Distinct brain networks underlie cognitive dysfunction in Parkinson and Alzheimer diseases
Distinct brain networks underlie cognitive dysfunction in Parkinson and Alzheimer diseases
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DOI：
10.1212/wnl.0000000000003285
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发表时间：
2016-11-01
期刊：
影响因子：
9.9
通讯作者：
Eidelberg, David
中科院分区：
文献类型：
--
作者：
Mattis, Paul J.;Niethammer, Martin;Eidelberg, David
目的：确定帕金森病（PD）和阿尔茨海默病（AD）的认知功能障碍是否源于相同的网络病理。我们分析了40例AD患者和40例年龄在18岁以下的老年人的F-18-氟脱氧葡萄糖PET扫描。与阿尔茨海默病神经影像学倡议的健康对照组相匹配，并在范斯坦医学研究所扫描了另外10名AD患者和10名健康对照组，以得出AD相关代谢模式（ADRP）类似于我们先前建立的PD认知相关模式（PDCP）和PD运动相关模式（PDRP）。我们计算了89例PD患者ADRP和PDCP的个体表达值，并将认知功能的汇总评分与网络表达相关联。我们还评估了ADRP和PDCP表达的变化，在一个单独的一组15例PD扫描连续超过4 yearperiod.Results：分析显示了显着的AD相关的代谢地形特征的协变代谢减少在海马，海马旁回，顶叶和颞叶的关联区域。两组AD患者的ADRP表达均升高，但PDCP表达无变化，且与认知综合评分下降相关。PD患者表现出轻微的ADRP表达，由于地形重叠的网络基础PD运动相关的模式退化，但只有他们的PDCP表达值增加认知功能和执行性能下降。纵向数据在PD披露了一个类似的解离网络expression.Conclusions：认知功能障碍在PD与一个特定的大脑网络，在很大程度上是空间和功能上不同的，看到有关AD。
Objective: To determine whether cognitive impairment in Parkinson disease (PD) and Alzheimer disease (AD) derives from the same network pathology.Methods: We analyzed F-18-fluorodeoxyglucose PET scans from 40 patients with AD and 40 age-matched healthy controls from the Alzheimer's Disease Neuroimaging Initiative and scanned an additional 10 patients with AD and 10 healthy controls at The Feinstein Institute for Medical Research to derive an AD-related metabolic pattern (ADRP) analogous to our previously established PD cognition-related pattern (PDCP) and PD motor-related pattern (PDRP). We computed individual subject expression values for ADRP and PDCP in 89 patients with PD and correlated summary scores for cognitive functioning with network expression. We also evaluated changes in ADRP and PDCP expression in a separate group of 15 patients with PD scanned serially over a 4-year period.Results: Analysis revealed a significant AD-related metabolic topography characterized by covarying metabolic reductions in the hippocampus, parahippocampal gyrus, and parietal and temporal association regions. Expression of ADRP, but not PDCP, was elevated in both AD groups and correlated with worse cognitive summary scores. Patients with PD showed slight ADRP expression, due to topographic overlap with the network underlying PD motor-related pattern degeneration, but only their PDCP expression values increased as cognitive function and executive performance declined. Longitudinal data in PD disclosed an analogous dissociation of network expression.Conclusions: Cognitive dysfunction in PD is associated with a specific brain network that is largely spatially and functionally distinct from that seen in relation to AD.