Chung Seok Jong, Kim Yae Ji, Kim Yun Joong, Lee Hye Sun, Yun Mijin, Lee Phil Hyu, Jeong Yong, Sohn Young H
Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
Department of Neurology, Yongin Severance Hospital, Yonsei University Health System, Yongin, Korea.
J Mov Disord. 2022 Sep;15(3):249-257. doi: 10.14802/jmd.22063. Epub 2022 Sep 7.
To investigate whether there is a link between cognitive function and motor reserve (i.e., individual capacity to cope with nigrostriatal dopamine depletion) in patients with newly diagnosed Parkinson's disease (PD).
A total of 163 patients with drug-naïve PD who underwent 18F-FP-CIT PET, brain MRI, and a detailed neuropsychological test were enrolled. We estimated individual motor reserve based on initial motor deficits and striatal dopamine depletion using a residual model. We performed correlation analyses between motor reserve estimates and cognitive composite scores. Diffusion connectometry analysis was performed to map the white matter fiber tracts, of which fractional anisotropy (FA) values were well correlated with motor reserve estimates. Additionally, Cox regression analysis was used to assess the effect of initial motor reserve on the risk of dementia conversion.
The motor reserve estimate was positively correlated with the composite score of the verbal memory function domain (γ = 0.246) and with the years of education (γ = 0.251). Connectometry analysis showed that FA values in the left fornix were positively correlated with the motor reserve estimate, while no fiber tracts were negatively correlated with the motor reserve estimate. Cox regression analysis demonstrated that higher motor reserve estimates tended to be associated with a lower risk of dementia conversion (hazard ratio, 0.781; 95% confidence interval, 0.576-1.058).
The present study demonstrated that the motor reserve estimate was well correlated with verbal memory function and with white matter integrity in the left fornix, suggesting a possible link between cognition and motor reserve in patients with PD.
探讨新诊断帕金森病（PD）患者的认知功能与运动储备（即应对黑质纹状体多巴胺耗竭的个体能力）之间是否存在关联。
共纳入163例未经药物治疗的PD患者，这些患者均接受了18F-FP-CIT PET、脑部MRI检查及详细的神经心理学测试。我们使用残差模型根据初始运动缺陷和纹状体多巴胺耗竭情况评估个体运动储备。我们对运动储备评估值与认知综合评分进行了相关性分析。进行了弥散连接ometry分析以绘制白质纤维束图谱，其中各向异性分数（FA）值与运动储备评估值高度相关。此外，使用Cox回归分析评估初始运动储备对痴呆转化风险的影响。
运动储备评估值与言语记忆功能领域的综合评分呈正相关（γ = 0.246），与受教育年限呈正相关（γ = 0.251）。连接ometry分析显示，左侧穹窿的FA值与运动储备评估值呈正相关，而没有纤维束与运动储备评估值呈负相关。Cox回归分析表明，较高的运动储备评估值往往与较低的痴呆转化风险相关（风险比，0.781；95%置信区间，0.576 - 1.058）。
本研究表明，运动储备评估值与言语记忆功能以及左侧穹窿的白质完整性密切相关，提示PD患者的认知与运动储备之间可能存在联系。
