Altered effective connectivity in cortico-striatal pathways during sentence processing and oral motors in Parkinson’s disease

Previous studies have demonstrated that sentence processing can be impaired in individuals with Parkinson’s disease (PD). However, it remains unclear whether the neural mechanisms underlying language impairments in PD are like the motor symptoms and related to dysfunction observed in cortico-striatal pathways. On the other hand, traumatic brain injury (TBI) is recognized as a significant non-genetic risk factor for developing PD later in life. This study investigated the functional changes in cortico-striatal pathways that impact sentence comprehension and oral motor functions in individuals with PD. It compared PD patients with a history of TBI to those without. Twenty-four PD patients (12 with and 12 without TBI) along with 12 age- and sex-matched controls, underwent functional MRI (fMRI) and dynamic causal modeling. These assessments aimed to evaluate brain activity and effective connectivity during sentence comprehension and oral motor tasks. Significant disruptions were observed in both activated brain regions and effective connectivity within cortico-striatal pathways in PD patients (p < .05). Those with TBI exhibited altered brain activity during canonical sentence comprehension when compared to those without TBI. The PD group without TBI displayed greater bidirectional connectivity between cortico-cortical and cortico-subcortical areas during oral motor tasks (p < .05). These findings suggest that reduced effective connectivity in motor and language networks may contribute to language and motor impairments in individuals with PD. Utilizing fMRI to evaluate activated brain regions and effective connectivity within motor and language networks may help identify TBI patients who are at a higher risk of developing PD in the future.