Slater Nicola M, Melzer Tracy R, Myall Daniel J, Anderson Tim J, Dalrymple-Alford John C
School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand.
New Zealand Brain Research Institute, Christchurch, New Zealand.
Mov Disord. 2024 Dec;39(12):2155-2172. doi: 10.1002/mds.30023. Epub 2024 Oct 3.
Cognitive impairment is a well-recognized and debilitating symptom of Parkinson's disease (PD). Degradation in the cortical cholinergic system is thought to be a key contributor. Both postmortem and in vivo cholinergic positron emission tomography (PET) studies have provided valuable evidence of cholinergic system changes in PD, which are pronounced in PD dementia (PDD). A growing body of literature has employed magnetic resonance imaging (MRI), a noninvasive, more cost-effective alternative to PET, to examine cholinergic system structural changes in PD. This review provides a comprehensive discussion of the methodologies and findings of studies that have focused on the relationship between cholinergic basal forebrain (cBF) integrity, based on T1- and diffusion-weighted MRI, and cognitive function in PD. Nucleus basalis of Meynert (Ch4) volume has been consistently reduced in cognitively impaired PD samples and has shown potential utility as a prognostic indicator for future cognitive decline. However, the extent of structural changes in Ch4, especially in early stages of cognitive decline in PD, remains unclear. In addition, evidence for structural change in anterior cBF regions in PD has not been well established. This review underscores the importance of continued cross-sectional and longitudinal research to elucidate the role of cholinergic dysfunction in the cognitive manifestations of PD. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
认知障碍是帕金森病（PD）一种公认的、使人衰弱的症状。皮质胆碱能系统的退化被认为是一个关键因素。尸检和体内胆碱能正电子发射断层扫描（PET）研究都为PD中胆碱能系统的变化提供了有价值的证据，这些变化在帕金森病痴呆（PDD）中更为明显。越来越多的文献采用磁共振成像（MRI），一种比PET更具成本效益的非侵入性替代方法，来研究PD中胆碱能系统的结构变化。这篇综述全面讨论了基于T1加权和扩散加权MRI，聚焦于胆碱能基底前脑（cBF）完整性与PD认知功能之间关系的研究方法和结果。在认知受损的PD样本中，Meynert基底核（Ch4）体积持续减小，并显示出作为未来认知衰退预后指标的潜在效用。然而，Ch4结构变化的程度，尤其是在PD认知衰退的早期阶段，仍不清楚。此外，PD中前脑cBF区域结构变化的证据尚未得到充分证实。这篇综述强调了持续进行横断面和纵向研究以阐明胆碱能功能障碍在PD认知表现中作用的重要性。© 2024作者。《运动障碍》由Wiley Periodicals LLC代表国际帕金森和运动障碍协会出版。
