Goldman Jennifer G, Bledsoe Ian O, Merkitch Doug, Dinh Vy, Bernard Bryan, Stebbins Glenn T
From the Department of Neurological Sciences (J.G.G., D.M., B.B., G.T.S.), Section of Parkinson Disease and Movement Disorders, Rush University Medical Center, Chicago, IL; Department of Neurology (I.O.B.), Movement Disorders and Neuromodulation Center, University of California, San Francisco; and School of Medicine and Public Health, University of Wisconsin, Madison (V.D.).
Neurology. 2017 Mar 28;88(13):1265-1272. doi: 10.1212/WNL.0000000000003764. Epub 2017 Feb 24.
To investigate atrophy of the corpus callosum on MRI in Parkinson disease (PD) and its relationship to cognitive impairment.
One hundred patients with PD and 24 healthy control participants underwent clinical and neuropsychological evaluations and structural MRI brain scans. Participants with PD were classified as cognitively normal (PD-NC; n = 28), having mild cognitive impairment (PD-MCI; n = 47), or having dementia (PDD; n = 25) by Movement Disorder Society criteria. Cognitive domain (attention/working memory, executive function, memory, language, visuospatial function) scores were calculated. With the use of FreeSurfer image processing, volumes for total corpus callosum and its subsections (anterior, midanterior, central, midposterior, posterior) were computed and normalized by total intracranial volume. Callosal volumes were compared between participants with PD and controls and among PD cognitive groups, covarying for age, sex, and PD duration and with multiple comparison corrections. Regression analyses were performed to evaluate relationships between callosal volumes and performance in cognitive domains.
Participants with PD had reduced corpus callosum volumes in midanterior and central regions compared to healthy controls. Participants with PDD demonstrated decreased callosal volumes involving multiple subsections spanning anterior to posterior compared to participants with PD-MCI and PD-NC. Regional callosal atrophy predicted cognitive domain performance such that central volumes were associated with the attention/working memory domain; midposterior volumes with executive function, language, and memory domains; and posterior volumes with memory and visuospatial domains.
Notable volume loss occurs in the corpus callosum in PD, with specific neuroanatomic distributions in PDD and relationships of regional atrophy to different cognitive domains. Callosal volume loss may contribute to clinical manifestations of PD cognitive impairment.
研究帕金森病(PD)患者磁共振成像(MRI)上胼胝体萎缩情况及其与认知障碍的关系。
100例PD患者和24名健康对照者接受了临床和神经心理学评估以及脑部结构MRI扫描。根据运动障碍学会标准,将PD患者分为认知正常(PD-NC;n = 28)、轻度认知障碍(PD-MCI;n = 47)或痴呆(PDD;n = 25)。计算认知领域(注意力/工作记忆、执行功能、记忆、语言、视觉空间功能)得分。使用FreeSurfer图像处理技术,计算胼胝体及其各部分(前部、前中部、中部、后中部、后部)的体积,并通过总颅内体积进行标准化。比较PD患者与对照组以及PD认知组之间的胼胝体体积,对年龄、性别和PD病程进行协变量调整,并进行多重比较校正。进行回归分析以评估胼胝体体积与认知领域表现之间的关系。
与健康对照相比,PD患者前中部和中部区域的胼胝体体积减小。与PD-MCI和PD-NC患者相比,PDD患者胼胝体多个节段的体积从前往后均减小。胼胝体区域萎缩可预测认知领域表现,即中部体积与注意力/工作记忆领域相关;后中部体积与执行功能、语言和记忆领域相关;后部体积与记忆和视觉空间领域相关。
PD患者胼胝体出现明显体积减小,在PDD中有特定的神经解剖分布,且区域萎缩与不同认知领域存在关联。胼胝体体积减小可能导致PD认知障碍的临床表现。