Jagust W J, Reed B R, Martin E M, Eberling J L, Nelson-Abbott R A
Department of Neurology, University of California, Davis.
Brain. 1992 Apr;115 ( Pt 2):521-37. doi: 10.1093/brain/115.2.521.
In order to investigate relationships between cognition and regional brain function, we studied 20 non-demented patients with idiopathic Parkinson's disease (PD), 21 mildly demented patients with Alzheimer's disease (AD) and 24 control subjects using cognitive testing and single photon emission computerized tomographic (SPECT) measurements of relative regional cerebral blood flow (rCBF). Neuropsychological tests were grouped into clusters reflecting frontal lobe executive abilities, perseveration, memory and visuospatial ability, with a summary score summarizing performance in all four of these spheres. SPECT imaging utilized the tracer [123I]N-isopropyl-p-iodoamphetamine with a relative measure of regional tracer uptake normalized to occipital radiotracer uptake (rCBF ratios). Patients with PD performed more poorly than controls in all cognitive domains, and were intermediate to AD patients and controls in tests of memory and overall cognitive functioning. Those PD patients who performed most poorly on neuropsychological testing showed lowest rCBF ratios in left and right temporal lobes. Using a stepwise multiple regression procedure, we examined patterns of correlations between cognitive clusters and predictor variables, including rCBF ratios, in the PD patients. We found that while patient age was a strong determinant of performance on the memory cluster and the summary score, dorsolateral frontal lobe perfusion and scores on a depression inventory accounted for a greater proportion of the variance of the frontal lobe and perseveration clusters than did age. These results imply that different neural mechanisms are responsible for the different aspects of cognitive decline seen in PD patients, with overall cognitive function closely related to age and temporal perfusion, while frontal lobe abilities are more linked to frontal perfusion and the presence of depression.
为了研究认知与局部脑功能之间的关系，我们使用认知测试和单光子发射计算机断层扫描（SPECT）测量相对局部脑血流量（rCBF），对20例非痴呆型特发性帕金森病（PD）患者、21例轻度痴呆型阿尔茨海默病（AD）患者和24名对照者进行了研究。神经心理学测试被分为反映额叶执行能力、持续性、记忆和视觉空间能力的几类，并有一个汇总分数总结这四个领域的表现。SPECT成像使用示踪剂[123I]N-异丙基-p-碘安非他明，以相对于枕部放射性示踪剂摄取量标准化的局部示踪剂摄取量的相对测量值（rCBF比率）。PD患者在所有认知领域的表现均比对照者差，在记忆和整体认知功能测试中处于AD患者和对照者之间。在神经心理学测试中表现最差的那些PD患者，其左右颞叶的rCBF比率最低。我们使用逐步多元回归程序，研究了PD患者认知类别与预测变量（包括rCBF比率）之间的相关模式。我们发现，虽然患者年龄是记忆类别和汇总分数表现的一个重要决定因素，但背外侧额叶灌注和抑郁量表得分在额叶和持续性类别变异中所占比例比年龄更大。这些结果表明，不同的神经机制负责PD患者认知衰退的不同方面，整体认知功能与年龄和颞叶灌注密切相关，而额叶能力与额叶灌注和抑郁状态的关系更为密切。
