Task based functional connectivity in Parkinson’s Disease with increase in disease duration.
Poster No:
284
Submission Type:
Abstract Submission
Authors:
Priyanka Bhat1, S Senthil Kumaran1, Achal K Srivastava1, Divya M Radhakrishnan1
Institutions:
1All India Institue of Medical Sciences (AIIMS), New Delhi, Delhi
First Author:
Co-Author(s):
Introduction:
Parkinson's disease (PD) is a movement disorder, progressive in nature. PD patients primarily experience bradykinesia with rigidity and tremor [Chen, 2015] along with deficits in motor planning and execution[Herz et al., 2014]. Dopamine intervention has a role in restoring the cortical activity [4], but dose requirements need to be periodically reviewed clinically. This study explores the effects of disease duration on functional cortical connectivity (cue-dependent movement execution task).
Methods:
The study was approved by the institute review board. Patients with PD were recruited from the movement disorders clinics and were recruited after obtaining their informed written consent in compliance with Declaration of Helsinki.
Subjects with PD as per UK Parkinson's disease Brain Bank Criteria of both gender and age above 45 years were chosen to be a part of the study. Patients with PD (n = 46) with Hoehn and Yahr (HY) ≤ 3, HAM A ≤ 14 (but not on any anxiolytics), HAM-D ≤ 7 and right sided onset of the first symptom (tremor, bradykinesia or akinesia, rigidity) were recruited. Participants with contraindications to the fMRI, history of any neuropsychiatry co-morbidities were excluded. Clinical assessments like UPDRS (Unified Parkinson's Disease Rating Scale) as well as fMRI sessions were conducted in drug ON phase.
Functional MRI data was acquired on a 3 Tesla MRI scanner (Achieva 3.0T M/s. Philips Medical Systems, Netherlands) with a 32-channel head coil. A single shot echo planar imaging (EPI) sequence with 29 slices of thickness = 5 mm, Slice gap: 0 mm, orientation: transverse, Fold-over direction: RL, multi-sliced-interleaved, Reconstruction matrix: 128, Scan mode technique: fast Fourier echo (FFE), Flip angle = 90°, Field of view (FOV) = 240 mm (RL); 232 mm (AP); with TR/TE =2000/30 ms, number of dynamics 192 was acquired. The task was presented using ePrime software (version 1.0, Psychology Software Tools, USA) and an E-sys IFIS system. Task had 6 alternating rest blocks (no response by the subjects) and active blocks (response to the direction), using an MRI compatible Lumina LP 400 (Cedrus Inc., USA) response pad. During active, a set of 8 images of turns in a corridor (4 of the right turn and 4 of the left turn) were randomly presented. Subjects responded whether the turn was towards the right or left with the respective hand. Functional data were analysed using Conn (ver.21a)[Whitfield-Gabrieli and Nieto-Castanon, 2012] and demographic data with SPSS 20 (IBM Corp) [IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 22.0. Armonk, 2013]. Pre-processing included realignment, outlier detection (using Artefact Detection Tool), co-registration (to subjects T1), normalization (to Montreal neurological institute template) and smoothing (kernel of FWHM=8mm), denoising (band-pass filter= 0.008 to 0.09 Hz). Task based connectivity (TBC) connectivity maps were computed from the active blocks of the fMRI timeseries as the Fisher-transformed bivariate correlation coefficients.
Subjects with PD as per UK Parkinson's disease Brain Bank Criteria of both gender and age above 45 years were chosen to be a part of the study. Patients with PD (n = 46) with Hoehn and Yahr (HY) ≤ 3, HAM A ≤ 14 (but not on any anxiolytics), HAM-D ≤ 7 and right sided onset of the first symptom (tremor, bradykinesia or akinesia, rigidity) were recruited. Participants with contraindications to the fMRI, history of any neuropsychiatry co-morbidities were excluded. Clinical assessments like UPDRS (Unified Parkinson's Disease Rating Scale) as well as fMRI sessions were conducted in drug ON phase.
Functional MRI data was acquired on a 3 Tesla MRI scanner (Achieva 3.0T M/s. Philips Medical Systems, Netherlands) with a 32-channel head coil. A single shot echo planar imaging (EPI) sequence with 29 slices of thickness = 5 mm, Slice gap: 0 mm, orientation: transverse, Fold-over direction: RL, multi-sliced-interleaved, Reconstruction matrix: 128, Scan mode technique: fast Fourier echo (FFE), Flip angle = 90°, Field of view (FOV) = 240 mm (RL); 232 mm (AP); with TR/TE =2000/30 ms, number of dynamics 192 was acquired. The task was presented using ePrime software (version 1.0, Psychology Software Tools, USA) and an E-sys IFIS system. Task had 6 alternating rest blocks (no response by the subjects) and active blocks (response to the direction), using an MRI compatible Lumina LP 400 (Cedrus Inc., USA) response pad. During active, a set of 8 images of turns in a corridor (4 of the right turn and 4 of the left turn) were randomly presented. Subjects responded whether the turn was towards the right or left with the respective hand. Functional data were analysed using Conn (ver.21a)[Whitfield-Gabrieli and Nieto-Castanon, 2012] and demographic data with SPSS 20 (IBM Corp) [IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 22.0. Armonk, 2013]. Pre-processing included realignment, outlier detection (using Artefact Detection Tool), co-registration (to subjects T1), normalization (to Montreal neurological institute template) and smoothing (kernel of FWHM=8mm), denoising (band-pass filter= 0.008 to 0.09 Hz). Task based connectivity (TBC) connectivity maps were computed from the active blocks of the fMRI timeseries as the Fisher-transformed bivariate correlation coefficients.
Results:
The study was conducted on a total of 46 subjects and then they were categorized into 3 groups depending on the duration of disease: A= less than 5 years of disease; B= 5 to 8 years of disease; C= above 8 years. Region of Interest (ROI) to ROI connectivity (RRC) analyses and graph theory measures revealed significant differences in group C (Figures-1). No significant differences were observed in age (p=0.068), UPDRS II (p=0.270) and UPDRS III (p=0.624) across the groups (Figure-2).
Conclusions:
With disease progression, instead of restoration of networks, a compensatory recruitment occurs between cortical and subcortical nodes in PD[Dayan and Browner, 2017; Guan et al., 2017; Kojovic et al., 2012; Little et al., 2013], as revealed by the altered functional connectivity in PD. These differences in connectivity measures are important to review specific treatments and rehabilitation strategies.
Disorders of the Nervous System:
Neurodegenerative/ Late Life (eg. Parkinson’s, Alzheimer’s) 1
Modeling and Analysis Methods:
fMRI Connectivity and Network Modeling 2
Motor Behavior:
Motor Planning and Execution
Novel Imaging Acquisition Methods:
BOLD fMRI
Keywords:
FUNCTIONAL MRI
Movement Disorder
Other - Task Based Functional Connectivity
1|2Indicates the priority used for review
Provide references using author date format
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5. IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 22.0. Armonk NICorp (2013): IBM SPSS V22.
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