Abnormal Spontaneous Neural Activity in Parkinson's Disease With "pure" Apathy

Hai-Hua Sun; Jian-Bin Hu; Jing Chen; Xue-Yang Wang; Xiao-Li Wang; Ping-Lei Pan; Chun-Feng Liu

doi:10.3389/fnins.2020.00830

Abnormal Spontaneous Neural Activity in Parkinson's Disease With "pure" Apathy

Front Neurosci. 2020 Aug 4:14:830. doi: 10.3389/fnins.2020.00830. eCollection 2020.

Authors

Hai-Hua Sun¹, Jian-Bin Hu², Jing Chen³, Xue-Yang Wang², Xiao-Li Wang⁴, Ping-Lei Pan², Chun-Feng Liu^{3

5}

Affiliations

¹ Department of Neurology, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, China.
² Department of Radiology, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, China.
³ Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China.
⁴ Department of Emergency, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, China.
⁵ Institute of Neuroscience, Soochow University, Suzhou, China.

Abstract

Background: Apathy is one of the most common non-motor symptoms of Parkinson's disease (PD). However, its pathophysiology remains unclear.

Methods: We analyzed resting-state functional magnetic resonance imaging (MRI) data acquired at a 3.0T MRI scanner using the amplitude of low-frequency fluctuation (ALFF) metric in 20 de novo, drug-naïve, non-demented PD patients with apathy (PD-A), 26 PD patients without apathy (PD-NA) without comorbidity of depressive or anxious symptoms, and 23 matched healthy control (HC) subjects.

Results: We found that the ALFF decreased significantly in the bilateral nucleus accumbens, dorsal anterior cingulate cortex (ACC), and left dorsolateral prefrontal cortex in patients with PD-A compared to patients with PD-NA and HC subjects. Furthermore, apathy severity was negatively correlated with the ALFF in the bilateral nucleus accumbens and dorsal ACC in the pooled patients with PD.

Conclusion: The present study characterized the functional pattern of changes in spontaneous neural activity in patients with PD-A. With the aim to better elucidate the pathophysiological mechanisms responsible for these changes, this study controlled for the potentially confounding effects of dopaminergic medication, depression, anxiety, and global cognitive impairment. The findings of the current study add to the literature by highlighting potential abnormalities in mesocorticolimbic pathways involved in the development of apathy in PD.

Keywords: Parkinson’s disease; amplitude of low-frequency fluctuation; apathy; dorsal anterior cingulate cortex; nucleus accumbens.