No laughing white matter: Reduced integrity of the cortical cholinergic pathways in Parkinson's disease-related cognitive impairment.
No laughing white matter: Reduced integrity of the cortical cholinergic pathways in Parkinson's disease-related cognitive impairment.
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DOI：
10.1016/j.nbd.2023.106243
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发表时间：
2023-09
影响因子：
6.1
通讯作者：
Bronte-Stewart, Helen M.
中科院分区：
文献类型：
--
作者：
Crockett, Rachel A.;Wilkins, Kevin B.;Aditham, Sudeep;Bronte-Stewart, Helen M.
关键词：
最近诊断的帕金森病（PD）患者中约有三分之一经历认知能力下降。Meynert基底核（NBM）在PD早期退化，对认知功能至关重要。两个主要的NBM白色物质路径包括外侧和内侧轨迹。然而，需要研究来确定哪种途径（如果有的话）与PD相关的认知下降相关。本研究纳入了37例无轻度认知功能障碍（MCI）的PD患者。参与者在1年随访时发生MCI（PD MCI转换者; n = 16）或未发生MCI（PD无MCI; n = 21）。平均扩散率（MD）和分数各向异性（FA）的内侧和外侧NBM束提取使用概率纤维束成像。使用ANCOVA比较各组间MD和FA的差异，控制年龄、性别和疾病持续时间。还对内囊MD和FA进行了对照比较。使用线性混合模型评估基线MD或FA与认知结果（工作记忆、心理速度、延迟回忆和视觉空间功能）之间的关联。与PD无MCI相比，PD MCI转换者的两个NBM束的MD显著更大，FA更低（p < .001）。对照区的MD（p = 0.06）或FA（p = 0.31）无差异。确定了以下趋势：1）外侧束MD和FA与工作记忆下降;和2）内侧束MD和精神运动速度降低。NBM束的完整性降低在PD患者中在MCI发展前长达一年是明显的。因此，PD患者NBM束的恶化可能是认知能力下降风险的早期标志。
Approximately one third of recently diagnosed Parkinson’s disease (PD) patients experience cognitive decline. The nucleus basalis of Meynert (NBM) degenerates early in PD and is crucial for cognitive function. The two main NBM white matter pathways include a lateral and medial trajectory. However, research is needed to determine which pathway, if any, are associated with PD-related cognitive decline. Thirty-seven PD patients with no mild cognitive impairment (MCI) were included in this study. Participants either developed MCI at 1-year follow up (PD MCI-Converters; n = 16) or did not (PD no-MCI; n = 21). Mean diffusivity (MD) and fractional anisotropy (FA) of the medial and lateral NBM tracts were extracted using probabilistic tractography. Between-group differences in MD and FA for each tract was compared using ANCOVA, controlling for age, sex, and disease duration. Control comparisons of the internal capsule MD and FA were also performed. Associations between baseline MD or FA and cognitive outcomes (working memory, psychomotor speed, delayed recall, and visuospatial function) were assessed using linear mixed models. PD MCI-Converters had significantly greater MD and lower FA (p < .001) of both NBM tracts compared to PD no-MCI. No difference was found in the MD (p = .06) or FA (p = .31) of the control region. Trends were identified between: 1) lateral tract MD and FA with working memory decline; and 2) medial tract MD and reduced psychomotor speed. Reduced integrity of the NBM tracts is evident in PD patients up to one year prior to the development of MCI. Thus, deterioration of the NBM tracts in PD may be an early marker of those at risk of cognitive decline.
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