Laurell Axel A S, Mak Elijah, O'Brien John T
Department of Psychiatry, University of Cambridge, Level E4, Addenbrooke's Hospital, Hills Road, Cambridge CB2 2QQ, United Kingdom.
Department of Psychiatry, University of Cambridge, Level E4, Addenbrooke's Hospital, Hills Road, Cambridge CB2 2QQ, United Kingdom.
Neurosci Biobehav Rev. 2025 Feb;169:106007. doi: 10.1016/j.neubiorev.2025.106007. Epub 2025 Jan 9.
We reviewed studies using diffusion tensor imaging (DTI) and tractography to characterise white matter changes in Dementia with Lewy Bodies (DLB) and Parkinson's Disease Dementia (PDD). The search included MEDLINE and EMBASE, and we used a narrative strategy to synthesise the evidence. Data was extracted from 57 studies, of which the majority were considered 'good quality'. Subjects with DLB and PDD had widespread white matter changes compared to healthy controls and Parkinson's disease without cognitive impairment, with a relative sparing of the hippocampus. Compared to subjects with Alzheimer's disease (AD), DLB had greater changes in thalamic connectivity and in the nigroputaminal tract, while AD had greater changes in the parahippocampal white matter and fornix. Cognition was associated with widespread white matter changes, visual hallucinations with thalamic and cholinergic connectivity, and parkinsonism with changes in structures involved in motor control. DTI and tractography may therefore be well suited for discriminating DLB and PDD from other types of dementia, and for studying the aetiology of common symptoms.
我们回顾了使用扩散张量成像（DTI）和纤维束成像来表征路易体痴呆（DLB）和帕金森病痴呆（PDD）中白质变化的研究。检索范围包括MEDLINE和EMBASE，我们采用叙述性策略来综合证据。数据来自57项研究，其中大多数被认为“质量良好”。与健康对照和无认知障碍的帕金森病患者相比，DLB和PDD患者存在广泛的白质变化，海马相对 spared。与阿尔茨海默病（AD）患者相比，DLB患者丘脑连接性和黑质纹状体束的变化更大，而AD患者海马旁白质和穹窿的变化更大。认知与广泛的白质变化相关，视幻觉与丘脑和胆碱能连接性相关，帕金森症与运动控制相关结构的变化相关。因此，DTI和纤维束成像可能非常适合于将DLB和PDD与其他类型的痴呆区分开来，并用于研究常见症状的病因。
