DISCORDANT TWINS WITH PARKINSONS-DISEASE - POSITRON EMISSION TOMOGRAPHY AND EARLY SIGNS OF IMPAIRED COGNITIVE CIRCUITS

被引:90
作者
HOLTHOFF, VA
VIEREGGE, P
KESSLER, J
PIETRZYK, U
HERHOLZ, K
BONNER, J
WAGNER, R
WIENHARD, K
PAWLIK, G
HEISS, WD
机构
[1] MAX PLANCK INST NEUROL RES,D-50866 COLOGNE,GERMANY
[2] UNIV LUBECK,NEUROL KLIN,LUBECK,GERMANY
关键词
D O I
10.1002/ana.410360209
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
We evaluated 7 pairs of twins (2 monozygotic and 5 dizygotic) discordant for Parkinson's disease (PD), of whom the cotwins showed no signs of motor impairment on neurological examination. All subjects underwent positron emission tomographic measurements of cerebral glucose metabolism and dopaminergic, nigrostriatal function following injection of 2-[F-18]fluoro-2-deoxy-D-glucose and L-6-[F-18])fluorodopa ([F-18]dopa), respectively, as well as testing for anterograde, verbal episodic, and semantic memory performance. Statistical analysis demonstrated significant reduction of striatal [F-18] dopa uptake not only in the twin patients with PD but also in all of the cotwins, who showed significantly (p < 0.05) impaired [F-18]dopa metabolism in at least one of the striatal measures including caudate, putaminal, and the rostrocaudal putaminal gradient of [F-18]dopa uptake. Compared with age-matched controls, regional glucose metabolism was unchanged in all the twins. Neuropsychological testing showed significant (p < 0.05) impairment in verbal memory processing in the twin patients with PD and in 6 of the cotwins. Semantic memory skills were affected in 2 twin patients only. A significant correlation was found between scores obtained in Buschke's Selective Reminding Test and striatal [F-18]dopa uptake, further substantiating the role of dopaminergic pathways in memory processing. The present study is the first to reveal not only significant disturbance of nigrostriatal dopaminergic function in asymptomatic cotwins of twin patients with PD, but also significant impairment in the processing of anterograde, verbal episodic memory that is known to be affected in PD. Larger studies with a longitudinal design will be necessary to answer the question of whether cognitive changes found in the cotwin group are signs of incipient PD.
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页码:176 / 182
页数:7
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