纹状体多巴胺耗竭对初发帕金森病认知的影响。
Effect of striatal dopamine depletion on cognition in de novo Parkinson's disease.
机构信息
Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea.
Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
出版信息
Parkinsonism Relat Disord. 2018 Jun;51:43-48. doi: 10.1016/j.parkreldis.2018.02.048. Epub 2018 Mar 2.
INTRODUCTION
To investigate the relationship between the sub-regional pattern of striatal dopamine depletion and cognitive impairment in early-stage Parkinson's disease (PD), and determine the effect of striatal dopamine density on cognitive prognosis.
METHODS
Patients with drug-naïve non-demented PD were divided into mild cognitive impairment (PD-MCI; n = 129) and cognitively normal (PD-CogN; n = 182) groups. Using quantification of the dopamine transporter (DAT) availability in each striatal sub-region with F-FP-CIT PET scans, we performed inter-group comparative analysis of DAT availability and multivariate linear regression analysis to assess the association between DAT availability and cognitive performance. Additionally, the effect of baseline DAT availability on the cognitive decline across time as well as on changes in the cognitive status was estimated.
RESULTS
The PD-MCI group exhibited more severely decreased DAT availability in all the striatal sub-regions compared to the PD-CogN group, although there was no significant difference in PD duration. The DAT availability in the caudate, anterior putamen, and ventral striatum was directly associated with attention/working memory, frontal/executive, and visuospatial functions, while the DAT availability of the posterior putamen was not. However, the baseline DAT availability of the striatal sub-regions did not influence the cognitive decline or cognitive status in the longitudinal cognitive assessment.
CONCLUSION
Our results suggest that striatal DAT availability may determine MCI in patients with de novo PD. Dopamine loss in the associative and limbic striatum is closely linked to cognitive deficits in early-stage PD, although it does not affect cognitive prognosis.
介绍
为了研究早期帕金森病（PD）患者纹状体多巴胺耗竭的亚区模式与认知障碍的关系，并确定纹状体多巴胺密度对认知预后的影响。
方法
将未经药物治疗的非痴呆性 PD 患者分为轻度认知障碍（PD-MCI；n=129）和认知正常（PD-CogN；n=182）两组。使用 F-FP-CIT PET 扫描定量每个纹状体亚区的多巴胺转运体（DAT）可用性，我们对 DAT 可用性进行组间比较分析，并进行多元线性回归分析，以评估 DAT 可用性与认知表现之间的关系。此外，还估计了基线 DAT 可用性对随时间推移的认知下降以及对认知状态变化的影响。
结果
与 PD-CogN 组相比，PD-MCI 组所有纹状体亚区的 DAT 可用性均明显降低，尽管 PD 病程无显著差异。尾状核、前壳核和腹侧纹状体的 DAT 可用性与注意力/工作记忆、额叶/执行功能和视空间功能直接相关，而后壳核的 DAT 可用性则无相关性。然而，纹状体亚区的基线 DAT 可用性并不影响纵向认知评估中的认知下降或认知状态。
结论
我们的研究结果表明，纹状体 DAT 可用性可能决定了新发 PD 患者的 MCI。在早期 PD 中，联合和边缘纹状体的多巴胺丢失与认知缺陷密切相关，尽管它不会影响认知预后。
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