Altered Brain Network Centrality In Dysphagic Patients With Parkinson Disease:A Resting-State Functional Magnetic Resonance Imaging Study

Objective:Dysphagia is a common non-motor symptom of patients with Parkinson disease (PD), which would lead to aspiration pneumonia, having a severe impact on the quality of life of PD patients and endangering patients’ lives. Although disturbances in some related cortical activations have been already reported, the pathophysiology of dysphagia in PD is still unclear. The aim of this study is to investigate the underlying alterations of brain cortex and the whole brain functional connectivity patterns in PD patients with dysphagia by using eigenvector centrality mapping technology of resting-state functional magnetic resonance imaging (rsfMRI), which helps understanding the pathophysiology of PD with dysphagia further.Method:We recruited 116 PD patients from outpatient to take Videofloroscopic study of swollowing (VFSS), according to which we screened out 13 PD patients with dysphagia and 10 PD patients without dysphagia.13 age and sex matched healthy subjects were also recruited as normal control (NCs). We preprocessed the functional MRI data which was further analyzed by eigenvector centrality mapping. Two sample t-test was used to detect the brain regions with abnormal functional connectivity.Result:No significant differences were found in age, sex, disease duration, UPDRS-III, H-Y stages and MMSE scores between PD with dysphagia and PD without dysphagia. PD patients with dysphagia had significantly increased functional connectivity in the cerebellum, left premotor cortex, the supplementary motor area (SMA) and the primary motor cortex and right temporal pole of superior temporal gyrus, inferior frontal gyrus, anterior cingulate cortex and insula, compared with PD patients without dysphagia.Conclusion:This study suggests that functional connectivity changes in swallowing related cortexes such as premotor cortex, the supplementary motor area (SMA), the primary motor cortex, anterior cingulate corte (ACC) and insula, might contribute to the physiopathologic mechanism of dysphagia in PD patients with dysphagia.