Homenko Ju G, Susin D S, Kataeva G V, Irishina Ju A, Zavolokov I G
N. Bekhtereva Institute of the Human Brain of the Russian Academy of Science, St. Petersburg, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2017;117(5):46-51. doi: 10.17116/jnevro20171175146-51.
To study the relationship between early cognitive impairment symptoms and cerebral glucose metabolism in different brain regions (according to the positron emission tomography (PET) data) in Parkinson's disease (PD) in order to increase the diagnostic and treatment efficacy.
Two groups of patients with PD (stage I-III), including 11 patients without cognitive disorders and 13 with mild cognitive impairment (MCI), were examined. The control group included 10 age-matched people with normal cognition. To evaluate cognitive state, the Mini mental state examination (MMSE), the Frontal assessment battery (FAB) and the 'clock drawing test' were used. The regional cerebral glucose metabolism rate (CMRglu) was assessed using PET with 18F-fluorodeoxyglucose (FDG).
In PD patients, CMRglu were decreased in the frontal (Brodmann areas (BA) 9, 10, 11, 46, 47), occipital (BA 19) and parietal (BA 39), temporal (BA 20, 37), and cingulate cortex (BA 32) compared to the control group. Cerebral glucose metabolism was decreased in the frontal (BA 8, 9, 10, 45, 46, 47), parietal (BA 7, 39, 40) and cingulate cortex (BA 23, 24, 31, 32) in the group of PD patients with MCI compared to PD patients with normal cognition. Hypometabolism in BA 7, 8, 23, 24, 31, 40 was revealed only in comparison of PD and PD-MCI groups, and did not appear in case of comparison of cognitively normal PD patients with the control group. It is possible to suggest that the mentioned above brain areas were associated with cognitive impairment. The revealed glucose hypometabolism pattern possibly has the diagnostic value for the early and preclinical diagnosis of MCI in PD and control of treatment efficacy.
根据正电子发射断层扫描（PET）数据，研究帕金森病（PD）患者早期认知障碍症状与不同脑区脑葡萄糖代谢之间的关系，以提高诊断和治疗效果。
对两组PD患者（I - III期）进行检查，其中11例无认知障碍，13例有轻度认知障碍（MCI）。对照组包括10名年龄匹配的认知正常者。采用简易精神状态检查表（MMSE）、额叶评估量表（FAB）和“画钟试验”评估认知状态。使用18F - 氟脱氧葡萄糖（FDG）PET评估局部脑葡萄糖代谢率（CMRglu）。
与对照组相比，PD患者额叶（布罗德曼区（BA）9、10、11、46、47）、枕叶（BA 19）、顶叶（BA 39）、颞叶（BA 20、37）和扣带回皮质（BA 32）的CMRglu降低。与认知正常的PD患者相比，MCI的PD患者组额叶（BA 8、9、10、45、46、47）、顶叶（BA 7、39、40）和扣带回皮质（BA 23、24、31、32）的脑葡萄糖代谢降低。仅在PD组与PD - MCI组比较时发现BA 7、8、23、24、31、40存在代谢减低，而认知正常的PD患者与对照组比较时未出现。可以认为上述脑区与认知障碍有关。所揭示的葡萄糖代谢减低模式可能对PD中MCI的早期和临床前诊断以及治疗效果的控制具有诊断价值。
