Spatiotemporal EEG microstate analysis in drug-free patients with Parkinson's disease

The clinical diagnosis of Parkinson's disease (PD) is very difficult, especially in the early stage of the disease, because there is no physiological indicator that can be referenced. Drug-free patients with early PD are characterized by clinical symptoms such as impaired motor function and cognitive decline, which was caused by the dysfunction of brain's dynamic activities. The indicators of brain dysfunction in patients with PD at an early unmedicated condition may provide a valuable basis for the diagnosis of early PD and later treatment. In order to find the spatiotemporal characteristic markers of brain dysfunction in PD, the resting-state EEG microstate analysis is used to explore the transient state of the whole brain of 23 drug-free patients with PD on the sub-second timescale compared to 23 healthy controls. EEG microstates reflect a transiently stable brain topological structure with spatiotemporal characteristics, and the spatial characteristic microstate classes and temporal parameters provide insight into the brain's functional activities in PD patients. The further exploration was to explore the relation between temporal microstate parameters and significant clinical symptoms to determine whether these parameters could be used as a basis for clinically assisted diagnosis. Therefore, we used a general linear model (GLM) to explore the relevance of microstate parameters to clinical scales and multiple patient attributes, and the Wilcoxon rank sum test was used to quantify the linear relation between influencing factors and microstate parameters. Results of microstate analysis revealed that there was an unique spatial microstate different from healthy controls in PD, and several other typical microstates had significant differences compared with the normal control group, and these differences were reflected in the microstate parameters, such as longer durations and more occurrences of one class of microstates in PD compared with healthy controls. Furthermore, correlation analysis showed that there was a significant correlation between multiple microstate classes' parameters and significant clinical symptoms, including impaired motor function and cognitive decline. These results indicate that we have found multiple quantifiable feature tags that reflect brain dysfunction in the early stage of PD. Importantly, such temporal dynamics in microstates are correlated with clinical scales which represent the motor function and recognize level. The obtained results may deepen our understanding of the brain dysfunction caused by PD, and obtain some quantifiable signatures to provide an auxiliary reference for the early diagnosis of PD.