Ge Yi-Lun, Gong Si-Yi, Wang Pu-Zhi, Yan Jia-Hui, Li Wen, Zhang Jin-Ru, Jin Hong, Zhuang Sheng, Hu Lei, Ding Chang-Wei, Yang Ya-Ping, Wang Fen, Li Dan, Chen Jing, Mao Cheng-Jie, Zhang Ying-Chun, Li Kai, Liu Chun-Feng
Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China.
Department of Ultrasound, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China.
Neuropsychiatr Dis Treat. 2022 Jul 12;18:1421-1431. doi: 10.2147/NDT.S358150. eCollection 2022.
Cognitive impairment (CI) is a common but debilitating non-motor symptom in Parkinson's disease (PD). Although cerebrovascular functions are related to cognitive performance in healthy individuals, such a relation in PD remains elusive. This study aims to assess the association between cerebrovascular function and cognitive performance in PD individuals.
Two-hundred-and-one PD individuals were retrospectively included. They were subsequently divided into two groups: PD with normal cognition (PD-NC) and PD with CI (PD-CI). Cerebral hemodynamic characteristics of the middle cerebral arteries were assessed by transcranial ultrasound. The association between scores in each cognitive domain and cerebral hemodynamic parameters was further analyzed using regression analyses. Additionally, a binary logistic regression model with backward stepwise procedure was applied to build the model for discriminating CI in PD individuals. An independent dataset of additional 46 PD individuals was used further.
The PD-CI group showed a relatively lower end-diastolic blood flow velocity (EDV, < 0.05) and a higher resistive index (RI, < 0.05) compared to the PD-NC group. RI showed significant associations with the memory item score of Montreal Cognitive Assessment ( < 0.05). A model combining clinical and hemodynamic variables was established with optimal efficiency (area under the curve, AUC = 0.651). Further replication of the model in an independent dataset yielded a great consistency (AUC = 0.704).
In our study, cerebrovascular functions were significantly associated with the cognitive performance in PD individuals, especially with the memory task. The established model was effective in identifying CI in PD individuals, which might be a potentially useful tool to screen the cognitive decline in PD individuals at an early stage of the disease. Further studies with larger sample sizes in different populations are warranted.
认知障碍（CI）是帕金森病（PD）中常见但使人衰弱的非运动症状。尽管脑血管功能与健康个体的认知表现相关，但在PD中这种关系仍不明确。本研究旨在评估PD患者脑血管功能与认知表现之间的关联。
回顾性纳入201例PD患者。随后将他们分为两组：认知正常的PD（PD-NC）和伴有CI的PD（PD-CI）。通过经颅超声评估大脑中动脉的脑血流动力学特征。使用回归分析进一步分析每个认知领域的得分与脑血流动力学参数之间的关联。此外，应用具有向后逐步程序的二元逻辑回归模型来建立区分PD患者CI的模型。进一步使用另外46例PD患者的独立数据集。
与PD-NC组相比，PD-CI组的舒张末期血流速度（EDV，<0.05）相对较低，阻力指数（RI，<0.05）较高。RI与蒙特利尔认知评估的记忆项目得分显著相关（<0.05）。建立了一个结合临床和血流动力学变量的模型，具有最佳效率（曲线下面积，AUC = 0.651）。该模型在独立数据集中的进一步验证产生了高度一致性（AUC = 0.704）。
在我们的研究中，脑血管功能与PD患者的认知表现显著相关，尤其是与记忆任务相关。所建立的模型在识别PD患者的CI方面有效，这可能是在疾病早期筛查PD患者认知衰退的潜在有用工具。有必要在不同人群中进行更大样本量的进一步研究。
