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帕金森病伴发和不伴发痴呆的脑容量测定:差异何在?

Brain volumetry in Parkinson's disease with and without dementia: where are the differences?

作者信息

Lee Seung-Hwan, Kim Sam Soo, Tae Woo-Suk, Lee Seo-Young, Lee Kang Uk, Jhoo Jinhyeoung

机构信息

Neuroscience of Research Institute Department of Neurology, Kangwon National University School of Medicine, Kangwon, Republic of Korea.

Neuroscience of Research Institute

出版信息

Acta Radiol. 2013 Jun;54(5):581-6. doi: 10.1177/0284185113476029. Epub 2013 Apr 30.

Abstract

BACKGROUND

Cognitive dysfunction is well documented in Parkinson's disease (PD). However, association between regional brain volume change and cognitive decline of PD is uncertain.

PURPOSE

To compare regional brain volume difference between PD without dementia (PDND) and PD with dementia (PDD).

MATERIAL AND METHODS

We enrolled 16 normal controls (mean ± SD: 69.5 ± 6.31) and 32 sex-, age-matched patients with PD (16 PDND and 16 PDD patients with Hoehn & Yahr stage II or III). Cognitive function was assessed using mini-mental status examination (MMSE). Intracranial volume (ICV) and the hippocampal volumes were manually measured using magnetic resonance imaging (MRI). Regional gray/white matter volume changes were analyzed using voxel-based morphometry.

RESULTS

Age, ICV, volume of gray matter volume (GMV), white matter, and hippocampi did not differ among the three groups. The regional GMV of PDD was significantly decreased in the areas of right middle frontal gyrus, short insular gyri, superior temporal gyri; both precuneus compared to PDND (uncorrected P < 0.001). In the partial correlation analysis (controlled for age, sex, ICV), regional GMV of PD was positively correlated with MMSE score in the areas of short insular gyri, right circular insular sulcus, right calcarine sulcus, left superior temporal gyrus (planum porale), and left inferior precentral sulcus (uncorrected P < 0.001).

CONCLUSION

We suggest that the volume loss of hippocampus may not be a finding in developing of PDD while variation of the regional volume of the frontal, insular cortex, superior temporal gyri, and precuneus lobes may be a phenomenon of PDD.

摘要

背景

认知功能障碍在帕金森病(PD)中已有充分记录。然而,脑区体积变化与PD认知衰退之间的关联尚不确定。

目的

比较非痴呆型帕金森病(PDND)和痴呆型帕金森病(PDD)之间的脑区体积差异。

材料与方法

我们纳入了16名正常对照者(平均±标准差:69.5±6.31)和32名性别、年龄匹配的PD患者(16名PDND患者和16名Hoehn & Yahr分期为II或III期的PDD患者)。使用简易精神状态检查表(MMSE)评估认知功能。通过磁共振成像(MRI)手动测量颅内体积(ICV)和海马体积。使用基于体素的形态学测量分析脑区灰质/白质体积变化。

结果

三组之间的年龄、ICV、灰质体积(GMV)、白质和海马体积无差异。与PDND相比,PDD的右侧额中回、岛短回、颞上回以及双侧楔前叶区域的GMV显著降低(未校正P<0.001)。在偏相关分析(校正年龄、性别、ICV)中,PD的脑区GMV在岛短回、右侧环状岛沟、右侧距状沟、左侧颞上回(颞平面)和左侧中央前回下沟区域与MMSE评分呈正相关(未校正P<0.001)。

结论

我们认为海马体积减少可能不是PDD发展过程中的一个表现,而额叶、岛叶皮质、颞上回和楔前叶脑区体积变化可能是PDD的一种现象。

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