Objective: We aimed to investigate the patterns of cerebral perfusion in early de novo Parkinson’s disease (PD) patients with different cognitive states and to determine whether these features are associated with cognitive impairment using a three-dimensional pulsed-continuous arterial spin labeling (3D pCASL) technique.

Background: To date, the mechanism underlying cognitive impairment in PD remains unclear. Brain structural and functional abnormalities, including volume loss, cortical thinning and cerebral dysmetabolism, have been reported in PD-MCI. However, these findings were not consistent.Recently, 3D pCASLand voxel-based analysis (VBA) were used to observe the regional cerebral blood flow (rCBF).

Method: Three groups of subjects were recruited in this study, including patients with de novo PD with mild cognitive impairment (PD-MCI, n = 20), patients with de novo PD without cognitive impairment (PD-NC, n = 43) and control subjects (n = 42). All subjects underwent clinical evaluations and MRI scanning. 3D pCASL scan was used to investigate CBF with a voxel-based brain analysis.

Results: Compared with the controls, the patients with PD-NC showed significantly decreased CBF values including left middle occipital gyrus, right lingual gyrus, left middle frontal gurus (MFG) and right caudate, which indicated cerebral perfusion changes both in cortical and subcortical regions. However, significantly increased CBF was detected in the right anterior cingulate cortex in PD-MCI patients compared with controls. When comparing PD-NC with PD-MCI, the relatively lower perfusion regions were detected in the right MFG and right superior frontal gyrus (SFG). Furthermore, a significant correlation was observed between performance in the 30-item Chinese version of the Boston Naming Test (BNT), a scale reflecting language domain, and CBF in right MFG and in right SFG controlling for age, gender and years of education in  PD patients.

Conclusion: The present study first demonstrated the cortical and subcortical perfusion changes in the patients with de novo PD-MCI and PD-NC using 3D pCASL. The investiga­tion of hyperperfusion in PD-MCI may provide valuable information of compensatory mechanism associated with cognitive impairment.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/pattern-of-cerebral-perfusion-in-early-de-novo-parkinsons-disease-with-mild-cognitive-impairment-using-voxel-based-analysis-of-3d-arterial-spin-labeling-imaging/