A signature combining brain functional connectivity with executive and motor function for general cognitive decline in Parkinson's disease

Jin Wang ^1,2,3* Zhilin Shu ⁴ Yue Wang ¹ Jiewei Lu ⁴ Xinyuan Zhang ¹ Yuanyuan Cheng ⁵ Yang Yu ⁵ Jianda Han ^4,6 Zhizhong Zhu ⁵ Ningbo Yu ^4,6 Jialing Wu ^1,2,3,5

• ¹ Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin, China
• ² Department of Neurology, Tianjin Huanhu Hospital, Tianjin, Tianjin, China
• ³ Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Diseases, Tianjin Neurosurgical Institute, Tianjin, China
• ⁴ College of Artificial Intelligence, Nankai University, Tianjin, China
• ⁵ Department of Rehabilitation Medicine, Tianjin Huanhu Hospital, Tianjin, China
• ⁶ Institute of Intelligence Technology and Robotic Systems, Shenzhen Research Institute of Nankai University, Shenzhen, China

Introduction: Cognitive decline is common in Parkinson’s disease (PD). Reliance on neuropsychological testing alone can lead to delayed identification, and an objective and comprehensive approach is needed in clinical practice. We assessed brain functional connectivity during PD-MCI (mild cognitive impairment) and PD-NC (normal cognition) patients, and healthy controls (HC) completing the Stroop color-word test (SCWT) using functional near-infrared spectroscopy (fNIRS), and explored the predictive value of combining relevant brain function and behavioral information for general cognitive decline in PD.Methods: Nineteen patients with PD-MCI, 21 with PD-NC and 33 age-matched HC were recruited. Group differences in executive performance and prefrontal functional connectivity were analyzed. Receiver operating characteristic analysis was used to measure the value of combining brain functional connectivity with executive and motor function in predicting PD-MCI.Results: During the color-word incongruent test, PD-MCI patients had significantly lower correct rate than HC and PD-NC patients. Meanwhile, PD-MCI patients exhibited significantly increased regional strength of the left and right prefrontal cortex (RSl, RSr), and global efficiency than HC, and compared with PD-NC, PD-MCI patients showed significantly higher RSr. For PD patients, MMSE score and correct rate during the color-word incongruent test were negatively associated with the RSr after adjusting for education level and age. After combined the RSr, correct rate and MDS-UPDRS III score, diagnostic sensitivity and specificity of PD-MCI reached 0.737 and 0.810, respectively, with an area under the curve of 0.830.Conclusion: We proposed a signature combining brain functional connectivity with executive and motor function for general cognitive decline in PD, which could provide new insights into early detection and intervention of this problem.