title: Abnormal Resting-State Neural Activity and Connectivity of Fatigue in Parkinson's Disease.
abstract: OBJECTIVE
  Fatigue is a common burdensome problem in patients with Parkinson's disease (PD), but its pathophysiological mechanisms are poorly understood. This study aimed at investigating the neural substrates of fatigue in patients with PD.
  
  
  METHODS
  A total of 17 PD patients with fatigue, 32 PD patients without fatigue, and 25 matched healthy controls were recruited. The 9-item fatigue severity scale (FSS) was used for fatigue screening and severity rating. Resting-state functional magnetic resonance imaging (RS-fMRI) data were obtained from all subjects. Amplitude of low-frequency fluctuations (ALFF) was used to measure regional brain activity, and functional connectivity (FC) was applied to investigate functional connectivity at a network level.
  
  
  RESULTS
  PD-related fatigue was associated with ALFF changes in right middle frontal gyrus within the attention network and in left insula as well as right midcingulate cortex within the salience network. FC analysis revealed that above three regions showing ALFF differences had altered functional connectivity mainly in the temporal, parietal, and motor cortices.
  
  
  CONCLUSIONS
  Our findings do reveal that abnormal regional brain activity within attention and salience network and altered FC of above abnormal regions are involved in neural mechanism of fatigue in patients with PD.
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
authors.forename: Jie-Jin
authors.initials: JJ
authors.lastname: Zhang
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Ding
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
authors.forename: Jun-Yi
authors.initials: JY
authors.lastname: Li
authors.affiliation: Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
authors.forename: Min
authors.initials: M
authors.lastname: Wang
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
authors.forename: Yong-Sheng
authors.initials: YS
authors.lastname: Yuan
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
authors.forename: Li
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
authors.forename: Si-Ming
authors.initials: SM
authors.lastname: Jiang
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
authors.forename: Xi-Xi
authors.initials: XX
authors.lastname: Wang
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Zhu
authors.affiliation: Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
authors.forename: Ke-Zhong
authors.initials: KZ
authors.lastname: Zhang
mesh_terms: D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001931:Brain Mapping; D005221:Fatigue / Q000209:etiology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009434:Neural Pathways / Q000000981:diagnostic imaging / Q000502:physiology*; D010100:Oxygen / Q000097:blood; D010300:Parkinson Disease / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology*; D012146:Rest; D012720:Severity of Illness Index
chemical_list: D010100:Oxygen
keywords: Amplitude of low-frequency fluctuations; Fatigue; Functional connectivity; Parkinson's disease