Cammisuli Davide Maria, Pagni Cristina, Palermo Giovanni, Frosini Daniela, Bonaccorsi Joyce, Radicchi Claudia, Cintoli Simona, Tommasini Luca, Tognoni Gloria, Ceravolo Roberto, Bonuccelli Ubaldo
Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
Azienda Unità Sanitaria Locale (USL) Toscana Nord Ovest, Pisa, Italy.
Front Psychol. 2021 Mar 30;12:546476. doi: 10.3389/fpsyg.2021.546476. eCollection 2021.
In the present study, we aimed to better investigate attention system profile of Parkinson's disease-Mild Cognitive Impairment (PD-MCI) patients and to determine if specific attentional deficits are associated with 123I-FP-CIT SPECT. A total of 44 de novo drug-naïve PD patients [(27) with normal cognition (PD-NC) and 17 with MCI (PD-MCI)], 23 MCI patients and 23 individuals with subjective cognitive impairment (SCI) were recruited at the Clinical Neurology Unit of Santa Chiara hospital (Pisa University Medical School, Italy). They were assessed by a wide neuropsychological battery, including Visual Search Test (VST) measuring selective attention. Performances among groups were compared by non-parametric tests (i.e., Kruskal-Wallis and Mann-Whitney, Bonferroni corrected). Further, Spearman's rank correlations were performed to explore the association between neuropsychological variables and 123I-FP-CIT SPECT data in PD subgroup. PD-MCI patients performed worse on VST than patients with PD-NC ( = 0.002), patients with MCI and individuals with SCI ( < 0.001). The performance of PD-MCI patients on VST significantly correlated with caudate nucleus 123I-FP-CIT SPECT uptake (rho = 0.582, < 0.05), whereas a negative correlation between such test and 123I-FP-CIT SPECT uptake in the left putamen (rho = -0.529, < 0.05) was found in PD-NC patients. We suggest that selective attention deficit might be a trigger of cognitive decay in de novo PD-MCI patients. The VST should be routinely used to detect attentional deficits in hospital clinical practice, in the light of its closely association with dopamine depletion of basal ganglia in mildly impaired PD patients.
在本研究中，我们旨在更好地研究帕金森病-轻度认知障碍（PD-MCI）患者的注意力系统概况，并确定特定的注意力缺陷是否与123I-FP-CIT单光子发射计算机断层扫描（SPECT）相关。在意大利比萨大学医学院圣基亚拉医院临床神经科招募了总共44例初发未用药的帕金森病患者[（27例）认知正常（PD-NC）和17例患有MCI（PD-MCI）]、23例MCI患者和23例主观认知障碍（SCI）个体。他们接受了广泛的神经心理学测试，包括测量选择性注意力的视觉搜索测试（VST）。通过非参数检验（即Kruskal-Wallis检验和Mann-Whitney检验，并进行Bonferroni校正）比较各组之间的表现。此外，进行Spearman等级相关性分析以探讨PD亚组中神经心理学变量与123I-FP-CIT SPECT数据之间的关联。PD-MCI患者在VST上的表现比PD-NC患者（P = 0.002）、MCI患者和SCI个体（P < 0.001）差。PD-MCI患者在VST上的表现与尾状核123I-FP-CIT SPECT摄取显著相关（rho = 0.582，P < 0.05），而在PD-NC患者中发现该测试与左侧壳核123I-FP-CIT SPECT摄取之间存在负相关（rho = -0.529，P < 0.05）。我们认为选择性注意力缺陷可能是初发PD-MCI患者认知衰退的触发因素。鉴于VST与轻度受损PD患者基底节多巴胺耗竭密切相关，在医院临床实践中应常规使用VST来检测注意力缺陷。
