Department of Surgical and Medical Sciences Advanced Technologies "G.F. Ingrassia", University of Catania, Via Santa Sofia 78, Catania, 95123, Italy.
Department of Experimental Biomedicine and Clinical Neuroscience (BioNeC), University of Palermo, Palermo, Italy.
Neurol Sci. 2021 Sep;42(9):3723-3731. doi: 10.1007/s10072-020-05034-9. Epub 2021 Jan 14.
Mild cognitive impairment (MCI) is common in Parkinson's disease (PD), but the underlying pathological mechanism has not been fully understood. Voxel-based morphometry could be used to evaluate regional atrophy and its relationship with cognitive performances in early PD-MCI.
One hundred and six patients with PD were recruited from a larger cohort of patients, the Parkinson's Disease Cognitive Impairment Study (PaCoS). Subject underwent a T1-3D MRI and a complete clinical and neuropsychological evaluation. Patients were divided into PD with normal cognition (PD-NC) and PD-MCI according to the MDS level II criteria-modified for PD-MCI. A subgroup of early patients with short disease duration (≤ 2 years) was also identified. VBM analysis between PD-NC and PD-MCI and between early PD-NC and PD-MCI was performed using two-sample t tests with whole-brain statistical threshold of p < 0.001 uncorrected in the entire PD group and p < 0.05 FWE inside ROIs, in the early PD.
Forty patients were diagnosed with MCI and 66 were PD-NC. PD-MCI patients showed significant gray matter (GM) reduction in several brain regions, including frontal gyrus, precuneus, angular gyrus, temporal lobe, and cerebellum. Early PD-MCI showed reduction in GM density in superior frontal gyrus and cerebellum. Moreover, correlation analysis between neuropsychological performances and GM volume of early PD-MCI patients showed associations between performances of Raven and superior frontal gyrus volume, Stroop time and inferior frontal gyrus volume, accuracy of Barrage and volume of precuneus.
The detection of frontal and cerebellar atrophy, even at an early stage, could be used as an early marker of PD-related cognitive impairment.
轻度认知障碍（MCI）在帕金森病（PD）中很常见，但潜在的病理机制尚未完全了解。体素形态计量学可用于评估早期 PD-MCI 中的区域性萎缩及其与认知表现的关系。
从帕金森认知障碍研究（PaCoS）的更大患者队列中招募了 106 名 PD 患者。所有患者均接受了 T1-3D MRI 扫描和完整的临床及神经心理学评估。根据 MDS 二级标准-帕金森病认知障碍修订版（MDS level II criteria-modified for PD-MCI），将患者分为 PD 伴认知正常（PD-NC）和 PD-MCI。还确定了疾病持续时间较短（≤2 年）的早期患者亚组。使用全脑统计阈值为 p<0.001 未校正的两样本 t 检验，在整个 PD 组和早期 PD 中 ROI 内 p<0.05 FWE 对 PD-NC 与 PD-MCI 之间和早期 PD-NC 与 PD-MCI 之间进行 VBM 分析。
40 名患者被诊断为 MCI，66 名患者为 PD-NC。PD-MCI 患者在多个脑区表现出显著的灰质（GM）减少，包括额回、楔前叶、角回、颞叶和小脑。早期 PD-MCI 患者的额上回和小脑 GM 密度降低。此外，早期 PD-MCI 患者的神经心理学表现与 GM 体积的相关性分析显示，表现出 Raven 与额上回体积、Stroop 时间与额下回体积、Barrage 准确性与楔前叶体积之间存在相关性。
即使在早期，也可以检测到额叶和小脑萎缩，作为 PD 相关认知障碍的早期标志物。
