The Study Of Cognitive Impairment In Sporadic Parkinson's Disease And Related Genetic Factors

Part OneCase-Control Studies on the Risk Factorsof Parkinson's Disease with dementia and Mild Cognitive ImpairmentsObjectives:To investigate the possible risk factors of cognitive impairment in PD including Parkinson's disease with dementia(PDD)and mild cognitive impairment(MCI),and evaluate the neuropsychologic features of cognitive impairment in PD.Methods:We conducted a case-control study among the PD patients and MCI patients in PD outpatient department from 2006 to 2007.forty-eight PDD cases and 73 MCI cases VS 52 nomal cognitive PD were selected.Each case-control group was matched for gender and education degree.Univariate and multivariate analyses were conducted using Logistic regression model.The demography factors,histories of disease,and distinctive features of Parkinson's disease were discussed in the relationship with PDD,MCI and normal cognitive PD.Results:1.The mean age of PDD group was 75.44 years old and 70.35 years old in normal cognitive PD group,while 70.86 years old in MCI group.Equilibrcium test showed the comparability between cases and controls.2.In univariate analysis,age,years of education,smoke index,age of onset,depression score,Hoehn & Yahr and UPDRS scores differed between groups.Tremor was protactive factor for PDD(OR=0.36,p＜0.05).Smoke(OR=2.89) was risk factor for MCI and depression score differed between MCI and PD group.3.Multivariate analysis showed that after adjusting for potential confounders,bilateral onset,age,years of education increased the risk of PDD while tremor decrease the risk.The values of OR were4.264,1.203,1.190,0.068 respectively.Smoke,depression score,age of onset,Hoehn & Yahr were risk factors for MCI.The adjustive OR were 1.666,1.779,0.945,1.864,respectively.4.There is evidence of cognitive impairment of visuospatial,attention, delayed recall,calculation,abstraction,Verbal fluency in PDD and MCI,while denomination and repeat were remained.5.Hcy was related negtively to VitB12,acidum folicum and MMSE,while positively related to H-Y.Conclusions:The study demonstrated age,years of education,smoke,age of onset,depression,Hoehn & Yahr and UPDNS scores were risk factors for PDD. The cognitive impairment in PDD and MCI included visuospatial,attention, delayed recall,calculation,abstraction,Verbal fluency.Hcy level was related to cognitive function and motor symptoms of PD. Analysis of ApoE polymorphisms and A10398G mutation in patients with Parkinson' s DiseaseObjectives:To analyze the relationship of ApoE polymorphism and A10398G mutation with sporadic PD,PDD and MCI.Methods:Peripheral blood samples of PD patients were collected from hospitals,including 86 cases and 49 controls.DNA was prepared by phenol chloroform extraction method from blood samples.The PCR-RFLP method was used to analyze the genotypes or mutations of ApoE genes.Allele frequencies and mutation frequencies were calculated.And the PCR products were sequencing for 10398 mutation.SPSS 13.0 Statistical software was used for data statistic analyses.Results:1.Among the 87 cases of sporadic PD and 49 cases of control group,the distribution of ApoEε4 allele frequency between two groups was no significant difference by statistical analysis and the same between PDD and PD group(P＞0.05).2.The mutation of A10398G was significant difference between PD and control group.While no difference between PDD,MCI and PD group.Conclusions:The test suggust that ApoEε4 allele isn't related to sporadic PD and cognitive impairment in PD.A 10398G was suggest to related to PD onset and no association is found about 10398 mutation and cognitive impairment in PD.