类目标,基于概率性影像学的基于分裂半球目标的SN分割被执行。比较了SN与边缘,联想和运动网络目标之间的相对子段体积和连接强度。结果我们的结果表明,与近期没有冲动的PD患者相比,近期有严重冲动病史的PD患者的SN和边缘网络靶标相对于运动和联想网络靶标的连通性可能性更高(P = 0.0075)。我们没有观察到各组之间相对体积子段的差异。结论首先,我们的结果表明,可将细微的,来自地图集的分类目标用于PD,以对SN的功能不同的子片段进行分类和分类,明显保留了先前报道的地形性边缘-内侧SN,联想-腹侧SN和感觉运动-外侧SN的方向。我们建议,SN相关的多巴胺能网络中的相对(相对于绝对)退化与PD中的冲动表型有关。
更新日期:2020-04-22
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