Schneider Christine B, Donix Markus, Linse Katharina, Werner Annett, Fauser Mareike, Klingelhoefer Lisa, Löhle Matthias, von Kummer Rüdiger, Reichmann Heinz, Storch Alexander
1 Division of Neurodegenerative Diseases, Department of Neurology, Technische Universität Dresden, 01307 Dresden, Germany.
2 Department of Psychiatry and Psychotherapy, Division of Old Age Psychiatry and Cognitive Neuropsychiatry, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany.
Am J Alzheimers Dis Other Demen. 2017 Sep;32(6):313-319. doi: 10.1177/1533317517698794. Epub 2017 May 4.
Patients with Parkinson disease are at high risk of developing dementia. During the course of the disease, a substantial number of patients will experience a cognitive decline, indicating the dynamics of the underlying neuropathology. Magnetic resonance imaging (MRI) has become increasingly useful for identifying structural characteristics in radiological brain anatomy existing prior to clinical symptoms. Whether these changes reflect pathology, whether they are aging related, or both often remains unclear. We hypothesized that aging-associated brain structural changes would be more pronounced in the hippocampal region among patients with Parkinson disease having mild cognitive deficits relative to cognitively unimpaired patients.
Using MRI, we investigated 30 cognitively healthy patients with Parkinson disease and 33 patients with nondemented Parkinson disease having mild cognitive impairment. All participants underwent structural MRI scanning and extensive clinical and neuropsychological assessments.
Irrespective of the study participants' cognitive status, older age was associated with reduced cortical thickness in various neocortical regions. Having mild cognitive impairment was not associated with an increased rate of cortical thinning or volume loss in these regions, except in the hippocampus bilaterally.
Patients with Parkinson disease having mild cognitive impairment show an accelerated age-dependent hippocampal volume loss when compared with cognitively healthy patients with Parkinson disease. This may indicate pathological processes in a key region for memory functioning in patients with Parkinson disease at risk of developing dementia. Structural MRI of the hippocampal region could potentially contribute to identifying patients who should receive early treatment aimed at delaying the clinical onset of dementia.
帕金森病患者患痴呆症的风险很高。在疾病过程中，相当数量的患者会出现认知能力下降，这表明潜在神经病理学的动态变化。磁共振成像（MRI）在识别临床症状出现之前放射学脑解剖结构中的结构特征方面变得越来越有用。这些变化是否反映病理学、是否与衰老相关，或者两者兼而有之，往往仍不清楚。我们假设，相对于认知未受损的患者，患有轻度认知缺陷的帕金森病患者海马区与衰老相关的脑结构变化会更明显。
我们使用MRI对30名认知健康的帕金森病患者和33名患有轻度认知障碍的非痴呆帕金森病患者进行了研究。所有参与者均接受了结构MRI扫描以及广泛的临床和神经心理学评估。
无论研究参与者的认知状态如何，年龄较大与各个新皮质区域的皮质厚度降低有关。除了双侧海马区外，轻度认知障碍与这些区域皮质变薄或体积损失的增加率无关。
与认知健康的帕金森病患者相比，患有轻度认知障碍的帕金森病患者表现出与年龄相关的海马体积加速损失。这可能表明有患痴呆症风险的帕金森病患者记忆功能关键区域存在病理过程。海马区的结构MRI可能有助于识别那些应接受旨在延迟痴呆症临床发作的早期治疗的患者。
