Movement Disorders Unit, Neurology Service, Institut Clínic de Neurociències, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación en Red de Enfermedades Neurodegenerativas, Hospital Clínic, Barcelona, Catalonia, Spain.
Mov Disord. 2009 Nov 15;24(15):2203-10. doi: 10.1002/mds.22594.
Alzheimer's disease (AD)-pathology may play a role in Parkinson's disease (PD)-related dementia (PDD). The aim of this study was to assess cerebrospinal fluid (CSF) levels of tau, phospho-tau, and beta-amyloid, proposed AD biomarkers, and their relationship with cognitive function in PD. Forty PD patients [20 nondemented (PDND); 20 PDD] and 30 controls underwent CSF tau, phospho-tau, and beta-amyloid analysis using specific ELISA techniques. All PD patients and 15 controls underwent neuropsychological testing of fronto-subcortical (attention, fluency) and neocortical (memory, naming, visuoperceptive) functions. CSF markers levels were compared between groups, and compared and correlated with neuropsychological measures in PDND and PDD separately and as a continuum (PD). CSF tau and phospho-tau were higher in PDD than in PDND and controls (P < 0.05). CSF beta-amyloid ranged from high (controls) to intermediate (PDND) and low (PDD) levels (P < 0.001). In all PD and PDD patients, high CSF tau and phospho-tau were associated with impaired memory and naming. In PDND, CSF beta-amyloid was related with phonetic fluency. These findings suggest underlying AD-pathology in PDD in association with cortical cognitive dysfunction, and that low CSF beta-amyloid in PDND patients with impaired phonetic fluency can constitute an early marker of cognitive dysfunction.
阿尔茨海默病(AD)病理学可能在帕金森病(PD)相关痴呆(PDD)中起作用。本研究旨在评估脑脊液(CSF)中tau、磷酸化 tau 和 β-淀粉样蛋白的水平,这些蛋白被认为是 AD 的生物标志物,并评估其与 PD 认知功能的关系。40 名 PD 患者[20 名非痴呆(PDND);20 名 PDD]和 30 名对照者接受了 CSF tau、磷酸化 tau 和 β-淀粉样蛋白的分析,使用了特定的 ELISA 技术。所有 PD 患者和 15 名对照者接受了额-皮质下(注意力、流畅性)和新皮质(记忆、命名、视知觉)功能的神经心理学测试。比较了各组之间 CSF 标志物水平,并分别比较了 PDND 和 PDD 以及作为连续体(PD)的 CSF 标志物水平与神经心理学测量值之间的相关性。PDD 中 CSF tau 和磷酸化 tau 高于 PDND 和对照组(P<0.05)。CSF β-淀粉样蛋白水平从高(对照组)到中(PDND)和低(PDD)(P<0.001)。在所有 PD 和 PDD 患者中,高 CSF tau 和磷酸化 tau 与记忆和命名障碍有关。在 PDND 中,CSF β-淀粉样蛋白与语音流畅性有关。这些发现表明 PDD 中存在潜在的 AD 病理学,与皮质认知功能障碍有关,而 PDND 患者中 CSF β-淀粉样蛋白水平较低,且语音流畅性受损,可能构成认知功能障碍的早期标志物。