Department of Neurology, Zhuhai People's Hospital (Zhuhai Hospital Affiliated With Jinan University), No.79 KangNing Road, Zhuhai, 519000, Guangdong Province, China.
Department of Neurology, The First Affiliated Hospital, Jinan University, 601 Huangpu Dadao West, Guangzhou, 510632, Guangdong Province, China.
BMC Neurol. 2022 Jul 29;22(1):282. doi: 10.1186/s12883-022-02819-7.
The widespread use of brain magnetic resonance imaging (MRI) has revealed the correlation between enlarged perivascular spaces (EPVS) and cognitive impairment (CI). However, few studies have examined the correlation between MRI-visible EPVS and CI in patients with Parkinson's disease (PD) and vascular parkinsonism (VaP). This study explored how the number and main location of EPVS in PD and VaP are correlated with the occurrence of CI in these diseases to provide radiology markers and other evidence for early clinical diagnosis in a Chinese cohort.
Clinical data were prospectively collected from 77 patients: 26 patients clinically diagnosed with PD or probable PD, 19 patients clinically diagnosed with VaP, and 32 control subjects with normal cognitive function and no stroke or parkinsonism. The patients with PD and VaP were divided into a CI group and a no CI (NCI) group according to the Montreal Cognitive Assessment Beijing version (MoCA-BJ). The relevant clinical data were statistically analysed.
The centrum semiovale (CSO)-EPVS, lacunes, Fazekas scores, global cortical atrophy scale (GCA) scores, Koedam posterior atrophy visual scale (KS) scores, and medial temporal atrophy (MTA) scores were higher in the PD-CI and VaP-CI groups than in the control group (adjusted P < 0.017). The number of basal ganglia (BG)-EPVS in the VaP group was higher than that in the PD and control groups (adjusted P < 0.017). BG-EPVS, Fazekas scores, GCA scores, KS scores, and MTA scores were higher in the VaP-CI group than in the PD-CI group (adjusted P < 0.017). Multivariate logistic regression analysis showed that the differences in BG-EPVS and Fazekas scores were not significant between PD-CI and VaP-CI patients (P > 0.05).
VaP-CI results from multiple factors and is significantly associated with BG-EPVS, lacunes, white matter hyperintensities and brain atrophy. BG-EPVS can be used as an imaging marker to distinguish VaP-CI from PD-CI.
脑磁共振成像（MRI）的广泛应用揭示了扩大的血管周围间隙（EPVS）与认知障碍（CI）之间的相关性。然而，很少有研究探讨帕金森病（PD）和血管性帕金森综合征（VaP）患者的 MRI 可见 EPVS 与 CI 之间的相关性。本研究旨在探讨 PD 和 VaP 中 EPVS 的数量和主要位置与这些疾病中 CI 的发生之间的相关性，为中国队列的早期临床诊断提供放射学标志物和其他证据。
前瞻性收集了 77 名患者的临床资料：26 名临床诊断为 PD 或可能 PD 的患者，19 名临床诊断为 VaP 的患者，32 名认知功能正常且无中风或帕金森病的对照者。根据蒙特利尔认知评估北京版（MoCA-BJ），将 PD 和 VaP 患者分为 CI 组和非 CI（NCI）组。对相关临床资料进行统计学分析。
PD-CI 组和 VaP-CI 组的半卵圆中心（CSO）-EPVS、腔隙、Fazekas 评分、全皮质萎缩量表（GCA）评分、Koedam 后萎缩视觉量表（KS）评分和内侧颞叶萎缩（MTA）评分均高于对照组（校正 P<0.017）。基底节（BG）-EPVS 的数量在 VaP 组高于 PD 组和对照组（校正 P<0.017）。VaP-CI 组的 BG-EPVS、Fazekas 评分、GCA 评分、KS 评分和 MTA 评分均高于 PD-CI 组（校正 P<0.017）。多变量逻辑回归分析显示，PD-CI 组和 VaP-CI 组患者的 BG-EPVS 和 Fazekas 评分差异无统计学意义（P>0.05）。
VaP-CI 是由多种因素引起的，与 BG-EPVS、腔隙、脑白质高信号和脑萎缩密切相关。BG-EPVS 可作为一种影像学标志物，用于区分 VaP-CI 与 PD-CI。
