Neurodegeneration Across Stages of Cognitive Decline in Parkinson Disease

萎缩 颞叶 白质 痴呆 帕金森病 心理学 海马结构 神经科学 神经退行性变 磁共振成像 认知功能衰退 基于体素的形态计量学 内科学 医学 病理 心脏病学 听力学 疾病 放射科 癫痫
作者
Daniel Weintraub,Jimit Doshi,Deepthi Koka,Christos Davatzikos,Andrew Siderowf,John E. Duda,David A. Wolk,Paul J. Moberg,Sharon X. Xie,Christopher M. Clark
出处
期刊:Archives of neurology [American Medical Association]
卷期号:68 (12): 1562-1562 被引量:182
标识
DOI:10.1001/archneurol.2011.725
摘要

Objective

To assess regions and patterns of brain atrophy in patients with Parkinson disease (PD) with normal cognition (PD-NC), mild cognitive impairment (PD-MCI), and dementia-level cognitive deficits (PDD).

Design

Images were quantified using a region-of-interest approach and voxel-based morphometry analysis. We used a high-dimensional pattern classification approach to delineate brain regions that collectively formed the Spatial Pattern of Abnormalities for Recognition of PDD.

Setting

The Parkinson's Disease and Movement Disorders Center at the University of Pennsylvania.

Subjects

Eighty-four PD patients (61 PD-NC, 12 PD-MCI, and 11 PDD) and 23 healthy control subjects (HCs) underwent magnetic resonance imaging of the brain.

Results

The PD-NC patients did not demonstrate significant brain atrophy compared with HCs. Compared with PD-NC patients, PD-MCI patients had hippocampal atrophy (β = −0.37; P = .001), and PDD patients demonstrated hippocampal (β = −0.32; P = .004) and additional medial temporal lobe atrophy (β = −0.36; P = .003). The PD-MCI patients had a different pattern of atrophy compared with PD-NC patients (P = .04) and a similar pattern to that of PDD patients (P = .81), characterized by hippocampal, prefrontal cortex gray and white matter, occipital lobe gray and white matter, and parietal lobe white matter atrophy. In nondemented PD patients, there was a correlation between memory-encoding performance and hippocampal volume.

Conclusions

Hippocampal atrophy is a biomarker of initial cognitive decline in PD, including impaired memory encoding and storage, suggesting heterogeneity in the neural substrate of memory impairment. Use of a pattern classification approach may allow identification of diffuse regions of cortical gray and white matter atrophy early in the course of cognitive decline.
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