A Preliminary Study Of Language Disorders And The Associated-structural Changes Of Brain Grey/white Matte In Chinese Patients With Parkinson's Disease

Language deficit is one of the common manifestations of cognitive impairment in Parkinson's disease(PD).The main complaint of language impairment for PD patients is speech disorder,while,in contrast,semantic and syntactic impairments are comparatively obscure and easily overlooked.At present,the researches on language impairment among PD patients,especially among those whose native language is Chinese,are very limited,and the associated modifications of the cerebral gray/white matter structures are still unclear.In order to explore these issues,the main topics of this research are as follows:(1)To study the characteristics of language disorders in Chinese patients with Parkinson's disease:through comparing differences between the performances of the PD group and the healthy control(HC)group on Aphasia Battery of Chinese(ABC),the Vocabulary test,the Similarity test(both of the two above-mentioned tests were from the Chinese version of the Wechsler intelligence test,CH-WIAS)and the Verbal fluency test,we found that PD group had lower scores than HC group on the parts of ABC subtests(including the Fluency,Information,Sentence repetition,Comprehension questions,Listen and identification,Oral instruction,Reading the sentence and gap filling and Disease writing),the Similarities test and the Verbal fluency test.Besides,compared with executive dysfunction,semantic retrieval impairment is more closely associated with high-level semantic processing disorder among Chinese PD patients.Regression analysis indicated that age,education years,disease severity correlated with PD language dysfunction.(2)The surface-based analysis for cerebral gray matter changes associated with PD language disorders:the surface-based analysis method was used to evaluate the morphological changes of gray matter associated with language disorders in PD language-dysfunction subgroups,and the main indexes included cortical thickness,sulcus depth,deep gray matter volume,brain surface area and curvature.After correction for multiple comparisons,positive results only have been observed in the PD patients with Similarities impairment(PDSI)subgroup:cortical thinning on the regions of the left superior frontal gyrus,superior parietal lobe and rostral middle frontal gyrus,sulcus depth reducing on the left superior frontal gyrus and atrophy in the right hippocampus.Regression analysis indicated that age and education were related to the changes of gray matter in PDSI subgroup.(3)The TBSS analysis for white matter changes associated with PD language disorders:the tract based spatial statistic(TBSS)analysis method was used to evaluate the variations of white matter fiber fractional anisotropy(FA)skeleton and mean diffusivity(MD)skeleton associated with language disorders in PD language-impairment subgroups.After correcting for multiple comparisons,no significant differences were found between the groups.We then analyzed the relationships between the language disorders and white matter fiber skeletons(included FA skeleton and MD skeleton)in PD language-dysfunction subgroups,respectively.Positive results only had been found in PDSI subgroup.The correlation between the Similarities test score and the white matter FA skeleton was observed in the right inferior longitudinal fasciculus,inferior fronto-occipital fasciculus,posterior internal capsule,posterior corona radiata and posterior thalamic radiation in PDSI subgroup,while these correlations had been found neither in HC group nor PDSP subgroup.However,no significant difference between the groups was found after extracting the mean FA values from the above whiter matter fiber skeleton.Regression analysis indicated that age,education level and disease duration were related to part of the white matter fiber FA skeleton.In this study,we evaluated the performance and characteristics of language disorders in Chinese patients with PD,and analyzed the association of high-level semantic processing disorder with sematnic retrival impairment and executive dysfunction among this cohort.In order to explore the relevant pathological changes on brain structure,we studied the gray/white matter morphological modification associated with PD language disorder.And we also found out that the influenced factors of PD language disorder and of the changed gray/white matter structures.The present study provides some value clues for further studies.