帕金森病轻度认知功能障碍纹状体体积的异常改变
|
摘要
目的应用基于体素的形态学测量方法(VBM)考察帕金森病轻度认知功能障碍(Parkinson’s disease withmild cognitive impairment,PD-MCI)特异的大脑灰质结构异常改变。方法采集50例PD患者(25例PD-MCI,25例PD未合并MCI,PD-NCI)及25例健康对照组(healthy control,HC)的全脑高分辨率T1加权结构像及包含5个认知域的神经心理量表。结果与PD-NCI及HC组相比,PD-MCI组双侧壳核及右侧尾状核体积显著下降。进一步分析发现,PD患者双侧壳核体积分别与执行功能及语言能力成正相关,此外,右侧壳核/尾状核体积与记忆成正相关。结论 PD-MCI基底节体积特异性萎缩与PD认知功能损害有关。该结果提示基底节形态学改变可能是PD-MCI的潜在影像学标记物。
Objective The present study aimed to examine the specific structural alterations in Parkinson's disease with mild cognitive impairment( PD-MCI). Methods Fifty patients with PD classified into 25 PD-MCI and 25 PD with no MCI( PD-NCI)and 25 healthy control( HC),who underwent T1-weighted structural MRI and neuropsychological assessments of five domains,were recruited in the present study. Voxel-based morphometry( VBM) analysis was performed to detect the structural atrophy inPD-MCI and its association with cognitive performance was further explored. Results Compared to PD-NCI and HC,reducedgrey matter volume( GMV) was observed in the bilateral putamen and right caudate specifically for PD-MCI. Further,it wasfound that reduced GMV in the bilateral putamen was positively correlated with executive function and language performance,anddecreased GMV in the right putamen/caudate was additionally positively correlated with memory. Conclusion PD-MCI exhibitedspecific basal ganglia atrophy,which was contributed to cognitive decline in PD. These findings suggest that basal ganglia alteration might be a potential biomarker for PD-MCI.
Objective The present study aimed to examine the specific structural alterations in Parkinson's disease with mild cognitive impairment( PD-MCI). Methods Fifty patients with PD classified into 25 PD-MCI and 25 PD with no MCI( PD-NCI)and 25 healthy control( HC),who underwent T1-weighted structural MRI and neuropsychological assessments of five domains,were recruited in the present study. Voxel-based morphometry( VBM) analysis was performed to detect the structural atrophy inPD-MCI and its association with cognitive performance was further explored. Results Compared to PD-NCI and HC,reducedgrey matter volume( GMV) was observed in the bilateral putamen and right caudate specifically for PD-MCI. Further,it wasfound that reduced GMV in the bilateral putamen was positively correlated with executive function and language performance,anddecreased GMV in the right putamen/caudate was additionally positively correlated with memory. Conclusion PD-MCI exhibitedspecific basal ganglia atrophy,which was contributed to cognitive decline in PD. These findings suggest that basal ganglia alteration might be a potential biomarker for PD-MCI.
引文
[1] Williams-Gray CH,Foltynie T,Brayne CE,et al. Evolution ofcognitive dysfunction in an incident Parkinson's disease cohort[J]. Brain,2007,130(7):1787-1798.
[2] Leroi I,Mc Donald K,Pantula H,et al. Cognitive impairment inparkinson disease:impact on quality of life,disability,and care-giver burden[J]. Journal of Geriatric Psychiatry and Neurology,2013,25(4):208-214.
[3] Litvan I,Goldman JG,Troster AI,et al. Diagnostic criteria formild cognitive impairment in Parkinson's disease:movement disor-der society task force guidelines[J]. Movement Disorders,2012,27(3):349-356.
[4] Lang A,Fahn S. Assessment of Parkinson’s disease,quantifica-tion of neurological deficit[J]. Boston:Butterworths,1989,12(2):285-309.
[5] Hoehn M,Yahr M. Parkinsonism:onset,progression and mortal-ity[J]. Neurology,1967,17(5):427-442.
[6] Tomlinson CL,Stowe R and Patel S,et al. Systematic review oflevodopa dose equivalency reporting in Parkinson's disease[J].Movement Disorders,2010,25(15):2649-2653.
