FMRI And DTI Based Study Of Subthalamic Nucleus In Early Parkinson’s Disease

Pathological studies confirmed that Parkinson’s disease (PD) have subclinicalstage, only middle-late patients developed motor symptoms. Both methods rely onHoehnyahr classification standards and Unified Parkinson’s Disease Rating Scale(UPDRS) to diagnose the patient’s condition lacking of timeliness, and easilymisdiagnosed. Therefore, it is necessary to develop a simple, safe, fast and effectivemonitoring method to provide an objective basis for the evaluation of early clinicaldiagnosis of Parkinson’s disease. subthalamic nucleus deep brain stimulation (STN-DBS)in the clinical treatment of Parkinson’s disease has been widely used and proven to beeffective in alleviating the motor symptoms for PD patients. However, what is the roleof the complicated subcortical structure of STN, plays in early PD is still unclear.Twenty-one PD patients and eighteen normal controls magnetic resonance imagingdata in this study were studied. Firstly, we used resting-state functional connectivity(rsFC) to characterize the role of bilateral STN in early PD with functional magneticresonance imaging (fMRI) data. The rsFC analyses revealed reduced functionalconnectivity (FC) in left insula, left superior temporal gyrus with left subthalamicnucleus, reduced FC in pars triangularis of left Inferior frontal gyrus, left insula, and leftputamen with the right subthalamic nucleus in PD patients. However, increased FC inposterior cingulate cortex, middle cingulate cortex and inferior precuneus with the leftsubthalamic nucleus, and increased FC in bilateral precuneus, left middle cingulatecortex, left paracentral lobe with the right subthalamic nucleus in PD patients. After, westudy the white matter integrity of early PD using whole brain voxel-based statisticalanalysis (VBA) method based on diffusion tensor imaging (DTI) data. Our foundingrevealed that significantly reduced white matter integrity in right middle frontal gyrus,left anterior cingulate cortex, and left insula in PD compared with normal controls.Finally, we using probability tracking algorithm to evaluate the anatomical connectivitypatterns of bilateral subthalamic nucleus, the results showed that, there is no statisticallysignificant difference of fiber connection strength between early PD with normalcontrols, especially in right inferior frontal cortex, pre-supplementary motor area and the anterior cingulate cortex.Extensive analyses in functional and structural aspects of magnetic resonanceimaging performed in our study may help for a better understanding of the earlydiagnosis and assessment of Parkinson’s disease, and provide some new methods forquantitatively assess the clinical therapeutic effect of STN-DBS in patients.