Cerebral specialization and inter-hemispheric cooperation are two of the most prominent functional architectures of the human brain, which can prevent the occurrence of conflicting signals and thus allows more efficient information processing (Chi et al., 1977; Gazzaniga, 2000; Moorman and Nicol, 2015; Stark et al., 2008; Toga and Thompson, 2003). Specialization and cooperation are mutually reinforcing and inseparable. Typically, language is lateralized to the left hemisphere such that inter-hemispheric competitions between muscles that control speech are avoided (Toga and Thompson, 2003). However, in the process of listening to a story, predictive inferences initially activated in the right hemisphere (RH) and following coherence inferences are completed in the left hemisphere (LH). This indicates that bilateral hemispheres process semantic information differently, but must share some information (Beeman et al., 2000). A similar mechanism in the motor system is also important for supporting bilateral motor function, and its disruption may involve the pathological mechanism of movement disorders (Beaulé et al., 2012).
Parkinson’s disease (PD) is one of the most common movement disorders, mainly manifested as resting tremors, rigidity, bradykinesia, and postural instability. These symptoms may be initially caused by the depletion of nigrostriatal dopamine (Hornykiewicz, 2006). Although the mechanism involving the dopamine deficit on behavior symptoms is still unknown, the unbalanced onset and progression of motor symptoms suggest an important role of brain functional specialization or cooperation in the development of PD(Cronin-Golomb, 2010; Kempster et al., 1989). In past decades, increasing studies have concentrated on these functions of PD.
Abnormal cerebral specialization in PD has been shown in studies from molecular biology and neuroimaging. For example, the asymmetry of DNA methylation in prefrontal cortex neurons is greater in PD patients than healthy controls, and has been linked to the disease course(Li et al., 2020). Diffusion tensor imaging studies also indicate abnormal structural asymmetry of the bilateral substantia nigra in PD patients (Prakash et al., 2012). However, resting-state functional magnetic resonance imaging (rs-fMRI) did not find abnormal hemispheric specialization in PD patients (Wu et al., 2020). Notably, this negative report was based on the region-of-interest level, which may not be sensitive to small volume abnormalities. Autonomy index (AI) is a novel measure of functional specialization that can be performed at the voxel level. More importantly, this connectome-based index does not always rely on structurally symmetric regions, thereby avoiding the potential bias of anatomical asymmetry. AI has been suggested as a reliable measurement for characterizing the functional specialization in both healthy and patient cohorts(Mueller et al., 2015; Wang et al., 2014a).
Inter-hemispheric cooperation reflects the ability to integrate information from bilateral hemispheres. Complex tasks, including sensory processing and motor control are dependent on information integration of homotopic regions (Davis and Cabeza, 2015). It has been suggested that the uncoordinated control of gait in PD is related to impaired inter-hemispheric cooperation (Li et al., 2018). In fMRI studies, this measure is usually quantified by the functional connectivity (FC) between each voxel in one hemisphere and its mirrored counterpart in the opposite hemisphere(Zuo et al., 2010). However, bilateral hemispheres are actually anatomically asymmetric (LeMay, 1976). Investigators have normalized the individual's brain into a symmetry atlas, which may produce unexpected bias. A better choice is defining the homotopic regions based on functional rather than structural features (Jo et al., 2012). The advantages of functional correspondences have been clearly demonstrated by the ability to characterize precise cross-hemispheric cortical maps(Jo et al., 2012).
In the present study, we aimed to explore two intrinsic architectures of brain function in patients with PD. To this end, we adopted AI to estimate cerebral specialization, and developed a novel index of inter-hemispheric cooperation involving the connectivity between functionally homotopic voxels (CFH). The functional homotopic region of a given voxel was defined as the point with the largest FC value in the contralateral hemisphere. Regions with higher CFH values indicated more communication across hemispheres.