What predicts cognitive decline in de novo Parkinson's disease?

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• 作者：Dario Arnaldi^a ; ^{dario.arnaldi@gmail.com} ; Claudio Campus^b ; Michela Ferrara^a ; Francesco Famà ; ^a ; Agnese Picco^a ; Fabrizio De Carli^c ; Jennifer Accardo^a ; Andrea Brugnolo^a ; Gianmario Sambuceti^d ; Silvia Morbelli^d ; Flavio Nobili^a ; ^d
• 关键词：Parkinson's disease ; Dopamine transporter SPECT ; Perfusion SPECT ; Cognitive decline ; Neuropsychological tests
• 刊名：Neurobiology of Aging
• 出版年：2012
• 期刊代码：202_01974580
• 类别：med
• 出版时间：June, 2012
• 卷：33
• 期：6
• 页码：1127.e11-1127.e20
• 文件大小：1372 K

摘要

Subtle cognitive impairment can be detected in early Parkinson's disease (PD). In a consecutive series of de novo, drug-naive PD patients, we applied stepwise regression analysis to assess which clinical, neuropsychological, and functional neuroimaging (dopamine transporter [DAT] and perfusion single photon emission computed tomography [SPECT]) characteristics at baseline was predictive of cognitive decline during an average follow-up time of about 4 years. Decline both in executive (R² = 0.54; p = 0.0001) and visuospatial (R² = 0.56; p = 0.0001) functions was predicted by the couple of Unified Parkinson's Disease Rating Scale (UPDRS)-III score and caudate dopamine transporter (DAT) uptake in the less affected hemisphere (LAH). Verbal memory and language decline was predicted instead by caudate DAT uptake and brain perfusion in a posterior parieto-temporal area of the less affected hemisphere (R² = 0.42; p = 0.0005). No significant effect was shown for age, baseline neuropsychological scores, and levodopa equivalent dose at follow-up. The combined use of clinical structured examination and brain functional assessment by means of dual single photon emission computed tomography imaging appears as a powerful approach to predict cognitive decline in de novo PD patients.