Department of Neurology, Shizuoka Institute of Epilepsy and Neurological Disorders, Urushiyama 886, Aoi-ku, Shizuoka 420-8688, Japan; Department of Biofunctional Imaging, Preeminent Medical Photonics Education & Research Center, Hamamatsu University School of Medicine, Handayama 1-20-1, Higashi-ku, Hamamatsu 431-3192, Japan.
Department of Psychiatry, Graduate School of Medicine, Kyoto University,54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan.
J Neurol Sci. 2018 Jul 15;390:231-238. doi: 10.1016/j.jns.2018.05.005. Epub 2018 May 7.
To identify the brain-volume reductions associated with frontal cognitive and behavioral impairments in Parkinson's disease (PD).
Forty PD patients without dementia or amnesia (Hoehn and Yahr stage 3) and 10 age-matched controls underwent brain magnetic resonance imaging. Cognitive and behavioral impairments were assessed by using the Frontal Assessment Battery (FAB) and Frontal Systems Behavioral Scale (FrSBe), respectively. We applied voxel-based morphometry to investigate the correlations of regional gray matter volume with FAB, FrSBe, and physical disability.
FAB was significantly lower in PD than in controls. FrSBe was significantly higher after PD onset than before, notably in the apathy subscale. FAB and FrSBe were significantly intercorrelated. In PD patients, left inferior frontal volume was positively correlated with FAB, whereas right precentral volume was negatively correlated with FrSBe total score. The brain volumes in both of these regions were not correlated with the Unified PD Rating Scale III.
Behavioral impairments in PD tended to coexist with progression of frontal cognitive impairment. Regional atrophy within the frontal lobe was associated with both frontal cognitive and behavioral impairments. However, the specific region responsible for behavioral impairment differed from that for frontal cognitive impairment. These associations were independent of physical disability.
确定与帕金森病（PD）患者额叶认知和行为障碍相关的脑容量减少。
40 名无痴呆或健忘症的 PD 患者（Hoehn 和 Yahr 分期 3 期）和 10 名年龄匹配的对照者接受了脑部磁共振成像检查。分别采用额叶评估量表（FAB）和额叶系统行为量表（FrSBe）评估认知和行为障碍。我们应用基于体素的形态计量学来研究局部灰质体积与 FAB、FrSBe 和躯体残疾的相关性。
PD 患者的 FAB 明显低于对照组。PD 发病后 FrSBe 明显升高，特别是在淡漠亚量表中。FAB 和 FrSBe 显著相关。在 PD 患者中，左侧额下回体积与 FAB 呈正相关，而右侧中央前回体积与 FrSBe 总分呈负相关。这两个区域的脑容量均与统一 PD 评定量表 III 不相关。
PD 患者的行为障碍往往与额叶认知障碍的进展同时存在。额叶内的区域性萎缩与额叶认知和行为障碍均相关。然而，导致行为障碍的特定区域与导致额叶认知障碍的区域不同。这些相关性与躯体残疾无关。
