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帕金森病患者中存在淀粉样蛋白-β沉积,这些患者有发展为痴呆的风险。

Aβ-amyloid deposition in patients with Parkinson disease at risk for development of dementia.

机构信息

Department of Radiology, Johns Hopkins School of Medicine, Baltimore, MD, USA.

出版信息

Neurology. 2012 Sep 11;79(11):1161-7. doi: 10.1212/WNL.0b013e3182698d4a. Epub 2012 Aug 29.

Abstract

OBJECTIVE

The aim of our study was to examine the relationship between corticostriatal Aβ-amyloid deposition and cognitive dysfunction in a cohort of patients with Parkinson disease (PD) at risk for dementia.

METHODS

This was a cross-sectional study of 40 patients with PD with mild cognitive impairment (MCI) or other known dementia risk factors. Subjects underwent dynamic Aβ-amyloid and vesicular monoamine transporter 2 PET imaging using [(11)C] Pittsburgh compound B (PiB) and [(11)C]dihydrotetrabenazine (DTBZ), respectively, and neuropsychological assessment. PiB and DTBZ PET data were analyzed using the Logan graphical method to determine cerebral PiB deposition relative to the cerebellar hemispheres and striatal DTBZ binding relative to occipital neocortex. Component z scores were calculated for individual cognitive domains (memory, visuospatial processing, working memory/attention, and executive function) and combined linearly for global estimation of cognition. Correlation of cognitive function and cortical PiB binding was investigated.

RESULTS

Elevated cerebral PiB binding at levels seen in patients with AD was infrequent (6 of 40 subjects). Mean cortical PiB binding in the entire cohort was 1.16 ± 0.16 (distribution volume ratio; range 0.96-1.78). A significant correlation was noted between cortical PiB binding and global composite cognitive function (r = -0.55, p < 0.005) as well as the Wechsler Adult Intelligence Scale score (r = -0.54, p = 0.0004).

CONCLUSION

Elevated cerebral Aβ-amyloid deposition at levels seen in Alzheimer disease is uncommon in subjects with PD at risk for dementia. In our sample, the prevalence of markedly elevated PiB binding was significantly lower than that found in prior studies of cognitively normal elderly individuals. Neocortical PiB binding correlated robustly with measures of cognitive impairment in our cohort.

摘要

目的

本研究旨在探讨皮质纹状体 Aβ-淀粉样蛋白沉积与痴呆风险帕金森病(PD)患者认知功能障碍的关系。

方法

这是一项横断面研究,共纳入 40 名轻度认知障碍(MCI)或其他已知痴呆危险因素的 PD 患者。患者接受了动态 Aβ-淀粉样蛋白和囊泡单胺转运体 2 PET 成像,分别使用 [(11)C]匹兹堡复合物 B(PiB)和 [(11)C]二氢四苯并嗪(DTBZ),并进行了神经心理学评估。使用 Logan 图形法分析 PiB 和 DTBZ PET 数据,以确定相对于小脑半球的大脑 PiB 沉积和相对于枕叶新皮层的纹状体 DTBZ 结合。为每个认知域(记忆、视空间处理、工作记忆/注意力和执行功能)计算分量 z 分数,并线性组合进行整体认知估计。研究了认知功能与皮质 PiB 结合的相关性。

结果

在 40 名患者中,AD 患者中观察到的脑内 PiB 结合升高并不常见(6 例)。整个队列的平均皮质 PiB 结合为 1.16±0.16(分布容积比;范围 0.96-1.78)。皮质 PiB 结合与整体综合认知功能(r=-0.55,p<0.005)以及韦氏成人智力量表评分(r=-0.54,p=0.0004)呈显著相关。

结论

在痴呆风险的 PD 患者中,阿尔茨海默病中观察到的大脑 Aβ-淀粉样蛋白沉积升高并不常见。在我们的样本中,显著升高的 PiB 结合的患病率明显低于先前对认知正常老年人的研究。我们队列中皮质 PiB 结合与认知障碍测量值密切相关。

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