Clinical characteristics of cognitive impairment in patients with Parkinson's disease and its related pattern in (18) F-FDG PET imaging.
Clinical characteristics of cognitive impairment in patients with Parkinson's disease and its related pattern in (18) F-FDG PET imaging.
复制标题
帕金森病患者认知障碍的临床特征及其在(18)F-FDG PET显像中的相关模式。
DOI：
10.1002/hbm.24311
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发表时间：
2018
影响因子：
4.8
通讯作者：
Wang Jian
中科院分区：
文献类型：
--
作者：
Wu Lei;Liu Feng-Tao;Ge Jing-Jie;Zhao Jue;Tang Yi-Lin;Yu Wen-Bo;Yu Huan;Anderson Tim;Zuo Chuan-Tao;Chen Ling;Wang Jian
本研究旨在用正电子发射断层扫描（PET）成像来描述帕金森病（PD）认知障碍的临床特征和相关的脑葡萄糖代谢模式。我们招募了168名PD患者和100名年龄匹配的健康对照者，他们的教育程度和性别分布相似。所有入组的患者均接受了临床评估，包括统一的帕金森病评定量表运动评分、Hoehn和Yahr量表以及综合神经心理学测试，包括执行功能、注意力、记忆力、视觉空间功能和语言领域。比较患者和健康对照组的人口统计学和认知测量结果。认知状态分类为PD痴呆患者（PD-D）、PD轻度认知障碍患者（PD-MCI）或PD认知正常患者（PD-NC）。在53例接受18 F-氟脱氧葡萄糖（18 F-FDG）PET成像的PD患者中，使用校正年龄和运动严重程度的统计参数图（SPM 8）评估不同认知领域的Z评分值与大脑18 F-FDG摄取之间的相关性。共有23.2%的PD患者为PD-MCI，8.9%为PD-D。在PD-MCI组中，96.3%的患者表现出多领域功能障碍，其中执行功能和注意力障碍最常见。除语言外，所有认知领域评分均与18 F-FDG代谢相关，主要在后颞顶枕联合皮质区。这项研究发现，PD中的认知障碍特别包括额叶/执行缺陷。后皮质区含有多种神经递质和神经回路，可能在PD认知功能障碍的发病机制中起重要作用。
This study aimed to characterize the clinical features and the related cerebral glucose metabolism pattern of cognitive impairments in Parkinson's disease (PD) with positron emission tomography (PET) imaging. We recruited 168 PD patients and 100 age‐matched healthy controls of similar education and gender distribution. All of those enrolled underwent clinical assessment including the unified Parkinson's disease rating scale motor score, Hoehn and Yahr scale, and comprehensive neuropsychological tests including domains of executive function, attention, memory, visuospatial function, and language. Demographics and the results of cognitive measures were compared between patients and healthy controls. Cognition status was classified as PD patients with dementia (PD‐D), PD patients with mild cognitive impairment (PD‐MCI), or PD patients with normal cognition (PD‐NC). In 53 PD patients who underwent18F‐fluorodeoxyglucose (18F‐FDG) PET imaging, correlations betweenZ‐score values of the different cognitive domains and cerebral18F‐FDG uptake were assessed using statistical parametric mapping (SPM8) corrected for age and motor severity. A total of 23.2% of PD patients were PD‐MCI and 8.9% were PD‐D. In the group of PD‐MCI, 96.3% showed multiple‐domain deficits, with executive function and attention impairment most predominantly involved. All the cognitive domain scores with the exception of language correlated with18F‐FDG metabolisms, primarily in posterior temporo‐parieto‐occipital association cortical areas. This study found that cognitive impairment in PD particularly encompasses frontal/executive deficits. Posterior cortical areas, containing multiple neurotransmitters and neural circuits, may play an important role in the pathogenesis of cognitive impairment in PD.