Category: Parkinson's Disease: Neuroimaging
Objective: This study investigated functional alterations within the cerebro-cerebellar system in tremor-dominant (TD) and postural-instability-and-gait-disorder (PIGD) subtypes of Parkinson’s disease (PD) using stepwise functional connectivity (SFC) method and identified neuroimaging features that predict the TD to PIGD conversion.
Background: PD patients can be classified in TD and PIGD subtypes. PIGD represents a more aggressive form of the disease to which TD patients eventually convert.
Method: Thirty-two PD-TD, 26 PD-PIGD and 60 controls performed clinical/cognitive evaluations and resting-state functional MRI (fMRI). PD-TD patients were classified in 10 converters (cTD-PD) and 18 non-converters (ncTD-PD) based on 4-year clinical follow-up. The cerebellar seed-region was identified using fMRI motor task. SFC analysis, characterizing regions that connect brain areas to cerebellar seed at different levels of link-step distances, evaluated similar and divergent alterations in PD-TD and PD-PIGD. The discriminatory power of clinical data and/or SFC in distinguishing cPD-TD from ncPD-TD patients was assessed using ROC curve analysis.
Results: Compared to PD-TD, PD-PIGD patients showed decreased SFC in temporal lobe and occipital lobes and increased SFC within the cerebellar cortex and in ponto-medullary junction. Considering the subtype-conversion analysis, cPD-TD patients were characterized by increased SFC in temporal and occipital lobes and within the cerebellum and in ponto-medullary junction relative to ncPD-TD group. Combining clinical and SFC data, ROC curves provided the highest classification power to identify conversion to PIGD.
Conclusion: These findings provide novel insights into the pathophysiology underlying different PD motor phenotypes and a potential tool for early characterization of PD-TD patients at risk of conversion to PIGD.
To cite this abstract in AMA style:
F. Agosta, S. Basaia, A. Francia, C. Cividini, R. Balestrino, T. Stojkovic, I. Stankovic, V. Markovic, E. Sarasso, A. Gardoni, R. de Micco, L. Albano, E. Stefanova, VS. Kostic, M. Filippi. Cerebro-cerebellar motor networks in clinical subtypes of Parkinson’s disease [abstract]. Mov Disord. 2022; 37 (suppl 2). https://www.mdsabstracts.org/abstract/cerebro-cerebellar-motor-networks-in-clinical-subtypes-of-parkinsons-disease/. Accessed May 18, 2025.« Back to 2022 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/cerebro-cerebellar-motor-networks-in-clinical-subtypes-of-parkinsons-disease/