The Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
The Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; The Department of Radiology, Wayne State University, 3990, John R, Detroit, MI, USA; The Department of Neurology, Wayne State University, 3990, John R, Detroit, MI, USA.
Parkinsonism Relat Disord. 2024 Jun;123:106558. doi: 10.1016/j.parkreldis.2024.106558. Epub 2024 Mar 15.
Although locus coeruleus (LC) has been demonstrated to play a critical role in the cognitive function of Parkinson's disease (PD), the underlying mechanism has not been elucidated. The objective was to investigate the relationship among LC degeneration, cognitive performance, and the glymphatic function in PD.
In this retrospective study, 71 PD subjects (21 with normal cognition; 29 with cognitive impairment (PD-MCI); 21 with dementia (PDD)) and 26 healthy controls were included. All participants underwent neuromelanin-sensitive magnetic resonance imaging (NM-MRI) and diffusion tensor image scanning on a 3.0 T scanner. The brain glymphatic function was measured using diffusion along the perivascular space (ALPS) index, while LC degeneration was estimated using the NM contrast-to-noise ratio of LC (CNR).
The ALPS index was significantly lower in both the whole PD group (P = 0.04) and the PDD subgroup (P = 0.02) when compared to the controls. Similarly, the CNR was lower in the whole PD group (P < 0.001) compared to the controls. In the PD group, a positive correlation was found between the ALPS index and both the Montreal Cognitive Assessment (MoCA) score (r = 0.36; P = 0.002) and CNR (r = 0.26; P = 0.03). Mediation analysis demonstrated that the ALPS index acted as a significant mediator between CNR and the MoCA score in PD subjects.
The ALPS index, a neuroimaging marker of glymphatic function, serves as a mediator between LC degeneration and cognitive function in PD.
尽管蓝斑（LC）已被证明在帕金森病（PD）的认知功能中发挥关键作用，但其中的机制仍未阐明。本研究旨在探讨 LC 退变、认知表现与 PD 患者脑内糖质液转运功能之间的关系。
在这项回顾性研究中，纳入了 71 名 PD 患者（认知正常 21 名，PD-MCI 29 名，PDD 21 名）和 26 名健康对照者。所有参与者均接受了基于神经黑色素的磁共振成像（NM-MRI）和扩散张量成像扫描。使用扩散沿血管周围空间（ALPS）指数测量脑内糖质液转运功能，通过 LC 的 NM 对比噪声比（CNR）评估 LC 退变。
与对照组相比，整个 PD 组（P=0.04）和 PDD 亚组（P=0.02）的 ALPS 指数均显著降低。同样，整个 PD 组的 CNR 也显著低于对照组（P<0.001）。在 PD 组中，ALPS 指数与蒙特利尔认知评估（MoCA）评分（r=0.36；P=0.002）和 CNR（r=0.26；P=0.03）呈正相关。中介分析表明，在 PD 患者中，ALPS 指数在 CNR 与 MoCA 评分之间起显著的中介作用。
ALPS 指数作为一种糖质液转运功能的神经影像学标志物，在 PD 患者的 LC 退变与认知功能之间发挥中介作用。
