轻度认知功能障碍与PD患者脑结构改变的相关性

Correlation between mild cognitive impairment and brain structural changes in PD patients

目的探讨轻度认知功能障碍与帕金森病(PD)患者脑结构改变的相关性。方法选取2020-01—2023-04淮北市人民医院收治的83例PD患者为研究对象,将其分为认知功能正常组(PD-N,n=28)、轻度认知功能障碍组(PD-M,n=28)、痴呆组(PDD,n=27)。比较各组患者MoCA评分、汉密尔顿抑郁量表、睡眠质量、疲劳严重度、脑叶萎缩评分、运动症状与非运动症状评分。结果PD-N组MoCA评分(26.34±2.15)、睡眠质量评分(7.25±1.67)高于PD-M组与PDD组,PD-M组MoCA评分(20.46±3.23)、睡眠质量评分(4.68±1.19)高于PDD组(P<0.05);PD-N组汉密尔顿抑郁量表评分(12.82±4.34)、疲劳严重度评分(3.13±0.81)低于PD-M组与PDD组,PD-M组汉密尔顿抑郁量表评分(18.67±5.20)、疲劳严重度评分(4.68±1.19)低于PDD组(P<0.05)。PD-N组前额叶萎缩评分(1.21±0.45)、颞叶萎缩评分(1.13±0.37)、顶叶萎缩评分(1.06±0.24)、枕叶萎缩评分(1.05±0.26)低于PD-M组与PDD组(P<0.05),PD-M组前额叶萎缩评分(1.84±0.56)、颞叶萎缩评分(1.62±0.48)、顶叶萎缩评分(1.49±0.31)、枕叶萎缩评分(1.43±0.37)低于PDD组(P<0.05)。PD-N组运动症状评分(18.52±6.24)、非运动症状评分(24.39±7.15)低于PD-M组与PDD组(P<0.05)。结论轻度认知功能障碍与PD患者的脑结构改变存在显著相关性。随着PD患者认知功能障碍的加重,其脑结构改变的程度也相应增加,这可能进一步加剧了认知功能的衰退,这一发现对于深入理解PD的病理生理机制以及早期识别和治疗PD患者的认知功能障碍具有重要意义。

Objective To investigate the correlation between mild cognitive impairment(MCI)and brain structural changes in patients with Parkinson’s disease(PD).Methods A total of 83 PD patients admitted to Huaibei People’s Hospital from January 2020 to April 2023 were selected as the research objects,and they were divided into normal cognitive function group(PD-N,n=28),mild cognitive impairment group(PD-M,n=28),and dementia group(PDD,n=27).The scores of MoCA,Hamilton depression scale,sleep quality,fatigue severity,lobar atrophy score,motor symptoms and non-motor symptoms were compared between the groups.Results The MoCA score(26.34±2.15)and sleep quality score(7.25±1.67)in the PD-N group were higher than those in the PD-M group and PDD group,and the MoCA score(20.46±3.23)and sleep quality score(4.68±1.19)in the PD-M group were higher than those in the PDD group(P<0.05).The Hamilton depression scale score(12.82±4.34)and fatigue severity score(3.13±0.81)in PD-N group were lower than those in PD-M group and PDD group.The Hamilton depression scale score(18.67±5.20)and fatigue severity score(4.68±1.19)in the PD-M group were lower than those in the PDD group(P<0.05).The scores of prefrontal lobe atrophy(1.21±0.45),temporal lobe atrophy(1.13±0.37),parietal lobe atrophy(1.06±0.24)and occipital lobe atrophy(1.05±0.26)in PD-N group were lower than those in PD-M group and PDD group(P<0.05).PD-M group of frontal lobe atrophy score(1.84±0.56),temporal lobe atrophy score(1.62±0.48),the parietal lobe atrophy score(1.49±0.31),occipital lobe atrophy score(1.43±0.37)below the PDD group(P<0.05).The scores of motor symptoms(18.52±6.24)and non-motor symptoms(24.39±7.15)in the PD-N group were lower than those in the PD-M and PDD groups(P<0.05).Conclusion There is a significant correlation between mild cognitive dysfunction and brain structure changes in PD patients.With the aggravation of cognitive dysfunction in PD patients,the degree of brain structural changes increases correspondingly,which may further aggravate the decline of cognitive function.This finding is of great significance for in-depth understanding of the pathophysiological mechanism of PD as well as early identification and treatment of cognitive dysfunction in PD patients.