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Neuroanatomical changes in early Parkinson’s disease with mild cognitive impairment: a VBM study; the Parkinson’s Disease Cognitive Impairment Study (PaCoS)
Neurological Sciences ( IF 3.3 ) Pub Date : 2021-01-14 , DOI: 10.1007/s10072-020-05034-9
Giulia Donzuso 1 , Roberto Monastero 2 , Calogero E Cicero 1 , Antonina Luca 1 , Giovanni Mostile 1 , Loretta Giuliano 1 , Roberta Baschi 2 , Maria Caccamo 2 , Cesare Gagliardo 3 , Stefano Palmucci 4 , Mario Zappia 1 , Alessandra Nicoletti 1
Affiliation  

Introduction

Mild cognitive impairment (MCI) is common in Parkinson’s disease (PD), but the underlying pathological mechanism has not been fully understood. Voxel-based morphometry could be used to evaluate regional atrophy and its relationship with cognitive performances in early PD-MCI.

Patients and Methods

One hundred and six patients with PD were recruited from a larger cohort of patients, the Parkinson’s Disease Cognitive Impairment Study (PaCoS). Subject underwent a T1-3D MRI and a complete clinical and neuropsychological evaluation. Patients were divided into PD with normal cognition (PD-NC) and PD-MCI according to the MDS level II criteria–modified for PD-MCI. A subgroup of early patients with short disease duration (≤ 2 years) was also identified. VBM analysis between PD-NC and PD-MCI and between early PD-NC and PD-MCI was performed using two-sample t tests with whole-brain statistical threshold of p < 0.001 uncorrected in the entire PD group and p < 0.05 FWE inside ROIs, in the early PD.

Results

Forty patients were diagnosed with MCI and 66 were PD-NC. PD-MCI patients showed significant gray matter (GM) reduction in several brain regions, including frontal gyrus, precuneus, angular gyrus, temporal lobe, and cerebellum. Early PD-MCI showed reduction in GM density in superior frontal gyrus and cerebellum. Moreover, correlation analysis between neuropsychological performances and GM volume of early PD-MCI patients showed associations between performances of Raven and superior frontal gyrus volume, Stroop time and inferior frontal gyrus volume, accuracy of Barrage and volume of precuneus.

Conclusion

The detection of frontal and cerebellar atrophy, even at an early stage, could be used as an early marker of PD-related cognitive impairment.



中文翻译:

伴有轻度认知障碍的早期帕金森病的神经解剖学变化:一项 VBM 研究;帕金森病认知障碍研究 (PaCoS)

介绍

轻度认知障碍(MCI)在帕金森病(PD)中很常见,但其潜在的病理机制尚未完全清楚。基于体素的形态测量可用于评估早期 PD-MCI 的区域萎缩及其与认知表现的关系。

患者和方法

从更大的患者队列——帕金森病认知障碍研究 (PaCoS) 中招募了 106 名 PD 患者。受试者接受了 T1-3D MRI 和完整的临床和神经心理学评估。根据MDS II级标准(针对PD-MCI修改)将患者分为认知正常的PD(PD-NC)和PD-MCI。还确定了一个病程短(≤ 2 年)的早期患者亚组。PD-NC 和 PD-MCI 之间以及早期 PD-NC 和 PD-MCI 之间的 VBM 分析使用两个样本t检验进行,全脑统计阈值p  < 0.001 在整个 PD 组中未校正, 内部p < 0.05 FWE投资回报率,在早期的 PD。

结果

40 名患者被诊断为 MCI,66 名患者为 PD-NC。PD-MCI 患者在几个大脑区域显示出显着的灰质 (GM) 减少,包括额叶回、楔前叶、角回、颞叶和小脑。早期 PD-MCI 显示额上回和小脑 GM 密度降低。此外,早期 PD-MCI 患者神经心理表现与 GM 体积之间的相关性分析显示,Raven 表现与额上回体积、Stroop 时间与额下回体积、弹幕准确性和楔前叶体积之间存在关联。

结论

即使在早期阶段,额叶和小脑萎缩的检测也可用作 PD 相关认知障碍的早期标志物。

更新日期:2021-01-15
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