Objective: The aim of this study was to investigate the structural and functional correlates of anxiety in PD and healthy controls (HC) applying voxel-based morphometry (VBM) and resting state-fMRI.

Background: Anxiety is a common symptom of Parkinson’s disease (PD). However, its neurobiology is still poorly understood.

Methods: We examined 31 PD patients (66.4±(SD)7.1 years) in the OFF and ON medication states and compared them with 30 matched HC. The State-Trait Anxiety Inventory was used to assess the severity of anxiety immediately before each fMRI session. For VBM analysis a T1-weighted MPRAGE sequence with a resolution of 1x1x1mm3 was acquired and grey matter density (GM) was measured in each voxel. To evaluate brain connectivity, we used resting state-fMRI (3T, TR=2s, 300 scans) and calculated Eigenvector centrality (EC). Image pre-processing and data analysis was performed using the CAT12/Lipsia/SPM12 software. All the results were reported at p<0.05 FWE corrected at cluster level. 

Results: PD patients in both states scored higher on trait anxiety compared to HC (p<0.02). While the trait anxiety (TA) in PD did not change between the sessions, the state anxiety (SA) increased during OFF compared to ON condition (p=0.01). In PD, significant findings were obtained for the TA, which was associated with decreased GM density in both cerebellar hemispheres and with increased GM density in the left paracentral sensorimotor region. In HC, higher TA was associated with the GM density decrease in the right precuneus, while the SA negatively correlated with the GM density in both temporal poles and the left orbito-frontal cortex. Functional connectivity analysis showed that the EC in PD positively correlated with the severity of the SA in the right orbito-frontal region, insula, amygdala and temporal cortex and in the left cerebellar hemisphere, and with severity of TA in postcentral and superior parietal areas. In contrast, the EC in HC negatively correlated with the SA in the ventral striatal regions, and with the TA in the medial prefrontal areas.

Conclusions: Our study revealed that both trait and state anxiety scores in PD and HC were associated with different structural and functional changes across the brain. Such differences might reflect specificity in pathophysiology of anxiety in Parkinson’s disease due to dopaminergic loss associated with cerebellar and sensorimotor dysfunction. Supported by GACR 16-13323S and PRVOUK P26/LF1/

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MDS Abstracts - https://www.mdsabstracts.org/abstract/structural-and-functional-correlates-of-anxiety-in-parkinsons-disease/