Neural networks associated with quality of life in patients with Parkinson's disease

Tomohito Nakano; Yuta Kajiyama; Gajanan S Revankar; Ryota Hashimoto; Yoshiyuki Watanabe; Haruhiko Kishima; Manabu Ikeda; Masahito Mihara; Hideki Mochizuki; Noriaki Hattori

doi:10.1016/j.parkreldis.2021.06.007

Neural networks associated with quality of life in patients with Parkinson's disease

Parkinsonism Relat Disord. 2021 Aug:89:6-12. doi: 10.1016/j.parkreldis.2021.06.007. Epub 2021 Jun 17.

Authors

Affiliations

¹ Department of Neurology, Osaka University Graduate School of Medicine, Osaka, Japan.
² Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan; Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.
³ Department of Radiology, Shiga University of Medical Science, Shiga, Japan.
⁴ Department of Neurosurgery, Osaka University Graduate School of Medicine, Osaka, Japan.
⁵ Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan.
⁶ Department of Neurology, Kawasaki Medical School, Okayama, Japan.
⁷ Department of Neurology, Osaka University Graduate School of Medicine, Osaka, Japan. Electronic address: hmochizuki@neurol.med.osaka-u.ac.jp.
⁸ Department of Neurology, Osaka University Graduate School of Medicine, Osaka, Japan; Department of Rehabilitation, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama, Japan; Endowed Research Department of Clinical Neuroengineering, Global Center for Medical Engineering and Informatics, Osaka University, Osaka, Japan. Electronic address: hattorin@med.u-toyama.ac.jp.

PMID: 34214862
DOI: 10.1016/j.parkreldis.2021.06.007

Abstract

Introduction: The neural underpinnings of health-related quality of life in Parkinson's disease remain unclear. This study was conducted to unravel which motor and non-motor symptoms in Parkinson's disease influence health-related quality of life and reveal neural networks most likely linked to it.

Methods: Comprehensive clinical assessments were conducted for 247 Parkinson's disease patients and image analyses were performed for 181 patients. Clinical scores commonly used to assess various symptoms related to health-related quality of life were investigated. Factor and resting-state functional magnetic resonance imaging analyses were reviewed to reveal health-related quality of life-associated brain networks.

Results: The Spearman's rank correlation coefficient for the Parkinson's disease Questionnaire-39 summary index was high in the Activities-specific Balance Confidence Scale, Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale part 2, Freezing of Gait Questionnaire, and Self-reported Autonomic Symptoms in Parkinson's disease. Multiple regression and Random Forest regression analyses indicated that health-related quality of life-associated factors were Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale part 1, Depression Rating Scales, and the above-mentioned scales. The resting-state functional magnetic resonance imaging analysis revealed decreased functional connectivity between the anterior cingulate cortex and right temporo-parietal junction as health-related quality of life worsened.

Conclusion: Fear of falling, daily living activities, gait freezing, and autonomic dysfunction have notable effects on health-related quality of life in Parkinson's disease. Brain networks consisting of the anterior cingulate cortex and temporo-parietal junction may be associated with the emotion-related and social factors of health-related quality of life in Parkinson's disease.

Keywords: Functional MRI; Parkinson's disease; Parkinson's disease Questionnaire-39; Quality of life.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Accidental Falls*
Activities of Daily Living*
Aged
Cerebral Cortex / diagnostic imaging
Cerebral Cortex / physiopathology*
Connectome*
Fear / psychology
Female
Gait Disorders, Neurologic / etiology
Gait Disorders, Neurologic / physiopathology*
Gyrus Cinguli / diagnostic imaging
Gyrus Cinguli / physiopathology
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Nerve Net / physiopathology*
Parietal Lobe / diagnostic imaging
Parietal Lobe / physiopathology
Parkinson Disease / complications
Parkinson Disease / diagnostic imaging
Parkinson Disease / physiopathology*
Parkinson Disease / psychology
Quality of Life*
Severity of Illness Index*
Temporal Lobe / diagnostic imaging
Temporal Lobe / physiopathology