Zhang Jing, Zhang Yun-Ting, Hu Wei-Dong, Li Li, Liu Guang-Yao, Bai Yu-Ping
Department of Nuclear Magnetic Resonance, The Second Hospital of Lanzhou University Lanzhou 730030, China.
Department of Radiology, General Hospital of Tianjin Medical University Tianjin 300052, China.
Int J Clin Exp Med. 2015 Sep 15;8(9):15383-92. eCollection 2015.
Mild cognitive impairment is common in Parkinson's disease, but the underlying pathological mechanism has not been fully understood. To examine the gray matter changes in patients with Parkinson's disease and those with mild cognitive impairment (MCI) using voxel based Morphometry (VBM).
Magnetic resonance images were obtained from 35 patients with PD and 20 age and sex-matched healthy control subjects. In the PD group, 14 subjects had no MCI and 21 had MCI. MRI 3D structural images were acquired and analyzed by means of the optimized VBM procedure with Statistical Parametric Mapping (SPM5).
Widespread areas of cortical atrophy were found in patients with PD compared with normal controls (in both temporal, occipital, parietal, frontal lobes and right limbic lobes, posterior lobes of the cerebellum and left caudate nucleus). Gray matter reductions were found in bilateral fusiform gyrus and lingual gyrus, left anterior cingulate cortex and insula, and right superior temporal gyrus, orbitofrontal cortex, central gyrus and precuneus in patients with PD with MCI compared with normal controls. Inpatients with PD with MCI, areas of reduced gray matter were found in both precentral gyrus and middle temporal gyrus, right cuneus, precuneus, and orbitofrontal cortex, and left fusiform gyrus compared with those without MCI.
These findings suggest that PD is associated with the gray matter atrophy in the neocortical areas, and that cognitive impairment in patients with PD may be associated with gray matter changes in the parieto-occipital association cortex, right orbitofrontal cortex, and middle temporal gyrus.
轻度认知障碍在帕金森病中很常见，但其潜在的病理机制尚未完全明确。本研究旨在采用基于体素的形态学测量（VBM）方法，研究帕金森病患者及轻度认知障碍（MCI）患者的灰质变化。
对35例帕金森病患者及20例年龄、性别匹配的健康对照者进行磁共振成像检查。在帕金森病组中，14例无MCI，21例有MCI。采用优化的VBM程序和统计参数映射（SPM5）对MRI三维结构图像进行采集和分析。
与正常对照组相比，帕金森病患者存在广泛的皮质萎缩（包括颞叶、枕叶、顶叶、额叶、右侧边缘叶、小脑后叶和左侧尾状核）。与正常对照组相比，帕金森病合并MCI患者双侧梭状回和舌回、左侧前扣带回皮质和脑岛、右侧颞上回、眶额皮质、中央回和楔前叶灰质减少。与无MCI的帕金森病患者相比，帕金森病合并MCI患者中央前回和颞中回、右侧楔叶、楔前叶和眶额皮质以及左侧梭状回灰质减少。
这些发现表明，帕金森病与新皮质区域的灰质萎缩有关，帕金森病患者的认知障碍可能与顶枕联合皮质、右侧眶额皮质和颞中回的灰质变化有关。
