Chang Zihan, Xie Fen, Li Hualing, Yuan Feilan, Zeng Lina, Shi Lin, Zhu Shuzhen, Lu Xiaohe, Wei Xiaobo, Wang Qing
Department of Neurology, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
Department of Ophthalmology, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
Front Aging Neurosci. 2022 Feb 10;14:832768. doi: 10.3389/fnagi.2022.832768. eCollection 2022.
This study intended to investigate whether retinal nerve fiber layer (RNFL) thickness could become a potential marker in patients with Parkinson's disease with cognitive impairment (PD-CI).
Fifty-seven PD patients and 45 age-matched healthy controls (HCs) were recruited in our cross-sectional study and completed optical coherence tomography (OCT) evaluations. PD with normal cognition (PD-NC) and cognitive impairment (PD-CI) patients were divided following the 2015 Movement Disorder Society criteria. RNFL thickness was quantified in subfields of the 3.0-mm circle surrounding the optic disk; while a battery of neuropsychiatric assessments was conducted to estimate the Parkinsonism severity. General linear models and one-way ANOVA were adopted to assess RNFL thickness between subgroups with different cognitive statuses; logistic regression analyses were applied to determine the relation between RNFL and PD-CI cases.
Compared with HCs, more thinning of the RNFL was observed in the inferior and temporal sectors in PD patients, especially in the PD-CI group. Inferior RNFL thickness was reduced in PD-CI compared with PD-NC patients. Logistic regression analysis found that inferior RNFL thickness was independently associated with PD-CI cases (odds ratio = 0.923, = 0.014). Receiver operating characteristic analysis showed that the RNFL-involved combined model provided a high accuracy in screening cognitive deficiency in PD cases (area under the curve = 0.85, < 0.001).
Reduced RNFL thickness especially in the inferior sector is independently associated with PD-CI patients. Our study present new perspectives into verifying possible indicators for neuropathological processes or disease severity in Parkinsonians with cognitive dysfunction.
本研究旨在调查视网膜神经纤维层（RNFL）厚度是否可成为帕金森病伴认知障碍（PD-CI）患者的潜在标志物。
在我们的横断面研究中招募了57例帕金森病患者和45例年龄匹配的健康对照者（HCs），并完成了光学相干断层扫描（OCT）评估。根据2015年运动障碍协会标准将认知正常的帕金森病（PD-NC）和认知障碍（PD-CI）患者进行分组。对围绕视盘的3.0毫米圆的子区域中的RNFL厚度进行量化；同时进行一系列神经精神评估以评估帕金森病的严重程度。采用一般线性模型和单因素方差分析评估不同认知状态亚组之间的RNFL厚度；应用逻辑回归分析确定RNFL与PD-CI病例之间的关系。
与HCs相比，PD患者的RNFL在下方和颞侧扇形区域更薄，尤其是在PD-CI组。与PD-NC患者相比，PD-CI患者的下方RNFL厚度降低。逻辑回归分析发现下方RNFL厚度与PD-CI病例独立相关（比值比=0.923， =0.014）。受试者工作特征分析表明，涉及RNFL的联合模型在筛查PD病例的认知缺陷方面具有较高的准确性（曲线下面积=0.85， <0.001）。
RNFL厚度降低，尤其是下方扇形区域，与PD-CI患者独立相关。我们的研究为验证帕金森病伴认知功能障碍患者神经病理过程或疾病严重程度的可能指标提供了新的视角。
