Apathy is associated with white matter network disruption and specific cognitive deficits in Parkinson's disease.

Autor:	Wen MC; Department of Research, National Neuroscience Institute, Singapore.; Duke-NUS Medical School, Singapore., Thiery A; Department of Statistics and Applied Probability, National University of Singapore, Singapore., Tseng WI; Institute of Medical Device and Imaging, National Taiwan University College of Medicine, Taipei, Taiwan., Kok T; Clinical Imaging Research Centre, National University of Singapore, Singapore., Xu Z; Department of Neurology, National Neuroscience Institute, Singapore., Chua ST; Department of Neurology, National Neuroscience Institute, Singapore., Tan LCS; Department of Research, National Neuroscience Institute, Singapore.; Duke-NUS Medical School, Singapore.; Department of Neurology, National Neuroscience Institute, Singapore.
Jazyk:	angličtina
Zdroj:	Psychological medicine [Psychol Med] 2022 Jan; Vol. 52 (2), pp. 264-273. Date of Electronic Publication: 2020 Jun 11.
DOI:	10.1017/S0033291720001907
Abstrakt:	Background: Apathy is common in Parkinson's disease (PD) but its underlying white matter (WM) architecture is not well understood. Moreover, how apathy affects cognitive functions in PD remains unclear. We investigated apathy-related WM network alterations and the impact of apathy on cognition in the context of PD. Methods: Apathetic PD patients (aPD), non-apathetic PD patients (naPD), and matched healthy controls (HCs) underwent brain scans and clinical assessment. Graph-theoretical and network-based analyses were used for group comparisons of WM features derived from diffusion spectrum imaging (DSI). Path analysis was used to determine the direct and indirect effects of apathy and other correlates on different cognitive functions. Results: The aPD group was impaired on neural integration measured by global efficiency (p = 0.009) and characteristic path length (p = 0.04), executive function (p < 0.001), episodic memory (p < 0.001) and visuospatial ability (p = 0.02), and had reduced connectivity between the bilateral parietal lobes and between the putamen and temporal regions (p < 0.05). In PD, executive function was directly impacted by apathy and motor severity and indirectly influenced by depression; episodic memory was directly and indirectly impacted by apathy and depression, respectively; conversely, visuospatial ability was not related to any of these factors. Neural integration, though being marginally correlated with apathy, was not associated with cognition. Conclusions: Our results suggest compromised neural integration and reduced structural connectivity in aPD. Apathy, depression, and motor severity showed distinct impacts on different cognitive functions with apathy being the most influential determinant of cognition in PD.
Databáze:	MEDLINE
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