Summerfield Christopher, Junqué Carme, Tolosa Eduardo, Salgado-Pineda Pilar, Gómez-Ansón Beatriz, Martí Maria José, Pastor Pau, Ramírez-Ruíz Blanca, Mercader José
Department de Psiquiatria i Psicobiologia, Universitat de Barcelona, Spain.
Arch Neurol. 2005 Feb;62(2):281-5. doi: 10.1001/archneur.62.2.281.
Parkinson disease with dementia (PDD) results from neuropathological changes in cortical and subcortical brain regions. Voxel-based morphometric analysis of magnetic resonance images can contribute to in vivo identification of the cerebral regions predominantly involved in PDD.
To identify structural cerebral regions most closely related to the presence of PDD.
Magnetic resonance images were obtained from 16 patients who had PDD, 13 patients with PD without dementia, and 13 age-matched healthy control subjects. Gray matter volumes were compared using optimized voxel-based morphometric analyses.
Compared with healthy controls, patients with PDD showed gray matter volume decreases in several of the following regions: bilateral putamen, accumbens nuclei, left side of the thalamus, bilateral hippocampus, parahippocampal region, and anterior cingulate gyrus. Patients with PD also showed gray matter reductions compared with healthy controls in the right side of the hippocampus, left anterior cingulate gyrus, and left superior temporal gyrus.
The hippocampus, thalamus, and anterior cingulate are the regions most affected in PDD. Our results agree with recent neuropathological findings suggesting the involvement of the limbic and cortical areas in PD.
帕金森病伴发痴呆（PDD）是由大脑皮质和皮质下区域的神经病理改变所致。基于体素的磁共振成像形态学分析有助于在活体中识别PDD主要累及的脑区。
识别与PDD存在最为密切相关的脑结构区域。
对16例PDD患者、13例无痴呆的帕金森病（PD）患者以及13例年龄匹配的健康对照者进行磁共振成像检查。采用优化的基于体素的形态学分析比较灰质体积。
与健康对照相比，PDD患者在以下几个区域灰质体积减少：双侧壳核、伏隔核、左侧丘脑、双侧海马、海马旁区域及前扣带回。与健康对照相比，PD患者在右侧海马、左侧前扣带回及左侧颞上回也有灰质减少。
海马、丘脑及前扣带回是PDD中受影响最严重的区域。我们的结果与最近的神经病理学发现一致，提示边缘系统和皮质区域参与了PD的发病过程。
