Association between Atrophy of the Caudate Nuclei, Global Brain Atrophy, Cerebral Small Vessel Disease and Mild Parkinsonian Signs in Neurologically and Cognitively Healthy Subjects Aged 45-84 Years: A Cross-sectional Study
Association between Atrophy of the Caudate Nuclei, Global Brain Atrophy, Cerebral Small Vessel Disease and Mild Parkinsonian Signs in Neurologically and Cognitively Healthy Subjects Aged 45-84 Years: A Cross-sectional Study
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DOI：
10.2174/1567205015666180702111110
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发表时间：
2018-01-01
影响因子：
2.1
通讯作者：
Camarda, Rosolino
中科院分区：
文献类型：
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作者：
Camarda, Cecilia;Torelli, Paola;Camarda, Rosolino
背景：轻度帕金森征象(MPS)常见于老年人，与脑小血管疾病(SVD)相关，但未见明确的结果。目的：本研究的目的是在一大群神经学和认知健康(NCH)的老年人中，研究MPS与脑白质高信号(WWH)、腔隙、尾状核萎缩和全脑萎缩的横断面关系。方法：对1219例NCH患者进行标准的脑MRI检查。采用统一帕金森病评定量表的运动部分项目评定震颤、僵直、运动迟缓、步态/平衡/轴向功能障碍。尾状核萎缩和全脑萎缩分别通过双尾状比率和侧脑室与脑比率进行评估。WMH采用两种视觉评定量表进行评定。缺憾也被评为等级。结果：额叶和基底节腔隙、额叶WMH、尾状核萎缩和全脑萎缩与运动迟缓有关。基底节陷窝、尾状核萎缩和全脑萎缩与步态/平衡/轴向功能障碍相关。强直与额叶WMH相关，震颤与尾状核萎缩和全脑萎缩相关。有MPS的NCH受试者在评估整体认知和语言的测试中的成绩低于没有MPS的受试者。结论：本研究表明，NCH老年个体的MPS与皮质和皮质下血管及萎缩的改变有关，可能是早期认知功能下降的警告信号。患有MPS的受试者应该严格管理大脑SVD，以防止未来的身体和认知障碍。
Background: Mild Parkinsonian signs (MPS) are commonly seen in aging, and have been related to cerebral Small Vessel Diseases (SVD) with no univocal results.Objective: The aim of this study was to investigate the cross-sectional relation between MPS and White Matter Hyperintensities (WWH), lacunes, caudate atrophy, and global cerebral atrophy in a large cohort of Neurologically and Cognitively Healthy (NCH) aging individuals.Method: 1,219 NCH individuals were included in the analysis, and underwent standard brain MRI. The items of the motor section of the Unified Parkinson's Disease Rating Scale were used to evaluate tremor, rigidity, bradykinesia, and gait/balance/axial dysfunction. Caudate atrophy and global cerebral atrophy were assessed through the bicaudate ratio and the lateral ventricles to brain ratio, respectively. WMH were assessed through two visual rating scales. Lacunes were also rated. Associations of MPS with vascular risk factors/diseases and imaging findings were determined through the logistic regression analysis.Results: Frontal and basal ganglia lacunes, frontal WMH, caudate atrophy, and global cerebral atrophy were associated with bradykinesia. Basal ganglia lacunes, caudate atrophy, and global cerebral atrophy were associated with gait/balance/axial dysfunction. Rigidity was associated with frontal WMH, and tremor with caudate atrophy and global cerebral atrophy. NCH subjects with MPS, performed less than subjects without MPS in tests evaluating global cognition and language.Conclusion: This study demonstrates that in NCH aging individuals, MPS are associated with cortical and subcortical vascular and atrophic changes, and are probably, a warning sign of incipient cognitive decline. Subjects with MPS should manage rigorously cerebral SVD to prevent future physical and cognitive disabilities.