Cognitive correlates of cerebellar resting-state functional connectivity in Parkinson disease
Abstract
Objective
To investigate in a cross-sectional study the contributions of altered cerebellar resting-state functional connectivity (FC) to cognitive impairment in Parkinson disease (PD).
Methods
We conducted morphometric and resting-state FC-MRI analyses contrasting 81 participants with PD and 43 age-matched healthy controls using rigorous quality assurance measures. To investigate the relationship of cerebellar FC to cognitive status, we compared participants with PD without cognitive impairment (Clinical Dementia Rating [CDR] scale score 0, n = 47) to participants with PD with impaired cognition (CDR score ≥0.5, n = 34). Comprehensive measures of cognition across the 5 cognitive domains were assessed for behavioral correlations.
Results
The participants with PD had significantly weaker FC between the vermis and peristriate visual association cortex compared to controls, and the strength of this FC correlated with visuospatial function and global cognition. In contrast, weaker FC between the vermis and dorsolateral prefrontal cortex was found in the cognitively impaired PD group compared to participants with PD without cognitive impairment. This effect correlated with deficits in attention, executive functions, and global cognition. No group differences in cerebellar lobular volumes or regional cortical thickness of the significant cortical clusters were observed.
Conclusion
These results demonstrate a correlation between cerebellar vermal FC and cognitive impairment in PD. The absence of significant atrophy in cerebellum or relevant cortical areas suggests that this could be related to local pathophysiology such as neurotransmitter dysfunction.
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Information & Authors
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© 2019 American Academy of Neurology.
Publication History
Received: February 27, 2019
Accepted: July 19, 2019
Published online: December 17, 2019
Published in print: January 28, 2020
Disclosure
The authors report no disclosures relevant to the manuscript. Go to Neurology.org/N for full disclosures.
Study Funding
This work was supported by National Institute for Neurological Disorders and Stroke/National Institute on Aging NIH RO1 NS075321, NIH RO1 NS097437, and P30 NS098577-01, American Academy of Neurology and American Brain Foundation Clinical Research Training Fellowship in Parkinson's Disease (to B.M), KL2 TR002346 National Center for Advancing Translational Sciences of the NIH (to B.M), Parkinson Study Group, Parkinson's Disease Foundation Mentored Clinical Research Award (to B.M), American Parkinson Disease Association, Greater St. Louis Chapter of American Parkinson Disease Association, Washington University ICTS/Barnes Jewish Hospital Foundation Clinical Translation Award (to M.C.C.), the Jo Oertli Fund, and the Barnes Jewish Hospital Foundation (Elliot Stein Family Fund and Parkinson Disease Research Fund).
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