White Matter and Cognition in Parkinson's Disease

描述（由申请人提供）：帕金森病（PD）仅在美国就影响超过150万人；其患病率随着年龄的增长而增加，大多数诊断发生在60岁以上。虽然PD主要与运动症状相关，如静息性震颤和僵硬，但它也与衰弱性认知症状相关。该申请的独特之处在于候选人专注于白质完整性在PD认知功能中的作用。尽管越来越多的研究表明白质的病理改变可能导致PD的退行性疾病，但人们对PD中白质和认知的关系知之甚少。职业发展计划包括两个核心培训目标：1)PD认知行为模式和理论的专业培训，2)扩散张量成像（DTI）方法的重点培训。还包括生物统计学、研究伦理和基金写作方面的补充培训。候选人的长期职业目标是将这些技能应用于纵向调查，研究白质与灰质对PD患者认知能力下降（痴呆）的预测价值，以及PD特定医疗干预（即深部脑刺激）后的认知结果。这些研究兴趣得到了候选人的主要学院，佛罗里达大学公共卫生和卫生专业学院以及她兼职的医学院的大力支持。候选人将与教授Dawn Bowers博士（神经心理学，佛罗里达大学），Thomas Mareci博士（生物化学和分子生物学，佛罗里达大学），Glen Stebbins博士（神经科学系，Rush大学）以及神经学，神经科学和生物统计学教授组成的顾问小组共同指导她的研究。研究将确定1)相对于年龄和教育程度匹配的对照组（n=45），白质完整性对特发性PD （n=45）的加工速度和工作记忆缺陷的贡献，以及2)一年后白质对认知变化的预测作用。方法包括基线MRI和认知评估，并在一年内进行重复认知评估。与公共卫生相关：该项目将有助于了解白质完整性在帕金森病患者认知功能中的作用。这些信息将有助于我们预测帕金森病的认知变化，从而改善帕金森病的治疗决策和干预选择。

DESCRIPTION (provided by applicant): Parkinson's disease (PD) affects more than 1.5 million people in the United States alone; its prevalence increases with age, and the majority of the diagnoses occur over age 60. While PD is primarily associated with motor symptoms such as resting tremor and rigidity, it is also associated with debilitating cognitive symptoms. The uniqueness of this application is the candidate's focus on the role of white matter integrity on cognitive function in PD. Little is known about white matter and cognition in PD despite growing research suggesting pathological changes in the white matter may contribute to the degenerative disease. The career development plan consists of two core training objectives: 1) specialty training on the cognitive-behavioral patterns and theories of PD, 2) focused training on Diffusion Tensor Imaging (DTI) methods. Supplementary training in biostatistics, research ethics and grant writing is included. The candidate's long-term career goals are to apply these skills towards longitudinal investigations examining the predictive value of white versus gray matter on cognitive decline (dementia) in PD and cognitive outcome following PD specific medical interventions (i.e., deep brain stimulation). These research interests are strongly supported by the candidate's primary college, The University of Florida's College of Public Health and Health Professions, as well as the College of Medicine where she has an adjunct appointment. The candidate will carry out her research with the co-mentorship of Professors Dawn Bowers, Ph.D. (Neuropsychology, UF), Thomas Mareci, Ph.D. (Biochemistry and Molecular Biology, UF), Glen Stebbins, Ph.D. (Department of Neurological Sciences, Rush University), and an advisory panel of Professors in the Departments of Neurology, Neuroscience and Biostatistics. The research will determine 1) the contribution of white matter integrity on the processing speed and working memory deficits of idiopathic PD (n=45) relative to that of an age and education matched control group (n=45), and 2) the predictive role of white matter on cognitive change after one year. Methods include a baseline MRI and cognitive assessment with a repeat cognitive assessment in one year. Relevance to Public Health: This project will contribute much needed knowledge about the role of white matter integrity on cognitive function in PD. The information will contribute to our ability to predict cognitive change in PD thereby improving treatment decisions and intervention options for PD.