Altered functional connectivity within the brain fear circuit in Parkinson's disease with anxiety: A seed-based functional connectivity study

OBJECTIVES: Aimed to investigate whether there are abnormal changes in the functional connectivity (FC) between the amygdala with other brain areas, in Parkinson's disease (PD) patients with anxiety. METHODS: Participants were enrolled prospectively, and the Hamilton Anxiety Rating (HAMA) Scale was used to quantify anxiety disorder. Rest-state functional MRI (rs-fMRI) was applied to analyze the amygdala FC patterns among anxious PD patients, non-anxious PD patients, and healthy controls. RESULTS: Thirty-three PD patients were recruited, 13 with anxiety, 20 without anxiety, and 19 non-anxious healthy controls. In anxious PD patients, FC between the amygdala with the hippocampus, putamen, intraparietal sulcus, and precuneus showed abnormal alterations compared with non-anxious PD patients and healthy controls. In particular, FC between the amygdala and hippocampus negatively correlated with the HAMA score (r = −0.459, p = 0.007). CONCLUSION: Our results support the role of the fear circuit in emotional regulation in PD with anxiety. Also, the abnormal FC patterns of the amygdala could preliminarily explain the neural mechanisms of anxiety in PD.