Lorenz R, Samnick S, Dillmann U, Schiller M, Ong M F, Faßbender K, Buck A, Spiegel J
Department of Nuclear Medicine, University of Würzburg, Würzburg, Germany.
Acta Neurol Scand. 2014 Sep;130(3):164-71. doi: 10.1111/ane.12259. Epub 2014 Apr 25.
Idiopathic Parkinson's disease (IPD) is characterized by the clinical motor symptoms of hypokinesia, rigidity, and tremor. Apart from these motor symptoms, cognitive deficits often occur in IPD. The positive effect of cholinesterase inhibitors on cognitive deficits in IPD and findings of earlier molecular imaging studies suggest that the cholinergic system plays an important role in the origin of cognitive decline in IPD.
Twenty-five non-demented patients with IPD underwent a 5-[123I]iodo-3-[2(S)-2-azetidinylmethoxy]pyridine (5-I-A-85380) SPECT to visualize α4β2 nicotinic acetylcholine receptors (nAchR) and cognitive testing with the CERAD (Consortium to Establish a Registry for Alzheimer's Disease) battery to identify domains of cognitive dysfunction.
In the CERAD, the IPD patients exhibited deficits in non-verbal memory, attention, psychomotor velocity, visuoconstructive ability, and executive functions. After Bonferroni correction for multiple comparisons, we found significant correlations between performance of the CERAD subtests Boston Naming Test (a specific test for visual perception and for detection of word-finding difficulties) and Word List Intrusions (a specific test for learning capacity and memory for language information) vs binding of α4β2 nAchR in cortical (the right superior parietal lobule) and subcortical areas (the left thalamus, the left posterior subcortical region, and the right posterior subcortical region).
These significant correlations between the results of the CERAD subtests and the cerebral α4β2 nAchR density, as assessed by 5-I-A-85380 SPECT, indicate that cerebral cholinergic pathways are relevant to cognitive processing in IPD.
特发性帕金森病（IPD）的临床运动症状表现为运动迟缓、僵硬和震颤。除了这些运动症状外，IPD患者常出现认知缺陷。胆碱酯酶抑制剂对IPD认知缺陷的积极作用以及早期分子影像学研究结果表明，胆碱能系统在IPD认知衰退的起源中起重要作用。
25例非痴呆的IPD患者接受了5-[123I]碘-3-[2(S)-2-氮杂环丁烷基甲氧基]吡啶（5-I-A-85380）单光子发射计算机断层扫描（SPECT）以可视化α4β2烟碱型乙酰胆碱受体（nAchR），并使用阿尔茨海默病注册协会（CERAD）成套测试进行认知测试，以确定认知功能障碍的领域。
在CERAD测试中，IPD患者在非言语记忆、注意力、精神运动速度、视觉构建能力和执行功能方面存在缺陷。经过Bonferroni多重比较校正后，我们发现CERAD子测试波士顿命名测试（一项用于视觉感知和发现找词困难的特定测试）和单词列表侵入（一项用于学习能力和语言信息记忆的特定测试）的表现与皮质（右侧顶上小叶）和皮质下区域（左侧丘脑、左侧皮质下后区和右侧皮质下后区）中α4β2 nAchR的结合之间存在显著相关性。
通过5-I-A-85380 SPECT评估，CERAD子测试结果与大脑α4β2 nAchR密度之间的这些显著相关性表明，大脑胆碱能通路与IPD的认知加工相关。
