Stav Ane Løvli, Aarsland Dag, Johansen Krisztina Kunszt, Hessen Erik, Auning Eirik, Fladby Tormod
Department of Neurology, Akershus University Hospital, 1478 Lørenskog, Norway.
Department of Neurology, Akershus University Hospital, 1478 Lørenskog, Norway; Alzheimer's Disease Research Centre, Department of Neurobiology, Care Sciences and, Society, Karolinska Institutet, Novum, 141 86 Stockholm, Sweden; Center for Age-Related Diseases, Stavanger University Hospital, 4000 Stavanger, Norway.
Parkinsonism Relat Disord. 2015 Jul;21(7):758-64. doi: 10.1016/j.parkreldis.2015.04.027. Epub 2015 May 2.
Cognitive impairment in early Parkinson's disease (PD) is common and distinct from early Alzheimer's disease. Predictors and mechanisms are only partially known, but α-synuclein, amyloid-β and tau dysmetabolism may be involved. Our aim was to study associations between cerebrospinal fluid biomarkers (CSF) and cognition in non-dementia PD compared to normal controls (NC) and non-PD patients with mild cognitive impairment (MCI non-PD).
Patients were classified as having normal, subjective or mild cognitive impairment after cognitive screening. CSF levels of total α-synuclein (t-α-syn), amyloid-β (Aβ) 38, 40 and 42, total tau (T-tau) and phosphorylated tau (P-tau) were measured in 34 NC, 31 early, non-dementia PD and 28 MCI non-PD patients. A well validated neuropsychological test battery was administered.
In the PD group, 13 had normal cognition, 4 had subjective and 14 mild cognitive impairment. PD patients had significantly lower CSF biomarker levels of t-α-syn, Aβ38, 40 and 42, T-tau and P-tau compared to NC. Compared to MCI non-PD, t-α-syn, Aβ38 and 40, T-tau and P-tau were also lower, while Aβ42 was significantly higher in the PD group. Aβ38 and 40 correlated strongly with t-α-syn levels in PD. Lower Aβ42 was associated with decreased verbal learning, delayed verbal recall and response inhibition in PD.
While Aβ38, 40 and t-α-syn levels are strongly correlated, only lower Aβ42 was associated with reduced cognitive functions in early PD, mainly connected to medial temporal lobe-based cognitive functions.
早期帕金森病（PD）中的认知障碍很常见，且与早期阿尔茨海默病不同。预测因素和机制仅部分为人所知，但α-突触核蛋白、淀粉样β蛋白和tau蛋白代谢异常可能与之有关。我们的目的是研究与正常对照组（NC）以及非PD的轻度认知障碍患者（非PD的MCI）相比，非痴呆型PD患者脑脊液生物标志物（CSF）与认知之间的关联。
经认知筛查后，患者被分类为认知正常、主观认知障碍或轻度认知障碍。检测了34名NC患者、31名早期非痴呆型PD患者和28名非PD的MCI患者脑脊液中总α-突触核蛋白（t-α-syn）、淀粉样β蛋白（Aβ）38、40和42、总tau蛋白（T-tau）和磷酸化tau蛋白（P-tau）的水平。实施了一套经过充分验证的神经心理测试。
在PD组中，13人认知正常，4人有主观认知障碍，14人有轻度认知障碍。与NC相比，PD患者脑脊液生物标志物t-α-syn、Aβ38、40和42、T-tau和P-tau的水平显著更低。与非PD的MCI相比，PD组的t-α-syn、Aβ38和40、T-tau和P-tau也更低，而Aβ42显著更高。在PD中，Aβ38和40与t-α-syn水平密切相关。较低的Aβ42与PD患者言语学习能力下降、言语回忆延迟和反应抑制有关。
虽然Aβ38、40和t-α-syn水平密切相关，但在早期PD中，只有较低的Aβ42与认知功能降低有关，主要与基于内侧颞叶的认知功能相关。
