Objective: Cognitive impairment in Parkinson disease (PD) places a high burden on patients and the pathophysiological mechanisms that differentiate patients with cognitive impairment from those without it are still incompletely understood.
Methods: We conducted a resting-state seed region-of-interest approach to investigate functional connectivity (FC) of important subdivisions of the caudate nucleus, putamen and thalamus in controls (n=33), cognitively unimpaired subjects (PD-CU, n=33), PD subjects with mild cognitive impairment (PD-MCI, n=22) and subjects with dementia (PDD, n=17). We then investigated how the morphology of these structures differed between groups.
Results: PD-CU subjects, compared to controls, displayed increased and decreased FC of caudate, putamen and thalamic subdivisions. PD-MCI subjects demonstrated reduced FC of the mediodorsal thalamus with the paracingulate cortex, compared to PD-CU, and reduced FC of the mediodorsal thalamus with the posterior cingulate cortex compared to PDD. Extensive volumetric and surface-based deflation was found in subjects with dementia.
Conclusions: Our research suggests that cognitive impairment and dementia in PD may be associated with a breakdown in FC of the mediodorsal thalamus with para- and posterior cingulate regions of the brain, respectively.
Significance: Cognitive impairment and dementia in PD may relate to pathophysiological changes in FC of the mediodorsal thalamus.