What predicts cognitive decline in de novo Parkinson's disease?
What predicts cognitive decline in de novo Parkinson's disease?
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DOI：
10.1016/j.neurobiolaging.2011.11.028
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发表时间：
2012-06-01
影响因子：
4.2
通讯作者：
Nobili, Flavio
中科院分区：
文献类型：
--
作者：
Arnaldi, Dario;Campus, Claudio;Nobili, Flavio
在早期帕金森病（PD）中可以检测到细微的认知障碍。在一系列连续的新发、未使用药物的PD患者中，我们应用逐步回归分析来评估基线时的临床、神经心理学和功能神经影像学（多巴胺转运体[DAT]和灌注单光子发射计算机断层扫描[SPECT]）特征预测认知能力下降，平均随访时间约为4年。执行功能（R-2 = 0.54, p = 0.0001）和视觉空间功能（R-2 = 0.56, p = 0.0001）的下降可通过统一帕金森病评定量表(UPDRS)-III评分和受影响较小的脑半球（LAH）的尾状多巴胺转运蛋白（DAT）摄取来预测。通过尾状核数据摄取和脑后顶叶颞叶区灌注来预测言语记忆和语言能力下降（R-2 = 0.42; p = 0.0005）。随访时，年龄、基线神经心理学评分和左旋多巴当量剂量均无显著影响。结合临床结构检查和双单光子发射计算机断层成像的脑功能评估似乎是预测新发PD患者认知能力下降的有效方法。(c) 2012 Elsevier Inc.版权所有。
Subtle cognitive impairment can be detected in early Parkinson's disease (PD). In a consecutive series of de novo, drug-naive PD patients, we applied stepwise regression analysis to assess which clinical, neuropsychological, and functional neuroimaging (dopamine transporter [DAT] and perfusion single photon emission computed tomography [SPECT]) characteristics at baseline was predictive of cognitive decline during an average follow-up time of about 4 years. Decline both in executive (R-2 = 0.54; p = 0.0001) and visuospatial (R-2 = 0.56; p = 0.0001) functions was predicted by the couple of Unified Parkinson's Disease Rating Scale (UPDRS)-III score and caudate dopamine transporter (DAT) uptake in the less affected hemisphere (LAH). Verbal memory and language decline was predicted instead by caudate DAT uptake and brain perfusion in a posterior parieto-temporal area of the less affected hemisphere (R-2 = 0.42; p = 0.0005). No significant effect was shown for age, baseline neuropsychological scores, and levodopa equivalent dose at follow-up. The combined use of clinical structured examination and brain functional assessment by means of dual single photon emission computed tomography imaging appears as a powerful approach to predict cognitive decline in de novo PD patients. (c) 2012 Elsevier Inc. All rights reserved.