Neurosciences Area, CIMA, Department of Neurology and Neurosurgery, Clinica Universidad de Navarra, University of Navarra, Pamplona, Spain.
Eur J Nucl Med Mol Imaging. 2012 Nov;39(11):1767-77. doi: 10.1007/s00259-012-2198-5. Epub 2012 Aug 8.
Patients with Parkinson's disease (PD) may have normal cognition, mild cognitive impairment (MCI) or dementia. We investigated differences in cerebral metabolism associated with these three cognitive states and the relationship between metabolism and cognitive dysfunction.
FDG PET and a battery of neuropsychological tests were used to study PD patients with dementia (n = 19), MCI (n = 28) and normal cognition (n = 21), and control subjects (n = 20). Regional glucose metabolism in patients and controls was analysed using statistical parametric mapping (SPM8) corrected for age, motor severity and depression. Correlations between the mini-mental state examination score and Z-score values of the different cognitive domains with respect to cerebral FDG uptake were assessed using SPM8.
PD patients with MCI (PD-MCI patients) exhibited decreased FDG uptake in the frontal lobe, and to a lesser extent in parietal areas compared with cognitively normal patients. Patients with dementia showed reduced metabolism in the parietal, occipital and temporal areas and a less extensive reduction in the frontal lobe compared with PD-MCI patients, while widespread hypometabolism was seen in comparison with patients with normal cognition. PD-MCI patients exhibited reduced FDG uptake in the parietal and occipital lobes and in localized areas of the frontal and temporal lobes compared with controls, whereas patients with dementia showed a widespread reduction of cortical metabolism. Mini-mental state examination score correlated positively with metabolism in several lobes, executive function with metabolism in the parietooccipitotemporal junction and frontal lobe, memory with temporoparietal metabolism, visuospatial function with occipitoparietal and temporal metabolism, and language with frontal metabolism.
PD patients with MCI exhibited hypometabolism in several cortical regions compared with controls, and in the frontal and parietal regions compared with cognitively normal patients. Hypometabolism was higher in patients with dementia than in those with MCI, mainly in the posterior cortical areas where it was correlated with visuospatial, memory and executive functions.
帕金森病（PD）患者可能认知正常、轻度认知障碍（MCI）或痴呆。我们研究了与这三种认知状态相关的脑代谢差异，以及代谢与认知功能障碍之间的关系。
使用 FDG PET 和一系列神经心理学测试来研究痴呆（n=19）、MCI（n=28）和认知正常（n=21）的 PD 患者，以及对照组（n=20）。使用统计参数映射（SPM8）校正年龄、运动严重程度和抑郁对患者和对照组的局部葡萄糖代谢进行分析。使用 SPM8 评估简易精神状态检查评分与不同认知领域的 Z 分数值与大脑 FDG 摄取之间的相关性。
MCI 的 PD 患者（PD-MCI 患者）与认知正常的患者相比，额叶和程度较轻的顶叶区域的 FDG 摄取减少。痴呆患者与 PD-MCI 患者相比，顶叶、枕叶和颞叶区域的代谢减少，额叶区域的代谢减少程度较轻，而与认知正常的患者相比，广泛的代谢减少。PD-MCI 患者与对照组相比，顶叶和枕叶以及额叶和颞叶的局部区域 FDG 摄取减少，而痴呆患者则表现为广泛的皮质代谢减少。简易精神状态检查评分与几个脑叶的代谢呈正相关，执行功能与顶枕颞交界处和额叶的代谢呈正相关，记忆与颞顶叶代谢呈正相关，视空间功能与枕顶颞代谢呈正相关，语言与额叶代谢呈正相关。
与对照组相比，PD-MCI 患者的几个皮质区域代谢减少，与认知正常的患者相比，额叶和顶叶区域代谢减少。痴呆患者的代谢减少程度高于 MCI 患者，主要是在后部皮质区域，与视空间、记忆和执行功能相关。
