Correlation Analysis Of Brain Atrophy And Cognitive Impairment In Patients With Parkinson’s Disease

Objectives:1.In 68 patients with different stages of Parkinson’s disease(Parkinson’s disease,PD),the stage of cognitive function assessment was performed to analyze the characteristics of cognitive impairment in PD patients.2.A wide range of cortical visual rating scales were used to evaluate the degree of brain lobe atrophy in patients with PD and analyze the relationship with cognitive impairment.The effect of brain atrophy on cognitive function in PD patients was explored to provide a basis for the prevention and treatment of cognitive impairment in PD patients.Methods:1.To collect 68 cases of Parkinson’s disease in the hospital of neurology and functional neurosurgery in the second affiliated Hospital of Kunming Medical University in September 2016～2018 January,according to the diagnostic criteria of PD,the subjects were divided into the group of patients with Parkinson disease without cognitive impairment(PD-NCI),Parkinson disease Mild Cognitive Dysfunction Group(PD-MCI),Parkinson’s Disease Group(PDD).2.Collect clinical data of all subjects,including history collection and analysis of risk factors,sex,age,years of education,PD disease course,UPDRS-Ⅲ score,HY classification,hypertension,heart disease,diabetes,homocysteine Acidemia,smoking history,drinking history,etc.All subjects took venous blood on the morning of the second day of admission to determine the fasting blood glucose,blood lipids,homocysteine,liver and kidney function.3.During the hospitalization,68 patients with PD were assessed with motor function using UPDRS-Ⅲ scale,Hoehn-Yahr grading method was used for severity assessment,MoCA scale was used for cognitive function assessment,and clinical dementia rating scale was used for dementia.Severity rating,Hamilton depression rating scale for depression assessment.4.Using 3.0T cranial MRI scan of 68 patients with Parkinson’s disease,according to the visual rating scale,followed by frontal,temporal lobe,parietal lobe atrophy score(0 to 3 points).5.The risk factors of brain atrophy in patients with Parkinson’s disease were evaluated by single factor variance analysis and two logistic regression analysis,and the atrophy and atrophy of brain atrophy in patients with Parkinson’s disease were statistically analyzed by SPSS 20.0 software.Results:(1)There was no significant difference in gender,hypertension,diabetes,smoking history and drinking history between PD-NCI,PD-MCI,and PDD(P>0.05);PD-NCI,PD-MCI,PDD Age,education years,PD course,HY grade,UPDRS-Ⅲ score,hyperhomocysteinemia were statistically significant(P<0.05);(2)PD-NCI,PD-MCI,and PDD There was a statistically significant difference between the MOCA scores and their sub-items(P<0.05).(3)PD-MCI and PDD brain atrophy scores and frontal atrophy scores Compared with the PD-NCI group,the difference was statistically significant(H=6.032,P=0.014;H=44.643,P=0.000).There was no significant difference in the temporal lobe atrophy score between the PD-MCI group and the PD-NCI group(P>0.05),there was no statistically significant difference in parietal atrophy between the three groups(P>0.05);(4)Pearson correlation analysis was performed on PD patients and found that there was a negative correlation between brain atrophy score and cognitive function score,among which the frontal lobe The atrophy score was significantly negatively correlated with the MOCA score and its subprojects(P<0.05);(5)Logistic stepwise regression analysis of the two-category classification found that After controlling for age,sex,years of education,UPDRS-Ⅲscore,HY classification,PD disease course,and vascular risk factors,age(regression coefficient=0.587,OR value=0.810)and years of education(regression coefficient=-0.241,OR)=0.778),UPDRS-Ⅲ score(regression coefficient=0.184,OR value=1.202),HY grade(regression coefficient=0.231,OR value=1.102)and hyperhomocysteinemia(regression coefficient=0.202,OR value =1.223)related to cognitive impairment,corrected for atrophy,atrophy,age,years of education,UPDRS-Ⅲ score,HY grade,hyperhomocysteinemia and cognitive function,with frontal lobe shrinking The impairment was significantly correlated(regression coefficient = 2.768,OR = 16.071).There was no significant correlation between atrophy of the temporal lobe and parietal lobe and cognitive impairment.Conclusions:(1)Frontal lobe atrophy is significantly associated with impaired cognitive function in patients with PD,and brain atrophy occurs predominantly in the frontal lobe,with subcortical atrophy predominating,and frontal lobe atrophy associated with executive dysfunction;temporal lobe atrophy Common in patients with Parkinson’s dementia,parietal atrophy is not obvious.(2)Frontal lobe atrophy can be regarded as a new imaging predictor of early cognitive impairment in patients with PD,but it still needs more large-scale,multicenter studies to confirm.(3)High level of education is a protective factor for cognitive impairment in patients with PD.Hyperhomocysteinemia may contribute to the progression of cognitive impairment in PD patients with advanced age,severe motor symptoms,and vascular risk factors.