Metabolic abnormalities associated with mild cognitive impairment in Parkinson disease
Metabolic abnormalities associated with mild cognitive impairment in Parkinson disease
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DOI：
10.1212/01.wnl.0000304050.05332.9c
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发表时间：
2008-04-15
期刊：
影响因子：
9.9
通讯作者：
Eidelberg, D.
中科院分区：
文献类型：
--
作者：
Huang, C.;Mattis, P.;Eidelberg, D.
目的：目的：应用18氟脱氧葡萄糖（FDG）和正电子发射计算机断层扫描（PET）研究帕金森病（PD）患者轻度认知功能损害（MCI）的局部代谢改变。认知异常在PD中很常见。然而，鲜为人知的功能异常的基础MCI的表现，在这种disorder.Methods：我们使用FDG PET测量区域葡萄糖代谢的PD患者与多域MCI（MD-MCI; n = 18），单域MCI（SD-MCI; n = 15），没有MCI（N-MCI; n = 18）。这些患者在年龄、教育程度、病程和运动障碍方面相匹配。使用统计参数图（SPM）比较三组的区域代谢图。我们还计算了患者组和年龄匹配的健康对照组（n = 15）中先前验证的认知相关空间协方差模式（PDCP）的表达。结果：SPM显示MD-MCI组与N-MCI组相比前额叶和顶叶代谢降低（p < 0.001），脑干/小脑代谢增加（p < 0.001）。在这些区域中，SD-MCI占据了其他两组之间的中间位置。在N-、SD-和MD-MCI组中，PDCP表达异常升高（p < 0.05），并且随着认知功能障碍的恶化而逐步增加（p < 0.01）。结论：帕金森病的早期认知功能下降（定义为轻度认知功能障碍）与离散的区域变化和异常的代谢网络活动有关。用18F-氟脱氧葡萄糖PET定量这些改变可以客观评估这种疾病表现的进展和治疗。
Objective: To use 18F-fluorodeoxyglucose (FDG) and PET to investigate changes in regional metabolism associated with mild cognitive impairment (MCI) in Parkinson disease (PD). Cognitive abnormalities are common in PD. However, little is known about the functional abnormalities that underlie the manifestations of MCI in this disorder.Methods: We used FDG PET to measure regional glucose metabolism in patients with PD with multiple-domain MCI (MD-MCI; n = 18), with single-domain MCI (SD-MCI; n = 15), and without MCI (N-MCI; n = 18). These patients were matched for age, education, disease duration, and motor disability. Maps of regional metabolism in the three groups were compared using statistical parametric mapping (SPM). We also computed the expression of a previously validated cognition-related spatial covariance pattern (PDCP) in the patient groups and in an age-matched healthy control cohort (n = 15). PDCP expression was compared across groups using analysis of variance.Results: SPM revealed decreased prefrontal and parietal metabolism (p < 0.001) in MD-MCI relative to N-MCI, as well as an increase in brainstem/cerebellar metabolism (p < 0.001) in this group. In these regions, SD-MCI occupied an intermediate position between the two other groups. PDCP expression was abnormally elevated in the N-, SD-, and MD-MCI groups (p < 0.05), increasing stepwise with worsening cognitive impairment (p < 0.01).Conclusions: Early cognitive decline in Parkinson disease as defined by mild cognitive impairment is associated with discrete regional changes and abnormal metabolic network activity. The quantification of these alterations with 18F-fluorodeoxyglucose PET may allow for the objective assessment of the progression and treatment of this disease manifestation.