Dement Neurocogn Disord.  2016 Dec;15(4):147-152. 10.12779/dnd.2016.15.4.147.

Longitudinal Cerebral Perfusion Changes in Parkinson's Disease with Subjective Cognitive Impairment

• Jeong HS
• Oh E
• Park JS
• Chung YA
• Park S
• Yang Y
• Song IU

• KMID: 2442841
• DOI: http://doi.org/10.12779/dnd.2016.15.4.147

Abstract

BACKGROUND AND PURPOSE
Although subjective cognitive impairment (SCI) is often accompanied by Parkinson's disease (PD) and may predict the development of mild cognitive impairment or dementia, longitudinal brain perfusion changes in PD patients with SCI remain to be elucidated. The current prospective study examined cerebral perfusion changes in PD patients with SCI using technetium-99m hexamethylpropylene amine oxime single photon emission computed tomography (SPECT).
METHODS
Among 53 PD patients at baseline, 30 patients were classified into the PD with SCI group and 23 patients were assigned to the PD without SCI group. The mean follow-up interval was 2.3±0.9 years. The Mini-Mental State Examination, Clinical Dementia Rating, and Global Deterioration Scale were used to assess impairments in cognitive function. Brain SPECT images were acquired at baseline and follow-up.
RESULTS
Significant differences between the two groups were not found for demographic variables, PD severity, or cognitive function at either baseline or follow-up. At baseline, the PD with SCI group showed decreased perfusion in the left angular gyrus compared to the PD without SCI group. Longitudinal analysis revealed widespread perfusion reductions primarily in the bilateral temporo-parieto-occipital areas and cerebellum in the PD with SCI group. Relative to the PD without SCI group, an excessive decrease of perfusion was found in the left middle frontal gyrus of the PD with SCI patients.
CONCLUSIONS
Our findings suggest that perfusion deficits in the middle frontal area may play an important role in the pathophysiology of SCI in PD.

Keyword

Parkinson's disease; subjective cognitive impairment; single photon emission computed tomography; regional cerebral blood flow; cerebral perfusion

MeSH Terms

Brain
Cerebellum
Cognition
Cognition Disorders*
Dementia
Follow-Up Studies
Humans
Mild Cognitive Impairment
Parietal Lobe
Parkinson Disease*
Perfusion*
Prospective Studies
Tomography, Emission-Computed, Single-Photon

Figure

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  Fig. 1 Decrease in cerebral perfusion in the PD with SCI group compared with the PD without SCI group. The color bar represents voxel-level t-values. PD: Parkinson's disease, SCI: subjective cognitive impairment.

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  Fig. 2 Decreases in brain perfusion at follow-up in the PD with SCI group compared with baseline. The images are shown in neurological conventions and the color bar represents voxel-level t-values. PD: Parkinson's disease, SCI: subjective cognitive impairment.

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  Fig. 3 Excessive decrease in cerebral perfusion specific to the PD with SCI group compared with the PD without SCI group. The color bar represents voxel-level t-values. PD: Parkinson's disease, SCI: subjective cognitive impairment.

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