Sawada Hiroyuki, Orimo Satoshi
Department of Rehabilitation, Kanto Central Hospital.
Department of Neurology, Kanto Central Hospital.
Rinsho Shinkeigaku. 2019 Dec 25;59(12):799-805. doi: 10.5692/clinicalneurol.cn-001293. Epub 2019 Nov 23.
We studied whether I-FP-CIT uptake in the striatum correlates with cognitive performance in patients with Parkinson's disease (PD). Sixty-nine patients with PD (24 men and 45 women, average age = 71.3 years, disease duration = 5.2 years) underwent I-FP-CIT SPECT and neuropsychiatric measurements. Cognitive performance was assessed using the MMSE (Mini-mental state examination), TMT (Trail making test), MoCA-J (Japanese version of Montreal cognitive assessment), FAB (Frontal assessment battery), ACE-R (Addenbrooke's cognitive examination revised), BDI-II (Beck depression inventory-II), and RBMT (Rivermead behavioural memory test) in the ON state. The average specific binding ratio (SBR) and AI (Asymmetry index) of striatal I-FP-CIT uptake were semi-quantitatively measured using DaTView software. Clinical data and SBR were compared. In addition, participants were divided into four groups according to the visibility of the striatum on I-FP-CIT SPECT images, and results of the Eagle Wing (EW) group and the Egg shape (ES) group were compared. SBR was negatively correlated with age (P < 0.001), disease duration (P < 0.001), H-Y stage (P < 0.001), levodopa equivalent dose (P = 0.004), TMT-A (P = 0.001), and TMT-B (P < 0.001), and positively correlated with MMSE (P = 0.021) and FAB (P = 0.029), MoCA-J (P = 0.012)，RBMT (P = 0.021). Multiple regression analysis confirmed that age (P = 0.016) and FAB (P = 0.035) were independent predictors for SBR. Furthermore, in the ES group, Movement Disorder Society - Unified Parkinson's disease rating scale part III scores were significantly higher (P = 0.013) and the AI was lower (P < 0.001) than those in the EW group. Conversely, there were no differences in the findings of neuropsychiatric measures between the two groups. Our study results demonstrate that imaging with I-FP-CIT SPECT is sensitive for detecting dopaminergic deficits associated with frontal lobe functions in patients with PD.
我们研究了帕金森病（PD）患者纹状体中I-FP-CIT摄取与认知功能之间是否存在相关性。69例PD患者（24例男性和45例女性，平均年龄 = 71.3岁，病程 = 5.2年）接受了I-FP-CIT单光子发射计算机断层扫描（SPECT）和神经精神测量。在“开”状态下，使用简易精神状态检查表（MMSE）、连线测验（TMT）、蒙特利尔认知评估量表日语版（MoCA-J）、额叶评估量表（FAB）、修订版Addenbrooke认知检查量表（ACE-R）、贝克抑郁量表第二版（BDI-II）和Rivermead行为记忆测试（RBMT）评估认知功能。使用DaTView软件对纹状体I-FP-CIT摄取的平均特异性结合率（SBR）和不对称指数（AI）进行半定量测量。比较临床数据和SBR。此外，根据I-FP-CIT SPECT图像上纹状体的可见性将参与者分为四组，并比较了鹰翼（EW）组和卵形（ES）组的结果。SBR与年龄（P < 0.001）、病程（P < 0.001）、Hoehn-Yahr分期（P < 0.001）、左旋多巴等效剂量（P = 0.004）、TMT-A（P = 0.001）和TMT-B（P < 0.001）呈负相关，与MMSE（P = 0.021）、FAB（P = 0.029）、MoCA-J（P = 0.012）、RBMT（P = 0.021）呈正相关。多元回归分析证实年龄（P = 0.016）和FAB（P = 0.035）是SBR的独立预测因素。此外，在ES组中，运动障碍协会统一帕金森病评定量表第三部分得分显著高于EW组（P = 0.013），AI低于EW组（P < 0.001）。相反，两组之间神经精神测量结果没有差异。我们的研究结果表明，I-FP-CIT SPECT成像对于检测PD患者中与额叶功能相关的多巴胺能缺陷很敏感。
