Kuroha Yasuko, Takahashi Tetsuya, Arai Yuki, Yoshino Mihoko, Kasuga Kensaku, Hasegawa Arika, Matsubara Nae, Koike Ryoko, Ikeuchi Takeshi
Department of Neurology, National Hospital Organization Nishiniigata Chuo Hospital.
Certified Clinical Psychologist, National Hospital Organization Nishiniigata Chuo Hospital.
Rinsho Shinkeigaku. 2022 Jul 29;62(7):532-540. doi: 10.5692/clinicalneurol.cn-001709. Epub 2022 Jun 24.
This study aimed to clarify associations between neuropsychological scales and regional cerebral blood flow (rCBF) of on I-IMP-SPECT in patients with Parkinson's disease with mild cognitive impairment (PD-MCI). Forty-two participants (mean age, 65.5 ± 8.9 years; mean disease duration, 11.1 ±5.7 years) were evaluated using the Wechsler Adult Intelligence Scale, third edition (WAIS-III), Wechsler Memory Scale, revised (WMS-R), Stroop test, Category word fluency, Auditory verbal learning test, Raven colored progressive matrices, Trail Making Test-B, and Clock drawing test. Participants were classified into PD-MCI and PD non-demented (PD-ND) using ten of these scales or its subtests. The rCBF of the posterior cingulate gyrus, precuneus, and parietal lobes was evaluated by I-IMP-SPECT using the easy Z-score imaging system (eZIS analysis). Extent was the extent index of voxels showing z-score > 2, and Severity was mean z-score in those regions on eZIS analysis. Cingulate island sign score (CIScore) was the ratio of integrated z-scores of the posterior cingulate gyrus to those of the posterior cortex.Twenty-three participants were diagnosed with PD-MCI (55%). The rCBF indices were significantly increased in the PD-MCI group compared to the PD-ND group (Extent: P = 0.047; CIScore: P = 0.006). These indices were significantly correlated with WAIS-III Processing Speed (Extent: P = 0.041, R = -0.317; Severity: P = 0.047, R = -0.309), Stroop effect (Extent: P = 0.003, R = 0.443; Severity: P = 0.004, R = 0.437), WMS-R Visual memory (Extent: P = 0.019, R = -0.361; Severity: P = 0.014, R = -0.375), and Delayed memory score (Extent: P = 0.005, R = -0.423; Severity: P = 0.044, R = -0.312). The rCBF indices showed no correlations with the number of impaired cognitive domains. Collectively, decreased posterior parietal area rCBF and lower scores on selective neuropsychological scales might be helpful to detect a transition period from PD-MCI to PD-D.
本研究旨在阐明帕金森病伴轻度认知障碍（PD-MCI）患者的神经心理量表与¹²³I-IMP-SPECT脑血流灌注显像（rCBF）之间的关联。42名参与者（平均年龄65.5±8.9岁；平均病程11.1±5.7年）接受了韦氏成人智力量表第三版（WAIS-III）、韦氏记忆量表修订版（WMS-R）、Stroop测验、分类词流畅性测验、听觉词语学习测验、瑞文彩色渐进矩阵测验、连线测验B和画钟测验评估。使用其中10种量表或其子测验将参与者分为PD-MCI组和非痴呆帕金森病（PD-ND）组。采用简易Z评分成像系统（eZIS分析）通过¹²³I-IMP-SPECT评估后扣带回、楔前叶和顶叶的rCBF。范围是z评分>2的体素范围指数，严重程度是eZIS分析中这些区域的平均z评分。扣带回岛征评分（CIScore）是后扣带回与后皮质综合z评分的比值。23名参与者被诊断为PD-MCI（55%）。与PD-ND组相比，PD-MCI组的rCBF指数显著升高（范围：P=0.047；CIScore：P=0.006）。这些指数与WAIS-III加工速度（范围：P=0.041，R=-0.317；严重程度：P=0.047，R=-0.309）、Stroop效应（范围：P=0.003，R=0.443；严重程度：P=0.004，R=0.437）、WMS-R视觉记忆（范围：P=0.019，R=-0.361；严重程度：P=0.014，R=-0.375）和延迟记忆评分（范围：P=0.005，R=-0.423；严重程度：P=0.044，R=-0.312）显著相关。rCBF指数与认知障碍领域的数量无相关性。总体而言，顶叶后部区域rCBF降低和选择性神经心理量表得分较低可能有助于检测从PD-MCI到帕金森病痴呆（PD-D）的过渡期。
