Zhihui Sun, Yinghua Li, Hongguang Zhao, Yuyin Dai, Xiaoxiao Du, Lulu Gao, Yi Li, Kangli Fan, Ying Zhang
Department of Neurology, First Hospital of Jilin University, Changchun, China.
Front Neurol. 2023 Jun 13;14:1195576. doi: 10.3389/fneur.2023.1195576. eCollection 2023.
Evaluation of the correlation between F-fluorodeoxyglucose-positron emission tomography (F-FDG PET) and cognitive function in first-diagnosed and untreated Parkinson's disease (PD) patients.
This cross-sectional study included 84 first diagnosed and untreated PD patients. The individuals were diagnosed by movement disorder experts based on the 2015 MDS Parkinson's disease diagnostic criteria. The patients also underwent F-FDG PET scans and clinical feature assessments including the Montreal Cognitive Assessment (MoCA) scale. Glucose metabolism rates were measured in 26 brain regions using region of interest (ROI) and pixel-wise analyses with displayed scores. The cognitive function was assessed by professionals using the MoCA scale, which covers five cognitive domains. Spearman's linear correlation and linear regression models were used to compare the correlations between F-FDG metabolism in each brain region and cognitive domain, using SPSS 25.0 software.
The results indicated a positive correlation between executive function and glucose metabolism in the lateral prefrontal cortex of the left hemisphere ( = 0.041). Additionally, a positive correlation between memory function and glucose metabolism in the right precuneus ( = 0.014), right lateral occipital cortex ( = 0.017), left lateral occipital cortex ( = 0.031), left primary visual cortex ( = 0.008), and right medial temporal cortex ( = 0.046). Further regression analysis showed that for every one-point decrease in the memory score, the glucose metabolism in the right precuneus would decrease by 0.3 ( = 0.30, = 0.005), the glucose metabolism in the left primary visual cortex would decrease by 0.25 ( = 0.25, = 0.040), the glucose metabolism in the right lateral occipital cortex would decrease by 0.38 ( = 0.38, = 0.012), and the glucose metabolism in the left lateral occipital cortex would decrease by 0.32 ( = 0.32, = 0.045).
This study indicated that cognitive impairment in PD patients mainly manifests as changes in executive function, visual-spatial function and memory functions, while glucose metabolism mainly decreases in the frontal and posterior cortex. Further analysis shows that executive function is related to glucose metabolism in the left lateral prefrontal cortex. On the other hand, memory ability involves changes in glucose metabolism in a more extensive brain region. This suggests that cognitive function assessment can indirectly reflect the level of glucose metabolism in the relevant brain regions.
评估首次诊断且未接受治疗的帕金森病(PD)患者中氟脱氧葡萄糖正电子发射断层扫描(F-FDG PET)与认知功能之间的相关性。
这项横断面研究纳入了84例首次诊断且未接受治疗的PD患者。这些个体由运动障碍专家根据2015年MDS帕金森病诊断标准进行诊断。患者还接受了F-FDG PET扫描以及包括蒙特利尔认知评估(MoCA)量表在内的临床特征评估。使用感兴趣区域(ROI)和逐像素分析在26个脑区测量葡萄糖代谢率,并显示得分。专业人员使用涵盖五个认知领域的MoCA量表评估认知功能。使用SPSS 25.0软件,采用Spearman线性相关性和线性回归模型比较每个脑区的F-FDG代谢与认知领域之间的相关性。
结果表明,左半球外侧前额叶皮质的执行功能与葡萄糖代谢之间存在正相关(=0.041)。此外,右楔前叶(=0.014)、右枕外侧皮质(=0.017)、左枕外侧皮质(=0.031)、左初级视觉皮质(=0.008)和右内侧颞叶皮质(=0.046)的记忆功能与葡萄糖代谢之间存在正相关。进一步回归分析表明,记忆得分每降低1分,右楔前叶的葡萄糖代谢将降低0.3(=0.30,=0.005),左初级视觉皮质的葡萄糖代谢将降低0.25(=0.25,=0.040),右枕外侧皮质的葡萄糖代谢将降低0.38(=0.38,=0.012),左枕外侧皮质的葡萄糖代谢将降低0.32(=0.32,=0.045)。
本研究表明,PD患者的认知障碍主要表现为执行功能、视觉空间功能和记忆功能的变化,而葡萄糖代谢主要在额叶和后皮质降低。进一步分析表明,执行功能与左外侧前额叶皮质的葡萄糖代谢有关。另一方面,记忆能力涉及更广泛脑区葡萄糖代谢的变化。这表明认知功能评估可以间接反映相关脑区的葡萄糖代谢水平。