Apathy in Parkinson's Disease Is Associated With Nucleus Accumbens Atrophy: A Magnetic Resonance Imaging Shape Analysis
Apathy in Parkinson's Disease Is Associated With Nucleus Accumbens Atrophy: A Magnetic Resonance Imaging Shape Analysis
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DOI：
10.1002/mds.25904
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发表时间：
2014-06-01
影响因子：
8.6
通讯作者：
Devos, David
中科院分区：
文献类型：
--
作者：
Carriere, Nicolas;Besson, Pierre;Devos, David
冷漠的特征是缺乏兴趣，失去主动性，情感平淡。它是帕金森病（PD）的一种常见的、非常致残的非运动并发症。当多巴胺能药物在丘脑底刺激开始后逐渐减少时，可能会发生这种情况，因此可以称为“多巴胺能冷漠”。“即使没有逐渐减少，随着PD的进展，一些患者可能会出现一种冷漠的形式。这种形式通常与认知能力下降有关，并且对多巴胺能药物没有反应（多巴胺抵抗性冷漠）。我们的目的是确定帕金森病患者的多巴抵抗性冷漠是否与纹状体前额形态学变化有关。我们比较了连续10例多巴胺难治性冷漠患者、10例匹配的非冷漠PD患者和10例健康对照者的纹状体形状（使用三维点分布模型[SPHARM-PDM]中的球谐参数化和采样）、皮质厚度和各向异性分数（使用基于轨迹的空间统计）。PD患者的冷漠与左侧延髓核萎缩有关。SPHARM-PDM分析强调了（1）冷漠的严重程度与左侧尾状核萎缩之间的正相关性，（2）冷漠患者的左侧尾状核背外侧头萎缩程度大于非冷漠患者，（3）冷漠患者的双侧尾状核萎缩程度大于对照组。皮质厚度或各向异性分数无显著组间差异。帕金森病患者多巴抵抗性冷漠与左侧延髓核和左侧尾状核背外侧头萎缩相关。(C)2014年国际帕金森和运动障碍协会
Apathy is characterized by lack of interest, loss of initiative, and flattening of affect. It is a frequent, very disabling nonmotor complication of Parkinson's disease (PD). The condition may notably occur when dopaminergic medications are tapered after the initiation of subthalamic stimulation and thus can be referred to as "dopaminergic apathy." Even in the absence of tapering, some patients may develop a form of apathy as PD progresses. This form is often related to cognitive decline and does not respond to dopaminergic medications (dopa-resistant apathy). We aimed at determining whether dopa-resistant apathy in PD is related to striatofrontal morphological changes. We compared the shape of the striatum (using spherical harmonic parameterization and sampling in a three-dimensional point distribution model [SPHARM-PDM]), cortical thickness, and fractional anisotropy (using tract-based spatial statistics) in 10 consecutive patients with dopamine-refractory apathy, 10 matched nonapathetic PD patients and 10 healthy controls. Apathy in PD was associated with atrophy of the left nucleus accumbens. The SPHARM-PDM analysis highlighted (1) a positive correlation between the severity of apathy and atrophy of the left nucleus accumbens, (2) greater atrophy of the dorsolateral head of the left caudate in apathetic patients than in nonapathetic patients, and (3) greater atrophy in the bilateral nucleus accumbens in apathetic patients than in controls. There were no significant intergroup differences in cortical thickness or fractional anisotropy. Dopa-resistant apathy in PD was associated with atrophy of the left nucleus accumbens and the dorsolateral head of the left caudate. (C) 2014 International Parkinson and Movement Disorder Society