Central European Institute of Technology, Brno, Czech Republic.
Mov Disord. 2012 Aug;27(9):1169-72. doi: 10.1002/mds.25066. Epub 2012 Jun 12.
The effect of brain-vessel pathology on mortality in 57 consecutive PD patients was studied.
Baseline clinical, neuropsychological, ultrasonographic (US), and MR data obtained from patients who died (n = 18) during a 4-year follow-up period were compared with the data of patients who survived.
US/MRI data displayed a more-severe vascular impairment in deceased patients. Differences were significant between both groups with respect to age, clinical and cognitive status, intima-media thickness, and resistance index (indicators of large and small vessel impairment). The sum score of white-matter hyperintensities was significantly higher among decedents. A cluster analysis displayed two clusters that differed in the two parameters (i.e. in age and in sum score).
This study provides evidence that comorbid atherosclerosis and otherwise subclinical impairment of brain vessels may contribute to mortality in PD. The vascular pathology may act in association with other comorbidities on the terrain of progressive neurodegenerative pathology.
研究了 57 例连续 PD 患者的脑血管病变对死亡率的影响。
将在 4 年随访期间死亡(n=18)的患者的基线临床、神经心理学、超声(US)和磁共振(MR)数据与存活患者的数据进行比较。
US/MRI 数据显示死亡患者的血管损伤更严重。两组在年龄、临床和认知状态、内膜中层厚度和阻力指数(大血管和小血管损伤的指标)方面存在显著差异。死者的脑白质高信号总评分明显更高。聚类分析显示两个聚类在两个参数(即年龄和总评分)上存在差异。
本研究提供的证据表明,合并的动脉粥样硬化和脑小血管的亚临床损伤可能导致 PD 患者的死亡。血管病理学可能与进行性神经退行性病理学领域的其他合并症一起起作用。