Wiltshire Katie, Foster Sheri, Kaye Jeffrey A, Small Brent J, Camicioli Richard
University of Alberta, Edmonton, Canada.
Dement Geriatr Cogn Disord. 2005;20(6):345-51. doi: 10.1159/000088526. Epub 2005 Sep 26.
Corpus callosum area has been examined in neurodegenerative diseases as a marker for cortical pathology and for differential diagnosis; however, it has not been examined in Parkinson's disease (PD). We compared callosal area in patients with PD and PD with dementia (PDD) to healthy controls and patients with Alzheimer's disease (AD). We subsequently compared our results to a meta-analysis of studies examining callosal area in AD, frontotemporal dementia (FTD), progressive supranuclear palsy (PSP), and corticobasal degeneration (CBD). For the imaging study, midsagittal T1-weighted MRIs were analyzed and the callosal area was determined in patients with PD (n = 24), PDD (n = 25), AD (n = 16) and controls (n = 27). The meta-analysis combined results from all publications (Medline or PubMed) representing unique samples and measuring callosal area in AD, FTD, PSP, and CBD. We found that PD and PDD patients did not show statistically significant callosal atrophy compared to controls (effect size d, 95% CI, d = 0.13, -0.26 to 0.52, and d = 0.05, -0.44 to 0.33, respectively) or AD. The AD patients had a significant loss of callosal area compared to controls (d = -0.58, -1.01 to -0.15). Dementia severity was correlated with total callosal atrophy in AD (R = 0.66, p < 0.01) but not in PDD patients (R = 0.18, p > 0.1). The meta-analysis revealed significant combined effect sizes for callosal atrophy of: AD (d = -1.03, -1.13 to -0.93), FTD (d = -1.21, -1.56 to -0.86), PSP (d = -1.09, -1.38 to -0.81), and CBD (d = -1.80, -2.18 to -1.43). We conclude that PD and PDD patients do not have callosal atrophy in contrast to other neurodegenerative diseases, including AD. Callosal atrophy was correlated with dementia severity in patients with AD but not PDD.
胼胝体区域已在神经退行性疾病中作为皮质病理学和鉴别诊断的标志物进行了研究;然而,尚未在帕金森病(PD)中进行过研究。我们将PD患者和帕金森病痴呆(PDD)患者的胼胝体区域与健康对照者以及阿尔茨海默病(AD)患者进行了比较。随后,我们将我们的结果与一项关于AD、额颞叶痴呆(FTD)、进行性核上性麻痹(PSP)和皮质基底节变性(CBD)中胼胝体区域研究的荟萃分析进行了比较。对于影像学研究,分析了矢状位T1加权磁共振成像,并确定了PD患者(n = 24)、PDD患者(n = 25)、AD患者(n = 16)和对照者(n = 27)的胼胝体区域。荟萃分析综合了所有代表独特样本并测量AD、FTD、PSP和CBD中胼胝体区域的出版物(Medline或PubMed)的结果。我们发现,与对照者(效应量d,95%置信区间,分别为d = 0.13,-0.26至0.52,以及d = 0.05,-0.44至0.33)或AD相比,PD和PDD患者未显示出统计学上显著的胼胝体萎缩。与对照者相比,AD患者的胼胝体区域有显著损失(d = -0.58,-1.01至-0.15)。痴呆严重程度与AD患者的胼胝体总萎缩相关(R = 0.66,p < 0.01),但与PDD患者无关(R = 0.18,p > 0.1)。荟萃分析显示,胼胝体萎缩的显著综合效应量为:AD(d = -1.03,-1.13至-0.93)、FTD(d = -1.21,-1.56至-0.86)、PSP(d = -1.09,-1.38至-0.81)和CBD(d = -1.80,-2.18至-1.43)。我们得出结论,与包括AD在内的其他神经退行性疾病相比,PD和PDD患者没有胼胝体萎缩。胼胝体萎缩与AD患者而非PDD患者的痴呆严重程度相关。