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Levodopa Changes Functional Connectivity Patterns in Subregions of the Primary Motor Cortex in Patients With Parkinson's Disease.
Front Neurosci. 2020; 14:647.FN

Abstract

Background

The primary motor cortex (M1) is a critical node in Parkinson's disease (PD)-related motor circuitry; however, the functional roles of its subregions are poorly understood. In this study, we investigated changes in the functional connectivity patterns of M1 subregions and their relationships to improved clinical symptoms following levodopa administration.

Methods

Thirty-six PD patients and 37 healthy controls (HCs) were enrolled. A formal levodopa challenge test was conducted in the PD group, and the Unified Parkinson's Disease Rating Scale motor section (UPDRS-III) was assessed before (off state) and 1 h after administration of levodopa (on state). The PD group underwent resting-state functional magnetic resonance imaging in both off and on states, whereas the HC group was scanned once. We used the Human Brainnetome Atlas template to subdivide M1 into twelve regions of interest (ROIs). Functional connectivity (FC) was compared between PD on and off states [paired t-test, voxel-level p < 0.001, cluster-level p < 0.05, Gaussian random field (GRF) correction] and between patients and HC (two-sample t-test voxel-level p < 0.001, cluster-level p < 0.05). Correlations between ΔFC (differences in FC between PD off and on states) and clinical symptom improvements were examined.

Results

There was decreased FC between the right caudal dorsolateral area 6 and the anterior cingulate gyrus (ACC), the right upper limb region and the left medial dorsal thalamus (mdTHA), as well as increased FC between the left tongue and larynx region and the left medial frontal gyrus. ΔFC between the right caudal dorsolateral area 6 and ACC was positively correlated with improvements in UPDRS-III total scores as well as the rigidity (item 22) and bradykinesia (items 23-26 and 31) subscores. ΔFC between the right upper limb region and left thalamus was positively correlated with improvements in the left upper limb tremor (items 20c and 21b) and postural tremor (item 21b) subscores.

Conclusions

Our results reveal novel information regarding the underlying mechanisms in the motor circuits in the M1 and a promising way to explore the internal function of the M1 in PD patients. Notably, M1 is a potential therapeutic target in PD, and the exploration of its subregions provides a basis and a source of new insights for clinical intervention and precise drug treatment.

Authors+Show Affiliations

Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.Department of Laboratory Medicine, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.Department of Rehabilitation, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China.Department of Functional Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32733186

Citation

Shen, Yang, et al. "Levodopa Changes Functional Connectivity Patterns in Subregions of the Primary Motor Cortex in Patients With Parkinson's Disease." Frontiers in Neuroscience, vol. 14, 2020, p. 647.
Shen Y, Hu J, Chen Y, et al. Levodopa Changes Functional Connectivity Patterns in Subregions of the Primary Motor Cortex in Patients With Parkinson's Disease. Front Neurosci. 2020;14:647.
Shen, Y., Hu, J., Chen, Y., Liu, W., Li, Y., Yan, L., Xie, C., Zhang, W., Yu, M., & Liu, W. (2020). Levodopa Changes Functional Connectivity Patterns in Subregions of the Primary Motor Cortex in Patients With Parkinson's Disease. Frontiers in Neuroscience, 14, 647. https://doi.org/10.3389/fnins.2020.00647
Shen Y, et al. Levodopa Changes Functional Connectivity Patterns in Subregions of the Primary Motor Cortex in Patients With Parkinson's Disease. Front Neurosci. 2020;14:647. PubMed PMID: 32733186.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Levodopa Changes Functional Connectivity Patterns in Subregions of the Primary Motor Cortex in Patients With Parkinson's Disease. AU - Shen,Yang, AU - Hu,Jun, AU - Chen,Yong, AU - Liu,Wan, AU - Li,Yuqian, AU - Yan,Lei, AU - Xie,Chunming, AU - Zhang,Wenbin, AU - Yu,Miao, AU - Liu,Weiguo, Y1 - 2020/07/08/ PY - 2019/10/29/received PY - 2020/05/25/accepted PY - 2020/8/1/entrez PY - 2020/8/1/pubmed PY - 2020/8/1/medline KW - Parkinson’s disease KW - acute levodopa challenge test KW - primary motor cortex KW - resting-state functional magnetic resonance imaging KW - subregion SP - 647 EP - 647 JF - Frontiers in neuroscience JO - Front Neurosci VL - 14 N2 - Background: The primary motor cortex (M1) is a critical node in Parkinson's disease (PD)-related motor circuitry; however, the functional roles of its subregions are poorly understood. In this study, we investigated changes in the functional connectivity patterns of M1 subregions and their relationships to improved clinical symptoms following levodopa administration. Methods: Thirty-six PD patients and 37 healthy controls (HCs) were enrolled. A formal levodopa challenge test was conducted in the PD group, and the Unified Parkinson's Disease Rating Scale motor section (UPDRS-III) was assessed before (off state) and 1 h after administration of levodopa (on state). The PD group underwent resting-state functional magnetic resonance imaging in both off and on states, whereas the HC group was scanned once. We used the Human Brainnetome Atlas template to subdivide M1 into twelve regions of interest (ROIs). Functional connectivity (FC) was compared between PD on and off states [paired t-test, voxel-level p < 0.001, cluster-level p < 0.05, Gaussian random field (GRF) correction] and between patients and HC (two-sample t-test voxel-level p < 0.001, cluster-level p < 0.05). Correlations between ΔFC (differences in FC between PD off and on states) and clinical symptom improvements were examined. Results: There was decreased FC between the right caudal dorsolateral area 6 and the anterior cingulate gyrus (ACC), the right upper limb region and the left medial dorsal thalamus (mdTHA), as well as increased FC between the left tongue and larynx region and the left medial frontal gyrus. ΔFC between the right caudal dorsolateral area 6 and ACC was positively correlated with improvements in UPDRS-III total scores as well as the rigidity (item 22) and bradykinesia (items 23-26 and 31) subscores. ΔFC between the right upper limb region and left thalamus was positively correlated with improvements in the left upper limb tremor (items 20c and 21b) and postural tremor (item 21b) subscores. Conclusions: Our results reveal novel information regarding the underlying mechanisms in the motor circuits in the M1 and a promising way to explore the internal function of the M1 in PD patients. Notably, M1 is a potential therapeutic target in PD, and the exploration of its subregions provides a basis and a source of new insights for clinical intervention and precise drug treatment. SN - 1662-4548 UR - https://www.unboundmedicine.com/medline/citation/32733186/Levodopa_Changes_Functional_Connectivity_Patterns_in_Subregions_of_the_Primary_Motor_Cortex_in_Patients_With_Parkinson's_Disease_ DB - PRIME DP - Unbound Medicine ER -
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