BACKGROUND Dynamic functional network analysis may add relevant information about the temporal nature of the neurocognitive alterations in PD patients with impulse control disorders (PD-ICD). Our aim was to investigate changes in dynamic functional network connectivity (dFNC) in PD-ICD patients, and topological properties of such networks. METHODS Resting state fMRI was performed on 16 PD PD-ICD patients, 20 PD patients without ICD and 17 healthy controls, whose demographic, clinical and behavioral scores were assessed. We conducted a group spatial independent component analysis, sliding window and graph-theory analyses. RESULTS PD-ICD patients, in contrast to PD-noICD and HC subjects, were engaged across time in a brain configuration pattern characterized by a lack of between-network connections at the expense of strong within-network connections (State III) in temporal, frontoinsular and cingulate cortices, all key nodes of the salience network. Moreover, this increased maintenance of State III in PD-ICD patients was positively correlated with the severity of impulsivity and novelty seeking as measured by specific scales. While in State III, these patients also exhibited increased local efficiency in all the aforementioned areas. CONCLUSIONS Our findings show for the first time that PD-ICD patients have a dynamic functional engagement of local connectivity involving the limbic circuit, leading to the inefficient modulation in emotional processing and reward-related decision-making. These results provide new insights into the pathophysiology of ICD in PD patients and indicate that the dFC study of fMRI could be a useful biomarker to identify patients at risk to develop ICD.

中文翻译：

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患有冲动控制障碍的帕金森氏病患者的显着性网络动态变化。

背景技术动态功能网络分析可以添加关于具有冲动控制障碍（PD-ICD）的PD患者中神经认知改变的时间性质的相关信息。我们的目的是研究PD-ICD患者动态功能网络连接（dFNC）的变化以及此类网络的拓扑特性。方法对16名PD PD-ICD患者，20名无ICD的PD患者和17名健康对照者进行静息状态fMRI检查，评估其人口统计学，临床和行为评分。我们进行了组空间独立分量分析，滑动窗口和图论分析。结果PD-ICD患者与PD-noICD和HC患者相反，跨时间参与了一种大脑配置模式，该模式的特点是缺乏网络之间的连接，但以时间，额叶皮层和扣带状皮质（显着网络的所有关键节点）中的强大的网络内连接（状态III）为代价。此外，PD-ICD患者对状态III的这种增加的维持与冲动的严重程度和寻求新颖性的程度呈正相关，如通过特定量表测量的。在第三状态时，这些患者在上述所有区域中均表现出更高的局部效率。结论我们的研究结果首次显示PD-ICD患者具有涉及边缘回路的局部连接的动态功能参与，从而导致情绪处理和与奖励相关的决策方面的效率低下。