[7] Lu J,Li D and Li F,et al. Montreal cognitive assessment in de-tecting cognitive impairment in chinese elderly individuals:a pop-ulation-based study[J]. Journal of Geriatric Psychiatry and Neu-rology,2012,24(4):184-190.
[8] Torbey E,Pachana NA,Dissanayaka NNW. Depression ratingscales in Parkinson's disease:a critical review updating recent lit-erature[J]. Journal of Affective Disorders,2015,184(9):216-224.
[9] Ashburner J. A fast diffeomorphic image registration algorithm[J]. Neuroimage,2007,38(1):95-113.
[10] Sawamoto N,Piccini P and Hotton G,et al. Cognitive deficitsand striato-frontal dopamine release in Parkinson's disease[J].Brain,2008,131(5):1294-1302.
[11] Ibarretxe-Bilbao N,Junque C,Marti MJ,et al. Brain structuralMRI correlates of cognitive dysfunctions in Parkinson's disease[J]. Journal of the Neurological Sciences,2011,310(1-2):70-74.
[12] Xu Y,Yang J and Hu X,et al. Voxel-based meta-analysis ofgray matter volume reductions associated with cognitive impair-ment in Parkinson’s disease[J]. Journal of Neurology,2016,263(6):1178-1187.
[13] Caspell-Garcia C,Simuni T,Tosun-Turgut D,et al. Multiplemodality biomarker prediction of cognitive impairment in prospec-tively followed de novo Parkinson disease[J]. Plos One,2017,12(5):1756-1774.
[14] Gee M,Dukart J,Draganski B,et al. Regional volumetricchange in Parkinson's disease with cognitive decline[J]. Journalof the Neurological Sciences,2017,373(2):88-94.
[15] Alexander GE,De Long MR,Strich PL,et al. Parallel organiza-tion of functionally segregated circuits linking basal ganglia andcortex[J]. Annu Rev Neurosci,1986,9(1):357-381.
[16] Zaja-Milatovic S,Milatovic D,Schantz AM,et al. Dendritic de-generation in neostriatal medium spiny neurons in Parkinson dis-ease[J]. Neurology,2005,64(3):545-547.
[17] Huot P,Levesque M,Parent A,et al. The fate of striatal dopam-inergic neurons in Parkinson's disease and Huntington's chorea[J]. Brain,2007,130(1):222-232.
[18] Lee JE,Cho KH,Song SK,et al. Exploratory analysis of neuro-psychological and neuroanatomical correlates of progressive mildcognitive impairment in Parkinson's disease[J]. Journal of Neu-rology,Neurosurgery&Psychiatry,2013,85(1):7-16.
[19] Foo H,Mak E,YongTT,et al. Progression of subcortical atrophyin mild Parkinson's disease and its impact on cognition[J]. Eur JNeurol,2017,24(2):341-348.
[20] Melzer TR,Watts R,Mac Askill MR,et al. Grey matter atrophyin cognitively impaired Parkinson's disease[J]. J Neurol Neuro-surg Psychiatry,2012,83(2):188-194.
[21] Mak E,Su L,Williams GB,et al. Baseline and longitudinal greymatter changes in newly diagnosed Parkinson’s disease:ICICLE-PD study[J]. Brain,2015,138(10):2974-2986.
[22] Mak E,Bergsland N,Dwyer MG,et al. Subcortical atrophy isassociated with cognitive impairment in mild Parkinson disease:acombined investigation of volumetric changes,cortical thickness,and vertex-based shape analysis[J]. AJNR,2014,35(12):2257-2264.
[23] Lewis SJ,Barker RA. Understanding the dopaminergic deficits inParkinson’s disease:Insights into disease heterogeneity[J].Journal of Clinical Neuroscience,2009,16(5):620-625.
[24] van Beilen M,Leenders KL. Putamen FDOPA uptake and its re-lationship tot cognitive functioning in PD[J]. Journal of the Neu-rological Sciences,2006,248(1-2):68-71.
[25] van Beilen M,Portman AT and Kiers HA,et al. Striatal FDOPAuptake and cognition in advanced non-demented Parkinson's dis-ease:a clinical and FDOPA-PET study[J]. Parkinsonism&Re-lated Disorders,2008,14(3):224-228.
[26] Mestres-MisséA,Rodriguez-Fornells A,Munte TF,et al. Neuraldifferences in the mapping of verb and noun concepts onto novelwords[J]. Neuro Image,2010,49(3):2826-2835.
