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Identifying the white matter structural network of motor reserve in early Parkinson's disease

 Yae Ji Kim  ;  Chan Wook Park  ;  Hye Won Shin  ;  Hye Sun Lee  ;  Yun Joong Kim  ;  Mijin Yun  ;  Phil Hyu Lee  ;  Young H Sohn  ;  Yong Jeong  ;  Seok Jong Chung 
 PARKINSONISM & RELATED DISORDERS, Vol.102 : 108-114, 2022-09 
Journal Title
Issue Date
Dopamine ; Dopamine Plasma Membrane Transport Proteins / metabolism ; Humans ; Levodopa ; Parkinson Disease* / diagnostic imaging ; Parkinson Disease* / pathology ; White Matter* / pathology
Motor reserve ; Parkinson's disease ; Structural connectivity ; White matter
Introduction: Motor reserve refers to the individual capacity to cope with nigrostriatal dopamine depletion in Parkinson's disease (PD). This study aimed to explore the white matter structural network associated with motor reserve in patients with newly diagnosed PD.

Methods: A total of 238 patients with early-stage drug-naïve PD who underwent 18F-FP-CIT PET and brain MRI scans at initial assessment were enrolled. We estimated individual motor reserve based on the Unified Parkinson's Disease Rating Scale Part III (UPDRS-III) scores and dopamine transporter availability in the posterior putamen using a residual model. Then, we performed threshold-free network-based statistics (TFNBS) analysis to identify the structural brain network associated with the estimated motor reserve. We also assessed the effect of the network connectivity strength on the longitudinal increase in levodopa-equivalent dose (LED).

Results: The mean age at PD symptom onset was 69.10 ± 9.03 years and the mean UPDRS-III score at the time of PD diagnosis was 22.44 ± 9.72. TFNBS analysis identified a motor reserve-associated structural network whose nodes were mainly in the frontal region and cerebellum. Higher network strength (i.e., greater motor reserve) was associated with a slower longitudinal increase in LED during a 3-year follow-up period.

Conclusion: The structural brain network is associated with motor reserve in patients with PD. Connectivity strength within the identified network indicates the individual's capacity to tolerate PD-related pathologies, which is maintained with disease progression and affects the long-term motor prognosis of PD.
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1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Kim, Yun Joong(김윤중) ORCID logo https://orcid.org/0000-0002-2956-1552
Park, Chan Wook(박찬욱) ORCID logo https://orcid.org/0000-0002-0208-5189
Sohn, Young Ho(손영호) ORCID logo https://orcid.org/0000-0001-6533-2610
Yun, Mi Jin(윤미진) ORCID logo https://orcid.org/0000-0002-1712-163X
Lee, Phil Hyu(이필휴) ORCID logo https://orcid.org/0000-0001-9931-8462
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
Chung, Seok Jong(정석종) ORCID logo https://orcid.org/0000-0001-6086-3199
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