期刊
ARCHIVES OF NEUROLOGY
卷 68, 期 12, 页码 1562-1568出版社
AMER MEDICAL ASSOC
DOI: 10.1001/archneurol.2011.725
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资金
- Department of Health of the Commonwealth of Pennsylvania [SAP4100027296]
- National Institute of Neurological Disorders and Stroke (Penn Udall Center) [P50 NS053488]
- National Institute on Aging [R01-14971, P30-AG10124]
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-ofinterest 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 hippocam-pal atrophy (beta=-0.37; P=.001), and PDD patients demonstrated hippocampal (beta=-0.32; P=.004) and additional medial temporal lobe atrophy (beta=-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. Arch Neurol. 2011; 68(12):1562-1568
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