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早期帕金森病伴轻度认知障碍的认知表现与多巴胺转运体成像:一项初步研究。

Cognitive performances and DAT imaging in early Parkinson's disease with mild cognitive impairment: a preliminary study.

作者信息

Pellecchia M T, Picillo M, Santangelo G, Longo K, Moccia M, Erro R, Amboni M, Vitale C, Vicidomini C, Salvatore M, Barone P, Pappatà S

机构信息

Center for Neurodegenerative Diseases, University of Salerno, Salerno, Italy.

出版信息

Acta Neurol Scand. 2015 May;131(5):275-81. doi: 10.1111/ane.12365. Epub 2015 Feb 3.

Abstract

OBJECTIVES

Mild cognitive impairment (MCI) is a common feature in Parkinson's disease (PD). We performed an exploratory study to investigate dopaminergic nigrostriatal innervation and its cognitive correlates in early untreated PD patients with MCI as compared to cognitively intact patients.

PATIENTS AND METHODS

A consecutive series of 34-de-novo, drug-naïve patients with PD were enrolled. They underwent [123-I] FP-CIT SPECT and comprehensive neuropsychological battery. MCI was identified in 15 of 34 patients with PD.

RESULTS

The two groups did not show any statistically significant difference in age, sex, disease duration, education, lateralization, and H&Y and Hospital Anxiety and Depression Scale scores. Logistic regression analysis showed that UPDRS-III was weakly associated with MCI (P = 0.034). Partial correlation analysis controlling for UPDRS-III and age suggested that in PD patients with MCI reduced V3″ values in the more affected caudate were correlated with reduced performances in frontal assessment battery, Trail Making Test: part B minus Part A and copy task of the Rey-Osterrieth complex figure test. Reduced V3″ values in the more and less affected putamen were significantly related with reduced performance in frontal assessment battery and in copy task of Rey-Osterrieth complex figure test, respectively. No correlation was found between neuropsychological scores and DAT availability in PD patients without MCI.

CONCLUSIONS

Although preliminary, our results suggest that striatal dopamine depletion may contribute to some cognitive deficit in early never treated PD patients with MCI.

摘要

目的

轻度认知障碍(MCI)是帕金森病(PD)的常见特征。我们进行了一项探索性研究,以调查未经治疗的早期PD伴MCI患者与认知功能正常患者相比的多巴胺能黑质纹状体神经支配及其认知相关性。

患者与方法

连续纳入34例初发、未用药的PD患者。他们接受了[123-I] FP-CIT单光子发射计算机断层扫描(SPECT)和全面的神经心理测试。34例PD患者中有15例被诊断为MCI。

结果

两组在年龄、性别、病程、教育程度、病变侧别、Hoehn-Yahr分级以及医院焦虑抑郁量表评分方面均无统计学显著差异。逻辑回归分析显示,统一帕金森病评定量表第三部分(UPDRS-III)与MCI弱相关(P = 0.034)。控制UPDRS-III和年龄后的偏相关分析表明,在PD伴MCI患者中,患侧尾状核V3″值降低与额叶评估量表、连线测验B减去A部分以及雷-奥斯特里赫复杂图形测验临摹任务的表现降低相关。患侧和未患侧壳核V3″值降低分别与额叶评估量表和雷-奥斯特里赫复杂图形测验临摹任务的表现降低显著相关。在无MCI的PD患者中,未发现神经心理评分与多巴胺转运体(DAT)可用性之间存在相关性。

结论

尽管是初步结果,但我们的研究结果表明,纹状体多巴胺耗竭可能导致未经治疗的早期PD伴MCI患者出现一些认知缺陷。

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