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Cerebro-cerebellar motor networks in clinical subtypes of Parkinson’s disease

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 (Milan, Italy)

Meeting: 2022 International Congress

Abstract Number: 126

Keywords: Functional magnetic resonance imaging(fMRI), Gait disorders: Pathophysiology, Parkinson’s

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.
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