Objective: Using resting-state functional MRI, we investigated intrinsic brain networks connectivity correlates of anxiety symptoms in a cohort of cognitively unimpaired drug-naïve patients with Parkinson’s disease (PD).

Background: Anxiety symptoms are common in PD and may affect both motor outcome and quality of life. Despite their clinical relevance, neural correlates potentially underpinning anxiety disorders in PD patients have not been completely clarified yet.

Methods: 3T MRI images of 41 drug-naïve PD patients (with and without anxiety), and 20 matched healthy controls (HC) were analyzed. Second-level Movement Disorders Society diagnostic criteria were applied to exclude PD patients with cognitive impairment. Anxiety presence and severity was assessed by means of a clinical interview and the Parkinson’s Disease Anxiety Scale (PAS). Single-subject and group-level independent component analysis was used to investigate functional connectivity differences within the major neurocognitive resting-state networks between patients sub-groups and HC. We also compared inter-network connectivity between PD patients with and without anxiety. Finally, linear regression analysis was used to investigate correlations between imaging and clinical data.

Results: Decreased connectivity within default mode (DMN) and fronto-parietal (FPN) networks as well as an increased connectivity within salience (SN) and executive control (ECN) networks were detected in PD patients with anxiety compared with those without. Moreover, PD patients with anxiety showed a disrupted inter-network connectivity between FPN and SN (p<0.05). Anxiety severity was correlated with functional abnormalities within all these neurocognitive networks.

Conclusions: Our findings demonstrated that an abnormal intrinsic brain connectivity within and between the large-scale neurocognitive networks may represent a potential neural correlates of anxiety symptoms and severity in drug-naïve PD patients, even in the absence of cognitive impairment. We hypothesize that these divergent cognitive and limbic networks connectivity changes could be proposed as a potential biomarker of treatment response in clinical trial.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/intrinsic-functional-connectivity-correlates-of-anxiety-in-cognitively-unimpaired-drug-naive-patients-with-parkinsons-disease/