Evidence map›Paper›PMID 41247531›Full record

ArticleJournal of neurology2025

Cholinergic network disruptions on cognitive function across the spectrum of cognitive impairment in Parkinson's disease.

Lina Huang, Xiaolu Li, Shuting Bu, Huize Pang, Mengwan Zhao, Juzhou Wang, Qin Niu, Hongmei Yu, Guoguang Fan

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Article in Journal of neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Lina HuangDepartment of Radiology, The First Hospital of China Medical University, 155 Nanjing North Street, Shenyang, 110001, Liaoning, China.
Xiaolu LiDepartment of Radiology, The First Hospital of China Medical University, 155 Nanjing North Street, Shenyang, 110001, Liaoning, China.
Shuting BuDepartment of Radiology, The First Hospital of China Medical University, 155 Nanjing North Street, Shenyang, 110001, Liaoning, China.
Huize PangDepartment of Radiology, The First Hospital of China Medical University, 155 Nanjing North Street, Shenyang, 110001, Liaoning, China.
Mengwan ZhaoDepartment of Radiology, The First Hospital of China Medical University, 155 Nanjing North Street, Shenyang, 110001, Liaoning, China.
Juzhou WangDepartment of Radiology, The First Hospital of China Medical University, 155 Nanjing North Street, Shenyang, 110001, Liaoning, China.
Qin NiuDepartment of Radiology, The First Hospital of China Medical University, 155 Nanjing North Street, Shenyang, 110001, Liaoning, China.
Hongmei YuDepartment of Neurology, The First Hospital of China Medical University, Shenyang, , 110001, Liaoning, China.
Guoguang FanDepartment of Radiology, The First Hospital of China Medical University, 155 Nanjing North Street, Shenyang, 110001, Liaoning, China. fanguog@sina.com.ORCID http://orcid.org/0009-0006-5196-045X

Funding

Liaoning Revitalization Talents Program 2412010
6 · The paper itself

Abstract

objectivesCognitive decline in Parkinson's disease (PD) is closely associated with degeneration of the cholinergic system; however, the stage-dependent reorganization of cholinergic networks remains poorly understood. This study aimed to delineate alterations in cholinergic connectivity across the spectrum of cognitive impairment in PD patients.

methodsWe enrolled 211 PD patients-classified as PD with normal cognition (PD-NC, n = 91), mild cognitive impairment (PD-MCI, n = 79), or dementia (PDD, n = 41)-and 71 healthy controls (HCs). Cholinergic functional networks were reconstructed by mapping predefined cholinergic subnetwork maps onto individual resting-state functional MRI data to derive subject-specific functional connectivity matrices. Graph theoretical measures were applied to quantify global and local topological characteristics. In addition, voxel-based morphometry (VBM) was used to assess group differences in cholinergic nuclei volumes. Furthermore, correlation and mediation analyses were conducted to explore the relationship between network disruption and cognitive performance.

resultsPD patients showed stage-dependent alterations in cholinergic network topology, with increased shortest path length (Lp) and global efficiency in the Ch1-3 pathway and reduced clustering coefficient, gamma, Lp, and sigma in the medial Ch4 pathway (p < 0.05). Regionally, right hippocampal nodal centrality (Ch1-3) and inferior occipital gyrus/local efficiency (Ch4 lateral capsular division) were reduced in PDD, while posterior orbital part of the right medial superior frontal gyrus (medial Ch4) degree centrality increased. Medial Ch4 topological brain metrics correlated with global cognition and key domains, whereas metrics of Ch4 lateral capsular division pathway related to visuospatial and language performance. Structurally, compared to HCs, Ch4 volume loss occurred in PD-NC and PD-MCI groups, while Ch5-6 atrophy was specific in PDD group. Mediation analysis confirmed that medial Ch4 Lp mediated the effect of disease stage on global cognition.

conclusionsThis study provides new insights into the stage-specific disruption of cholinergic network topology and structural atrophy in PD, demonstrating that Ch4 nucleus degeneration is critically associated with stage-dependent network dysfunction and domain-specific cognitive impairment, thereby offering cholinergic network biomarkers as potential tools for stratifying cognitive stages.

Indexed as

Cholinergic NeuronsCognitive DysfunctionDementiaNerve NetParkinson DiseaseAgedConnectomeFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedCognitive impairmentNetwork connectivityParkinson’s diseaseResting-state fMRI

Identifiers

PMID41247531

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.