Insular and limbic abnormal functional connectivity in early-stage Parkinson’s disease patients with autonomic dysfunction

Author:

Conti Matteo12,Garasto Elena12,Bovenzi Roberta12,Ferrari Valerio12,Mercuri Nicola B12,Di Giuliano Francesca34,Cerroni Rocco125,Pierantozzi Mariangela12,Schirinzi Tommaso12,Stefani Alessandro125ORCID,Rocchi Camilla12

Affiliation:

1. Neurology Unit , Department of Systems Medicine, , Via Montpellier 1, 00133 Rome , Italy

2. University of Rome “Tor Vergata” , Department of Systems Medicine, , Via Montpellier 1, 00133 Rome , Italy

3. Neuroradiology Unit , Department of Biomedicine and Prevention, , Via Montpellier 1, 00133 Rome , Italy

4. University of Rome “Tor Vergata” , Department of Biomedicine and Prevention, , Via Montpellier 1, 00133 Rome , Italy

5. UOSD Parkinson Centre, Tor Vergata University Hospital , Viale Oxford 81, 00133 Rome , Italy

Abstract

Abstract Autonomic symptoms in Parkinson’s disease result from variable involvement of the central and peripheral systems, but many aspects remain unclear. The analysis of functional connectivity has shown promising results in assessing the pathophysiology of Parkinson’s disease. This study aims to investigate the association between autonomic symptoms and cortical functional connectivity in early Parkinson’s disease patients using high-density EEG. 53 early Parkinson’s disease patients (F/M 18/35) and 49 controls (F/M 20/29) were included. Autonomic symptoms were evaluated using the Scales for Outcomes in Parkinson’s disease–Autonomic Dysfunction score. Data were recorded with a 64-channel EEG system. We analyzed cortical functional connectivity, based on weighted phase-lag index, in θ-α-β-low-γ bands. A network-based statistic was used to perform linear regression between Scales for Outcomes in Parkinson’s disease–Autonomic Dysfunction score and functional connectivity in Parkinson’s disease patients. We observed a positive relation between the Scales for Outcomes in Parkinson’s disease–Autonomic Dysfunction score and α-functional connectivity (network τ = 2.8, P = 0.038). Regions with higher degrees were insula and limbic lobe. Moreover, we found positive correlations between the mean connectivity of this network and the gastrointestinal, cardiovascular, and thermoregulatory domains of Scales for Outcomes in Parkinson’s disease–Autonomic Dysfunction. Our results revealed abnormal functional connectivity in specific areas in Parkinson’s disease patients with greater autonomic symptoms. Insula and limbic areas play a significant role in the regulation of the autonomic system. Increased functional connectivity in these regions might represent the central compensatory mechanism of peripheral autonomic dysfunction in Parkinson’s disease.

Funder

NEXTGENERATIONEU

Ministry of University and Research

National Recovery and Resilience Plan

MNESYS

A Multiscale Integratedapproach to the Study of the Nervous System in Health and Disease

Publisher

Oxford University Press (OUP)

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