Study on the relationship between cognitive function and leukoaraiosis in different brain region of patients with Parkinson's disease
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摘要: 目的 探讨帕金森病(Parkinson's disease,PD)患者不同脑区白质疏松(leukoaraiosis,LA)对认知功能的影响。 方法 收集2015年1月—2017年1月于温州医科大学附属第一医院神经内科住院的PD患者87例,采用MMSE和MoCA量表评估认知功能。运用UPDRS-Ⅲ评价PD患者运动功能,Hoehn-Yahr分期进行病情分级。根据认知评分和诊断标准,将PD患者分为3组:认知功能正常组(PD-NC)、轻度认知功能障碍组(PD-MCI)和痴呆组(PD-D),入组者均行头颅MRI (3.0 T)检查,运用Scheltens量表对侧脑室旁、深部白质评分。 结果 3组间不同部位白质疏松比较,额叶、深部白质、侧脑室旁、LA总分差异有统计学意义(均P<0.05)。顶叶、枕叶、颞叶、基底节、幕下白质疏松评分差异无统计学意义(均P>0.05),PD-MCI组与PD-NC组相比较,额叶LA评分差异有统计学意义。侧脑室旁LA评分PD-D组与其余两组相比较,差异有统计学意义。回归分析结果显示,MMSE与教育程度(P<0.001)、H-Y分期(P=0.008)、深部白质(P<0.001)显著相关,教育程度呈正相关,H-Y分期和深部白质呈负相关。MMSE与深部白质关系最显著(β=-1.034)。 结论 PD认知功能与LA具有相关性,尤其是额叶、深部白质,PD患者MMSE与深部白质关系最为显著。Abstract: Objective To investigate the effect of leukoaraiosis (LA) in different brain regions on cognitive function in patients with Parkinson's disease (PD). Methods A total of 87 patients with PD hospitalized in the Department of Neurology of the First Affiliated Hospital of Wenzhou Medical University from 2015 to 2017 were enrolled in the study. The cognitive function was evaluated by MMSE and MoCA Scale. UPDRS-Ⅲ was used to evaluate the motor function and Hoehn-Yahr staging was used to judge the grade of illness. According to the cognitive scoring and diagnostic criteria, PD patients were divided into 3 groups:normal cognitive function group (PD-NC), mild cognitive impairment group (PD-MCI) and dementia group (PD-D). All the patients completed head MRI (3.0T) examination, and the Scheltens scale was used to evaluate the lateral and deep white matter. Results Comparison of leukoaraiosis in different parts of three groups, there were significant difference in total score of LA and LA scores in the frontal lobe, deep white matter, lateral ventricle (all P<0.05). Meanwhile there were no significant difference in LA scores in the parietal lobe, occipital lobe, temporal lobe, basal ganglia and infratentorial and white matter (all P>0.05). There was significant difference in LA scores of frontal lobe between the PD-MCI group and PD-NC group. There was significant difference in the LA scores of the lateral ventricle between PD-D group and the other two groups. Regression analysis showed that MMSE was significantly correlated with education level (P<0.001), H-Y stage (P=0.008), and deep white matter (P<0.001), in which education level was positively correlated, and H-Y stage and deep white matter were negatively correlated. MMSE was most significant with the deep white matter (β=-1.034). Conclusion There is a correlation between cognitive function of PD and LA, especially in the frontal lobe and deep white matter. The relationship between MMSE and the deep white matter in PD patients is the most significant.
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Key words:
- Parkinson's disease /
- Cognitive function /
- Leukoaraiosis
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