Correlation between Executive Network Integrity and Sarcopenia in Patients with Parkinson’s Disease

Lee, Chih Ying; Chen, Hsiu-Ling; Chen, Pei Chin; Chen, Yueh Sheng; Chiang, Pi-Ling; Wang, Chengkang; Lu, Cheng Hsien; Chen, Meng Hsiang; Chou, Kun Hsien; Huang, Yu Chi; Lin, Wei Che

doi:10.3390/ijerph16244884

Cited by 16 publications

(32 citation statements)

References 32 publications

(41 reference statements)

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“…Our results showed a greater loss in WM integrity with lower EF in PIGD-N compared to TD-N phenotype, which is in agreement with a previous study [14]. In addition, we confirmed that SLF MD and RD values are correlated with EF in PD-N patients, as previously reported [12,[49][50][51][52].…”

Section: Discussionsupporting

confidence: 93%

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Executive function network’s white matter alterations relate to Parkinson’s disease motor phenotype

Nanivadekar

Taylor

et al. 2020

Preprint

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Parkinson's disease (PD) patients with postural instability and gait disorder phenotype (PIGD) are at high risk of cognitive deficits compared to those with tremor dominant phenotype (TD). Alterations of white matter (WM) integrity can occur in patients with normal cognitive functions (PD-N). However, the alterations of WM integrity related to cognitive functions in PD-N, especially in these two motor phenotypes, remain unclear. Diffusion tensor imaging (DTI) is a non-invasive neuroimaging method to evaluate WM properties and by applying DTI tractography, one can identify WM tracts connecting functional regions. Here, we 1) compared the executive function (EF) in PIGD phenotype with normal cognitive functions (PIGD-N) and TD phenotype with normal cognitive functions (TD-N) phenotypes; 2) used DTI tractography to evaluated differences in WM alterations between these two phenotypes within a task-based functional network; and 3) examined the WM integrity alterations related to EF in a whole brain network for PD-N patients regardless of phenotypes. Thirty-four idiopathic PD-N patients were classified into two groups based on phenotypes: TD-N and PIGD-N, using an algorithm based on UPDRS part III. Neuropsychological tests were used to evaluate patients' EF, including the Trail making test part A and B, the Stroop color naming, the Stroop word naming, the Stroop color-word interference task, as well as the FAS verbal fluency task and the animal category fluency tasks. DTI measures were calculated among WM regions associated with the verbal fluency network defined from previous task fMRI studies, and compared between PIGD-N and TD-N groups. In addition, the relationship of DTI measures and verbal fluency scores were evaluated for our full cohort of PD-N patients within the whole brain network. These values were also correlated with the scores of the FAS verbal fluency task. Only the FAS verbal fluency test showed significant group differences, having lower scores in PIGD-N when compared to TD-N phenotype (p < 0.05). Compared to the TD-N, PIGD-N group exhibited significantly higher MD and RD in the tracts connecting the left superior temporal gyrus and left insula, and those connecting the right pars opercularis and right insula. Moreover, compared to TD-N, PIGD-N group had significantly higher RD in the tracts connecting right pars opercularis and right pars triangularis, and the tracts connecting right inferior temporal gyrus and right middle temporal gyrus. For the entire PD-N cohort, FAS verbal fluency scores positively correlated with MD in the superior longitudinal fasciculus (SLF). This study confirmed that PIGD-N phenotype has more deficits in verbal fluency task than TD-N phenotype. Additionally, our findings suggest: (1) PIGD-N shows more microstructural changes related to FAS verbal fluency task when compared to TD-N phenotype; (2) SLF plays an important role in FAS verbal fluency task in PD-N patients regardless of motor phenotypes.

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Section: Discussionsupporting

confidence: 93%

“…We also found the SLF integrity was correlated to the EF in PD, as previous studies reported [12,[49][50][51][52].…”

Section: Characteristics Of Wm Integrity Correlated With Performance supporting

confidence: 76%

Executive function network’s white matter alterations relate to Parkinson’s disease motor phenotype

Nanivadekar

Taylor

et al. 2020

Preprint

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“…We also found that T2DM patients exhibited lower MoCA scores and higher TMT-A/TMT-B scores and that the susceptibility values of some brain regions showed significant correlation with TMT-A or TMT-B. These phenomena suggest that the synergy of these changes might have an influence on fronto-striato-thalamic circuits of the brain and then impact EF ( Lee et al, 2019 ; Wu et al, 2020 ). The results suggest that an increase in iron deposition within the brain might function as a risk factor for the seriousness of brain injury in patients with T2DM.…”

Section: Discussionmentioning

confidence: 56%

Increased Brain Iron Detection by Voxel-Based Quantitative Susceptibility Mapping in Type 2 Diabetes Mellitus Patients With an Executive Function Decline

Zhang²,

Zhang

et al. 2021

Front. Neurosci.

