Functional connectivity in the basal ganglia network differentiates PD patients from controls

Konrad Szewczyk-Krolikowski, Ricarda A L Menke, Michal Rolinski, Eugene Duff, Gholamreza Salimi-Khorshidi, Nicola Filippini, Giovanna Zamboni, Michele T M Hu, Clare E Mackay

Research output: Contribution to journalArticle (Academic Journal)peer-review

102 Citations (Scopus)

Abstract

OBJECTIVE: To examine functional connectivity within the basal ganglia network (BGN) in a group of cognitively normal patients with early Parkinson disease (PD) on and off medication compared to age- and sex-matched healthy controls (HC), and to validate the findings in a separate cohort of participants with PD.

METHODS: Participants were scanned with resting-state fMRI (RS-fMRI) at 3T field strength. Resting-state networks were isolated using independent component analysis. A BGN template was derived from 80 elderly HC participants. BGN maps were compared between 19 patients with PD on and off medication in the discovery group and 19 age- and sex-matched controls to identify a threshold for optimal group separation. The threshold was applied to 13 patients with PD (including 5 drug-naive) in the validation group to establish reproducibility of findings.

RESULTS: Participants with PD showed reduced functional connectivity with the BGN in a wide range of areas. Administration of medication significantly improved connectivity. Average BGN connectivity differentiated participants with PD from controls with 100% sensitivity and 89.5% specificity. The connectivity threshold was tested on the validation cohort and achieved 85% accuracy.

CONCLUSIONS: We demonstrate that resting functional connectivity, measured with MRI using an observer-independent method, is reproducibly reduced in the BGN in cognitively intact patients with PD, and increases upon administration of dopaminergic medication. Our results hold promise for RS-fMRI connectivity as a biomarker in early PD.

CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that average connectivity in the BGN as measured by RS-fMRI distinguishes patients with PD from age- and sex-matched controls.

Original languageEnglish
Pages (from-to)208-214
Number of pages7
JournalNeurology
Volume83
Issue number3
Early online date11 Jun 2014
DOIs
Publication statusPublished - 15 Jul 2014

Keywords

  • Aged
  • Aged, 80 and over
  • Basal Ganglia
  • Cohort Studies
  • Diagnosis, Differential
  • Female
  • Functional Neuroimaging
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Nerve Net
  • Parkinson Disease

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