Liu Yanmei, Wu Lei, Yang Chao, Xian Wenbiao, Zheng Yifan, Zhang Caixia, Hong Guixun, Jiang Lulu, Yang Zhiyun, Pei Zhong, Liu Jinlong, Chen Ling
Department of Neurology, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, No.58 Zhongshan Road 2, Guangzhou 510080, PR China.
Department of Neurosurgery, The First Affiliated Hospital, Sun Yat-sen University, No.58 Zhongshan Road 2, Guangzhou 510080, China.
J Neurol Sci. 2020 Nov 15;418:117121. doi: 10.1016/j.jns.2020.117121. Epub 2020 Sep 6.
White matter hyperintensities (WMHs) in the cholinergic pathways are associated with cognitive impairment in Parkinson's disease (PD). This study aimed to investigate the role of WMHs within the cholinergic pathways in cognitive performance following bilateral subthalamic nucleus deep brain stimulation (STN DBS) in patients with PD.
38 patients with PD who underwent bilateral STN DBS were assessed using the Cholinergic Pathways Hyperintensities Scale (CHIPS) with magnetic resonance imaging before surgery. Their cognitive statuses were evaluated pre-surgically and 6 months, 1 year, and 2 years post operation. The correlations between the CHIPS score and cognitive performance were analyzed. The differences in cognitive performance before and after the surgery between the high-CHIPS and low-CHIPS groups were also compared.
The CHIPS score in patients with PD negatively correlated with the general cognition assessed using Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) both at baseline and after DBS. No correlation was found between the CHIPS score and the change of MMSE and MoCA scores after DBS. No significant difference was observed in the change in cognitive performance after the surgery between the high and low-CHIPS groups.
The severity of cholinergic WMHs was correlated with the cognition in patients with PD both before and after the STN DBS. However, it does not correlate with the cognitive change in patients with PD after bilateral STN-DBS.
胆碱能通路中的白质高信号（WMHs）与帕金森病（PD）的认知障碍有关。本研究旨在探讨双侧丘脑底核深部脑刺激（STN DBS）术后，胆碱能通路内WMHs在PD患者认知表现中的作用。
对38例行双侧STN DBS的PD患者在术前采用磁共振成像，使用胆碱能通路高信号量表（CHIPS）进行评估。在术前、术后6个月、1年和2年评估他们的认知状态。分析CHIPS评分与认知表现之间的相关性。还比较了高CHIPS组和低CHIPS组手术前后认知表现的差异。
PD患者的CHIPS评分在基线和DBS术后与使用简易精神状态检查表（MMSE）和蒙特利尔认知评估量表（MoCA）评估的总体认知呈负相关。未发现CHIPS评分与DBS术后MMSE和MoCA评分的变化之间存在相关性。高CHIPS组和低CHIPS组术后认知表现的变化未观察到显著差异。
胆碱能WMHs的严重程度在STN DBS术前和术后均与PD患者的认知相关。然而，它与双侧STN - DBS术后PD患者的认知变化无关。
