Frequency of cholinergic and caudate nucleus dopaminergic deficits across the predemented cognitive spectrum of Parkinson disease and evidence of interaction effects.
Frequency of cholinergic and caudate nucleus dopaminergic deficits across the predemented cognitive spectrum of Parkinson disease and evidence of interaction effects.
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胆碱能和尾状核多巴胺能缺陷的频率在帕金森氏病的预测认知范围内以及相互作用效应的证据。
DOI：
10.1001/jamaneurol.2014.2757
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发表时间：
2015-03
期刊：
影响因子：
29
通讯作者：
Frey KA
中科院分区：
文献类型：
--
作者：
Bohnen NI;Albin RL;Müller ML;Petrou M;Kotagal V;Koeppe RA;Scott PJ;Frey KA
人们对帕金森病（PD）中多系统退行性过程的相对贡献知之甚少。研究认知受损PD患者尾状核多巴胺能和前脑胆碱能缺陷的相对频率，以探讨它们对PD患者认知障碍的相对个体和综合贡献。横断面研究。学术运动障碍诊所。以非痴呆为主的143名PD患者，平均年龄65.5±7.4岁，平均Hoehn和Yahr分期2.4±0.6。基于规范数据的[11C]PMP乙酰胆碱酯酶与尾状核[11C]DTBZ单胺能PET成像二元分类。基于正常值的显著退行性过程的频率被确定为认知障碍的连续间隔，范围从无或轻微（Z> - 0.5）到更严重的认知障碍（Z≤- 2）。在从最小（Z>−0.5）到更严重的整体认知障碍评分（Z≤−2）范围内，尾状核多巴胺能失神经在认知变化较小或无变化的受试者中相对频繁（51.1%），在认知障碍较严重的受试者中增加（χ2=12.8， P=0.012）。皮层胆碱能去神经频率随认知障碍程度的增加而单调增加，从24.7% （Z> - 0.5）增加到85.7% （Z≤- 2;χ2=23.2， P=0.0001）。87.0%的新皮质胆碱能缺损患者存在尾状核多巴胺能缺损。多元回归分析（模型F=7.51， P<0.0001）显示尾状核多巴胺能（F=7.25， P=0.008）和皮质胆碱能（F=7.50， P=0.007）退化和相互作用效应（F=5.40， P=0.022）的独立认知预测。皮层胆碱能去神经支配是一种主要的神经退行性疾病，与PD患者认知功能障碍的进行性下降有关，通常发生在显著的尾状核多巴胺能去神经支配的背景下。我们的研究结果表明，多巴胺能和胆碱能变性对帕金森病的认知障碍既有独立的作用，也有相互作用的作用。
Little is known about the relative contributions of multisystem degenerative processes across the spectrum of pre-demented cognitive decline in Parkinson disease (PD). To investigate the relative frequency of caudate nucleus dopaminergic and forebrain cholinergic deficits across a spectrum of cognitively impaired PD subjects in order to explore their relative individual and combined contributions to cognitive impairment in PD. Cross-sectional study. Academic movement disorders clinic. A predominantly non-demented cohort of 143 PD subjects, mean age 65.5±7.4 years, mean Hoehn and Yahr stage 2.4±0.6. Binary classification of [11C]PMP acetylcholinesterase and caudate nucleus [11C]DTBZ monoaminergic PET imaging based on normative data. The frequency of significant degenerative processes based on normative values was determined for consecutive intervals of cognitive impairment ranging from no or minimal (Z>−0.5) to more severe cognitive impairment (Z≤ −2). Across the spectrum ranging from minimal (Z>−0.5) to more severe global cognitive impairment scores (Z≤ −2), caudate nucleus dopaminergic denervation was relatively frequent in those with minimal or no cognitive changes (51.1%) and increased in subjects with more severe cognitive impairments (χ2=12.8, P=0.012). Cortical cholinergic denervation frequency increased monotonically with increasing cognitive impairment from 24.7% (Z>−0.5) to 85.7% (Z≤ −2; χ2=23.2, P=0.0001). 87.0% of subjects with neocortical cholinergic deficits had caudate nucleus dopaminergic deficits. Multiple regression analysis (model F=7.51, P<0.0001) showed both independent cognitive predictions for caudate nucleus dopaminergic (F=7.25, P=0.008) and cortical cholinergic (F=7.50, P=0.007) degenerations and also interaction effects (F=5.40, P=0.022). Cortical cholinergic denervation is a major neurodegeneration associated with progressive declines across the spectrum of cognitive impairment in PD and typically occurs in the context of significant caudate nucleus dopaminergic denervation. Our findings imply that dopaminergic and cholinergic degenerations exhibit both independent and interactive contributions to cognitive impairment in PD.
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影响因子：
9.3
作者：
Petrou, Myria;Frey, Kirk A.;Koeppe, Robert A.
通讯作者：
Koeppe, Robert A.
影响因子：
1.8
作者：
Shao, Xia;Hoareau, Raphael;Hockley, Brian G.;Tluczek, Louis J. M.;Henderson, Bradford D.;Padgett, Henry C.;Scott, Peter J. H.
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Scott, Peter J. H.
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Halliday, Glenda M.;Leverenz, James B.;Schneider, Jay S.;Adler, Charles H.
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Adler, Charles H.
影响因子：
9.9
作者：
Hilker, R;Thomas, AV;Heiss, WD
通讯作者：
Heiss, WD
影响因子：
11
作者：
HUGHES, AJ;DANIEL, SE;LEES, AJ
通讯作者：
LEES, AJ