Gait speed in Parkinson disease correlates with cholinergic degeneration
Gait speed in Parkinson disease correlates with cholinergic degeneration
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DOI：
10.1212/wnl.0b013e3182a9f558
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发表时间：
2013-10-29
期刊：
影响因子：
9.9
通讯作者：
Mueller, Martijn L. T. M.
中科院分区：
文献类型：
--
作者：
Bohnen, Nicolaas I.;Frey, Kirk A.;Mueller, Martijn L. T. M.
目的：我们研究了帕金森病（PD）和非PD对照受试者的步态速度的多巴胺能和胆碱能相关性，以检验PD步态功能障碍可能导致多系统degeneration.Methods的假设：这是一个横断面研究。患有PD但无痴呆的受试者（n =125，年龄65.6 ± 7.3岁）和无PD的老年受试者（n = 32，年龄66.0 ± 10.6岁）进行[C-11]二氢丁苯那嗪多巴胺能和[C-11]甲基-4-哌啶基丙酸酯乙酰胆碱酯酶PET成像，以及认知和临床测试，包括在多巴胺能“关闭”状态下步行8.5米。第五百分位数的皮质胆碱能活性在老年人没有PD被用来定义正常范围内的活动与PD.Results：正常范围的皮质胆碱能活性存在于87例（69.6%）。以步态速度为因变量的协方差分析表明，模型具有显著性（F = 6.70，p < 0.0001），具有显著的组效应（F = 3.36，p = 0.037）和低胆碱能PD亚组中步态速度显著较慢（0.97 +/- 0.22 m/s），正常范围胆碱能PD亚组（1.12 +/- 0.20 m/s）和对照受试者（1.17 +/- 0.18 m/s）之间无显著差异。协变量的影响是显着的认知（F = 6.58，P = 0.011），但不是纹状体多巴胺能神经支配，性别，或age.Conclusion：共病皮质胆碱能去神经是一个更强大的标志物PD步态比单独黑质纹状体去神经减慢。相对孤立的黑质纹状体去神经支配的PD受试者的步态速度并不明显慢于正常。
Objective: We investigated dopaminergic and cholinergic correlates of gait speed in Parkinson disease (PD) and non-PD control subjects to test the hypothesis that gait dysfunction in PD may result from multisystem degeneration.Methods: This was a cross-sectional study. Subjects with PD but without dementia (n =125, age 65.6 +/- 7.3 years) and elderly subjects without PD (n = 32, age 66.0 +/- 10.6 years) underwent [C-11] dihydrotetrabenazine dopaminergic and [C-11] methyl-4-piperidinyl propionate acetylcholinesterase PET imaging, and cognitive and clinical testing, including an 8.5-m walk in the dopaminergic "off" state. The fifth percentile of cortical cholinergic activity in the elderly without PD was used to define normal-range activity in the subjects with PD.Results: Normal-range cortical cholinergic activity was present in 87 subjects with PD (69.6%). Analysis of covariance using gait speed as the dependent variable demonstrated a significant model (F = 6.70, p < 0.0001) with a significant group effect (F = 3.36, p = 0.037) and significant slower gait speed in the low cholinergic PD subgroup (0.97 +/- 0.22 m/s) with no significant difference between the normal-range cholinergic PD subgroup (1.12 +/- 0.20 m/s) and control subjects (1.17 +/- 0.18 m/s). Covariate effects were significant for cognition (F = 6.58, p = 0.011), but not for striatal dopaminergic innervation, sex, or age.Conclusion: Comorbid cortical cholinergic denervation is a more robust marker of slowing of gait in PD than nigrostriatal denervation alone. Gait speed is not significantly slower than normal in subjects with PD with relatively isolated nigrostriatal denervation.