Anterior insular network disconnection and cognitive impairment in Parkinson's disease.,NeuroImage: Clinical

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Anterior insular network disconnection and cognitive impairment in Parkinson's disease.
NeuroImage: Clinical ( IF 3.4 ) Pub Date : 2020-07-25 , DOI: 10.1016/j.nicl.2020.102364
Yasmine Y Fathy ₁ , Dagmar H Hepp ₂ , Frank J de Jong ₃ , Jeroen J G Geurts ₄ , Elisabeth M J Foncke ₂ , Henk W Berendse ₂ , Wilma D J van de Berg ₄ , Menno M Schoonheim ₄

Affiliation

Background

The insula is a central brain hub involved in cognition and affected in Parkinson’s disease (PD). The aim of this study was to assess functional connectivity (FC) and betweenness centrality (BC) of insular sub-regions and their relationship with cognitive impairment in PD.

Methods

Whole-brain 3D-T1, resting-state functional MRI and a battery of cognitive tests (CAMCOG) were included for 53 PD patients and 15 controls. The insular cortex was segmented into ventral (vAI) and dorsal (dAI) anterior and posterior sub-regions. Connectivity between insular sub-regions and resting-state networks was assessed and related to cognition; BC was used to further explore nodes associated with cognition.

Results

Cognitive performance was significantly lower in PD patients compared to controls (p < 0.01) and was associated with FC of the dAI with default mode network (DMN) (adjusted R² = 0.37, p < 0.001). In controls, cognitive performance was positively related to FC of the dAI with the fronto-parietal network (FPN) only (adjusted R² = 0.5, p = 0.003). Regionally, FC of the dAI with the anterior cingulate cortex (ACC) was significantly reduced in PD (F(1,65) = 11, p = 0.002) and correlated with CAMCOG (r = 0.4, p = 0.001). DMN and FPN showed increased BC in PD which correlated with cognition and reduced connectivity of dAI with the ACC (r_s = −0.33, p = 0.014 and r_s = −0.44, p = 0.001 respectively).

Conclusions

These results highlight the relevance of the insula in cognitive dysfunction in PD. Disconnection of the dAI with ACC was related to altered centrality in the DMN and FPN only in patients. Disturbance in this network triad appears to be particularly relevant for cognitive impairment in PD.

中文翻译：

帕金森氏病的前岛隔网络断开和认知障碍。

背景

岛突是参与认知的帕金森氏病（PD）的中央大脑枢纽。这项研究的目的是评估岛状次区域的功能连通性（FC）和中间性中心（BC）及其与PD认知障碍的关系。

方法

包括53例PD患者和15例对照的全脑3D-T1，静息状态功能MRI和一系列认知测试（CAMCOG）。岛状皮层被分为腹侧（vAI）和背侧（dAI）的前和后子区域。评估了岛屿次区域与静止状态网络之间的连通性，并与认知有关；BC用于进一步探索与认知相关的节点。

结果

与对照组相比，PD患者的认知能力显着降低（p <0.01），并且与默认模式网络（DMN）的dAI的FC相关（校正后的R ² = 0.37，p <0.001）。在对照组中，仅通过额顶网络（FPN），认知能力与dAI的FC正相关（调整后R ² = 0.5，p = 0.003）。在区域上，具有前扣带回皮质（ACC）的dAI的FC在PD中显着降低（F（1,65）= 11，p = 0.002），并与CAMCOG相关（r = 0.4，p = 0.001）。DMN和FPN显示PD中的BC增加，与认知和dAI与ACC的连通性降低相关（r _s = -0.33，p = 0.014和r _s = -0.44，p = 0.001）。