Hyeonyong Lee, Hyonghu Park, Jaeseung Lee, Inchul Im Department of Radiology, Inje Univiersity Busan Paik Hospital, Department of Radiology, Bongseng Memorial Hospital**, Department of Radiological Science, Dongeui University 이현용, 박형후, 이재승, 임인철 인제대학교부산백병원영상의학과, 봉생병원영상의학과, 동의대학교방사선학과 This study is to investigate neuro-anatomical correlation between neuropsychological results and cerebral cortex thickness of cognitive ability in the brain MRI targeting the patients with mild cognitive impairment. It was that 78 people who were diagnosed as first Parkinson s disease followed by neuropsychological screening battery(parkinson s disease with mild cognitive impairment: 39 people; Parkinson s disease with normal cognition: 39 people) and 32 people of normal group were selected. Correlation between mild cognitive impairment and normal cognitive impairment and correlation between neuropsychological screening battery and cerebral cortex thickness in the brain MRI were performed by independent sample t-test or Pearson correlation coefficient and then level of significance of collected data was verified in p<0.05. As a result, cerebral cortex thickness of the Parkinson s disease with mild cognitive impairment in both side precuneas and right inferiortemporal lobe had statistically significant decrease. In addition, function of visuospatial ability, verbal and visual memory was reduced in neuropsychological screening battery for cognitive assessment. Especially, there was correlation between neuropsychological screening battery of verbal and visual memory anatomical left precuneus. Key Words : Brain Magnetic resonance image (MRI), Cerebral cortex thickness, Parkinson's disease, impairment (PD-MCI), Neuropsychological screening battery (NSB) Parkinson's disease with mild cognitive. Corresponding Author: Inchul Im E-mail:icim@deu.ac.kr Tel: +82-51-890-2678 No. 614-714, Dong-Eui University, 995 Eomgwang-no, Busanjin-gu, Busan, korea Received : April 30, 2014 Revised :June 15, 2014 Accepted : June 25, 2014
78 ( : 39 ; : 39 ) 32. T p<0.05.,.. :,,,, Ⅰ. (substantia nigra) (pars compacta) (Parkinson's disease. PD) 0.3%, 65 1.6% 2002 32,235 2008 68,894 18.9%. 70% (trmor), (brady), (rigidity), (postural instability) (cognitive impairment), (dementia), (depressive disorder), (mental disorders).,,,, (activities of daily living). (mild cognitive impairment. MCI). (neuropsychological screening battery. NSB), (cognitive assessment. CA), (autonomic function test. AFT). (gradient echo. GE) (susceptibility weighted image. SWI) (Fe) (magnetic resonance image. MRI). 23%.. Ⅱ. 2011 05 2012 12 78 (, Parkinson's disease with mild cognitive impairment. PD-MCI: 39 ;, Parkinson's disease with normal cognition. PD-NC: 39 ).
32. 1987 MDS-UPDRS (Movement Disorder Society-The Unified Parkinson's Disease Rating Scale) (non-motor experiences of daily living: Part 1), (motor experiences of daily living: Part 2), (Motor examination: Part 3), (Motor complication: Part 4). 5 "0" (normal), "1" (slight), "2" (mild), "3" (moderate), "4" (severe) Fig. 1. (cytoarchitectonic) 52 (Brodmann),,,, 5. (clinical dementia rating scale. CDR) (global deterioration scale. GDS) (CDR>1) (GDS>4). 3.0T MR(Achieva 3.0T TX, Philips, netherlands) 16 (Sense-NV-16 coil, Philips, netherlands). T1 T2 (T1- and T2-weighted image) (fluid attenuation inversion recovery. FLAIR). 3 T1 (sagittal) Table 1. Parameters 3-D sagittal images TR/TE (msec) 9.8/4.6 FOV (mm) 250 250 Flip angle ( ) 8 Slice thickness (mm) 1 Matrix/Pixel size 254/254 NEX 1 Scan time (min:sec) 5:16 Note) TR/TE: repetition time/echo time, FOV: field of view, NEX: number of excitations. MR techniques was used the number of slice 170, fold over direction AP, SENSE, P reduction 1, S reduction 2, and Phase of data sample factor 1.5. (Pia mater) (inter-subject registration),, (brain folding) (Freesurfer Ver. 5.1, MGH: Massachusetts General Hospital, Boston MA, USA). Fig. 2.