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PurposeBrain iron accumulation has been suggested as a pathomechanism in patients with type 2 diabetes mellitus (T2DM) with cognitive impairment. This research aims to examine the total-brain pattern of iron accumulation in relation to executive function decline in patients with T2DM by voxel-based quantitative susceptibility mapping (QSM) analysis.Materials and MethodsA total of 32 patients with T2DM and 34 age- and sex-matched healthy controls (HCs) were enrolled in this study. All participants underwent brain magnetic resonance examination, and 48 individuals underwent cognitive function assessments. Imaging data were collected with three-dimensional fast low-angle shot sequences to achieve magnitude as well as phase images. Using voxel-based QSM analysis, we compared the voxel-wise susceptibility values of the whole brain among groups and explored whether the susceptibility values had correlations with cognitive data.ResultsAmong the 66 participants, cognitive function was estimated in 23 patients with T2DM (11 males and 12 females; average age, 64.65 ± 8.44 years) and 25 HCs (13 males and 12 females; average age, 61.20 ± 7.62 years). T2DM patients exhibited significantly (t = 4.288, P < 0.001) lower Montreal Cognitive Assessment (MoCA) scores [T2DM, 27 (27, 28); HCs, 29 (28, 29); normal standard ≥ 26)] and higher Trail-making Test (TMT)-A/TMT-B scores [71 (51, 100)/185 (149, 260)] than HCs [53 (36.5, 63.5)/150 (103, 172.5)] (Z = 2.612, P = 0.009; Z = 2.797, P = 0.005). Subjects with T2DM showed significantly higher susceptibility values than HCs in the caudate/putamen/pallidum, frontal inferior triangular gyrus, and precentral gyrus on the right hemisphere. In contrast (HC > T2DM), no region showed a significant difference in susceptibility values between the groups. The correlation analysis between susceptibility values and cognitive function scores was tested by voxel-based susceptibility value with sex and age as covariates. After multiple comparison correction, in T2DM patients, the left thalamus showed a significant relationship with TMT-A (R2 = 0.53, P = 0.001). The right thalamus and left thalamus showed a significant relationship with TMT-B (R2 = 0.35, P = 0.019; and R2 = 0.38, P = 0.017, respectively). In HCs, the cluster of right precentral/middle frontal gyrus/inferior frontal gyrus/inferior triangular gyrus showed a significant relationship with TMT-B (R2 = 0.59, P = 0.010). No relationship was found between the susceptibility values with MoCA in the brain region in both two groups.ConclusionPatients with T2DM presented declined cognitive assessments and elevated iron deposition in the striatum and frontal lobe, suggesting that executive function decline in T2DM might be associated with the cerebral iron burden and that changes in susceptibility values may represent a latent quantitative imaging marker for early assessment of cognitive decline in patients with T2DM.

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“…Fractional anisotropy values reduction in the left cingulum and right anterior thalamic radiation in PD patients with sarcopenia exhibited the strongest correlations with decreased muscle mass (14), which represented WM alterations in the executive functional network in PD patients with sarcopenia (14). Moreover, decreased ASMMI was associated with reduced fractional anisotropy in the fronto-striato-thalamic circuits in PD patients with sarcopenia (14). Thirdly, besides affecting the central nervous system, the decrease in the numbers of motoneurons, i.e., mild motor neuron degeneration, might be another mechanism for neurogenic sarcopenia in PD since a low number of motor units were observed only in PD patients compared with controls (29).…”

Section: Discussionmentioning

confidence: 90%

“…In addition, some studies found that falls incidence (15,16) and female proportion (20) in PD with sarcopenia were higher than those in PD without sarcopenia. However, some studies reported that there were no differences in falls incidence (20) and female proportion (14,15) between PD patients with and without sarcopenia. Therefore, the main objective of the current study was acted in accordance with PICOS through systematical review and meta-analysis method: participants (P): patients with a diagnosis of PD from medical institutions or population; intervention (I): PD patients with sarcopenia; control (C): PD patients without sarcopenia; outcome (O): the prevalence of sarcopenia in PD patients, and the differences in clinical features between PD patients with and without sarcopenia; and study design (S): cohort study, case-control study, or cross-sectional study.…”

Section: Introductionmentioning

confidence: 97%

Sarcopenia in Patients With Parkinson's Disease: A Systematic Review and Meta-Analysis

et al. 2021

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Background: Parkinson's disease (PD) and sarcopenia are two common diseases in aging people. To date, the prevalence of sarcopenia in PD patients and the relationship between clinical features and sarcopenia in PD patients are not clear. The aim of the study was to (1) assess the prevalence of sarcopenia in PD patients and (2) reveal the clinical features between PD patients with and without sarcopenia.Method: A systematic review was carried out through screening PubMed, EMBASE, and Cochrane database in May 2020. All study designs (case–control, cohort, and cross-sectional studies) were eligible for meta-analysis. Data of patients' characteristics, sarcopenia criteria, sarcopenia prevalence, and sarcopenia measures were retrieved. The primary outcome was estimated prevalence of sarcopenia by a pooled prevalence (%) and its 95% confidence interval (CI), using a random-effects model. The secondary outcome was the differences in clinical features between PD patients with and without sarcopenia by meta-analysis. Included articles were assessed for risk of bias. Potential sources of variation were investigated by using subgroup analyses and meta-regression.Result: Ten studies were included in the review. Among them, nine were cross-sectional studies, and one was a prospective cohort study. Age of participants with PD in the studies ranged from 51.1 to 80.7 years. The estimated prevalence of sarcopenia ranged from 6 to 55.5%. The random-effects pooled prevalence was 29% (95% CIs: 0.18–0.40). When only studies at low risk of bias were considered, pooled prevalence decreased to 17% (95% CIs: 0.02–0.33), with still high heterogeneity. The incidence of falls in PD patients with sarcopenia was higher than that in PD patients without sarcopenia. There was no difference in sex ratio between PD patients with and without sarcopenia.Conclusion: Sarcopenia seems to be common in patients with PD. Early assessment of sarcopenia should be implemented in PD to avoid fall and disability.

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Correlation between Executive Network Integrity and Sarcopenia in Patients with Parkinson’s Disease

Cited by 16 publications

References 32 publications

Executive function network’s white matter alterations relate to Parkinson’s disease motor phenotype

Executive function network’s white matter alterations relate to Parkinson’s disease motor phenotype

Increased Brain Iron Detection by Voxel-Based Quantitative Susceptibility Mapping in Type 2 Diabetes Mellitus Patients With an Executive Function Decline

Sarcopenia in Patients With Parkinson's Disease: A Systematic Review and Meta-Analysis

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