Department of NMR & MRI Facility, All India Institute of Medical Sciences, New Delhi, India.
Department of NMR & MRI Facility, All India Institute of Medical Sciences, New Delhi, India.
J Clin Neurosci. 2020 May;75:99-105. doi: 10.1016/j.jocn.2020.03.015. Epub 2020 Mar 16.
Mild cognitive impairment (MCI) affects nearly 20-50% patients with Parkinson's disease (PD). It may be the prodromal stage of dementia and impacts quality of life of the patient and caregiver. Characterizing PD cognition at the stage of MCI may help in understanding of cognitive pathophysiology. This study assessed and compared cognition in patients with PD and mild cognitive impairment (PD-MCI, n = 32, age = 61.09 ± 5.97 years), PD patients with normal cognition (PD-NC, n = 32, age = 58.81 ± 6.15 years) and healthy controls (HC, n = 38, age = 57.39 ± 7.14 years). Montreal Cognitive Assessment Test (MoCA) was used for categorization of subjects. Cognitive assessment of five domains: executive function, attention, visuospatial function, memory and language (using two tests in each domain) were performed. The effect of PD clinical scores on cognition and cognitive domain specificity in diagnosing PD-MCI were assessed by correlation and receiver operating curve (ROC) analyses, respectively. All the analyses followed removal of potential confounds (age, education and clinical scores). Attention, memory, executive and visuospatial functions were impaired in PD-MCI on comparison with HC and PD-NC groups. Performance in digit span forward and trail making tests for attention and memory (immediate recall) were comparable in both the PD groups. Both the PD groups revealed impairment in attention, memory and language with respect to HC, suggesting the fronto-striatal and posterior cortical syndrome in PD. Highly significant Visual-N-back correlation with UPDRS-III may implicate the shared motor-visuospatial neural pathways. Visual-N-back/PGI delayed recall domains are promising in characterizing PD-MCI stage.
轻度认知障碍 (MCI) 影响近 20-50%的帕金森病 (PD) 患者。它可能是痴呆的前驱阶段，影响患者和护理人员的生活质量。在 MCI 阶段描述 PD 的认知情况可能有助于理解认知病理生理学。本研究评估并比较了 MCI 患者 (PD-MCI，n=32，年龄=61.09±5.97 岁)、认知正常的 PD 患者 (PD-NC，n=32，年龄=58.81±6.15 岁) 和健康对照组 (HC，n=38，年龄=57.39±7.14 岁) 的认知。使用蒙特利尔认知评估测试 (MoCA) 对受试者进行分类。对五个认知域的认知进行评估：执行功能、注意力、视空间功能、记忆和语言(每个域使用两个测试)。通过相关性和接受者操作曲线 (ROC) 分析分别评估 PD 临床评分对认知和认知域特异性诊断 PD-MCI 的影响。所有分析均遵循消除潜在混杂因素(年龄、教育和临床评分)。与 HC 和 PD-NC 组相比，PD-MCI 患者的注意力、记忆、执行和视空间功能受损。注意力和记忆(即时回忆)的数字跨度正向和追踪测试的数字跨度正向和追踪测试表现，在两个 PD 组之间相似。两个 PD 组在注意力、记忆和语言方面与 HC 相比均存在损害，提示 PD 存在额纹状体和后皮质综合征。视觉 N 回与 UPDRS-III 的高度显著相关性可能暗示共享的运动-视空间神经通路。视觉 N 回/PGI 延迟回忆域在表征 PD-MCI 阶段方面很有前途。
