Objective: To identify the contributions of abnormal brain spontaneous activity and functional connectivity in anxiety in patients with Parkinson’s disease (PD) using resting-state functional magnetic resonance imaging (rsfMRI).

Background: Anxiety is a frequent symptom of PD, yet it is still overlooked. Its associations with the dopaminergic medication and the motor symptoms need clarification. While anxiety in PD has been extensively studied clinically, a limited number of neuroimaging studies mainly focused on structural or dopaminergic changes. RsfMRI is used to measure the low frequency BOLD signal fluctuation of the brain. It is a fairly recent method allowing the assessment of the baseline of the spontaneous cerebral activity, especially interesting to brain dysfunctions in neurological or psychiatric pathologies.

Methods: 39 patients with PD were recruited for this study, 20 with higher anxiety scores and 19 with lower anxiety scores. They all underwent a rsfMRI scan. The amplitude of low-frequency fluctuation (ALFF) and seed-based connectivity were investigated to reveal the changes of the spontaneous activity and the interaction among different related regions.

Results: The ALFF analysis revealed hyperactivity in the high anxiety group in 6 clusters localized in the right amygdala, the right middle frontal gyrus, the anterior cingulate cortex, left middle frontal gyrus, left rectus and the left lingual gyrus,. This analysis also revealed hypoactivity in the high anxiety group in 4 clusters localized in the right insula, the right dorsolateral prefrontal cortex, the left dorsomedial prefrontal cortex and the right middle frontal gyrus. Regions of interest (ROIs) were created from the clusters showing hyperactivity in the ALFF analysis. The functional connectivity analyses revealed a positive correlation between the anxiety scale and the synchronization of the activity of the amygdala ROI and the medial prefrontal cortex and the lingual gyrus. A negative correlation was found between the anxiety score and synchronization of the activity of the left middle frontal gyrus ROI and the putamen and insula.

Conclusions: Our results confirmed a dysfunction of key regions associated with anxiety in PD. We also showed a change in functional connectivity from some of these regions correlated with anxiety. Further analyses are necessary to assess the interaction of anxiety and motor symptoms in PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/abnormal-spontaneous-activity-and-functional-connectivity-in-patients-with-parkinsons-disease-with-anxiety/