Amnestic mild cognitive impairment in Parkinson's disease: White matter structural changes and mechanisms
Amnestic mild cognitive impairment in Parkinson's disease: White matter structural changes and mechanisms
复制标题
帕金森病的遗忘性轻度认知障碍：白质结构变化和机制
DOI：
10.1371/journal.pone.0226175
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发表时间：
2019-12-12
期刊：
影响因子：
3.7
通讯作者：
Zhang, Haobo
中科院分区：
文献类型：
--
作者：
Chen, Fuyong;Wu, Tao;Zhang, Haobo
轻度认知障碍（MCI）是一种异质性认知障碍，常与帕金森病（PD）共病。PD-MCI的遗忘亚型（PD-aMCI）具有更高的发展痴呆的风险。然而，目前缺乏对PD-aMCI的白色物质（WM）结构变化的研究。我们使用基于体素和基于轨迹的空间统计（TBSS）分析对分数各向异性（FA）轴向扩散率（AD）和径向扩散率（RD）的分析，表征了具有认知正常PD（PD-CN，n = 19）和正常对照（n = 20）的PD-aMCI（n = 17）的WM结构变化。通过在PD-aMCI和PD-CN之间的比较分析中排除运动表现作为协变量，然后将其包括在内，我们试图辨别两种神经病理机制对PD-aMCI的WM结构变化的影响。所有PD患者的记忆和基于体素的WM测量之间的相关性分析也进行了（n = 36）。结果显示，PD-aMCI组弥漫性WM区FA值小于PD-CN组，PD-CN组右侧尾状核AD和RD值高于正常对照组。PD-aMCI和PD-CN之间的FA差异可通过运动调节而减弱。PD-aMCI和PD-CN之间的FA差异在很大程度上与记忆相关的FA值在空间上重叠。我们的研究结果表明，PD-aMCI和PD-CN之间的WM结构差异主要与记忆有关，运动调节的影响可能表明PD-aMCI运动和记忆障碍的共同机制，可能反映了多巴胺能神经病理学的主导影响。
Mild cognitive impairment (MCI) is a heterogeneous cognitive disorder that is often comorbid with Parkinson's diseases (PD). The amnestic subtype of PD-MCI (PD-aMCI) has a higher risk to develop dementia. However, there is a lack of studies on the white matter (WM) structural changes of PD-aMCI. We characterized the WM structural changes of PD-aMCI (n = 17) with cognitively normal PD (PD-CN, n = 19) and normal controls (n = 20), using voxel-based and tract-based spatial statistics (TBSS) analyses on fractional anisotropy (FA) axial diffusivity (AD), and radial diffusivity (RD). By excluding and then including the motor performance as a covariate in the comparison analysis between PD-aMCI and PD-CN, we attempted to discern the influences of two neuropathological mechanisms on the WM structural changes of PD-aMCI. The correlation analyses between memory and voxel-based WM measures in all PD patients were also performed (n = 36). The results showed that PD-aMCI had smaller FA values than PD-CN in the diffuse WM areas, and PD-CN had higher AD and RD values than normal controls in the right caudate. Most FA difference between PD-aMCI and PD-CN could be weakened by the motor adjustment. The FA differences between PD-aMCI and PD-CN were largely spatially overlapped with the memory-correlated FA values. Our findings demonstrated that the WM structural differences between PD-aMCI and PD-CN were mainly memory-related, and the influence of motor adjustment might indicate a common mechanism underlying both motor and memory impairment in PD-aMCI, possibly reflecting a predominant influence of dopaminergic neuropathology.