[27] Lewis SJ,Dove A,Robbins TW,et al. Cognitive impairments inearly Parkinson's disease are accompanied by reductions in activityin frontostriatal neural circuitry[J]. J Neurosci,2003,23(15):6351-6356.
[28] Kalbe E,Rehberg SP,Heber I,et al. Subtypes of mild cognitiveimpairment in patients with Parkinson's disease:evidence from theLANDSCAPE study[J]. J Neurol Neurosurg Psychiatry,2016,87(10):1099-1105.
[29] Goldman JG,Williams-Gray C,Barker RA,et al. The spectrumof cognitive impairment in Lewy body diseases[J]. MovementDisorders,2014,29(5):608-621.
[30] Feldmann A,Illes Z and Kosztolanyi P,et al. Morphometricchanges of gray matter in Parkinson's disease with depression:avoxel-based morphometry study[J]. Mov Disord,2008,23(1):42-46.
[31] Mak E,Su L,Williams GB,et al. Baseline and longitudinal greymatter changes in newly diagnosed Parkinson's disease:ICICLE-PD study[J]. Brain,2015,138(10):2974-2986.
[32] Lee HM,Kwon KY,Kim MJ,et al. Subcortical grey matterchanges in untreated,early stage Parkinson's disease without de-mentia[J]. Parkinsonism Relat Disord,2014,20(6):622-626.
[33] Jia X,Liang P and Li Y,et al. Longitudinal study of gray matterchanges in parkinson disease[J]. AJNR,2015,36(12):2219-2226.
[2] Leroi I,Mc Donald K,Pantula H,et al. Cognitive impairment inparkinson disease:impact on quality of life,disability,and care-giver burden[J]. Journal of Geriatric Psychiatry and Neurology,2013,25(4):208-214.
[3] Litvan I,Goldman JG,Troster AI,et al. Diagnostic criteria formild cognitive impairment in Parkinson's disease:movement disor-der society task force guidelines[J]. Movement Disorders,2012,27(3):349-356.
[4] Lang A,Fahn S. Assessment of Parkinson’s disease,quantifica-tion of neurological deficit[J]. Boston:Butterworths,1989,12(2):285-309.
[5] Hoehn M,Yahr M. Parkinsonism:onset,progression and mortal-ity[J]. Neurology,1967,17(5):427-442.
[6] Tomlinson CL,Stowe R and Patel S,et al. Systematic review oflevodopa dose equivalency reporting in Parkinson's disease[J].Movement Disorders,2010,25(15):2649-2653.
[7] Lu J,Li D and Li F,et al. Montreal cognitive assessment in de-tecting cognitive impairment in chinese elderly individuals:a pop-ulation-based study[J]. Journal of Geriatric Psychiatry and Neu-rology,2012,24(4):184-190.
[8] Torbey E,Pachana NA,Dissanayaka NNW. Depression ratingscales in Parkinson's disease:a critical review updating recent lit-erature[J]. Journal of Affective Disorders,2015,184(9):216-224.
[9] Ashburner J. A fast diffeomorphic image registration algorithm[J]. Neuroimage,2007,38(1):95-113.
[10] Sawamoto N,Piccini P and Hotton G,et al. Cognitive deficitsand striato-frontal dopamine release in Parkinson's disease[J].Brain,2008,131(5):1294-1302.
[11] Ibarretxe-Bilbao N,Junque C,Marti MJ,et al. Brain structuralMRI correlates of cognitive dysfunctions in Parkinson's disease[J]. Journal of the Neurological Sciences,2011,310(1-2):70-74.
[12] Xu Y,Yang J and Hu X,et al. Voxel-based meta-analysis ofgray matter volume reductions associated with cognitive impair-ment in Parkinson’s disease[J]. Journal of Neurology,2016,263(6):1178-1187.
[13] Caspell-Garcia C,Simuni T,Tosun-Turgut D,et al. Multiplemodality biomarker prediction of cognitive impairment in prospec-tively followed de novo Parkinson disease[J]. Plos One,2017,12(5):1756-1774.
[14] Gee M,Dukart J,Draganski B,et al. Regional volumetricchange in Parkinson's disease with cognitive decline[J]. Journalof the Neurological Sciences,2017,373(2):88-94.
