Exploratory analysis of neuropsychological and neuroanatomical correlates of progressive mild cognitive impairment in Parkinson's disease
Exploratory analysis of neuropsychological and neuroanatomical correlates of progressive mild cognitive impairment in Parkinson's disease
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DOI：
10.1136/jnnp-2013-305062
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发表时间：
2014-01-01
影响因子：
11
通讯作者：
Lee, Phil Hyu
中科院分区：
文献类型：
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作者：
Lee, Ji E.;Cho, Kyoo H.;Lee, Phil Hyu
帕金森氏病伴轻度认知障碍（PD-MCI）在认知特征和向痴呆的转化方面是一个异质性实体。然而，PD-MCI患者持续认知能力下降的危险因素尚未明确定义。方法对51例PD-MCI患者进行为期2年的前瞻性随访。根据受试者随后是否被诊断为PD痴呆，将其分为MCI转换者（n=15）和MCI非转换者（n=36）。我们使用基于体素的灰质（GM）密度形态测量（VBM）和基于感兴趣区域的无名物质（SI）体积分析来探索PD-MCI转换者的认知特征和神经解剖学特征。结果PD-MCI转换者在额叶执行功能、即时言语记忆和视觉识别记忆方面的认知缺陷较PD-MCI非转换者更为严重。VBM分析显示，PD-MCI转换者的左前额叶区、左岛叶皮质和双侧尾状核GM密度显著低于PD-MCI非转换者。PD-MCI转换器的平均归一化SI体积明显更小(1.19 +/- 0.35,p
Background Parkinson's disease with mild cognitive impairment (PD-MCI) is a heterogeneous entity in terms of cognitive profiles and conversion to dementia. However, the risk factors for ongoing cognitive decline in patients with PD-MCI are not clearly defined.Methods 51 patients with PD-MCI were prospectively followed-up for a minimum of 2 years. Subjects were classified as MCI converters (n=15) or MCI non-converters (n=36) based on whether they were subsequently diagnosed with PD dementia. We explored cognitive profiles and neuroanatomical characteristics of PD-MCI converters using voxel based morphometry (VBM) of grey matter (GM) density and region of interest based volumetric analysis of the substantia innominata (SI).Results PD-MCI converters showed more severe cognitive deficits in frontal executive functions, immediate verbal memory and visual recognition memory compared with PD-MCI non-converters. VBM analysis revealed that PD-MCI converters had significantly lower GM density in the left prefrontal areas, left insular cortex and bilateral caudate nucleus compared with that in PD-MCI non-converters. The mean normalised SI volume was significantly smaller in both PD-MCI converters (1.19 +/- 0.35, p