Deficits in cognitive functioning are a common yet poorly understood symptom in Parkinson’s disease (PD). Recent studies have highlighted the importance of (dynamic) interactions between resting-state networks for cognition, which remains understudied in PD. We investigated how altered (dynamic) functional interactions between brain networks relate to cognitive dysfunction in PD patients.

In this fMRI study, 50 PD patients (mean age 65.5 years ±6.27) on dopaminergic medication were studied cross-sectionally, and of this cohort 31 PD patients were studied longitudinally. MRI imaging and neuropsychological testing was performed at two time points, with a follow-up duration of approximately three years. Functional connectivity within and between seven resting-state networks was calculated (both statically and dynamically) and correlated with four neuropsychological test scores; a combined score of (four) executive tasks, a motor perseveration, memory, and category fluency task. Cognitive dysfunction was determined based on a longitudinal sample of age-matched healthy controls (n=13).

PD patients showed dysfunction on six out of seven cognitive tasks when compared to healthy controls. Severity of executive dysfunction was correlated with higher static and lower dynamic functional connectivity between deep gray matter regions and the frontoparietal network (DGM-FPN). Over time, declining executive function was related to increasing static DGM-FPN connectivity, together with changes of connectivity involving the dorsal attention network (amongst others with the ventral attention network). Static functional connectivity between the ventral and dorsal attention network correlated with motor perseveration.

Our findings demonstrate that in PD patients, dysfunctional communication between (i) subcortical, fronto-parietal and attention networks mostly underlies worsening of executive functioning, (ii) attention networks are involved in motor perseveration.

认知功能障碍是帕金森氏病（PD）的常见症状，但知之甚少。最近的研究强调了静止状态网络之间（动态）相互作用对于认知的重要性，这在PD中仍未得到充分研究。我们研究了大脑网络之间改变的（动态）功能相互作用与PD患者的认知功能障碍之间的关系。

在这项功能磁共振成像研究中，对50名接受多巴胺能药物治疗的PD患者（平均年龄65.5岁±6.27岁）进行了横断面研究，其中31例PD患者进行了纵向研究。在两个时间点进行MRI成像和神经心理学测试，随访时间约为三年。计算（静态和动态）七个静止状态网络内部和之间的功能连接性，并与四个神经心理学测试分数相关；（四个）执行任务，运动坚持，记忆力和类别流利性任务的总分。根据年龄匹配的健康对照者的纵向样本（n = 13）确定认知功能障碍。

与健康对照组相比，PD患者在七项认知任务中有六项表现出功能障碍。执行功能障碍的严重程度与深灰质区和额顶网（DGM-FPN）之间较高的静态功能和较低的动态功能连接性相关。随着时间的流逝，执行功能的下降与静态DGM-FPN的连接性增加以及涉及背侧注意力网络（尤其是腹侧注意力网络）的连接性变化有关。腹侧和背侧注意网络之间的静态功能连接与运动持续性相关。

我们的研究结果表明，在PD患者中，（i）皮质下，额顶叶和注意网络之间的沟通障碍主要是执行功能恶化的原因，（ii）注意网络与运动持束力有关。