Altered Interhemispheric Functional Connectivity Associated With Early Verbal Fluency Decline After Deep Brain Stimulation in Parkinson's Disease

Bei Luo; Wenwen Dong; Lei Chang; Chang Qiu; Yue Lu; Dongming Liu; Chen Xue; Li Zhang; Weiguo Liu; Wenbin Zhang; Jun Yan

doi:10.3389/fnagi.2022.799545

Altered Interhemispheric Functional Connectivity Associated With Early Verbal Fluency Decline After Deep Brain Stimulation in Parkinson's Disease

Front Aging Neurosci. 2022 Apr 1:14:799545. doi: 10.3389/fnagi.2022.799545. eCollection 2022.

Authors

Bei Luo¹, Wenwen Dong¹, Lei Chang¹, Chang Qiu¹, Yue Lu¹, Dongming Liu², Chen Xue³, Li Zhang⁴, Weiguo Liu⁵, Wenbin Zhang¹, Jun Yan⁴

Affiliations

¹ Department of Functional Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.
² Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.
³ Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.
⁴ Department of Geriatric Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.
⁵ Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.

Abstract

Background: Patients with Parkinson's disease (PD) experience a decline in verbal fluency (VF) immediately after undergoing deep brain stimulation (DBS) of the subthalamic nucleus (STN). This phenomenon is thought to be related to surgical microlesions.

Purpose: We investigated the alterations in interhemispheric functional connectivity after STN-DBS in PD patients. We also evaluated the correlation between these changes and decreased VF scores.

Method: Overall, 30 patients with PD were enrolled in the study. Resting-state functional magnetic resonance imaging scans were performed twice, once before and once after DBS, in PD patients. Voxel-mirrored homotopic connectivity (VMHC) was applied in order to evaluate the synchronicity of functional connectivity between the hemispheres.

Result: After undergoing STN-DBS, PD patients demonstrated reduced VMHC value in the posterior cerebellum lobe, angular gyrus, precuneus/posterior cingulate gyrus (PCC), supramarginal gyrus, superior frontal gyrus (SFG) (medial and dorsolateral) and middle frontal gyrus (MFG). In addition, we observed a significant positive correlation between the altered VMHC value in the SFG and MFG and the change of phonemic VF scores.

Conclusion: PD patients demonstrated an interhemispheric coordination disorder in the prefrontal cortex, cerebellum, supramarginal gyrus and DMN after undergoing STN-DBS. The positive correlation between reduced VMHC value in the SFG and MFG and the changes of VF scores provides a novel understanding with regard to the decline of VF after DBS.

Keywords: Parkinson’s disease; deep brain stimulation; resting state functional magnetic resonance; verbal fluency; voxel-mirrored homotopic connectivity.