Hu M T, White S J, Chaudhuri K R, Morris R G, Bydder G M, Brooks D J
Robert Steiner MR Unit, Imperial College School of Medicine, Hammersmith Hospital, London, United Kingdom.
J Neural Transm (Vienna). 2001;108(5):571-80. doi: 10.1007/s007020170057.
We studied eight clinically non-demented PD patients and ten age-matched controls with serial volumetric T1-weighted MRI. All PD patients underwent full neuropsychological testing at baseline and follow up scans. Sub-voxel coregistration of the serial MRI scans with quantification of changes in total brain substance and ventricular size per year was performed. The PD patients had significant reductions in both percentage and absolute annual brain volume loss when compared to age-matched controls (p < 0.001). There were significant correlations between reductions in percentage brain volume loss and estimated reductions in performance IQ (r = 0.841, p = 0.004) and full scale IQ (r = 0.63, p = 0.049), measured by subtracting IQ measures at time of follow up scan from premorbid estimates. In conclusion, PD patients have a significant rate of median brain volume loss [10.35 (range) 6.69-16.90 ml/year] with no significant loss seen in age-matched controls, and these changes correlate with global measures of cognitive decline. Further longitudinal studies could evaluate whether serial volumetric MRI is a useful technique in predicting the preclinical onset of dementia in Parkinson's disease patients, and its role in the assessment of putative treatments for slowing disease progression.
我们对8名临床诊断为非痴呆的帕金森病患者和10名年龄匹配的对照者进行了系列容积性T1加权磁共振成像（MRI）研究。所有帕金森病患者在基线和随访扫描时均接受了全面的神经心理学测试。对系列MRI扫描进行亚体素配准，并对每年全脑实质和脑室大小的变化进行量化。与年龄匹配的对照者相比，帕金森病患者的脑容量年损失百分比和绝对量均显著降低（p < 0.001）。通过用病前估计值减去随访扫描时的智商测量值来计算，脑容量损失百分比的降低与估计的操作智商降低（r = 0.841，p = 0.004）和全量表智商降低（r = 0.63，p = 0.049）之间存在显著相关性。总之，帕金森病患者的脑容量中位数损失率显著[10.35（范围）6.69 - 16.90 ml/年]，而年龄匹配的对照者未见显著损失，且这些变化与认知衰退的整体测量相关。进一步的纵向研究可以评估系列容积性MRI是否是预测帕金森病患者痴呆临床前期发病的有用技术，以及其在评估延缓疾病进展的假定治疗方法中的作用。
