Department of Neurology and Brain Research Institute, Yonsei University College of Medicine, Seoul 120-752, Korea.
Mov Disord. 2010 Jan 15;25(1):28-34. doi: 10.1002/mds.22858.
Despite clinical and neuropsychological similarities between Parkinson's disease dementia (PDD) and dementia with Lewy bodies (DLB), recent studies have demonstrated that structural and pathological changes are more severe in DLB than in PDD. We used voxel-based morphometry using a 3-T MRI scanner to compare gray and white matter densities in 20 patients with probable PDD and 18 patients with probable DLB, who had similar overall severity of dementia and similar demographic characteristics. The gray matter density was significantly decreased in the left occipital, parietal, and striatal areas in patients with DLB compared with patients with PDD. The white matter density was significantly decreased in bilateral occipital and left occipito-parietal areas in patients with DLB compared with those with PDD. The degree of white and gray matter atrophy was similar in patients with DLB; in contrast, there was markedly less atrophy in the white matter than in the gray matter in patients with PDD. On analyzing the change of WM density relative to that of GM density in patients with DLB compared to those with PDD, the area of WM atrophy in the occipital areas was more extensive than that of GM atrophy. Our data demonstrate that atrophy of both gray and white matter was more severe in patients with DLB and that white matter atrophy relative to gray matter atrophy was less severe in patients with PDD. These data may reflect a difference in the underlying nature of PDD and DLB.
尽管帕金森病痴呆（PDD）和路易体痴呆（DLB）在临床和神经心理学方面存在相似之处，但最近的研究表明，DLB 的结构和病理变化比 PDD 更为严重。我们使用 3T MRI 扫描仪进行基于体素的形态测量，比较了 20 例可能患有 PDD 的患者和 18 例可能患有 DLB 的患者的灰质和白质密度，这些患者的痴呆总体严重程度和人口统计学特征相似。与 PDD 患者相比，DLB 患者的左枕叶、顶叶和纹状体区域的灰质密度明显降低。与 PDD 患者相比，DLB 患者双侧枕叶和左枕顶叶区域的白质密度明显降低。DLB 患者的白质和灰质萎缩程度相似；相比之下，PDD 患者的白质萎缩程度明显低于灰质萎缩程度。在分析 DLB 患者与 PDD 患者相比 WM 密度相对于 GM 密度的变化时，发现枕叶区域的 WM 萎缩面积大于 GM 萎缩面积。我们的数据表明，DLB 患者的灰质和白质萎缩均更为严重，而 PDD 患者的白质相对于灰质的萎缩程度较轻。这些数据可能反映了 PDD 和 DLB 潜在性质的差异。
