Abstract：
BACKGROUND: Although locus coeruleus (LC) has been demonstrated to play a critical role in the cognitive function of Parkinson\'s disease (PD), the underlying mechanism has not been elucidated. The objective was to investigate the relationship among LC degeneration, cognitive performance, and the glymphatic function in PD.
METHODS: In this retrospective study, 71 PD subjects (21 with normal cognition; 29 with cognitive impairment (PD-MCI); 21 with dementia (PDD)) and 26 healthy controls were included. All participants underwent neuromelanin-sensitive magnetic resonance imaging (NM-MRI) and diffusion tensor image scanning on a 3.0 T scanner. The brain glymphatic function was measured using diffusion along the perivascular space (ALPS) index, while LC degeneration was estimated using the NM contrast-to-noise ratio of LC (CNRLC).
RESULTS: The ALPS index was significantly lower in both the whole PD group (P = 0.04) and the PDD subgroup (P = 0.02) when compared to the controls. Similarly, the CNRLC was lower in the whole PD group (P < 0.001) compared to the controls. In the PD group, a positive correlation was found between the ALPS index and both the Montreal Cognitive Assessment (MoCA) score (r = 0.36; P = 0.002) and CNRLC (r = 0.26; P = 0.03). Mediation analysis demonstrated that the ALPS index acted as a significant mediator between CNRLC and the MoCA score in PD subjects.
CONCLUSIONS: The ALPS index, a neuroimaging marker of glymphatic function, serves as a mediator between LC degeneration and cognitive function in PD.
METHODS: In this retrospective study, 71 PD subjects (21 with normal cognition; 29 with cognitive impairment (PD-MCI); 21 with dementia (PDD)) and 26 healthy controls were included. All participants underwent neuromelanin-sensitive magnetic resonance imaging (NM-MRI) and diffusion tensor image scanning on a 3.0 T scanner. The brain glymphatic function was measured using diffusion along the perivascular space (ALPS) index, while LC degeneration was estimated using the NM contrast-to-noise ratio of LC (CNRLC).
RESULTS: The ALPS index was significantly lower in both the whole PD group (P = 0.04) and the PDD subgroup (P = 0.02) when compared to the controls. Similarly, the CNRLC was lower in the whole PD group (P < 0.001) compared to the controls. In the PD group, a positive correlation was found between the ALPS index and both the Montreal Cognitive Assessment (MoCA) score (r = 0.36; P = 0.002) and CNRLC (r = 0.26; P = 0.03). Mediation analysis demonstrated that the ALPS index acted as a significant mediator between CNRLC and the MoCA score in PD subjects.
CONCLUSIONS: The ALPS index, a neuroimaging marker of glymphatic function, serves as a mediator between LC degeneration and cognitive function in PD.
摘要：
背景：尽管蓝斑（LC）已被证明在帕金森病（PD）的认知功能中起关键作用，潜在的机制尚未阐明。目的是探讨LC变性之间的关系，认知表现，和PD中的淋巴功能。
方法：在这项回顾性研究中，包括71名PD受试者（21名认知正常；29名认知障碍（PD-MCI）；21名痴呆（PDD））和26名健康对照。所有参与者在3.0T扫描仪上接受了神经黑色素敏感磁共振成像（NM-MRI）和扩散张量图像扫描。使用沿血管周围间隙扩散（ALPS）指数测量脑淋巴功能，而LC变性是使用LC的NM对比噪声比(CNRLC)来估计的。
结果：与对照组相比，整个PD组（P=0.04）和PDD亚组（P=0.02）的ALPS指数均显着降低。同样，与对照组相比，整个PD组的CNRLC较低（P<0.001）。在PD组，ALPS指数与蒙特利尔认知评估(MoCA)评分(r=0.36;P=0.002)和CNRLC评分(r=0.26;P=0.03)呈正相关.中介分析表明，ALPS指数在PD受试者的CNRLC和MoCA评分之间起重要的中介作用。
结论：ALPS指数，一个神经成像标记的淋巴淋巴功能，在PD中充当LC变性和认知功能之间的中介。
方法：在这项回顾性研究中，包括71名PD受试者（21名认知正常；29名认知障碍（PD-MCI）；21名痴呆（PDD））和26名健康对照。所有参与者在3.0T扫描仪上接受了神经黑色素敏感磁共振成像（NM-MRI）和扩散张量图像扫描。使用沿血管周围间隙扩散（ALPS）指数测量脑淋巴功能，而LC变性是使用LC的NM对比噪声比(CNRLC)来估计的。
结果：与对照组相比，整个PD组（P=0.04）和PDD亚组（P=0.02）的ALPS指数均显着降低。同样，与对照组相比，整个PD组的CNRLC较低（P<0.001）。在PD组，ALPS指数与蒙特利尔认知评估(MoCA)评分(r=0.36;P=0.002)和CNRLC评分(r=0.26;P=0.03)呈正相关.中介分析表明，ALPS指数在PD受试者的CNRLC和MoCA评分之间起重要的中介作用。
结论：ALPS指数，一个神经成像标记的淋巴淋巴功能，在PD中充当LC变性和认知功能之间的中介。
