Fornari Luís Henrique Tieppo, da Silva Júnior Neivo, Muratt Carpenedo Camila, Hilbig Arlete, Rieder Carlos Roberto de Mello
Movement Disorders Department, Division of Neurology, Santa Casa de Misericórdia de Porto Alegre Hospital Porto Alegre, Brazil.
Nuclear Medicine Department, Santa Casa de Misericórdia de Porto Alegre Hospital Porto Alegre, Brazil.
Am J Nucl Med Mol Imaging. 2021 Feb 15;11(1):10-19. eCollection 2021.
Parkinson's disease (PD) is clinically characterized by motor symptoms, however, specific cognitive impairments are common and poorly understood. This study was designed to assess whether cognitive performances are related to dopamine active transporter (DAT) availability in non-demented PD subjects. Fifty-four non-demented PD patients were enrolled. They underwent [Tc] TRODAT-1 SPECT/CT and a comprehensive neuropsychological battery including attention/executive and memory tests. Multiple linear regression controlling the effect of age, disease duration and education was applied. The significance level was set at values of < 0.02. After controlling the effect of age, disease duration and education, lower scores in Rey's Auditory-Verbal Learning Test (RAVLT)/immediate recall were significantly related with lower uptake values in the less affected striatum and more affected caudate. Lower scores in RAVLT/short-term recall were also significantly associated with lower uptake values in the more affected caudate and reduced performance in Trail Making Test part B was related with reduced DAT values in the less affected anterior putamen. Our findings suggest that reduced DAT availability in both caudate and putamen is related to reduced performances in some memory and attention/executive tasks. Nigrocaudate dysfunction is related to lower memory performance while dopamine depletion in the anterior putamen is related to poorer attention performance. If the dopaminergic defects can mostly explain all the cognitive symptoms or this phenomenon just co-occur with other anatomical and biochemical changes remains unknown. Further studies in larger patient samples are required to clarify this issue.
帕金森病(PD)的临床特征为运动症状,然而,特定的认知障碍也很常见且了解甚少。本研究旨在评估认知表现是否与非痴呆型PD患者的多巴胺活性转运体(DAT)可用性有关。招募了54名非痴呆型PD患者。他们接受了[锝]TRODAT - 1单光子发射计算机断层扫描/计算机断层扫描(SPECT/CT)以及包括注意力/执行功能和记忆测试在内的全面神经心理测验。应用多元线性回归来控制年龄、病程和教育程度的影响。显著性水平设定为<0.02。在控制了年龄、病程和教育程度的影响后:在雷伊听觉词语学习测验(RAVLT)/即时回忆中得分较低与受累较轻的纹状体和受累较重的尾状核摄取值较低显著相关;RAVLT/短期回忆得分较低也与受累较重的尾状核摄取值较低显著相关;连线测验B部分表现降低与受累较轻的前壳核DAT值降低相关。我们的研究结果表明,尾状核和壳核中DAT可用性降低与某些记忆和注意力/执行功能任务表现降低有关。黑质纹状体功能障碍与记忆表现较低有关,而前壳核中的多巴胺耗竭与注意力表现较差有关。多巴胺能缺陷是否能主要解释所有认知症状,或者这种现象是否只是与其他解剖和生化变化同时出现,尚不清楚。需要在更大的患者样本中进行进一步研究以阐明这个问题。