Altered Putamen Functional Connectivity Is Associated With Anxiety Disorder In Parkinson's Disease

Aims Anxiety disorder is common as one of non-motor symptoms in Parkinson's disease(PD),but little is known about its mechanism and it is still unclear.In this study,we used resting state-functional magnetic resonance imaging(RS-fMRI)to explore altered putamen functional connectivity(FC)in PD patients with anxiety disorder.Methods We divided 65 Parkinson's disease patients into anxiety(PD-A;n=18)and non-anxiety(PD-NA;n=45)groups based on a Hamilton Anxiety Rating Scale cutoff score of 12.Besides,24 healthy controls were recruited.We used the Unified Parkinson's Disease Rating Scale motor part and the Hoehn&Yahr staging scale to assess disease severity and staging of each patient.We also calculated their detailed medication and assessed demographic characteristics,cognitive function and emotional state of each subject.Then,RS-fMRI was performed.The images were preprocessed and analyzed using the FC analysis method based on the regions of interest.The clinical data of three subject groups were statistically analyzed by IBM SPSS Statistics 20.Results The PD-A group exhibited altered putamen FC with cortical and subcortical regions.Compared with PD-NA,the PD-A group showed following differences:(1)reduced left putamen FC with right orbitofrontal gyrus;(2)reduced right putamen FC with left orbitofrontal gyrus,right cerebellum and right precuneus;(3)increased right putamen FC with right insula,left temporal pole,left middle occipital gyrus,left caudatum and right middle cingulate gyrus.Further,the PD-A group showed enhanced putamen FC with the caudatum,which was correlated with increased emotional processing during anxiety.Decreased putamen FC with the orbitofrontal gyrus and cerebellum also correlated with increased anxiety in PD.Conclusions Our findings demonstrate that anxiety disorder in PD is associated with abnormal putamen FC networks,especially with caudatum,orbitofrontal gyrus and cerebellum.