Hou Miaomiao, Hou Xiaojun, Qiu Yiqing, Wang Jiali, Zhang Mingyang, Mao Xiaowei, Wu Xi
Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Neurology, The First Affiliated Hospital of Naval Medical University, Shanghai, China.
Front Aging Neurosci. 2022 Jul 7;14:884506. doi: 10.3389/fnagi.2022.884506. eCollection 2022.
This study aimed to investigate the characteristics of cognitive dysfunctions and their relationship with total cerebral small vascular disease (CSVD) in Parkinson's disease (PD).
A total of 174 idiopathic PD patients who underwent brain magnetic resonance imaging (MRI) were recruited. Demographic information, vascular disease risk factors, motor function (MDS-UPDRS III score), and cognitive level (MoCA, MMSE) were collected for these patients. The total CSVD burden was scored based on lacunes, enlarged perivascular spaces (EPVS), high-grade white matter hyperintensities (WMH), and cerebral microbleeds (CMBs) for each subject.
Cognitive scores on MoCA for language, delayed recall, and orientation were significantly reduced in PD patients with CSVD burden ≥ 1 than in those with CSVD burden = 0. Educational level, PDQ 39, and CSVD burden were significantly associated with MoCA scores in individuals with PD. For the whole group, the full model accounted for 33.6% variation in total MoCA scores. In which, CSVD burden explained 2.7% of the results, and the detection of lacunes, WMH, EPVS, and strictly lobar CMBs were significantly correlated with MoCA scores. The stability of the outcomes was confirmed by sensitivity analysis.
CSVD can independently contribute to cognitive decline in PD and cause damage in specific cognitive domains. Promoting neurovascular health may help preserve cognitive functions in PD.
本研究旨在调查帕金森病（PD）患者认知功能障碍的特征及其与全脑小血管疾病（CSVD）的关系。
共招募了174例接受脑磁共振成像（MRI）检查的特发性PD患者。收集这些患者的人口统计学信息、血管疾病危险因素、运动功能（MDS-UPDRS III评分）和认知水平（MoCA、MMSE）。根据腔隙、血管周围间隙扩大（EPVS）、高级别白质高信号（WMH）和脑微出血（CMB）对每个受试者的CSVD总负担进行评分。
CSVD负担≥1的PD患者在语言、延迟回忆和定向方面的MoCA认知评分显著低于CSVD负担=0的患者。教育水平、PDQ 39和CSVD负担与PD患者的MoCA评分显著相关。对于整个组，完整模型解释了总MoCA评分中33.6%的变异。其中，CSVD负担解释了2.7%的结果，腔隙、WMH、EPVS和严格的叶性CMB的检测与MoCA评分显著相关。敏感性分析证实了结果的稳定性。
CSVD可独立导致PD患者认知功能下降，并在特定认知领域造成损害。促进神经血管健康可能有助于保留PD患者的认知功能。
