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目的 研究帕金森病 (PD)患者认知障碍及脑代谢特点。 方法 对 35例PD患者及年龄、性别、受教育程度相匹配的 32例对照组进行脑1 8F 脱氧葡萄糖正电子发射计算机断层 (1 8F FDGPET)、中国修订韦氏成人智力量表 (WAIS RC)、简易精神状态检测法 (MMSE)及磁共振 (MRI)检查。 结果 PD组WAIS RC的操作智商 (PIQ)为 81 73± 10 15、言语智商 (VIQ) 78 32± 10 10、总智商(FIQ) 78 77± 10 10及MMSE 2 0 4 0± 6 4 1,较对照组显著减退 (P <0 0 1)。PD组PIQ、知觉组织因子(17 14± 7 4 5 )、记忆不分心因子 (16 2 3± 6 0 2 )降低较VIQ、言语理解因子 (2 6 0 0± 9 0 0 )明显 (P <0 0 1)。PD组黑质 纹状体系统及大脑皮质代谢较对照组的下降 (P <0 0 1) ,认知障碍重者脑代谢下降更显著。 结论 PD患者存在认知障碍 ,操作能力及记忆障碍尤著 ,可能与黑质 纹状体系统及大脑代谢障碍有关 ,PET为PD脑功能评价提供一个客观指标。
Objective To study the cognitive impairment and brain metabolism in patients with Parkinson’s disease (PD). Methods Thirty-five control subjects with PD and age, sex and education level underwent 18F FDG PETET, WAIS RC (Chinese Revised Webster Adult Intelligence Scale) , Simple mental state test (MMSE) and magnetic resonance imaging (MRI). Results The PIQ of WAIS RC in the PD group was 81 73 ± 10 15, VIQ 78 32 ± 10 10, FIQ 78 77 ± 10 10 and MMSE 2 0 4 0 ± 6 4 1, Which was significantly lower than that of the control group (P <0.01). PIQ in conscious group (17 14 ± 7 45), memory indifferent factor (16 2 3 ± 6 0 2) decreased significantly compared with VIQ, and speech comprehension factor (26 0 0 ± 9 0 0) significantly (P <0 0 1). Metabolism of nigrostriatum and cerebral cortex in PD group was lower than that in control group (P <0.01), and the decline of brain metabolism was more significant in severe cognitive impairment. Conclusions There is cognitive impairment, operational ability and memory impairment in PD patients, which may be related to the nigrostriatal system and cerebral metabolic disorders. PET provides an objective index for PD brain function evaluation.