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个体神经心理学表现的变异性可预测早期帕金森病的皮质体积进行性丧失。

Intraindividual variability in neuropsychological performance predicts longitudinal cortical volume loss in early Parkinson's disease.

机构信息

Department of Psychology.

Department of Psychiatry and Biobehavioral Sciences.

出版信息

Neuropsychology. 2022 Sep;36(6):513-519. doi: 10.1037/neu0000809. Epub 2022 Apr 4.

Abstract

OBJECTIVE

Cognitive impairment is common among individuals with Parkinson's disease (PD). Intraindividual variability (IIV) is a measure of variability across multiple tasks of cognitive functioning. Due to the limited amount of research, particularly among individuals with PD, IIV has been an underutilized metric of cognitive functioning both in research and clinical practice. Previous research demonstrated that individuals with PD have greater variability in cognitive performance relative to controls, and that IIV is predictive of future cognitive impairments. The aim of this study is to investigate the association between baseline IIV and change in cortical and subcortical volumes among individuals with PD.

METHOD

The present study used data from 80 newly diagnosed PD patients who were part of a longitudinal cohort study (Parkinson progression marker initiative [PPMI]). Participants completed neuropsychological measures and underwent T1 structural magnetic resonance imaging (MRI) at baseline and the first annual follow-up. Neuropsychological tests assessed attention, processing speed, visuospatial functioning, verbal fluency learning, and memory. T1 scans were processed using standard Freesurfer protocols for extraction of regional volumes.

RESULTS

Greater IIV at baseline was predictive of change in cortical volume in posterior temporal/parietal regions over the 1-year period. Baseline IIV predicted cortical volume changes above and beyond the main effect of motor severity and the baseline statistical mean/global cognition score.

CONCLUSION

Our results provide initial evidence that IIV is a marker of longitudinal cortical volume loss. Evidence is building that IIV is a sensitive marker of cognitive impairment and the underlying neurodegeneration among individuals with PD. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

摘要

目的

认知障碍在帕金森病(PD)患者中很常见。个体内变异性(IIV)是衡量认知功能多项任务变异性的指标。由于研究数量有限,特别是在 PD 患者中,IIV 在研究和临床实践中都没有得到充分利用,作为认知功能的衡量指标。先前的研究表明,与对照组相比,PD 患者的认知表现变异性更大,且 IIV 可预测未来的认知障碍。本研究旨在探讨 PD 患者基线 IIV 与皮质和皮质下体积变化之间的关系。

方法

本研究使用了 80 名新诊断为 PD 的患者的数据,这些患者是一项纵向队列研究(帕金森进展标志物倡议[PPMI])的一部分。参与者在基线和第一年的随访时完成了神经心理学测试和 T1 结构磁共振成像(MRI)检查。神经心理学测试评估了注意力、处理速度、视空间功能、言语流畅性学习和记忆力。T1 扫描使用标准的 Freesurfer 协议进行处理,以提取区域体积。

结果

基线时的 IIV 越大,预示着在 1 年内后颞/顶叶皮质体积的变化。基线 IIV 预测了皮质体积变化,超过了运动严重程度的主要影响和基线统计平均值/全球认知评分的影响。

结论

我们的结果初步提供了证据,表明 IIV 是纵向皮质体积损失的一个标志物。越来越多的证据表明,IIV 是 PD 患者认知障碍和潜在神经退行性变的敏感标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c65e/9620776/209a35755f63/nihms-1843233-f0001.jpg

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