NeuroImage. Clinical · 2025
A multi-modal study on cerebrovascular dysfunction in cognitive decline of de novo Parkinson's disease.
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Li Hongwei, Shao Xiali, Jia Jia, Wang Bingyi, Wang Jian, Liu Kai, Chen Jinhan, Chen Zhensen, Jin Lirong, Wang He
Аннотация
BACKGROUND: Vascular risk factors are increasingly implicated in Parkinson's disease (PD), but the role of altered cerebrovascular dysfunction in early-stage PD remains unclear. Here, we investigated resting-state cerebrovascular reactivity (RS-CVR), cerebral blood flow (CBF), arterial morphological changes, and corresponding alterations in functional connectivity density (FCD) in de novo PD patients with different cognitive status.
METHODS: 25 de novo PD patients with mild cognitive impairment (PD-MCI), 34 with normal cognition (PD-NC), and 48 healthy controls (HCs) underwent neuropsychological assessments and multimodal MRI. CBF derived from arterial spin labeling, RS-CVR and FCD generated from resting-state functional MRI and the arterial morphology extracted from the magnitude images of multi-echo gradient echo.
RESULTS: RS-CVR significantly decreased in PD patients, particularly in the left occipital gyrus and posterior cerebral artery (PCA) territories. Long-range FCD was reduced in the left inferior occipital gyrus in both PD-NC and PD-MCI compared to HCs (p = 0.005, p < 0.001). In PD-MCI, negative correlations between Stroop Color-Word Test time and RS-CVR in the distal right PCA (r = -0.71, pFDR = 0.030) and middle left PCA (r = -0.66, pFDR = 0.044) were observed. A significant correlation was found between decreased long-range FCD in the left inferior occipital gyrus and poorer Trail Making Test Part B performance (r = -0.63, pFDR = 0.029) in the PD-MCI. No significant differences in CBF, but significant dilation of the left PCA and compensatory CBF increases in the corresponding territory in PD-MCI were found (r = 0.57, pFDR = 0.023).
DISCUSSION: Microvascular dysfunction, rather than perfusion defects, might underlie early-stage of the de novo PD, especially in the patients with PD-MCI.
METHODS: 25 de novo PD patients with mild cognitive impairment (PD-MCI), 34 with normal cognition (PD-NC), and 48 healthy controls (HCs) underwent neuropsychological assessments and multimodal MRI. CBF derived from arterial spin labeling, RS-CVR and FCD generated from resting-state functional MRI and the arterial morphology extracted from the magnitude images of multi-echo gradient echo.
RESULTS: RS-CVR significantly decreased in PD patients, particularly in the left occipital gyrus and posterior cerebral artery (PCA) territories. Long-range FCD was reduced in the left inferior occipital gyrus in both PD-NC and PD-MCI compared to HCs (p = 0.005, p < 0.001). In PD-MCI, negative correlations between Stroop Color-Word Test time and RS-CVR in the distal right PCA (r = -0.71, pFDR = 0.030) and middle left PCA (r = -0.66, pFDR = 0.044) were observed. A significant correlation was found between decreased long-range FCD in the left inferior occipital gyrus and poorer Trail Making Test Part B performance (r = -0.63, pFDR = 0.029) in the PD-MCI. No significant differences in CBF, but significant dilation of the left PCA and compensatory CBF increases in the corresponding territory in PD-MCI were found (r = 0.57, pFDR = 0.023).
DISCUSSION: Microvascular dysfunction, rather than perfusion defects, might underlie early-stage of the de novo PD, especially in the patients with PD-MCI.