Department of Medical Psychology | Neuropsychology & Gender Studies, Center for Neuropsychological Diagnostic and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 68, 50937, Cologne, Germany.
Department of Neurology, University Hospital of Marburg, Marburg, Germany.
Neurol Sci. 2022 May;43(5):3153-3163. doi: 10.1007/s10072-021-05734-w. Epub 2021 Nov 25.
Subjective cognitive decline (SCD) may occur very early in the course of Parkinson's disease (PD) before the onset of objective cognitive decline. Data on neural correlates and determinants of SCD in PD are rare.
The aim of the present study was to identify neural correlates as well as sociodemographic, clinical, and neuropsychological predictors of SCD in patients with PD.
We retrospectively analyzed 30 patients with PD without cognitive impairment (23% female, 66.90 ± 7.20 years, UPDRS-III: 19.83 ± 9.29), of which n = 12 patients were classified as having no SCD (control group, PD-CG) and n = 18 as having SCD (PD-SCD). Neuropsychological testing and 18-fluoro-2-deoxyglucose positron emission tomography (FDG-PET) were conducted. SCD was assessed using a questionnaire covering multiple cognitive domains.
SCD subscores differed significantly between PD-CG and PD-SCD and correlated significantly with other scales measuring related concepts. FDG-PET whole-brain voxel-wise regression analysis revealed hypometabolism in middle frontal, middle temporal, and occipital areas, and the angular gyrus as neural correlates of SCD in PD. Next to this hypometabolism, depressive symptoms were an independent significant determinant of SCD in a stepwise regression analysis (adjusted R = 50.3%).
This study strengthens the hypothesis of SCD being an early manifestation of future cognitive decline in PD and, more generally, early pathological changes in PD. The early identification of the vulnerability for future cognitive decline constitutes the basis for successful prevention and delay of this non-motor symptom.
主观认知衰退（SCD）可能在帕金森病（PD）的早期就发生，在客观认知衰退之前。关于 PD 中 SCD 的神经相关性以及决定因素的数据很少。
本研究的目的是确定 SCD 在 PD 患者中的神经相关性以及社会人口学、临床和神经心理学预测因素。
我们回顾性分析了 30 名无认知障碍的 PD 患者（女性占 23%，66.90±7.20 岁，UPDRS-III：19.83±9.29），其中 12 名患者被分类为无 SCD（对照组，PD-CG），18 名患者被分类为 SCD（PD-SCD）。进行神经心理学测试和 18-氟-2-脱氧葡萄糖正电子发射断层扫描（FDG-PET）。使用涵盖多个认知领域的问卷评估 SCD。
PD-CG 和 PD-SCD 之间的 SCD 亚评分差异显著，与其他测量相关概念的量表显著相关。FDG-PET 全脑体素回归分析显示，额中回、颞中回和枕叶以及角回的代谢率降低，这些是 PD 中 SCD 的神经相关性。除了这种代谢率降低外，抑郁症状是逐步回归分析中 SCD 的独立显著决定因素（调整后的 R=50.3%）。
本研究加强了 SCD 是 PD 未来认知衰退的早期表现的假说，更广泛地说，是 PD 早期的病理变化。早期识别未来认知衰退的易感性是成功预防和延缓这种非运动症状的基础。