(raw data) RF(radio frequency) (eddy currents) (intensity bias correction) (normalization). (Talairach template) T1 watershed (skull, eyes, neck, dura) (triangular tesselation) (smoothing). (mesh) (Euclidean distance).,,,, 5,,,. T (Pearson correlation coefficient) p<0.05. Ⅲ. Table 2. 65. 20 9. Table 3 5. (attention), (language), (visuospatial ability), (memory), (Frontal/executive functions) 5 (p<0.05). (Rey complex figure test. RCFT) 12.3% (verbal memory) (delay recall) 48.4%, (visual memory) (immediately recall) 37.6%. SPSS Windows Ver.19.0(SPSS Inc., Chicago, USA). (Chi square test) (Fisher exact test). (n=39) Characteristics PD-MCI PD-NC p-value Sex (female. %) 53.8 56.4 Age (year) 68.15±7.60 67.20±8.90 0.603 Age at onset (year) 66.40±7.50 65.50±9.00 0.634 Disease duration (month) 18.80±2.13 19.20±2.30 0.941 Education (year) 8.60±4.60 7.50±4.50 0.989 Note) PD-MCI: Parkinson's disease patients with mild cognitive impairment, PD-NC: Parkinson's disease patients with normal cognitive.
(n=39) Items PD-MCI PD-NC p-value Attention Forward digit span Backward digit span Stroop-color reading Language korean-boston naming teat Calculation 5.10±1.60 5.50±1.40 3.02±0.80 3.50±1.00 67.40±27.80 78.40±24.80 41.80±9.10 9.80±2.90 44.90±8.80 12.40±2.30 0.339 0.204 0.088 0.190 0.310 Visuospatial ability Rey complex figure test 27.00±9.60 30.80±6.50 0.026 Memory Verbal memory Immediately recall Delay recall Recognition Visual memory Immediately recall Delay recall Recognition Frontal/executive functions mean contrast program score mean go-no-go test score 14.90±4.60 3.30±2.20 19.50±1.80 8.80±6.10 11.24±6.30 18.40±2.40 18.20±4.90 17.90±5.40 20.70±8.10 6.40±3.00 20.50±2.80 14.10±6.90 13.50±6.70 19.40±2.20 19.50±3.30 19.20±3.60 0.003 0.002 0.014 0.180 0.055 Note) PD-MCI: Parkinson's disease patients with mild cognitive impairment, PD-NC: Parkinson's disease patients with normal cognitive. Fig. 3 Linux-centos 4. 3 T1 ( ) ( ). (left and right precuneus), (right-inferiortemporal lobe) (p<0.05). 5.63±1.83mm2, 4.51±0.94mm2, 2.26±1.06mm2 (Talairach) X, Y, Z 48.80, -32.10, -23.00 (Table 4). Table 5 6. Item Area (mm 2 ) PD-MCI PD-NC Neuroanatomical area RIT RP LP 182.06±21.72 175.53±22.61 53.95±11.27 187.85±26.19 180.11±25.17 56.45±12.36 Difference (mm 2 ) 5.63±1.83 4.51±0.94 2.26±1.06 Talairach * X Y Z 48.80-32.10-23.00 18.10-55.60 14.60-10.60-57.00 10.30 NVC 330 367 128 Note) RIT: right-inferiortemporal lobe, RP and LP: right and left precuneus, PD-MCI: Parkinson's disease patients with mild cognitive impairment, PD-NC: Parkinson's disease patients with normal cognitive. *, Talairach (MN1305) coordinate of the maximum., number of the vertices in cluster. NSB items Right-inferiortemporal lobe r-value * p-value Visuospatial ability Rey complex figure test 0.507 0.64 *, the result value by Pearson correlation analysis., the result value by independent two sample T test
NSB items Memory Verbal memory Immediately recall Delay recall Recognition Visual memory Immediately recall Delay recall Recognition Left precuneus Right precuneus r-value * p-value r-value * p-value 0.613 0.588 0.225 0.564 0.557 0.047 0.002 0.116 0.168 *, the result value by Pearson correlation analysis., the result value by independent two sample T test -0.051-0.059 0.225 0.202 0.313-0.198 0.504 0.227 0.534 (r) 0.507 (p>0.05). (verbal and visual memory) (immediately and delay recall) (r) 0.613, 0.588, 0.564, 0.557 (p<0.05). (r<±0.1 r<±0.3, p>0.05). IV.. 84% 5 17%... 5 (visuospatial ability) (Rey complex figure test. RCFT) (memory) (verbal memory) (visual memory). Yarnall (amnestic MCI) (non-amnestic MCI) (Alzheimer's disease) (dementia with Lewy body). 3 T1 (left and right precuneus), (right-inferiortemporal lobe) (Pearson correlation coefficient. r>±0.5). (p>0.05). (Seoul neuropsychological screening battery. SNSB)
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