Dementia in Parkinson disease - Functional imaging of cholinergic and dopaminergic pathways
Dementia in Parkinson disease - Functional imaging of cholinergic and dopaminergic pathways
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DOI：
10.1212/01.wnl.0000191154.78131.f6
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发表时间：
2005-12-13
期刊：
影响因子：
9.9
通讯作者：
Heiss, WD
中科院分区：
文献类型：
--
作者：
Hilker, R;Thomas, AV;Heiss, WD
目的：评价帕金森病（PD）相关痴呆（PDD）患者的神经化学功能缺损。研究方法：作者使用N-[C-11]-甲基-4-哌啶乙酸酯（MP 4A）和F-18-氟多巴（FDOPA）联合进行PET，以评价17例非痴呆PD患者和10例PDD患者的胆碱能和多巴胺能递质变化。数据进行了比较，31个年龄匹配的控制相结合的区域的利益和体素为基础的统计参数映射分析。结果：PD组和PDD组纹状体FDOPA摄取均明显降低，但组间差异无统计学意义。在PDD中，整体皮质MP 4A结合严重降低（29.7%，p < 0.001 vs对照），在PD中中度降低（10.7%，p < 0.01 vs对照）。PDD组顶叶MP 4A摄取率低于PD患者。额叶和颞顶叶皮质显示PDD患者纹状体FDOPA减少和MP 4A结合减少的显著协方差。结论：虽然非痴呆帕金森病患者有中度胆碱能功能障碍，帕金森病相关性痴呆（PDD）的受试者在各个皮质区域出现严重的胆碱能缺陷。发现纹状体FDOPA和皮质MP 4A结合减少密切相关，提示PDD中导致复杂递质缺乏综合征的常见疾病过程。
Objective: To assess neurochemical deficits in patients with Parkinson disease (PD) associated dementia (PDD) in vivo. Methods: The authors performed combined PET with N-[C-11]-methyl-4-piperidyl acetate (MP4A) and F-18-fluorodopa (FDOPA) for evaluation of cholinergic and dopaminergic transmitter changes in 17 non-demented patients with PD and 10 patients with PDD. Data were compared to 31 age-matched controls by a combined region-of-interest and voxel-based Statistical Parametric Mapping analysis. Results: The striatal FDOPA uptake was significantly decreased in PD and PDD without differences between the groups. The global cortical MP4A binding was severely reduced in PDD ( 29.7%, p < 0.001 vs controls) and moderately decreased in PD (10.7%, p < 0.01 vs controls). The PDD group had lower parietal MP4A uptake rates than did patients with PD. Frontal and temporo-parietal cortices showed a significant covariance of striatal FDOPA reduction and decreased MP4A binding in patients with PDD. Conclusions: While non-demented patients with Parkinson disease had a moderate cholinergic dysfunction, subjects with Parkinson disease associated dementia (PDD) presented with a severe cholinergic deficit in various cortical regions. The finding of a closely associated striatal FDOPA and cortical MP4A binding reduction suggests a common disease process leading to a complex transmitter deficiency syndrome in PDD.