White matter abnormalities in the corpus callosum with cognitive impairment in Parkinson disease
White matter abnormalities in the corpus callosum with cognitive impairment in Parkinson disease
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DOI：
10.1212/wnl.0000000000006646
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发表时间：
2018-12-11
期刊：
影响因子：
9.9
通讯作者：
Goldman, Jennifer G.
中科院分区：
文献类型：
--
作者：
Bledsoe, Ian O.;Stebbins, Glenn T.;Goldman, Jennifer G.
目的应用弥散张量成像（DTI）评价帕金森病（PD）患者胼胝体的显微结构特征及其与认知功能障碍的关系。方法对75名PD患者和24名健康对照（HC）患者进行结构MRI脑扫描，包括DTI序列和临床和神经心理学评估。根据运动障碍学会的标准，PD参与者被分为正常认知（PD- nc, n = 23）、轻度认知障碍（PD- mci, n = 35）或痴呆（PDD, n = 17）。计算认知领域（注意/工作记忆、执行功能、语言、记忆、视觉空间功能）z分数。采用地形衍生的分割方法，在中矢状面单片上建立5个胼胝体节段的DTI标量值，包括分数各向异性（FA）、平均扩散率（MD）、轴向扩散率（AD）和径向扩散率（RD）。比较各参与组间的标量值。对认知域z得分和DTI指标进行回归分析。结果与健康对照组相比，PD患者胼胝体前3段的AD值增加。与PD-NC患者相比，PDD患者的前2节段AD、MD和RD显著增加，与PD-MCI患者相比，PDD患者的大部分前节段AD、MD和RD显著增加。FA值在PD患者和HC患者之间或PD认知组之间没有显著差异。DTI指标与认知表现的最强关联发生在最前部和最后部的胼胝体节段，也分别反映了额纹状体和后皮质型认知缺陷。结论DTI测量的胼胝体白质微结构异常可能通过破坏半球间和胼胝体-皮层投射的信息传递而导致PD认知障碍。
ObjectiveTo evaluate microstructural characteristics of the corpus callosum using diffusion tensor imaging (DTI) and their relationships to cognitive impairment in Parkinson disease (PD).MethodsSeventy-five participants with PD and 24 healthy control (HC) participants underwent structural MRI brain scans including DTI sequences and clinical and neuropsychological evaluations. Using Movement Disorder Society criteria, PD participants were classified as having normal cognition (PD-NC, n = 23), mild cognitive impairment (PD-MCI, n = 35), or dementia (PDD, n = 17). Cognitive domain (attention/working memory, executive function, language, memory, visuospatial function) z scores were calculated. DTI scalar values, including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD), were established for 5 callosal segments on a midsagittal plane, single slice using a topographically derived parcellation method. Scalar values were compared among participant groups. Regression analyses were performed on cognitive domain z scores and DTI metrics.ResultsParticipants with PD showed increased AD values in the anterior 3 callosal segments compared to healthy controls. Participants with PDD had significantly increased AD, MD, and RD in the anterior 2 segments compared to participants with PD-NC and most anterior segment compared to participants with PD-MCI. FA values did not differ significantly between participants with PD and participants with HC or among PD cognitive groups. The strongest associations for the DTI metrics and cognitive performance occurred in the most anterior and most posterior callosal segments, and also reflected fronto-striatal and posterior cortical type cognitive deficits, respectively.ConclusionsMicrostructural white matter abnormalities of the corpus callosum, as measured by DTI, may contribute to PD cognitive impairment by disrupting information transfer across interhemispheric and callosal-cortical projections.