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探索轻度认知障碍的表型以辅助预测有转化为帕金森病和路易体痴呆风险的人群。

Exploring the Phenotype in Mild Cognitive Impairment to Aid the Prediction of Those at Risk of Transitioning to Parkinson Disease and Dementia With Lewy Bodies.

作者信息

Szeto Jennifer Y Y, Halliday Glenda M, Naismith Sharon L, Lewis Simon J G

机构信息

1 Healthy Brain Ageing Program and Parkinson's Disease Research Clinic, Brain and Mind Centre and Charles Perkins Centre, University of Sydney, New South Wales, Australia.

S. L. Naismith and S. J. G. Lewis are joint senior authors.

出版信息

J Geriatr Psychiatry Neurol. 2017 Jul;30(4):196-205. doi: 10.1177/0891988717711451.

DOI:10.1177/0891988717711451
PMID:28639878
Abstract

To date, only limited research has concurrently investigated the presence of rapid eye movement sleep behavior disorder (RBD) and other features associated with Parkinson disease (PD) and dementia with Lewy bodies (DLB) in people presenting with mild cognitive impairment (MCI). As a first step towards a longitudinal research project, the present study explored the relationships between MCI, RBD, and depression in 108 older adults who presented with subjective memory complaints but were not known to have a neurodegenerative condition. The present study found that RBD was a frequent feature in individuals with MCI (35%). Furthermore, MCI patients with RBD were more likely to exhibit nonamnestic MCI (89%) rather than an amnestic MCI phenotype (χ = 4.99, P = .025). Specifically, nonamnestic MCI patients with RBD had selective deficits in executive function and verbal memory, as well as a higher level of depressive symptoms. This cognitive and psychiatric profile is aligned with PD and DLB patients at their time of initial diagnosis and suggests that targeting nonamnestic MCI patients who report RBD with additional biomarker testing including smell, color vision, and neuroimaging (eg, dopamine transporters scan and transcranial ultrasonography) may aid in early diagnosis and prediction of these α-synucleinopathies.

摘要

迄今为止,仅有有限的研究同时调查了轻度认知障碍(MCI)患者中快速眼动睡眠行为障碍(RBD)以及与帕金森病(PD)和路易体痴呆(DLB)相关的其他特征。作为一项纵向研究项目的第一步,本研究探讨了108名存在主观记忆主诉但尚无神经退行性疾病的老年人中MCI、RBD和抑郁之间的关系。本研究发现,RBD是MCI患者中的常见特征(35%)。此外,患有RBD的MCI患者更有可能表现为非遗忘型MCI(89%),而非遗忘型MCI表型(χ = 4.99,P = 0.025)。具体而言,患有RBD的非遗忘型MCI患者在执行功能和言语记忆方面存在选择性缺陷,且抑郁症状水平更高。这种认知和精神状态与PD和DLB患者初诊时的情况相符,这表明针对报告有RBD的非遗忘型MCI患者进行包括嗅觉、色觉和神经影像学(如多巴胺转运体扫描和经颅超声检查)在内的额外生物标志物检测,可能有助于这些α-突触核蛋白病的早期诊断和预测。

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