Altered brain activation and connectivity in early Parkinson disease tactile perception

Abstract

Background and purpose: Deficits in tactile perception are common in patients with PD. However, the neural mechanisms have not been previously reported in the early stages. This study aims to investigate how the brain activity and connectivity changed under tactile perception at early Parkinsonian state by using functional MR imaging.

Materials and methods: Twenty-one patients with early PD and 22 age- and sex-matched controls were recruited and scanned under a passive tactile stimulation task. Within-group and between-group activation maps were acquired, and regions of interest were defined according to the group-comparison result. This was followed by a functional connectivity analysis based on the graph theory.

Results: We found that in the PD group, bilateral sensorimotor cortex was hypoactive during the task, whereas the hyperactive regions were mainly in bilateral prefrontal cortex, bilateral cerebellum, and contralateral striatum. There was a significant decrease of total connectivity degree in ipsilateral SMA in PD, which was negatively correlated with the Unified Parkinson's Disease Rating Scale score. Furthermore, the connection strengths among the areas of prefrontal cortex, striatum, and cerebellum were increased.

Conclusions: This study illustrated that early PD was associated with not only altered brain activation but also changed functional connectivity in tactile perception. The most significant impairment was in SMA, whereas striato-prefrontal and cerebello-prefrontal loops may play a compensatory role in early PD tactile function.

Fig 1.

Within-group activation maps in controls (A) and patients with early PD (B). The hot colors indicate the activated regions under tactile perception (P < .05 with FWE correction, voxels >10).

Fig 2.

The hyperactive (red) and hypoactive (blue) brain regions in a patient with PD compared with the control under tactile perception (P < .005, uncorrected).

Fig 3.

Correlation between connectivity degrees (Γ) and UPDRS scores in ispilateral supplementary motor area in PD.

Fig 4.

Reduced (A) and enhanced (B) connection strengths (z) in brain links in patients with PD compared with controls (P < .005).