帕金森病痴呆患者皮质萎缩的定位。
Mapping cortical atrophy in Parkinson's disease patients with dementia.
机构信息
Department of Neurology, University of California, Los Angeles, CA, USA.
出版信息
J Parkinsons Dis. 2013;3(1):69-76. doi: 10.3233/JPD-120151.
BACKGROUND
Cognitive impairment is very common in patients with Parkinson's disease (PD). Brain changes accompanying cognitive decline in PD are still not fully established.
METHODS
We applied cortical pattern matching and cortical thickness analyses to the three-dimensional T1-weighted brain MRI scans of 14 age-matched cognitively normal elderly (NC), 12 cognitively normal PD (PDC), and 11 PD dementia (PDD) subjects. We used linear regression models to investigate the effect of diagnosis on cortical thickness. All maps were adjusted for multiple comparisons using permutation testing with a threshold p < 0.01.
RESULTS
PDD showed significantly thinner bilateral sensorimotor, perisylvian, lateral parietal, as well as right posterior cingulate, parieto-occipital, inferior temporal and lateral frontal cortices relative to NC (left p(corrected) = 0.06, right p(corrected) = 0.009). PDD showed significantly thinner bilateral sensorimotor, right frontal and right parietal-occipital cortices relative to PDC (right p(corrected) = 0.05). The absolute difference in cortical thickness between PDD and the other diagnostic groups ranged from 3% to 19%.
CONCLUSION
Our data shows that cognitive decline in PD is associated with cortical atrophy. PDD subjects have the most widespread gray matter atrophy suggesting more cortical involvement as PD patients progress to dementia.
背景
认知障碍在帕金森病（PD）患者中非常常见。伴随 PD 认知能力下降的大脑变化仍未完全确定。
方法
我们将皮质模式匹配和皮质厚度分析应用于 14 名年龄匹配的认知正常老年人（NC）、12 名认知正常 PD（PDC）和 11 名 PD 痴呆（PDD）受试者的三维 T1 加权脑 MRI 扫描。我们使用线性回归模型来研究诊断对皮质厚度的影响。所有图谱均使用置换检验进行多重比较调整，阈值为 p < 0.01。
结果
与 NC 相比，PDD 双侧感觉运动、侧顶颞叶以及右侧后扣带回、顶枕叶、下颞叶和外侧额叶皮质明显变薄（左侧 p(corrected) = 0.06，右侧 p(corrected) = 0.009）。与 PDC 相比，PDD 双侧感觉运动、右侧额叶和右侧顶枕叶皮质明显变薄（右侧 p(corrected) = 0.05）。PDD 与其他诊断组之间的皮质厚度绝对差异范围为 3%至 19%。
结论
我们的数据表明，PD 中的认知能力下降与皮质萎缩有关。PDD 患者的灰质萎缩最广泛，表明随着 PD 患者进展为痴呆，皮质受累更多。
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