title: The trajectory of disturbed resting-state cerebral function in Parkinson's disease at different Hoehn and Yahr stages.
abstract: OBJECTIVE
  We aim to investigate the disturbance of neural network associated with the different clinical stages of Parkinson's disease (PD).
  
  
  METHODS
  We recruited 80 patients at different H&Y stages of PD (28 at H&Y stage I, 28 at H&Y stage II, 24 at H&Y stage III) and 30 normal controls. All participants underwent resting-state fMRI scans on a 3-T MR system. The amplitude of low-frequency fluctuation (ALFF) of blood oxygen level-dependent signals was used to characterize regional cerebral function. Functional integration across the brain regions was evaluated by a seed voxel correlation approach.
  
  
  RESULTS
  PD patients had decreased regional activities in left occipital and lingual regions; these regions show decreased functional connection pattern with temporal regions, which is deteriorating as H&Y stage ascending. In addition, PD patients, especially those at stage II, exhibit increased regional activity in the posterior regions of default mode network (DMN), increased anticorrelation between posterior cingulate cortex (PCC) and cortical regions outside DMN, and higher temporal coherence within DMN. Those indicate more highly functioned DMN in PD patients at stage II.
  
  
  CONCLUSIONS
  Our study demonstrated the trajectories of resting-state cerebral function disturbance in PD patients at different H&Y stages. Impairment in functional integration of occipital-temporal cortex might be a promising measurement to evaluate and potentially track functional substrates of disease evolution of PD.
authors.affiliation: Department of Neurology, West China Hospital, SiChuan University, Chengdu Sichuan, China.
authors.forename: ChunYan
authors.initials: C
authors.lastname: Luo
authors.affiliation: Department of Neurology, West China Hospital, SiChuan University, Chengdu Sichuan, China.
authors.forename: XiaoYan
authors.initials: X
authors.lastname: Guo
authors.affiliation: Department of Neurology, West China Hospital, SiChuan University, Chengdu Sichuan, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Song
authors.affiliation: Department of Neurology, West China Hospital, SiChuan University, Chengdu Sichuan, China.
authors.forename: Qin
authors.initials: Q
authors.lastname: Chen
authors.affiliation: Department of Neurology, West China Hospital, SiChuan University, Chengdu Sichuan, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Yang
authors.affiliation: Huaxi MR Research Center, Department of Radiology, West China Hospital, SiChuan University, Chengdu Sichuan, China.
authors.forename: QiYong
authors.initials: Q
authors.lastname: Gong
authors.affiliation: Department of Neurology, West China Hospital, SiChuan University, Chengdu Sichuan, China.
authors.forename: Hui-Fang
authors.initials: HF
authors.lastname: Shang
mesh_terms: D001921:Brain / Q000473:pathology / Q000503:physiopathology*; D001931:Brain Mapping; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009434:Neural Pathways / Q000473:pathology / Q000503:physiopathology; D010300:Parkinson Disease / Q000473:pathology / Q000503:physiopathology*; D012146:Rest; D012815:Signal Processing, Computer-Assisted
keywords: Hoehn and Yahr stage; Parkinson's disease; default mode network; occipital-temporal; resting-state fMRI