Identifying Mild Cognitive Impairment in Parkinson's Disease With Electroencephalogram Functional Connectivity.

OBJECTIVE: Cognitive impairment occurs frequently in Parkinson's disease (PD) and negatively impacts the patient's quality of life. However, its pathophysiological mechanism remains unclear, hindering the development of new therapies. Changes in brain connectivity are related to cognitive impairment in patients with PD, with the dorsolateral prefrontal cortex (DLPFC) being considered the essential region related to PD cognitive impairment. Nevertheless, few studies have focused on the global connectivity responsible for communication with the DLPFC node, the posterior division of the middle frontal gyrus (PMFG) in patients with PD; this was the focus of this study. METHODS: We applied resting-state electroencephalography (EEG) and calculated a reliable functional connectivity measurement, the debiased weighted phase lag index (dWPLI), to examine inter-regional functional connectivity in 68 patients with PD who were classified into two groups according to their cognitive condition. RESULTS: We observed that altered left and right PMFG-based functional connectivity associated with cognitive impairment in patients with PD in the theta frequency bands under the eyes closed condition (r = -0.426, p < 0.001 and r = -0.437, p < 0.001, respectively). Exploratory results based on the MoCA subdomains indicated that poorer visuospatial function was associated with higher right PMFG-based functional connectivity (r = -0.335, p = 0.005), and poorer attention function was associated with higher left and right PMFG-based functional connectivity (r = -0.380, p = 0.001 and r = -0.256, p = 0.035, respectively). Further analysis using logistic regression and receiver operating characteristic (ROC) curves found that this abnormal functional connectivity was an independent risk factor for cognitive impairment [odds ratio (OR): 2.949, 95% confidence interval (CI): 1.294-6.725, p = 0.01 for left PMFG; OR: 11.278, 95% CI: 2.578-49.335, p = 0.001 for right PMFG, per 0.1 U], and provided moderate classification power to discriminate between cognitive abilities in patients with PD [area under the ROC curve (AUC) = 0.770 for left PMFG; AUC = 0.809 for right PMFG]. CONCLUSION: These preliminary findings indicate that abnormal PMFG-based functional connectivity patterns associated with cognitive impairment in the theta frequency bands under the eyes closed condition and altered functional connectivity patterns have the potential to act as reliable biomarkers for identifying cognitive impairment in patients with PD.

Effect of morning blood pressure peak on early progressive ischemic stroke: a prospective clinical study.

OBJECTIVE: To prospectively evaluate the effect of morning blood pressure peak (MBPP) on early progressive ischemic stroke (EPIS). PATIENTS AND METHODS: A total of 135 patients with acute ischemic stroke were enrolled and completed all assessments. The patients were divided into EPIS group and non-EPIS group, with 22 and 113 cases in each group, respectively, according to the assessment of Scandinavian stroke scale within three days after onset. All cases received conventional treatment for stroke and its risk factors. 24 -h dynamic blood pressure monitoring was performed within 24 h after admission. Based on the 24 -h mean blood pressure, MBPP, morning blood pressure, and other risk factors for EPIS, we conducted a logistic regression analysis to evaluate whether MBPP was an independent risk factor for EPIS. RESULTS: Mean systolic blood pressure, systolic and diastolic MBPP, morning systolic and diastolic blood pressure were all significantly higher in EPIS group than in non-EPIS group (p = 0.037, p = 0.001, p = 0.035, p = 0.003, p = 0.042, respectively). Logistic regression analysis showed that MBPP was an independent risk factor for EPIS (OR = 1.057, 95% CI 1.014-1.102, p = 0.009). Further stratified analysis showed that incidences of EPIS in patients with elevated MBPP combined with large artery atherosclerosis or small artery occlusion were comparable (41.2% vs. 25.0%, p = 0.367), and the systolic MBPP was significantly higher in morning EPIS group than in non-morning EPIS group (p = 0.041). CONCLUSION: Elevated systolic MBPP might be an independent risk factor for EPIS, and play a more obvious effect on EPIS manifesting in the morning especially.