The Study Of Magnetic Resonance Spectroscopy In Parkinson’s Disease With Executive Dysfunction

OBJECTIVETo explore the characteristics of cognitive impairment in PD patients,and analyze the metabolic change of different parts of the brain in patients with PD executive dysfunction by proton magnetic resonance spectroscopy(1H-MRS).METHODSFrom August 2016 to January 2019,the patients diagnosed with PD in the Department of Neurology,Guangdong Provincial People’s Hospital,were collected.A total of 45 patients were identified according to the inclusion and exclusion criteria.Collecting the clinical data of all patients such as age,gender,course of disease,years of education.MDS-UPDRS III,the classification of H-Y,HAMD,HAMA.MMSE,MoCA.According to the MDS Level-Ⅱ diagnostic criteria for mild cognitiveimpairment in Parkinson’s disease,the global cognitive function and five cognitive domains of PD patients are evaluated,all cases were divided into PD-NC group and PD-MCI group,then the PD-MCI was divided into executive dysfunction and non-executive dysfunction.By the monomer 1H-MRS technology,bilateral prefrontal lobes,anterior cingulate gyrus,and bilateral striatum were detected in all patients.The changes of NAA/Cr and Cho/Cr were compared,and the brain metabolite indexes of each group were compared.In this study,SPSS 25.0 statistical software was used to analyze and compare the data.The test level was two-sided.A P value of<0.05 was considered statistically significant.RESULTS1.PD-NC vs PD-MCI:The differences between the two groups in UPDRS-III,MMSE,and MoCA were statistically significant,and there were no statistical differences in the distribution of age,gender,years of education,course of disease,H-Y classification,HAMA,and HAMD.2.PD-NC vs PD-MCI-EL:The differences between the two groups in the years of education,MMSE,and MoCA were statistically significant.But no differences were found in the age,gender,duration,UPDRS-III,HY,HAMA,and HAMD.3.PD-NC vs PD-MCI-NEL:There were statistically significant differences in age,UPDRS-Ⅲ,MMSE,and MoCA between the two groups of patients.There were no statistical differences in gender,educational years,course of disease,HY,HAMA,and HAMD.4.Compared with patients with normal cognitive function and non-executive dysfunction,there was no statistical difference in NAA/Cr,Cho/Cr in bilateral prefrontal lobe,anterior cingulate gyrus and bilateral striatum in PD patients with executive dysfunction.CONCLUSION1.Cognitive impairment occurs in the early stage of PD patients,especially memory impairment.2.No significant differences in NAA/Cr and Cho/Cr ratios were found in PD-MCI with bilateral prefrontal lobes,bilateral basal ganglia and bilateral anterior cingulate gyrus.