Besser Lilah M, Litvan Irene, Monsell Sarah E, Mock Charles, Weintraub Sandra, Zhou Xiao-Hua, Kukull Walter
National Alzheimer's Coordinating Center, University of Washington, 4311 11th Ave NE, Suite 300, Seattle, WA, 98105, USA.
University of California San Diego, Department of Neurosciences, National Parkinson Foundation Movement Disorder Center of Excellence, 8950 Villa La Jolla Drive, Suite C112, La Jolla, CA, 92037, USA.
Parkinsonism Relat Disord. 2016 Jun;27:54-60. doi: 10.1016/j.parkreldis.2016.04.007. Epub 2016 Apr 9.
No known studies have compared longitudinal characteristics between individuals with incident mild cognitive impairment due to Parkinson's disease (PD-MCI) versus Alzheimer's Disease (AD-MCI).
We used longitudinal data from the National Alzheimer's Coordinating Center's Uniform Data Set to compare 41 PD-MCI and 191 AD-MCI participants according to their demographics, presence of ≥1 APOE e4 allele, and baseline and change over time in clinical characteristics, neuropsychological test scores, and Clinical Dementia Rating sum of boxes (CDR-SB). Multivariable linear regression models with generalized estimating equations were used to account for clustered data and to test for baseline and longitudinal differences in neuropsychological test scores.
PD-MCI and AD-MCI participants differed by many demographic and clinical characteristics. Significantly fewer PD-MCI participants developed dementia over one year. Compared to AD-MCI participants, PD-MCI participants performed better at baseline and over time on a global measure of cognition (Mini Mental State Exam), memory measures (immediate and delayed Logical Memory), and a language measure (Boston Naming Test), and additionally performed better over time on an attention measure (Digit Span Forward), a language measure (Vegetable List), a processing speed measure (Digit Symbol), and an overall measure of memory and functional impairment (CDR-SB).
Our study provides further evidence that PD-MCI is clinically distinct from AD-MCI and requires different tools for diagnosis and monitoring clinical progression. More importantly, this study suggests that PD-MCI takes longer to convert into dementia than AD-MCI, findings that require replication by other studies.
尚无已知研究比较帕金森病所致轻度认知障碍（PD-MCI）患者与阿尔茨海默病所致轻度认知障碍（AD-MCI）患者的纵向特征。
我们使用了来自国家阿尔茨海默病协调中心统一数据集的纵向数据，根据人口统计学特征、是否存在≥1个APOE e4等位基因以及临床特征、神经心理学测试分数和临床痴呆评定量表框和（CDR-SB）的基线情况及随时间的变化，对41名PD-MCI参与者和191名AD-MCI参与者进行比较。采用带有广义估计方程的多变量线性回归模型来处理聚类数据，并检验神经心理学测试分数的基线差异和纵向差异。
PD-MCI和AD-MCI参与者在许多人口统计学和临床特征方面存在差异。在一年时间里，发展为痴呆的PD-MCI参与者明显较少。与AD-MCI参与者相比，PD-MCI参与者在认知综合测量（简易精神状态检查）、记忆测量（即刻和延迟逻辑记忆）和语言测量（波士顿命名测试）的基线及随时间推移的表现更好，此外在注意力测量（数字广度顺背）、语言测量（蔬菜列表）、处理速度测量（数字符号）以及记忆和功能损害综合测量（CDR-SB）方面随时间推移表现也更好。
我们的研究进一步证明，PD-MCI在临床上与AD-MCI不同，需要不同的工具来进行诊断和监测临床进展。更重要的是，本研究表明PD-MCI转化为痴呆的时间比AD-MCI长，这一发现需要其他研究进行重复验证。
