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Progressive brain atrophy in Parkinson's disease patients who convert to mild cognitive impairment.
CNS Neuroscience & Therapeutics ( IF 5.5 ) Pub Date : 2019-07-06 , DOI: 10.1111/cns.13188
Cheng Zhou 1 , Xiao-Jun Guan 1 , Tao Guo 1 , Qiao-Ling Zeng 1 , Ting Gao 2 , Pei-Yu Huang 1 , Min Xuan 1 , Quan-Quan Gu 1 , Xiao-Jun Xu 1 , Min-Ming Zhang 1
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AIMS Cognitive impairment is a common symptom in the trajectory of Parkinson's disease (PD). However, the pathological underpinning is not fully known. We aimed to explore the critical structural alterations in the process of cognitive decline and its relationships with the dopaminergic deficit and the level of related cerebrospinal fluid (CSF) proteins. METHODS Ninety-four patients with PD and 32 controls were included in this study. Neuropsychological tests were performed at baseline and after 28 months to identify which patients had normal cognition and which ones developed PD-MCI after follow-up ("converters"). Gray matter atrophy was assessed in cross-sectional and longitudinal analyses, respectively. The associations between altered GMV with dopamine transporter (DAT) results and the level of CSF proteins were assessed. RESULTS Among the 94 patients with normal cognition at baseline, 24 (mean age, 63.1 years) developed PD-MCI after 28 months of follow-up, and 70 (mean age, 62.3 years) remained nonconverters. The converters showed significant right temporal atrophy at baseline and extensive atrophy in temporal lobe at follow-up. Progressive bilateral frontal lobe atrophy was found in the converters. Baseline right temporal atrophy was correlated with the striatal dopaminergic degeneration in the converters. No correlation was found between the right temporal atrophy and the alterations of CSF proteins. CONCLUSION Early atrophy in temporal lobes and progressive atrophy in frontal lobes might be a biomarker for developing multidomain impairment of cognition and converting to PD-MCI. Furthermore, cognition-related temporal atrophy might be associated with dopaminergic deficit reflected by DAT scan but independent of CSF proteins in patients with PD who convert to PD-MCI.

中文翻译:

帕金森氏病患者的进行性脑萎缩症可转变为轻度认知障碍。

目的认知障碍是帕金森氏病(PD)轨迹中的常见症状。但是,病理基础尚不完全清楚。我们旨在探讨认知能力下降过程中的关键结构改变及其与多巴胺能缺陷和相关脑脊液(CSF)蛋白水平的关系。方法这项研究包括94例PD患者和32例对照。在基线和28个月后进行了神经心理学测试,以识别哪些患者的认知正常,以及哪些患者在随访后出现了PD-MCI(“转化者”)。灰质萎缩分别在横断面和纵向分析中进行评估。评估了GMV改变与多巴胺转运蛋白(DAT)结果与CSF蛋白水平之间的关联。结果94例基线时认知正常的患者中,有24例(平均年龄,63.1岁)在随访28个月后发展为PD-MCI,而70例(平均年龄,62.3岁)仍未转变。转换器在基线时显示明显的右颞萎缩,在随访时显示颞叶广泛萎缩。在转换器中发现进行性双侧额叶萎缩。基线右颞萎缩与转换器中的纹状体多巴胺能变性有关。在右颞萎缩和脑脊液蛋白的变化之间没有发现相关性。结论颞叶的早期萎缩和额叶的进行性萎缩可能是发展认知多域障碍并转化为PD-MCI的生物标志物。此外,
更新日期:2019-11-18
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