■帕金森病认知评定量表(PD-CRS)是一种广泛使用的工具,用于检测帕金森病(PD)患者的轻度认知障碍(MCI),然而,这项测试结果的神经解剖学基础需要澄清。这项研究的目的是:(a)调查表现出轻度认知障碍(PD-MCI)的PD患者和那些保持认知能力(PD-IC)的患者之间的皮质体积(CVol)和皮质厚度(CTh)差异;和(b)确定整体PD-CRS表现的磁共振成像(MRI)的结构相关性,包括它的子测试分数,在非痴呆PD队列中。
■这项研究涉及51名患有Hoehn和YahrI-II期的PD患者,分为两组:PD-IC(n=36)和PD-MCI(n=15)。认知筛查评估使用PD-CRS和蒙特利尔认知评估(MoCA)。PD-MCI分类符合运动障碍协会工作队的标准,纳入广泛的神经心理学评估。使用FreeSurfer确定大脑形态与认知表现之间的相互关系。
■对整个大脑的顶点分析显示,在2,934mm2的集群内,CVol显着减少,包括顶叶和颞区,相对于PD-IC组,PD-MCI组。较低的PD-CRS总分与中额叶CVol降低相关,上颞叶,下顶叶,和扣带回皮质。持续注意和时钟绘制的PD-CRS子测试与不同区域的皮质变薄有关:时钟绘制子测试与顶叶的变化相关,脑岛,和上颞叶皮层形态;而PD-CRS额叶-皮质下评分与横颞叶的CTh呈正相关,内侧眶额,上颞叶,precuneus,梭形,和上边缘区域。此外,用于语义和交替言语流畅性的PD-CRS子测试与眶额的CTh变化有关,temporal,梭形,脑岛,和前中央区域。
■PD-CRS表现反映了广泛的额颞顶区的神经解剖学变化,覆盖外侧和内侧皮质表面,在没有痴呆的PD患者中。观察到的与该认知筛查工具相关的CVol和CTh的变化表明它们作为PD认知下降的替代标志物的潜力。这些发现值得在涉及独立患者队列的多中心研究中进一步探索和验证。
UNASSIGNED: The Parkinson\'s Disease-Cognitive Rating Scale (PD-CRS) is a widely used tool for detecting mild cognitive impairment (MCI) in Parkinson\'s Disease (PD) patients, however, the neuroanatomical underpinnings of this test\'s outcomes require clarification. This study aims to: (a) investigate cortical volume (CVol) and cortical thickness (CTh) disparities between PD patients exhibiting mild cognitive impairment (PD-MCI) and those with preserved cognitive abilities (PD-IC); and (b) identify the structural correlates in magnetic resonance imaging (MRI) of overall PD-CRS performance, including its subtest scores, within a non-demented PD cohort.
UNASSIGNED: This study involved 51 PD patients with Hoehn & Yahr stages I-II, categorized into two groups: PD-IC (n = 36) and PD-MCI (n = 15). Cognitive screening evaluations utilized the PD-CRS and the Montreal Cognitive Assessment (MoCA). PD-MCI classification adhered to the Movement Disorder Society Task Force criteria, incorporating extensive neuropsychological assessments. The interrelation between brain morphology and cognitive performance was determined using FreeSurfer.
UNASSIGNED: Vertex-wise analysis of the entire brain demonstrated a notable reduction in CVol within a 2,934 mm2 cluster, encompassing parietal and temporal regions, in the PD-MCI group relative to the PD-IC group. Lower PD-CRS total scores correlated with decreased CVol in the middle frontal, superior temporal, inferior parietal, and cingulate cortices. The PD-CRS subtests for Sustained Attention and Clock Drawing were associated with cortical thinning in distinct regions: the Clock Drawing subtest correlated with changes in the parietal lobe, insula, and superior temporal cortex morphology; while the PD-CRS frontal-subcortical scores presented positive correlations with CTh in the transverse temporal, medial orbitofrontal, superior temporal, precuneus, fusiform, and supramarginal regions. Additionally, PD-CRS subtests for Semantic and Alternating verbal fluency were linked to CTh changes in orbitofrontal, temporal, fusiform, insula, and precentral regions.
UNASSIGNED: PD-CRS performance mirrors neuroanatomical changes across extensive fronto-temporo-parietal areas, covering both lateral and medial cortical surfaces, in PD patients without dementia. The observed changes in CVol and CTh associated with this cognitive screening tool suggest their potential as surrogate markers for cognitive decline in PD. These findings warrant further exploration and validation in multicenter studies involving independent patient cohorts.