Wang Hai-Yang, Ren Lu, Yan Zhongrui, Zhou Tingting, Liang Zhanhua
Department of Neurology, The First Affiliated Hospital of Dalian Medical University, Dalian, China.
Department of Neurology, Jining No. 1 People's Hospital, Shandong First Medical University, Jining, China.
NPJ Parkinsons Dis. 2025 Jun 12;11(1):163. doi: 10.1038/s41531-025-01013-z.
Parkinson's disease with mild cognitive impairment (PD-MCI) includes various cognitive deficits, classified into two subtypes based on the "dual syndrome hypothesis": the executive-dominant dopamine pathway dysfunction impairing executive and language functions (PD-EL subtype), and the visuospatial-dominant non-dopaminergic dysfunction affecting visuospatial perception, attention, and memory (PD-VAM subtype). This study involved 182 participants (122 PD, 60 controls) undergoing cognitive assessments. Using PD-MCI Level II criteria, patients were categorized as PD with normal cognition (PD-NC, 48), PD-EL (34), or PD-VAM (40). Functional near-infrared spectroscopy measured brain activation during verbal fluency (executive) and line orientation (visuospatial) tasks. PD-EL showed lower word accuracy and reduced activation in dorsolateral/ventrolateral prefrontal cortices, supplementary motor area, and orbitofrontal cortex compared to PD-NC. PD-VAM had lower line orientation scores and reduced ventrolateral prefrontal activation. These findings suggest that PD-MCI subtypes may exhibit differential neural activation patterns reflecting their cognitive deficits, underscoring the need for targeted interventions and mechanistic research.
伴有轻度认知障碍的帕金森病（PD-MCI）包括各种认知缺陷，根据“双重综合征假说”分为两种亚型：以执行功能为主导的多巴胺能通路功能障碍，损害执行功能和语言功能（PD-EL亚型），以及以视觉空间功能为主导的非多巴胺能功能障碍，影响视觉空间感知、注意力和记忆力（PD-VAM亚型）。本研究纳入了182名接受认知评估的参与者（122名帕金森病患者，60名对照）。根据PD-MCI二级标准，患者被分为认知正常的帕金森病患者（PD-NC，48例）、PD-EL（34例）或PD-VAM（40例）。功能近红外光谱测量了言语流畅性（执行功能）和直线定向（视觉空间功能）任务期间的大脑激活情况。与PD-NC相比，PD-EL表现出较低的单词准确性，背外侧/腹外侧前额叶皮质、辅助运动区和眶额叶皮质的激活减少。PD-VAM的直线定向得分较低，腹外侧前额叶激活减少。这些发现表明，PD-MCI亚型可能表现出不同的神经激活模式，反映了它们的认知缺陷，强调了针对性干预和机制研究的必要性。
