帕金森病痴呆患者的神经心理测试与^18氟-氟代脱氧葡萄糖正电子发射断层摄影术脑显像分析  

Neuropsychological test and 18F-fluorodeoxyglucose positron emission tomography analysis in patients with Parkinson＇ s disease dementia

作　　者：王永坚[1] 叶钦勇[1] 陈晓春[1] 王晖[2] 季仲友[3] 蒋日烽[3] 张立万[3] 段青[3] 

机构地区：[1]福建医科大学附属协和医院神经内科,福州350001 [2]福建医科大学附属协和医院重症医学科,福州350001 [3]福建医科大学附属协和医院影像科,福州350001

出　　处：《中华神经科杂志》2013年第4期247-251,共5页Chinese Journal of Neurology

摘　　要：目的研究帕金森病痴呆（PDD）患者的神经心理学特点及^18氟-氟代脱氧葡萄糖（^18F-FDG）PET脑代谢显像的影像学特征。方法（1）对12例PDND患者、12例PDD患者和12名健康对照者运用蒙特利尔认知评估量表（MoCA）进行检查。（2）静脉注射^18F—FDG后行PET脑代谢显像，获得12例PDND患者和12例PDD患者的PET图像。结果（1）PDD组的MoCA总成绩（分）低于PDND组，其中MoCA子项目中的视空间与执行功能（1．50±1．08与4．25±0．87，t=-1．891）、注意（3．67±1．37与6．00±0．00，t’=-2．199）、语言（1．83±0．94与2．67±0．49，t’=-2．745）、抽象（0．67±0．65与1．75-±O．45，t=-4．732）、延迟回忆（0．25±0．45与3．00±1．28，t’=-7．021）和定向（4．25±1．71与6．00±0．00，t’=-3．545）成绩低于PDND组，差异均具有统计学意义（均P〈0．05）。PDD组MoCA总成绩低于健康对照组，差异具有统计学意义（15．10±3．82与28．10±1．16，t’=-11．280，P〈0．05）。（2）±F—FDGPET脑代谢显像：PDND组的大脑半球脑代谢不对称性轻度减低，PDD组的大脑半球脑代谢不对称性重度减低。结论PDD表现为多认知域受损，以视空间与执行功能、注意、语言、抽象、延迟回忆和定向障碍较为严重。±F-FDGPET脑代谢显像检测对PDD的诊断可能有一定的帮助。Objective To describe the neuropsychologieal test results in patients with Parkinson＇ s disease with dementia and to analyze IS F-fluorodeoxyglucose positron emission tomography （18 F-FDG PET） figures performed in this group of patients. Methods （ 1 ） Montreal Cognitive Assessment （MoCA） was performed in 12 patients with Parkinson＇ s disease, 12 patients with Parkinson＇ s disease with dementia and 12 normal controls. （2）Positron emission tomography-computerized tomography （PET-CT） were performed in these 12 patients with Parkinson＇ s disease and 12 patients with Parkinson＇ s disease dementia. Results （ 1 ） MoCA score in Parkinson＇ s disease dementia group was lower than that of Parkinson＇ s disease group, especially in the following categories ： visuospatialand execution function （ 1.50 ± 1.08 vs 4. 25 ± 0. 87, t = - 1. 891 ）, attention （3.67 ± 1.37 vs 6. O0 ± 0.00, t＇ = - 2. 199 ）, language skills （ 1.83 ± O. 94 vs 2. 67 ±0.49, t＇ = - 2. 745） , abstract thought （0. 67±0. 65 vs 1.75 ± 0.45, t = - 4. 732）, long-term memory （0.25±0.45 vs 3.00 ± 1.28, t＇ = -7.021） and orientation（4.25 ± 1.71 vs 6.00±0.00, t＇ = -3. 545 ）. The results were statistically significant different（ all P 〈 0. 05 ）. MoCA score in Parkinson＇ s disease dementia group was lower than that incontrol group . The result was statistically significant different （ 15. 10± 3.82 vs 28.10 ±1.16, t＇ = - 11. 280, P 〈 0. 05）. （2） Analysis ISF-FDG PET showed that the cerebral metabolism in Parkinson＇ s disease group reduced slightly asymmetrically. The cerebral metabolism in Parkinson＇ s disease dementia group reduced significantly asymmetrically. Conclusions The cognitive domains are impaired more severe in Parkinson＇ s disease dementia group, including visuospatial skills, executing skills, attention, language skills, abstract thought, long-term memory and orientation. 18F-FDG PET may provide helpful information used in Parkinson＇ s disease dem

关 键 词：帕金森病 痴呆 神经心理学测验 氟脱氧葡萄糖F18 正电子发射断层显像术 

分 类 号：R742.5[医药卫生—神经病学与精神病学]