Department of Advanced Medical and Surgical Sciences - MRI Research Center Vanvitelli-FISM, University of Campania "Luigi Vanvitelli", Piazza Miraglia 2, 80138, Naples, Italy; Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico 31, 81100, Caserta, Italy.
Department of Advanced Medical and Surgical Sciences - MRI Research Center Vanvitelli-FISM, University of Campania "Luigi Vanvitelli", Piazza Miraglia 2, 80138, Naples, Italy.
Parkinsonism Relat Disord. 2024 Oct;127:107077. doi: 10.1016/j.parkreldis.2024.107077. Epub 2024 Aug 5.
Mild cognitive impairment is a common feature of Parkinson's disease (PD-MCI), even at the earliest disease stages. Growing evidence supports the instability of PD-MCI over time, without a consistent linear evolution to dementia, and in some patients, the potential of reversion to normal cognition. However, which features are associated with reversion from PD-MCI to normal cognition in early PD-MCI are not fully known.
In our longitudinal study of early drug naïve PD patients, 65 of 134 (48 %) patients had PD-MCI at baseline. Study participants underwent comprehensive assessments at baseline and 1-year follow-up. Sixteen (24.6 %) patients with PD-MCI reverted to normal cognition (Reverters), and 49 (75.4 %) had persistent PD-MCI (Non-Reverters) after 1-year follow-up. We performed single- and multiple-variable logistic regression analyses to identify baseline variables predicting reversion of PD-MCI to normal cognition after 1-year. We also compared brain morphometric measures (cortical thickness and volumes) at baseline between the PD-MCI Reverters and Non-Reverters.
Higher educational level and better performance on measures of attention and memory at baseline predicted the reversion to normal cognition at 1-year follow-up. Reverters had greater cortical thickness in the left inferior temporal gyrus than Non-Reverters.
Our results show PD-MCI with a higher chance of reverting to normal cognition over time have a higher educational level, better frontotemporal-related cognitive function, and increased thickness of the inferior temporal lobe gyrus. These findings may potentially help researchers to select the candidates for clinical trials focusing on the treatment of cognitive impairment in the early stages of PD.
轻度认知障碍是帕金森病（PD-MCI）的常见特征，即使在疾病的早期阶段也是如此。越来越多的证据支持 PD-MCI 随时间的不稳定性，没有向痴呆症的一致线性发展，并且在一些患者中，认知能力有恢复正常的潜力。然而，在早期 PD-MCI 中，哪些特征与 PD-MCI 向正常认知的恢复有关尚不完全清楚。
在我们对早期药物-naive PD 患者的纵向研究中，134 名患者中有 65 名（48%）基线时有 PD-MCI。研究参与者在基线和 1 年随访时接受了全面评估。16 名（24.6%）PD-MCI 患者恢复为正常认知（逆转者），49 名（75.4%）患者在 1 年随访后仍有 PD-MCI（非逆转者）。我们进行了单变量和多变量逻辑回归分析，以确定预测 PD-MCI 在 1 年后恢复正常认知的基线变量。我们还比较了基线时 PD-MCI 逆转者和非逆转者之间的脑形态计量学测量值（皮质厚度和体积）。
基线时较高的教育水平和更好的注意力和记忆测试表现预测了 1 年后认知恢复正常。逆转者左侧颞下回的皮质厚度大于非逆转者。
我们的研究结果表明，随着时间的推移，PD-MCI 恢复正常认知的可能性更高，具有更高的教育水平、更好的额颞叶相关认知功能和增加的颞下回皮质厚度。这些发现可能有助于研究人员选择更适合临床试验的患者，以治疗 PD 早期的认知障碍。
