| Objective: Parkinson's disease(PD)is a progressive neurodegenerative disease and its prevalence is increasing year by year.Although the main symptom of Parkinson's disease is an impairment of motor function,it is increasingly associated with cognitive dysfunction in terms of executive function,attention,memory,visual space,and language.Cognitive function gradually develops into mild cognitive impairment and dementia over time,which has a serious impact on the quality of life of patients with Parkinson's disease.In this study,the Brain Geodesic Positioning System(Brain GPS)based on the multi-atlas algorithm was used to analyze the brain volume changes in patients with Parkinson's disease which is explored to reveal intrinsic characteristics and pathological changes in Parkinson's disease.Methods: From March 2017 to March 2018,39 patients with Parkinson's disease who were admitted to the First Affiliated Hospital of Fujian Medical University were included in the study.Parkinson's disease patients were divided into 17 patients with no cognitive impairment(PD-CN)and 22 patients with mild cognitive impairment(PD-MCI)based on the criteria for the diagnosis of mild cognitive impairment in Parkinson's disease.At the same time,22 sex and age matched healthy people(HC)in the same period of our hospital were collected as control group.The general conditions and clinical data of the subjects were collected,and a 3D T1 WI sequence of all subjects was obtained using a 3.0T magnetic resonance scanner.Images and data were processed and statistically analyzed using BrainGPS tools and SPSS software to evaluate brain structural changes and overall cognitive function in patients with Parkinson's disease.Result: 1.The MMSE and MoCA scores in the PD-MCI group were significantly lower than those in the PD-CN group(25.23 vs.29.18,P=0.000;19.27 vs.27.41,P=0.000).2.Changes in volume were found in the left clustrum complex and the left lateral fronto-orbital white matter in the three groups(P = 0.027,P = 0.038).Compared with the PD-CN group,the left frontal lobe volume in the PD-MCI group was significantly reduced(P=0.022),indicating that the decrease in frontal volume was biased toward the decline in PD cognitive function.In addition,compared with the HC group,the left temporal lobe volume of the PD-MCI group was decreased and had statistical significance(P=0.014),indicating that the decrease in temporal lobe volume may be related to PD.3.A comparison of the brain volume in the PD and HC groups revealed a statistically significant volume change in the left lateral fronto-orbital white matter(P=0.021),further suggesting that the left frontal lobe may be associated with PD.However,there was no statistical difference in the volume change of the left clustrum complex.Combined with the comparison of the left clustrum complex of the three groups,there was a statistically significant difference between the PD groups.It can be predicted that the left clustrum complex may be related to cognitive function of PD.Further multiple stepwise regression analysis showed that the left lateral fronto-orbital white matter had statistical significance(P=0.002)and ROC curve was made(area under the curve=0.783,95% confidence interval=0.669-0.897).4.A comparison of brain volumes between PD patients and multiple stepwise regression analysis can be used to generate ROC curves for the left side of the screen nucleus(area under the curve=0.751,95% confidence interval=0.591-0.912).Conclusion: There is atrophy in the left lateral fronto-orbital white matter volume of PD patients;impaired cognitive function in patients with PD-MCI is associated with brain atrophy in the local area of the left clustrum complex;BrainGPS technology can analyze the changes of brain structure and explore the neuroimaging markers of the physiological and pathological mechanisms of PD. |
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