Department of Ultrasound, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215004, China.
Department of Ultrasound, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215004, China.
J Clin Neurosci. 2021 Aug;90:273-278. doi: 10.1016/j.jocn.2021.06.006. Epub 2021 Jun 21.
This study aimed to explore the association of homocysteine (Hcy) with third ventricle (V3) dilatation and mesencephalic area (MA) atrophy as determined by transcranial sonography (TCS) in Parkinson's disease (PD) with cognitive impairment.
The final statistical analysis included 101 PD patients and 20 age- and sex-matched controls. Using the Movement Disorder Society (MDS) level II criteria for PD with cognitive impairment, we categorized the PD patients into PD with normal cognition group (PD) and PD with cognitive impairment group (PDC). All subjects underwent TCS and laboratory analysis.
The V3 width (r = 0.349, P = 0.005) and the MA (r = -0.484, P < 0.001) were significantly correlated with the Hcy concentration in the PDC patients. Binary logistic regression analysis revealed that age (OR [95% CI] = 1.114 [0.991-1.251], P = 0.002), and Hcy level (OR [95% CI] = 0.931 [0.752-1.153], P = 0.411) were independent risk factors for V3 dilatation. Hcy level (OR [95% CI] = 0.557 [0.323-0.967], P = 0.035) were independent risk factors for MA atrophy. After adjustment for confounding factors, the odds ratio of V3 dilatation was 3.50 (95% CI 1.054-11.399, P = 0.031) and the odds ratio of MA atrophy was 4.67 (95% CI 1.395-15.602, P = 0.012) in the patients with higher Hcy level compared with the lower level.
The results revealed a close association between the V3 width, MA and Hcy concentration in PD patients with cognitive impairment. We hypothesized that increased Hcy concentration played a significant role in the development of brain atrophy in PD with cognitive impairment.
本研究旨在探讨同型半胱氨酸（Hcy）与第三脑室（V3）扩张和中脑区域（MA）萎缩的关系，这些改变通过经颅超声（TCS）在伴有认知障碍的帕金森病（PD）患者中被确定。
最终的统计分析纳入了 101 例 PD 患者和 20 名年龄和性别匹配的对照者。根据运动障碍协会（MDS）PD 伴有认知障碍的 II 级标准，我们将 PD 患者分为 PD 伴有正常认知组（PD）和 PD 伴有认知障碍组（PDC）。所有受试者均接受了 TCS 和实验室分析。
PDC 患者的 V3 宽度（r=0.349，P=0.005）和 MA（r=-0.484，P<0.001）与 Hcy 浓度显著相关。二元逻辑回归分析显示，年龄（OR [95%CI] = 1.114 [0.991-1.251]，P=0.002）和 Hcy 水平（OR [95%CI] = 0.931 [0.752-1.153]，P=0.411）是 V3 扩张的独立危险因素。Hcy 水平（OR [95%CI] = 0.557 [0.323-0.967]，P=0.035）是 MA 萎缩的独立危险因素。在调整混杂因素后，与 Hcy 水平较低的患者相比，Hcy 水平较高的患者 V3 扩张的比值比为 3.50（95%CI 1.054-11.399，P=0.031），MA 萎缩的比值比为 4.67（95%CI 1.395-15.602，P=0.012）。
本研究结果揭示了伴有认知障碍的 PD 患者 V3 宽度、MA 和 Hcy 浓度之间的密切关系。我们假设，Hcy 浓度升高在 PD 伴有认知障碍患者的脑萎缩发展中发挥了重要作用。
