Unlocking the Code of Cognitive Function in Parkinson’s Disease

Published on October 20, 2022

Think of the brain as a complex puzzle. Researchers have used a data-driven approach to uncover one of the main pieces that contributes to cognitive functioning in Parkinson’s disease (PD). By analyzing positron emission tomography (PET) imaging data, they identified cholinergic centro-cingulate topography as a key factor in cognitive impairment. This region, responsible for coordinating various cognitive processes, appears to be specifically affected in PD patients. Interestingly, this finding suggests that the degeneration of the cholinergic system in PD is not simply a consequence of aging but rather an integral part of the disease. The researchers also found that motor impairment score alongside specific cholinergic components were significant predictors of cognitive functioning in PD patients. These findings shed new light on the role of the cholinergic system and its impact on both local and widespread networks involved in cognition. So if you’re curious about how the brain works and its role in Parkinson’s disease, dive into the fascinating research behind this study!

BackgroundDegeneration of the cholinergic system plays an important role in cognitive impairment in Parkinson’s disease (PD). Positron emission tomography (PET) imaging using the presynaptic vesicular acetylcholine transporter (VAChT) tracer [18F]Fluoroethoxybenzovesamicol ([18F]FEOBV) allows for regional assessment of cholinergic innervation. The purpose of this study was to perform a data-driven analysis to identify co-varying cholinergic regions and to evaluate the relationship of these with cognitive functioning in PD.Materials and methodsA total of 87 non-demented PD patients (77% male, mean age 67.9 ± 7.6 years, disease duration 5.8 ± 4.6 years) and 27 healthy control (HC) subjects underwent [18F]FEOBV brain PET imaging and neuropsychological assessment. A volume-of-interest based factor analysis was performed for both groups to identify cholinergic principal components (PCs).ResultsSeven main PCs were identified for the PD group: (1) bilateral posterior cortex, (2) bilateral subcortical, (3) bilateral centro-cingulate, (4) bilateral frontal, (5) right-sided fronto-temporal, (6) cerebellum, and (7) predominantly left sided temporal regions. A complementary principal component analysis (PCA) analysis in the control group showed substantially different cholinergic covarying patterns. A multivariate linear regression analyses demonstrated PC3, PC5, and PC7, together with motor impairment score, as significant predictors for cognitive functioning in PD. PC3 showed most robust correlations with cognitive functioning (p < 0.001).ConclusionA data-driven approach identified covarying regions in the bilateral peri-central and cingulum cortex as a key determinant of cognitive impairment in PD. Cholinergic vulnerability of the centro-cingulate network appears to be disease-specific for PD rather than being age-related. The cholinergic system may be an important contributor to regional and large scale neural networks involved in cognitive functioning.

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