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タイトル: | Frontoparietal-Striatal Network and Nucleus Basalis Modulation in Patients With Parkinson Disease and Gait Disturbance |
著者: | Nishida, Akira Shima, Atsushi ![]() ![]() ![]() Kambe, Daisuke Furukawa, Koji Sakamaki-Tsukita, Haruhi Yoshimura, Kenji Wada, Ikko Sakato, Yusuke Terada, Yuta Sawamura, Masanori Nakanishi, Etsuro ![]() ![]() Taruno, Yosuke Yamakado, Hodaka ![]() ![]() Fushimi, Yasutaka ![]() ![]() ![]() Okada, Tomohisa Nakamoto, Yuji ![]() ![]() ![]() Takahashi, Ryosuke ![]() ![]() ![]() Sawamoto, Nobukatsu ![]() ![]() |
著者名の別形: | 島, 淳 澤村, 正典 中西, 悦郎 樽野, 陽亮 山門, 穂高 伏見, 育崇 岡田, 知久 中本, 裕士 高橋, 良輔 澤本, 伸克 |
発行日: | 13-Aug-2024 |
出版者: | Wolters Kluwer Health American Academy of Neurology |
誌名: | Neurology |
巻: | 103 |
号: | 3 |
論文番号: | e209606 |
抄録: | Background and Objectives: Neural computations underlying gait disorders in Parkinson disease (PD) are multifactorial and involve impaired expression of stereotactic locomotor patterns and compensatory recruitment of cognitive functions. This study aimed to clarify the network mechanisms of cognitive contribution to gait control and its breakdown in patients with PD. Methods: Patients with PD were instructed to walk at a comfortable pace on a mat with pressure sensors. The characterization of cognitive-motor interplay was enhanced by using a gait with a secondary cognitive task (dual-task condition) and a gait without additional tasks (single-task condition). Participants were scanned using 3-T MRI and ¹²³I-ioflupane SPECT. Results: According to gait characteristics, cluster analysis assisted by a nonlinear dimensionality reduction technique, t-distributed stochastic neighbor embedding, categorized 56 patients with PD into 3 subpopulations. The preserved gait (PG) subgroup (n = 23) showed preserved speed and variability during gait, both with and without additional cognitive load. Compared with the PG subgroup, the mildly impaired gait (MIG) subgroup (n = 16) demonstrated deteriorated gait variability with additional cognitive load and impaired speed and gait variability without additional cognitive load. The severely impaired gait (SIG) subgroup (n = 17) revealed the slowest speed and highest gait variability. In addition, group differences were found in attention/working memory and executive function domains, with the lowest performance in the SIG subgroup than in the PG and MIG subgroups. Using resting-state functional MRI, the SIG subgroup demonstrated lower functional connectivity of the left and right frontoparietal network (FPN) with the caudate than the PG subgroup did (left FPN, d = 1.21, p < 0.001; right FPN, d = 1.05, p = 0.004). Cortical thickness in the FPN and ¹²³I-ioflupane uptake in the striatum did not differ among the 3 subgroups. By contrast, the severity of Ch4 density loss was significantly correlated with the level of functional connectivity degradation of the FPN and caudate (left FPN–caudate, r = 0.27, p = 0.04). Discussion: These findings suggest that the functional connectivity of the FPN with the caudate, as mediated by the cholinergic Ch4 projection system, underlies the compensatory recruitment of attention and executive function for damaged automaticity in gait in patients with PD. |
記述: | パーキンソン病患者の歩行障害に関与する脳内ネットワーク. 京都大学プレスリリース. 2024-07-10. |
著作権等: | This is a pre-copyedited, author-produced version of an article accepted for publication in [Neurology]. The published version of record [Akira Nishida, Atsushi Shima, Daisuke Kambe, Koji Furukawa, Haruhi Sakamaki-Tsukita, Kenji Yoshimura, Ikko Wada, Yusuke Sakato, Yuta Terada, Masanori Sawamura, Etsuro Nakanishi, Yosuke Taruno, Hodaka Yamakado, Yasutaka Fushimi, Tomohisa Okada, Yuji Nakamoto, Ryosuke Takahashi, Nobukatsu Sawamoto, Frontoparietal-Striatal Network and Nucleus Basalis Modulation in Patients With Parkinson Disease and Gait Disturbance, Neurology, Volume 103, Issue 3, 2024, e209606] is available online at: https://doi-org.kyoto-u.idm.oclc.org/10.1212/WNL.0000000000209606 The full-text file will be made open to the public on July 8, 2025 in accordance with publisher's 'Terms and Conditions for Self-Archiving'. This is not the published version. Please cite only the published version. この論文は出版社版でありません。引用の際には出版社版をご確認ご利用ください。 |
URI: | http://hdl.handle.net/2433/293305 |
DOI(出版社版): | 10.1212/WNL.0000000000209606 |
PubMed ID: | 38976821 |
関連リンク: | https://www.kyoto-u.ac.jp/ja/research-news/2024-07-10 |
出現コレクション: | 学術雑誌掲載論文等 |

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