Department of Neurology, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts, 02118, USA.
Department of Neurology, Boston Medical Center, Boston, Massachusetts, 02118, USA.
Ann Clin Transl Neurol. 2024 Sep;11(9):2301-2313. doi: 10.1002/acn3.52144. Epub 2024 Jul 19.
Previous studies have suggested a link between peripheral inflammation and cognitive outcomes in the general population and individuals with Parkinson's disease (PD). We sought to test the association between peripheral inflammation, measured by the neutrophil-to-lymphocyte ratio (NLR), cognitive performance, and mild cognitive impairment (MCI) status in individuals with PD.
A retrospective, longitudinal analysis was carried out using data from the Parkinson's Progression Markers Initiative (PPMI), including 422 participants with PD followed over 5 years. Cognitive performance was assessed using a neuropsychological battery including the Montreal Cognitive Assessment (MoCA) and tests of verbal learning, visuospatial function, processing speed, and executive function. Mixed-effect regression models were used to analyze the association between NLR, cognitive performance, and MCI status, controlling for age, sex, education, APOE genotype, and motor severity.
There was a negative association between NLR and MoCA, even after adjusting for covariates (b = -0.12, p = 0.033). MoCA scores for individuals in the high NLR category exhibited a more rapid decline over time compared to the low NLR group (b = -0.16, p = 0.012). Increased NLR was associated with decreased performance across all cognitive domains. However, NLR was not associated with MCI status over 5 years of follow-up.
This study demonstrates a link between elevated NLR and cognitive performance in PD, but not with MCI status over 5 years. This suggests that NLR is more strongly associated with day-to-day cognitive performance than with incident MCI, but this requires further study in more heterogeneous cohorts.
先前的研究表明，在普通人群和帕金森病（PD）患者中，外周炎症与认知结果之间存在关联。我们试图检验外周炎症与 PD 患者认知表现和轻度认知障碍（MCI）状态之间的相关性，外周炎症通过中性粒细胞与淋巴细胞比值（NLR）来衡量。
采用帕金森进展标志物倡议（PPMI）的数据进行回顾性、纵向分析，共纳入 422 名随访 5 年以上的 PD 患者。认知表现通过神经心理学测试进行评估，包括蒙特利尔认知评估（MoCA）和语言学习、视空间功能、处理速度和执行功能测试。采用混合效应回归模型分析 NLR、认知表现和 MCI 状态之间的关系，控制年龄、性别、教育程度、APOE 基因型和运动严重程度等因素。
即使在调整了协变量后，NLR 与 MoCA 之间仍呈负相关（b=-0.12，p=0.033）。与 NLR 低值组相比，NLR 高值组的 MoCA 评分随时间的推移下降更快（b=-0.16，p=0.012）。NLR 升高与所有认知域的表现下降有关。然而，在 5 年的随访中，NLR 与 MCI 状态无关。
本研究表明，PD 患者中 NLR 升高与认知表现有关，但与 5 年内的 MCI 状态无关。这表明 NLR 与日常认知表现的相关性更强，而与新发 MCI 的相关性较弱，但这需要在更多异质队列中进一步研究。
