统计学定义的帕金森病执行和记忆认知表型：人口统计学、行为和结构神经影像学比较。
Statistically Defined Parkinson's Disease Executive and Memory Cognitive Phenotypes: Demographic, Behavioral, and Structural Neuroimaging Comparisons.
机构信息
Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.
Department of Biochemistry and Molecular Biology, Gainesville, FL, USA.
出版信息
J Parkinsons Dis. 2021;11(1):283-297. doi: 10.3233/JPD-202166.
BACKGROUND
Some individuals with Parkinson's disease (PD) experience working memory and inhibitory difficulties, others learning and memory difficulties, while some only minimal to no cognitive deficits for many years.
OBJECTIVE
To statistically derive PD executive and memory phenotypes, and compare PD phenotypes on disease and demographic variables, vascular risk factors, and specific neuroimaging variables with known associations to executive and memory function relative to non-PD peers.
METHODS
Non-demented individuals with PD (n = 116) and non-PD peers (n = 62) were recruited to complete neuropsychology measures, blood draw, and structural magnetic resonance imaging. Tests representing the cognitive domains of interest (4 executive function, 3 memory) were included in a k-means cluster analysis comprised of the PD participants. Resulting clusters were compared demographic and disease-related variables, vascular risk markers, gray/white regions of interest, and white matter connectivity between known regions involved in executive and memory functions (dorsolateral prefrontal cortices to caudate nuclei; entorhinal cortices to hippocampi).
RESULTS
Clusters showed: 1) PD Executive, n = 25; 2) PD Memory, n = 35; 3) PD Cognitively Well; n = 56. Even after disease variable corrections, PD Executive had less subcortical gray matter, white matter, and fewer bilateral dorsolateral-prefrontal cortex to caudate nucleus connections; PD Memory showed bilaterally reduced entorhinal-hippocampal connections. PD Cognitively Well showed only reduced putamen volume and right entorhinal cortex to hippocampi connections relative to non-PD peers. Groups did not statistically differ on cortical integrity measures or cerebrovascular disease markers.
CONCLUSION
PD cognitive phenotypes showed different structural gray and white matter patterns. We discuss data relative to phenotype demographics, cognitive patterns, and structural brain profiles.
背景
一些帕金森病 (PD) 患者存在工作记忆和抑制困难，另一些患者存在学习和记忆困难，而还有一些患者多年来仅有轻微至无认知缺陷。
目的
从统计学上得出 PD 执行和记忆表型，并比较 PD 表型在疾病和人口统计学变量、血管危险因素以及与执行和记忆功能相关的特定神经影像学变量方面与非 PD 同龄人的差异。
方法
招募非痴呆 PD 患者（n = 116）和非 PD 对照者（n = 62）完成神经心理学测试、血液采集和结构磁共振成像。代表有兴趣的认知领域（4 项执行功能，3 项记忆）的测试包含在 PD 参与者的 k-均值聚类分析中。结果聚类与人口统计学和疾病相关变量、血管风险标志物、灰质/白质感兴趣区域以及已知参与执行和记忆功能的区域（背外侧前额叶皮质到尾状核；内嗅皮质到海马体）之间的白质连接进行比较。
结果
聚类显示：1）PD 执行功能，n = 25；2）PD 记忆功能，n = 35；3）PD 认知良好，n = 56。即使在纠正疾病变量后，PD 执行功能组的皮质下灰质、白质更少，双侧背外侧前额叶皮质到尾状核的连接也更少；PD 记忆功能组表现为双侧内嗅皮质-海马体连接减少。PD 认知良好组仅表现为与非 PD 对照组相比，纹状体体积减小和右侧内嗅皮质到海马体的连接减少。各组在皮质完整性测量或脑血管疾病标志物方面无统计学差异。
结论
PD 认知表型显示出不同的结构灰质和白质模式。我们讨论了与表型人口统计学、认知模式和结构脑谱相关的数据。
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