Identifying the Functional Brain Network of Motor Reserve in Early

Parkinson's Disease

Abstract

The severity of motor symptoms in Parkinson's disease (PD) does not always correlate with
the degree of nigral dopaminergic neuronal loss. Individuals with greater motor reserve may
have milder motor signs than their striatal dopamine loss. In this study, we explored the
functional brain network associated with motor reserve in early-stage PD.

We analyzed 134 patients with de novo PD who underwent dopamine transporter scans and
resting-state functional magnetic resonance imaging. We estimated individual motor reserve
based on initial motor deficits and striatal dopamine depletion using a residual model. We
applied network-based statistic analysis to identify the functional brain network associated
with the measure of motor reserve (ie, motor reserve network). We also assessed the effect
of motor reserve network connectivity strength on the longitudinal increase in levodopa-
equivalent dose during the 2-year follow-up period.

Во наведениот цитат станува збор за интегрално пишување од страна на авторот кое е

исто така многу по застапено заразлика од не интегралното пишување. Авторот одбрал
да шува интегрално според мене, за да може целиот научен труд да звучи по
формален. Во зависност од референците оваа е генерализирана информација која што
сака авторот да ни ја пренесе на нас, најчестите стаии се или сумирани или
генерализирани.

Network-based statistic analysis identified the motor reserve network composed of the basal
ganglia, inferior frontal cortex, insula, and cerebellar vermis at a primary threshold of P value
0.001. Patients with an increased degree of functional connectivity within the motor reserve
network had greater motor reserve. There was a significant interaction between the motor
reserve network strength and time in the linear mixed model, indicating that higher motor
reserve network strength was associated with slower longitudinal increase in levodopa-
equivalent dose.

The present study revealed the functional brain network associated with motor reserve in
patients with early-stage PD. Functional connections within the motor reserve network are
associated with the individual's capacity to cope with PD-related pathologies.

KEYWORDS:

Parkinson's disease; dopamine transporter; functional connectivity; motor reserve; network-

based statistic

Овој текст е интегрално цитиран, што според мене е и почеста појава во научни
трудови. Уште еднаш авторот одбрал интегрално пишување за да се одржува
формалност во научниот труд. Трудот е всушност генерализиран и сумиран од фактите
што се дадени погоре, кои се исто така едни од почестите типиво на цитирање
застапени.

Cognitive anosognosia is associated with frontal dysfunction and lower

depression in Parkinson's disease.

Abstract

Anosognosia refers to a deficit of self-awareness or impaired insight for cognitive and

behavioral problems. We explored cognitive anosognosia in de novo patients with
Parkinson's disease (PD) and investigate its relationship to cognitive function and
neuropsychiatric symptoms.

The cross-sectional study enrolled 340 drug-naïve patients with PD. According to the
presence of mild cognitive impairment (MCI) and subjective cognitive complaint, patients
were classified as patients with cognitive anosognosia (PD-CA, n = 74), with normal cognitive
recognition (PD-NR, n = 184), or with cognitive underestimation (PD-CU, n = 82). After
controlling for covariates, we compared cognitive performance and neuropsychiatric
symptoms among the PD groups.

Cognitive anosognosia was found in 21.8% of patients with de novo PD. The PD-CA group
showed poorer performance in all cognitive domains except for attention. Among PD
patients with MCI, those with cognitive anosognosia showed lower composite z-scores in the
Stroop color reading test than those without. The Beck Depression Inventory (BDI) score in
the PD-NR group was lower than that the PD-CU group and higher than that in the PD-CA
group. Cognitive Complaints Interview score mediated the association between cognitive
anosognosia and BDI score.

Cognitive anosognosia in PD was associated with greater frontal dysfunction and lower
depression. Since cognitive anosognosia has a harmful impact on PD patients and their
caregivers due to overestimation of their abilities in everyday life, early identification of
cognitive anosognosia in PD is important in management and prognosis.

This article is protected by copyright. All rights reserved.

KEYWORDS:
Cognitive anosognosia; Depression; Parkinson's disease; Subjective cognitive complaint

© 2020 International Parkinson and Movement Disorder Society.