[15] Alexander GE,De Long MR,Strich PL,et al. Parallel organiza-tion of functionally segregated circuits linking basal ganglia andcortex[J]. Annu Rev Neurosci,1986,9(1):357-381.
[16] Zaja-Milatovic S,Milatovic D,Schantz AM,et al. Dendritic de-generation in neostriatal medium spiny neurons in Parkinson dis-ease[J]. Neurology,2005,64(3):545-547.
[17] Huot P,Levesque M,Parent A,et al. The fate of striatal dopam-inergic neurons in Parkinson's disease and Huntington's chorea[J]. Brain,2007,130(1):222-232.
[18] Lee JE,Cho KH,Song SK,et al. Exploratory analysis of neuro-psychological and neuroanatomical correlates of progressive mildcognitive impairment in Parkinson's disease[J]. Journal of Neu-rology,Neurosurgery&Psychiatry,2013,85(1):7-16.
[19] Foo H,Mak E,YongTT,et al. Progression of subcortical atrophyin mild Parkinson's disease and its impact on cognition[J]. Eur JNeurol,2017,24(2):341-348.
[20] Melzer TR,Watts R,Mac Askill MR,et al. Grey matter atrophyin cognitively impaired Parkinson's disease[J]. J Neurol Neuro-surg Psychiatry,2012,83(2):188-194.
[21] Mak E,Su L,Williams GB,et al. Baseline and longitudinal greymatter changes in newly diagnosed Parkinson’s disease:ICICLE-PD study[J]. Brain,2015,138(10):2974-2986.
[22] Mak E,Bergsland N,Dwyer MG,et al. Subcortical atrophy isassociated with cognitive impairment in mild Parkinson disease:acombined investigation of volumetric changes,cortical thickness,and vertex-based shape analysis[J]. AJNR,2014,35(12):2257-2264.
[23] Lewis SJ,Barker RA. Understanding the dopaminergic deficits inParkinson’s disease:Insights into disease heterogeneity[J].Journal of Clinical Neuroscience,2009,16(5):620-625.
[24] van Beilen M,Leenders KL. Putamen FDOPA uptake and its re-lationship tot cognitive functioning in PD[J]. Journal of the Neu-rological Sciences,2006,248(1-2):68-71.
[25] van Beilen M,Portman AT and Kiers HA,et al. Striatal FDOPAuptake and cognition in advanced non-demented Parkinson's dis-ease:a clinical and FDOPA-PET study[J]. Parkinsonism&Re-lated Disorders,2008,14(3):224-228.
[26] Mestres-MisséA,Rodriguez-Fornells A,Munte TF,et al. Neuraldifferences in the mapping of verb and noun concepts onto novelwords[J]. Neuro Image,2010,49(3):2826-2835.
[27] Lewis SJ,Dove A,Robbins TW,et al. Cognitive impairments inearly Parkinson's disease are accompanied by reductions in activityin frontostriatal neural circuitry[J]. J Neurosci,2003,23(15):6351-6356.
[28] Kalbe E,Rehberg SP,Heber I,et al. Subtypes of mild cognitiveimpairment in patients with Parkinson's disease:evidence from theLANDSCAPE study[J]. J Neurol Neurosurg Psychiatry,2016,87(10):1099-1105.
[29] Goldman JG,Williams-Gray C,Barker RA,et al. The spectrumof cognitive impairment in Lewy body diseases[J]. MovementDisorders,2014,29(5):608-621.
[30] Feldmann A,Illes Z and Kosztolanyi P,et al. Morphometricchanges of gray matter in Parkinson's disease with depression:avoxel-based morphometry study[J]. Mov Disord,2008,23(1):42-46.
[31] Mak E,Su L,Williams GB,et al. Baseline and longitudinal greymatter changes in newly diagnosed Parkinson's disease:ICICLE-PD study[J]. Brain,2015,138(10):2974-2986.
[32] Lee HM,Kwon KY,Kim MJ,et al. Subcortical grey matterchanges in untreated,early stage Parkinson's disease without de-mentia[J]. Parkinsonism Relat Disord,2014,20(6):622-626.
[33] Jia X,Liang P and Li Y,et al. Longitudinal study of gray matterchanges in parkinson disease[J]. AJNR,2015,36(12):2219-2226.