Separate neural representations of depression, anxiety and apathy in Parkinson’s disease

• Published in: Scientific reports 2017-09, Vol.7 (1), p.12164-10, Article 12164
• Main Authors: Dan, Rotem, Růžička, Filip, Bezdicek, Ondrej, Růžička, Evžen, Roth, Jan, Vymazal, Josef, Goelman, Gadi, Jech, Robert
• Format: Article
• Language: English
• Subjects: 59/36; 631/378/1689/1300; 631/378/1689/1414; 631/378/1689/1718; Anxiety; Anxiety - complications; Anxiety - diagnostic imaging; Anxiety - physiopathology; Apathy; Brain - diagnostic imaging; Brain - physiopathology; Depression - complications; Depression - diagnostic imaging; Depression - physiopathology; Emotional behavior; Emotions; Functional magnetic resonance imaging; Hippocampus; Humanities and Social Sciences; Humans; Magnetic Resonance Imaging; Mental depression; Mental disorders; Movement disorders; multidisciplinary; Nerve Net - diagnostic imaging; Nerve Net - physiopathology; Neural networks; Neurodegenerative diseases; Parahippocampal gyrus; Parkinson Disease - complications; Parkinson Disease - diagnostic imaging; Parkinson Disease - physiopathology; Parkinson's disease; Prefrontal cortex; Science; Science (multidisciplinary); Sensorimotor system; Thalamus
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-017-12457-6

Depression, anxiety and apathy are distinct neuropsychiatric symptoms that highly overlap in Parkinson’s disease (PD). It remains unknown whether each symptom is uniquely associated with a functional network dysfunction. Here, we examined whether individual differences in each neuropsychiatric symptom predict functional connectivity patterns in PD patients while controlling for all other symptoms and motor function. Resting-state functional connectivity MRI were acquired from 27 PD patients and 29 healthy controls. Widespread reduced functional connectivity was identified in PD patients and explained by either the neuropsychiatric or motor symptoms. Depression in PD predicted increased functional connectivity between the orbitofrontal, hippocampal complex, cingulate, caudate and thalamus. Apathy in PD predicted decreased caudate-thalamus and orbitofrontal-parahippocampal connectivity. Anxiety in PD predicted three distinct types of functional connectivity not described before: (i) increased limbic-orbitofrontal cortex; (ii) decreased limbic-dorsolateral prefrontal cortex and orbitofrontal-dorsolateral prefrontal cortices and (iii) decreased sensorimotor-orbitofrontal cortices. The first two types of functional connectivity suggest less voluntary and more automatic emotion regulation. The last type is argued to be specific to PD and reflect an impaired ability of the orbitofrontal cortex to guide goal-directed motor actions in anxious PD patients.