Álvarez-Avellón Tania, Solares Carmen, Álvarez-Carriles Juan, Franco-Rosado Pablo, Diaz-Galvan Patricia, Santos-García Diego, Mir Pablo, Menéndez-González Manuel
Universidad de Oviedo, Oviedo, Spain.
Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain.
Brain Imaging Behav. 2025 Jun 24. doi: 10.1007/s11682-025-01031-8.
Cognitive decline is a major non-motor symptom in Parkinson's disease (PD), often linked to brain atrophy. This study examines the relationship between cortical atrophy and age groups in predicting cognitive decline in PD over five years. 188 PD patients from the COPPADIS cohort were stratified by age: young (30-55 years, N = 47), middle-aged (56-65 years, N = 59), and older adults (66-75 years, N = 82). Baseline cortical volume was assessed using T1-weighted MRI, and cognitive decline was evaluated using the annual rate of change of the Parkinson's Disease-Cognitive Rating Scale (PD-CRS). Parametric or non-parametric tests were applied to evaluate group differences. Main analyses consist of several multiple regression analyses to examine associations between baseline brain atrophy and cognitive decline by age group. Older adults exhibited significantly greater cognitive decline in comparison to the younger age groups in the three compose scores of the PDCRS -Fronto-subcortical (H(2) = 41.08, p < 0.001), Posterior Cortical (H(2) = 22.03, p < 0.001), and Total(H(2) = 41.13, p < 0.001). Higher educational level has a significant positive effect on older adults, specifically for working memory performance, delayed verbal memory and the fronto-subcortical composed score. Multiple regression models underscored the predictive value of the bilateral hippocampus, bilateral medial orbitofrontal cortex, right precuneus, and right isthmus cingulate gyrus, together with being an older adult or having a higher education. MRI measures, age, and education predict cognitive decline in PD. Longitudinal assessments are essential for refining atrophy-cognition correlations and optimizing patient stratification.
认知功能衰退是帕金森病（PD）的主要非运动症状，常与脑萎缩相关。本研究探讨皮质萎缩与年龄组之间的关系，以预测PD患者五年内的认知功能衰退。来自COPPADIS队列的188例PD患者按年龄分层：青年（30 - 55岁，N = 47）、中年（56 - 65岁，N = 59）和老年人（66 - 75岁，N = 82）。使用T1加权磁共振成像评估基线皮质体积，并使用帕金森病认知评定量表（PD - CRS）的年变化率评估认知功能衰退。应用参数或非参数检验来评估组间差异。主要分析包括多项多元回归分析，以检验基线脑萎缩与各年龄组认知功能衰退之间的关联。在PDCRS的三个综合评分中，老年人相较于年轻年龄组表现出显著更大的认知功能衰退——额颞叶皮质下（H(2) = 41.08，p < 0.001）、后皮质（H(2) = 22.03，p < 0.001）和总分（H(2) = 41.13，p < 0.001）。较高的教育水平对老年人有显著的积极影响，特别是在工作记忆表现、延迟言语记忆和额颞叶皮质下综合评分方面。多元回归模型强调了双侧海马体、双侧内侧眶额皮质、右侧楔前叶和右侧扣带回峡部的预测价值，以及年龄较大或教育程度较高的因素。磁共振成像测量、年龄和教育程度可预测PD患者的认知功能衰退。纵向评估对于完善萎缩与认知的相关性以及优化患者分层至关重要。
