Tang Yilin, Ge Jingjie, Liu Fengtao, Wu Ping, Guo Sisi, Liu Zhenyang, Wang Yixuan, Wang Ying, Ding Zhengtong, Wu Jianjun, Zuo Chuantao, Wang Jian
Department of Neurology, Huashan Hospital, Fudan Universtiy, 12 Wulumuqi Zhong Road, Shanghai, 200040, China.
PET center, Huashan Hospital, Fudan University, 518 East Wuzhong Road, Shanghai, 200235, China.
PLoS One. 2016 Apr 11;11(4):e0152716. doi: 10.1371/journal.pone.0152716. eCollection 2016.
To characterize cerebral glucose metabolism associated with different cognitive states in Parkinson's disease (PD) using 18F-fluorodeoxyglucose (FDG) and Positron Emission Tomography (PET).
Three groups of patients were recruited in this study including PD patients with dementia (PDD; n = 10), with mild cognitive impairment (PD-MCI; n = 20), and with no cognitive impairment (PD-NC; n = 30). The groups were matched for age, sex, education, disease duration, motor disability, levodopa equivalent dose and Geriatric Depression Rating Scale (GDS) score. All subjects underwent a FDG-PET study. Maps of regional metabolism in the three groups were compared using statistical parametric mapping (SPM5).
PD-MCI patients exhibited limited areas of hypometabolism in the frontal, temporal and parahippocampal gyrus compared with the PD-NC patients (p < 0.01). PDD patients had bilateral areas of hypometabolism in the frontal and posterior parietal-occipital lobes compared with PD-MCI patients (p < 0.01), and exhibited greater metabolic reductions in comparison with PD-NC patients (p < 0.01).
Compared with PD-NC patients, hypometabolism was much higher in the PDD patients than in PD-MCI patients, mainly in the posterior cortical areas. The result might suggest an association between posterior cortical hypometabolism and more severe cognitive impairment. PD-MCI might be important for early targeted therapeutic intervention and disease modification.
使用18F-氟脱氧葡萄糖（FDG）和正电子发射断层扫描（PET）来描述帕金森病（PD）中与不同认知状态相关的脑葡萄糖代谢情况。
本研究招募了三组患者，包括患有痴呆的PD患者（PDD；n = 10）、患有轻度认知障碍的PD患者（PD-MCI；n = 20）和无认知障碍的PD患者（PD-NC；n = 30）。这些组在年龄、性别、教育程度、病程、运动功能障碍、左旋多巴等效剂量和老年抑郁量表（GDS）评分方面进行了匹配。所有受试者均接受了FDG-PET研究。使用统计参数映射（SPM5）比较三组的区域代谢图。
与PD-NC患者相比，PD-MCI患者在额叶、颞叶和海马旁回表现出有限区域的代谢减低（p < 0.01）。与PD-MCI患者相比，PDD患者在额叶和顶枕叶后部有双侧代谢减低区域（p < 0.01），并且与PD-NC患者相比表现出更大程度的代谢降低（p < 0.01）。
与PD-NC患者相比，PDD患者的代谢减低程度比PD-MCI患者高得多，主要在皮质后部区域。该结果可能提示皮质后部代谢减低与更严重的认知障碍之间存在关联。PD-MCI可能对早期靶向治疗干预和疾病修饰很重要。
