Objective To explore a possible relation between the changes of cortical thickness and cognitive deficits in patients with Parkinson's disease(PD).Methods Sixty-two patients with PD were enrolled in the department of neurology of Guangdong General Hospital from 2015-08 to 2017-08 and they were divided into PD patients with cognitive impairment(MoCA≤26,PD-CI)and PD patients with normal cognition(MoCA>26,PD-NC)according to MoCA scores.Twenty-six age and sex-matched healthy controls were also included in the study.General clinical materials, MRIs and neuropsychological evaluation of all the subjects were collected.We used Freesurfer software and voxel-based morphometry to investigate the pattern of cortical atrophy.Results Compared to the PD-NC patients,cortical atrophy in PD-CI patients were found in the precuneus,superior temporal gyrus,fusiform gyrus,inferior temporal gyrus,rostral anterior cingulate cortex, pars opercularis of the left cerebral hemisphere and supramarginal gyrus of right cerebral hemisphere;especially in the left precuneus,left rostral anterior cingulate gyrus and left inferior temporal gyrus(P < 0.05). Moreover,we found significant positive correlations between mean cortical thickness(MCT)of left precuneus and scores of visuospatial and executive function(r=0.27,P=0.034),MCT of left rostral anterior cingulate gyrus and scores of abstract(r=0.31,P=0.015),and MCT of left superior temporal gyrus and abstract(r=0.25,P= 0.048)or delayed recall(r= 0.26, P= 0.046).Conclusions MCT of many brain regions in patients with PD-CI significantly decreased and MCT of the ROIs had a positive and significant association with cognitive function,which provides imaging markers in the early diagnosis of PD-CI.%目的 探讨早期帕金森病(PD)患者脑部皮层厚度改变与认知功能障碍(cognitive impairment,CI)的相关性.方法 收集2015-08—2017-08广东省人民医院神经内科就诊的 PD患者62例,根据蒙特利尔认知量表(MoCA)评分将患者分为PD伴CI组(MoCA≤26分,PD-CI组)和PD未伴CI组(MoCA>26分,PD-NC组).另选择26名年龄、性别相匹配的健康对照者,收集所有受试者一般临床资料、脑M RI图像资料以及神经心理学评估结果.利用FreeSurfer软件和基于体素(VBM)的方法观察 PD患者大脑皮层厚度改变情况,及其与CI的相关性.结果 与PD-NC组相比,PD-CI组在左侧的楔前叶、颞上回、梭状回、颞下回、前喙扣带回、额下回岛盖部及右侧缘上回出现皮层厚度减少,且左侧的楔前叶、前喙扣带回、颞下回三个脑区平均皮层厚度(MCT)显著减少(P<0.05).PD患者左侧楔前叶的MCT 与视空间与执行功能(r=0.27,P=0.034)、左侧前喙扣带回的MCT与抽象(r=0.31,P=0.015)、左侧颞下回的MCT与抽象(r=0.25,P=0.048)、左侧颞下回的MCT和延迟回忆(r=0.26,P=0.046)存在显著正相关.结论 PD-CI患者多个脑区的皮层厚度显著变薄,且这些脑区的皮层厚度与认知功能存在正相关,其可能成为PD-CI早期诊断的影像学标记物.
展开▼
