Posterior Vermis Structural and Functional Changes in Parkinson's Disease with Gait Dysfunction
Poster No:
91
Submission Type:
Abstract Submission
Authors:
Liuzhenxiong Yu1, Rong Ye2, Panpan Hu1
Institutions:
1The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, 2Anhui Medical University, Hefei, N/A
First Author:
Co-Author(s):
Introduction:
Cerebellar involvement in Parkinson's disease (PD) is heterogeneous across disease stages and sub-regions. The posterior vermis (PV) plays a crucial role in the PD-related gait disturbances. However, the specific contribution of these subdivisions remains unclear. This study investigated the relationship between structural and functional alterations in PV sub-regions across PD progression and their association with gait impairments in patients with predominant postural instability and gait difficulty (PD-PIGD).
Methods:
In retrospective cross-sectional study, we examined the structural and functional characteristics of the posterior vermis (PV) in patients with PD-PIGD across various disease stages defined by the Hoehn and Yahr (HY) scale. The study cohort comprised 94 patients with PD-PIGD, stratified by HY stage (HY1, n = 33; HY2, n = 30; HY3-4, n = 31). Additionally, 46 age- and sex-matched healthy controls (HC) were included for comparative analysis. Our focus was on the posterior superior vermis (PSV) and the posterior inferior vermis (PIV), the two primary anatomical subdivisions of the PV. Differences in PV volume and seed-based resting-state functional connectivity (FC) among the groups were assessed using one-way analysis of variance and general linear model approaches, respectively. Furthermore, Bonferroni (Bonf) correction and false discovery rate correction were applied during volumetric and FC analyses to mitigate the risk of false positives due to multiple comparisons. Spearman's correlation coefficients were utilized to explore the relationships among volumetric measurements, FC, gait impairments, and cognitive function. Mediation analyses were conducted to elucidate the potential pathways through which structural and functional alterations may influence gait impairments.
Results:
Patients at the HY1 stage exhibited significantly increased PSV volume when compared to HC (Cohen's d = 0.76, p_Bonf = 0.007). Conversely, patients at the HY3-4 stage displayed a marked decrease in PSV volume relative to those at the HY1 stage (Cohen's d = -0.94, p_Bonf = 0.001). FC analysis revealed significant alterations in the connections between the PSV and motor cortex, specifically involving the left paracentral lobule and right precentral gyrus, across different disease stages. Notably, no differences in structural or functional metrics were observed in the PIV. Moreover, both PSV volume and FC between the PSV and the left paracentral lobule were significantly correlated with gait impairments, as measured by PIGD scores, as well as with cognitive performance, assessed using the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA), in patients with PD-PIGD. Mediation analysis further indicated that cognitive functioning serves as a mediator in the relationship between PSV alterations and gait impairments.
·Posterior vermis volume and correlation with both motor and cognitive functions
·Posterior superior vermis functional connectivity and correlation with both motor and cognitive functions
Conclusions:
Our underscored the critical role of the PSV in the pathophysiology of PD-PIGD. The dynamic changes in PSV volume and FC across disease stages suggested a complex interplay of compensatory adaptations and progressive neurodegeneration. The strong associations between PSV integrity, gait performance, and cognitive function highlighted the need for comprehensive management strategies. Targeted neuromodulation of the cerebellum emerged as a promising therapeutic approach. Additionally, longitudinal studies utilizing advanced neuroimaging techniques were deemed essential to further elucidate these complex relationships and to develop effective interventions for patients with PD-PIGD.
Disorders of the Nervous System:
Neurodegenerative/ Late Life (eg. Parkinson’s, Alzheimer’s) 1
Novel Imaging Acquisition Methods:
BOLD fMRI
Multi-Modal Imaging 2
Keywords:
Cerebellum
Cognition
FUNCTIONAL MRI
Motor
Movement Disorder
STRUCTURAL MRI
1|2Indicates the priority used for review
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