Rong Siming, Li Yan, Li Bing, Nie Kun, Zhang Piao, Cai Tongtong, Mei Mingjin, Wang Lijuan, Zhang Yuhu
Department of Neurology, Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
Quant Imaging Med Surg. 2021 Apr;11(4):1554-1566. doi: 10.21037/qims-20-444.
Cognitive impairment in Parkinson's disease (PD) involves the cholinergic system and cholinergic neurons, especially the nucleus basalis of Meynert (NBM/Ch4) located in the basal forebrain (BF). We analyzed associations between NBM/Ch4 volume and cortical thickness to determine whether the NBM/Ch4-innervated neocortex shows parallel atrophy with the NBM/Ch4 as disease progresses in PD patients with cognitive impairment (PD-MCI).
We enrolled 35 PD-MCI patients, 48 PD patients with normal cognition (PD-NC), and 33 age- and education-matched healthy controls (HCs), with all participants undergoing neuropsychological assessment and structural magnetic resonance imaging (MRI). Correlation analyses between NBM/Ch4 volume and cortical thickness and correlation coefficient comparisons were conducted within and across groups.
In the PD-MCI group, NBM/Ch4 volume was positively correlated with cortical thickness in the bilateral posterior cingulate, parietal, and frontal and left insular regions. Based on correlation coefficient comparisons, the atrophy of NBM/Ch4 was more correlated with the cortical thickness of right posterior cingulate and precuneus, anterior cingulate and medial orbitofrontal lobe in PD-MCI versus HC, and the right medial orbitofrontal lobe and anterior cingulate in PD-NC versus HC. Further partial correlations between cortical thickness and NBM/Ch4 volume were significant in the right medial orbitofrontal (PD-NC: r=0.3, P=0.045; PD-MCI: r=0.51, P=0.003) and anterior cingulate (PD-NC: r=0.41, P=0.006; PD-MCI: r=0.43, P=0.013) in the PD groups and in the right precuneus (r=0.37, P=0.04) and posterior cingulate (r=0.46, P=0.008) in the PD-MCI group.
The stronger correlation between NBM/Ch4 and cortical thinning in PD-MCI patients suggests that NBM/Ch4 volume loss may play an important role in PD cognitive impairment.
帕金森病（PD）中的认知障碍涉及胆碱能系统和胆碱能神经元，尤其是位于基底前脑（BF）的Meynert基底核（NBM/Ch4）。我们分析了NBM/Ch4体积与皮质厚度之间的关联，以确定在患有认知障碍的帕金森病患者（PD-MCI）中，随着疾病进展，NBM/Ch4支配的新皮质是否与NBM/Ch4呈现平行萎缩。
我们纳入了35例PD-MCI患者、48例认知正常的帕金森病患者（PD-NC）和33例年龄及教育程度匹配的健康对照（HCs），所有参与者均接受神经心理学评估和结构磁共振成像（MRI）。在组内和组间进行NBM/Ch4体积与皮质厚度之间的相关性分析以及相关系数比较。
在PD-MCI组中，NBM/Ch4体积与双侧后扣带回、顶叶、额叶及左侧岛叶区域的皮质厚度呈正相关。基于相关系数比较，与健康对照相比，PD-MCI组中NBM/Ch4的萎缩与右侧后扣带回和楔前叶、前扣带回及内侧眶额叶皮质厚度的相关性更强；与健康对照相比，PD-NC组中NBM/Ch4的萎缩与右侧内侧眶额叶皮质和前扣带回的相关性更强。在PD组中，右侧内侧眶额叶（PD-NC：r = 0.3，P = 0.045；PD-MCI：r = 0.51，P = 0.003）和前扣带回（PD-NC：r = 0.41，P = 0.006；PD-MCI：r = 0.43，P = 0.013）以及在PD-MCI组中右侧楔前叶（r = 0.37，P = 0.04）和后扣带回（r = 0.46，P = 0.008）的皮质厚度与NBM/Ch4体积之间的进一步偏相关性显著。
PD-MCI患者中NBM/Ch4与皮质变薄之间更强的相关性表明，NBM/Ch4体积减少可能在PD认知障碍中起重要作用。
