Neural Substrates of Cognitive Subtypes in Parkinson%26apos;s Disease: A 3-Year Longitudinal Study

作者：Shoji Yumiko; Nishio Yoshiyuki^*; Baba Toru; Uchiyama Makoto; Yokoi Kayoko; Ishioka Toshiyuki; Hosokai Yoshiyuki; Hirayama Kazumi; Fukuda Hiroshi; Aoki Masashi; Hasegawa Takafumi; Takeda Atsushi; Mori Etsuro

来源：PLos One, 2014, 9(10): e110547.

DOI：10.1371/journal.pone.0110547

Background: The neuropsychological features and neuropathological progression patterns associated with rapidly evolving cognitive decline or dementia in Parkinson%26apos;s disease (PD) remain to be elucidated. %26lt;br%26gt;Methods: Fifty-three PD patients without dementia were recruited to participate in a 3-year longitudinal cohort study. The patients were grouped according to the Clinical Dementia Rating (CDR). Group-wise comparisons were made with regard to demographic characteristics, motor symptoms, neuropsychological performances and 18F-fluorodeoxyglucose positron emission tomography. %26lt;br%26gt;Results: Patients who had memory-plus cognitive impairment (patients whose CDR was 0 at baseline and 0.5 in memory and other domains at follow-up, and those whose baseline CDR was 0.5 in memory and other domains) exhibited higher age at onset, visuoperceptual impairment, non-tremor-dominant motor disturbance, rapid symptomatic progression and posterior neocortical hypometabolism. In patients who were cognitively unimpaired and those who had memory-dominant cognitive impairment (patients whose CDR was 0 at baseline and 0.5 only in memory domain at follow-up, and those whose baseline CDR was 0.5 only in memory domain), the posterior neocortex was relatively unaffected until a later stage of the disease. %26lt;br%26gt;Conclusions: These results suggest that visuoperceptual impairment and the early involvement of the posterior neocortex may be risk factors for rapid symptomatic progression and dementia in PD.

• 出版日期2014-10-20