Camicioli Richard, Moore M Milar, Kinney Anthony, Corbridge Elizabeth, Glassberg Kathryn, Kaye Jeffrey A
Department of Neurology, Oregon Health and Science University, Portland, Oregon, USA.
Mov Disord. 2003 Jul;18(7):784-90. doi: 10.1002/mds.10444.
Patients with Parkinson's disease (PD) may have hippocampal atrophy compared with controls. We compared hippocampal, and extra-hippocampal volumes between PD, PDD (patients with PD who have mild cognitive impairment or dementia), Alzheimer's disease (AD) and controls using volumetric magnetic resonance imaging (MRI). Participants (10 patients with PD, 10 with PDD, 11 with AD, and 12 control subjects) had an informant interview, neurological examination, and psychometric testing. Established, reliable methods were used to measure the hippocampus, parahippocampal gyrus, temporal, frontal, and parieto-occipital lobes. Correction for intracranial volume was carried out before comparison. There was no age difference between groups (mean age, 74 years). On the Clinical Dementia Rating scale (CDR) cognitive impairment was mild (CDR = 0.5) in the majority of PDD and AD patients. Hippocampal (P < 0.0004) volumes were smaller in the patient groups. Effect sizes compared with the control group were: PD, 0.66; PDD, 1.22; and AD, 1.81. The other volumes did not differ significantly. Among PD and PDD patients, recognition memory (r = 0.54, P = 0.015) and Mini-Mental State Examination scores (r = 0.56, P = 0.01) correlated with left, but not right hippocampal volume. In conclusion, hippocampal volume showed a pattern (Control > PD > PDD > AD) suggesting progressive hippocampal volume loss in PD. Volumetric MRI imaging might provide an early marker for dementia in PD.
与对照组相比,帕金森病(PD)患者可能存在海马萎缩。我们使用容积磁共振成像(MRI)比较了PD患者、帕金森病痴呆(PDD,即患有轻度认知障碍或痴呆的PD患者)、阿尔茨海默病(AD)患者和对照组之间的海马及海马外体积。参与者(10例PD患者、10例PDD患者、11例AD患者和12例对照者)接受了 informant 访谈、神经学检查和心理测量测试。采用成熟、可靠的方法测量海马、海马旁回、颞叶、额叶和顶枕叶。在比较前对颅内体积进行了校正。各组之间年龄无差异(平均年龄74岁)。在临床痴呆评定量表(CDR)上,大多数PDD和AD患者的认知障碍为轻度(CDR = 0.5)。患者组的海马体积较小(P < 0.0004)。与对照组相比的效应量为:PD,0.66;PDD,1.22;AD,1.81。其他体积无显著差异。在PD和PDD患者中,识别记忆(r = 0.54,P = 0.015)和简易精神状态检查表评分(r = 0.56,P = 0.01)与左侧而非右侧海马体积相关。总之,海马体积呈现出一种模式(对照组>PD>PDD>AD),表明PD患者海马体积逐渐丧失。容积MRI成像可能为PD患者的痴呆提供早期标志物。