Corticolimbic gray matter loss in Parkinson's disease without dementia
Corticolimbic gray matter loss in Parkinson's disease without dementia
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DOI：
10.1111/j.1468-1331.2010.02980.x
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发表时间：
2010-08-01
影响因子：
5.1
通讯作者：
Mori, E.
中科院分区：
文献类型：
--
作者：
Nishio, Y.;Hirayama, K.;Mori, E.
背景：非痴呆性帕金森病（PD）患者皮质边缘受累与认知功能障碍之间的关系尚未阐明。目的：描述非痴呆性PD的大脑皮层和边缘结构的受累性，并阐明非痴呆性PD伴认知障碍（PD- ci）和无认知障碍（PD- nc）之间灰质损失的分布差异。方法：采用基于临床痴呆评分的操作标准来识别PD-CI。在40例连续的PD非痴呆患者中，13例被分类为PD- ci， 27例被分类为PD- nc。使用基于体素的形态测量法比较PD-CI组、PD-NC组和对照组的区域灰质体积（rGMV）。结果：目前未痴呆的PD患者在额叶、颞叶、顶叶和枕叶皮层广泛发现灰质丢失。PD-NC组和PD-CI组的额内侧和枕内侧皮质的rGMV明显减少。左脑皮层灰质损失的严重程度从对照组到PD-NC组，再到PD-CI组依次增加。PD-CI的rGMV减少主要发生在外侧和眶额、内侧和外侧颞叶、内侧和外侧顶叶、外侧枕皮质和小脑。结论：我们的研究结果表明，皮质边缘变性发生在非痴呆性PD患者中，并且广泛累及边缘和后皮质区域以及额皮质与PD患者的认知障碍有关。
Background:The relationship between corticolimbic involvement and cognitive dysfunction in non-demented Parkinson's disease (PD) patients has not yet been elucidated.Objectives:To delineate involvement of the cerebral cortex and limbic structures in non-demented PD and to clarify distributional differences of gray matter loss between non-demented PD with impaired cognition (PD-CI) and without cognitive impairment (PD-NC).Methods:Operational criteria based on the Clinical Dementia Rating were used to identify PD-CI. Of 40 consecutive non-demented patients with PD, 13 were classified as PD-CI and 27 as PD-NC. Comparisons of regional gray matter volume (rGMV) were made amongst the PD-CI, PD-NC, and control groups using voxel-based morphometry.Results:Gray matter loss was found extensively in the frontal, temporal, parietal, and occipital cortices in the present non-demented patients with PD. rGMV in the medial frontal and medial occipital cortices was reduced comparably in the PD-NC and PD-CI groups. The severity of gray matter loss in the perisylvian cortices increased in order from the control, to the PD-NC, to the PD-CI groups. rGMV reduction in the lateral and orbital frontal, medial and lateral temporal, medial and lateral parietal, and lateral occipital cortices and cerebellum was found specifically in PD-CI.Conclusions:Our results suggest that corticolimbic degeneration occurs in non-demented patients with PD, and extensive involvement of the limbic and posterior cortical regions as well as the frontal cortices is associated with cognitive impairment in PD.