Altered putamen functional connectivity is associated with anxiety disorder in Parkinson's disease

Abstract

In this study, we used resting state-functional magnetic resonance imaging (rs-fMRI) to explore altered putamen functional connectivity (FC) in Parkinson's disease patients with anxiety disorder. We divided 65 Parkinson's disease patients into anxiety (PD-A; n=18) and non-anxiety (PD-NA; n=45) groups based on a Hamilton Anxiety Rating Scale cutoff score of 12. The PD-A patients exhibited altered putamen FC with cortical and subcortical regions. The PD-A patients showed enhanced putamen FC with the caudatum, which correlated with increased emotional processing during anxiety. Decreased putamen FC with the orbitofrontal gyrus and cerebellum also correlated with increased anxiety in Parkinson's disease. Our findings demonstrate that anxiety disorder in Parkinson's disease is associated with abnormal putamen FC networks, especially with caudatum, orbitofrontal gyrus and cerebellum.

Keywords: FC; Parkinson’s disease; anxiety; pathogenesis; resting state functional magnetic resonance imaging.

Figure 1. Analysis of putamen FC differences in PD-A and PD-NA patients

A. Comparison of putamen FC in PD-A and PD-NA patients. B. Comparison of putamen FC in PD and healthy control subjects. C. Comparison of putamen FC in PD-NA and healthy control subjects. Note: p < 0.01 corrected by AlphaSim denoted statistical significance. HC, healthy control; PD-A, Parkinson’s disease patients with anxiety; PD-NA, Parkinson’s disease patients without anxiety.

Figure 2. Correlation analysis between HAMA scores and FC values of brain regions in the study groups

The positive and negative correlations in PD-A patients based on the Pearson correlation analysis between mean FC values and HAMA scores are shown. P < 0.01 was considered statistically significant. Note: HAMA, Hamilton Anxiety Rating Scale; FC, functional connectivity; OFG, orbitofrontal gyrus.