Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute and Department of Neurology, Weill Cornell Medicine, New York, NY, USA.
Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute and Department of Neurology, Weill Cornell Medicine, New York, NY, USA; Parkinson's Disease and Movement Disorders Institute, Department of Neurology, Weill Cornell Medicine, New York, NY, USA.
J Clin Neurosci. 2024 Jan;119:10-16. doi: 10.1016/j.jocn.2023.11.019. Epub 2023 Nov 16.
Cognitive decline is a common but variable non-motor manifestation of Parkinson's disease. Chronic liver disease contributes to dementia, but its impact on cognitive performance in Parkinson's disease is unknown. We assessed the effect of liver fibrosis on cognition in Parkinson's disease.
We conducted a retrospective cohort study using data from the Parkinson's Progression Markers Initiative. Our exposure was liver fibrosis at baseline, based on the validated Fibrosis-4 score. Our primary outcome was the Montreal Cognitive Assessment, and additional outcome measures were the Symbol Digit Modalities Test, the Benton Judgement of Line Orientation, the Letter-Number Sequencing Test, and the Modified Semantic Fluency Test. We used linear regression models to assess the relationship between liver fibrosis and scores on cognitive assessments at baseline and linear mixed models to evaluate the association between baseline Fibrosis-4 score with changes in each cognitive test over five years. Models were adjusted for demographics, comorbidities, and alcohol use.
We included 409 participants (mean age 61, 40 % women). There was no significant association between liver fibrosis and baseline performance on any of the cognitive assessments in adjusted models. However, over the subsequent five year period, liver fibrosis was associated with more rapid decline in scores on the Montreal Cognitive Assessment (interaction coefficient, -0.07; 95 % CI, -0.12, -0.02), the Symbol Digit Modalities Test, the Benton Judgement of Line Orientation, and the Modified Semantic Fluency Test.
In people with Parkinson's disease, the presence of comorbid liver fibrosis was associated with more rapid decline across multiple cognitive domains.
认知衰退是帕金森病常见但可变的非运动表现。慢性肝脏疾病会导致痴呆，但它对帕金森病患者认知表现的影响尚不清楚。我们评估了肝纤维化对帕金森病认知的影响。
我们使用帕金森病进展标志物倡议的数据进行了回顾性队列研究。我们的暴露因素是基线时的肝纤维化，基于经过验证的纤维化-4 评分。我们的主要结局是蒙特利尔认知评估，其他结局指标包括符号数字模态测试、本顿线定向判断、字母数字序列测试和改良语义流畅性测试。我们使用线性回归模型评估基线肝纤维化与认知评估得分之间的关系，使用线性混合模型评估基线纤维化-4 评分与五年内每个认知测试变化之间的关联。模型调整了人口统计学、合并症和酒精使用情况。
我们纳入了 409 名参与者（平均年龄 61 岁，40%为女性）。在调整后的模型中，肝纤维化与任何认知评估的基线表现均无显著相关性。然而，在随后的五年期间，肝纤维化与蒙特利尔认知评估（交互系数，-0.07；95%置信区间，-0.12，-0.02）、符号数字模态测试、本顿线定向判断和改良语义流畅性测试的评分下降速度更快相关。
在帕金森病患者中，合并存在肝纤维化与多个认知领域的快速下降相关。
