Journal of the Korean Society of Radiology (한국방사선학회논문지)

The Korean Society of Radiology (한국방사선학회)
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Correlation between the Seoul Neuropsychological Screening Battery of the Parkinson's Disease Patient with Mild Cognitive Impairment and Change of the Cerebral Ventricle Volume in the Brain MRI

경도인지장애를 동반한 파킨슨병 환자의 서울신경심리검사와 뇌 자기공명영상에서 뇌실 체적 변화에 대한 상관관계

  • Lee, Hyunyong (Department of Radiology, Inje Univiersity Busan Paik Hospital) ;
  • Kim, Hyeonjin (Department of Radiology, Good Samsun Hospital) ;
  • Im, Inchul (Department of Radiological Science, Dongeui University) ;
  • Lee, Jaeseung (Department of Radiological Science, Dongeui University)
  • 이현용 (인제대학교 부산백병원 영상의학과) ;
  • 김현진 (좋은삼선병원 영상의학과) ;
  • 임인철 (동의대학교 방사선학과) ;
  • 이재승 (동의대학교 방사선학과)
  • Received : 2014.05.12
  • Accepted : 2014.06.25
  • Published : 2014.08.30
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Abstract

The purpose of this study were to analyze that the Seoul neuropsychological screening battery (SNSB) for the evaluating cognitive assessment of the Parkinson's disease patients with mild cognitive impairment (PD-MCI) and the changes of the cerebral ventricle volume in the brain magnetic resonance imaging (MRI), and we has been bring forward the guideline to determine the diagnostic criteria for the PD-MCI. To achieve this, we was diagnosed with Parkinson's disease patients (PD-MCI group: 34 patients; Parkinson's disease with normal cognition, PD-NC group: 34 patients) to perform the SNSB test for the attention, language, memory, visuospatial, and frontal/executive functions and the brain MRI. Additionally, to compared the change of the cerebral ventricle volume, we performed the brain MRI for the 32 normal control (NC) group. The volumetric analysis for a specific cerebral ventricle performed by using Freesurfer Ver. 5.1 (Massachusetts general Hospital, Boston MA, USA). As a results, compared to the PD-NC group, the PD-MCI group were statistically significant reduction in the ability to perform the memory and the visuospatial function (p<0.05). The volumetric changes for a specific cerebral ventricle were statistically significant variation in the left and right lateral ventricle, left and right inferior lateral ventricle, and 3rd ventricle. Although, in order to compared the objectification, the normalized percentage applied to the volumetric changes showed to extend the PD-MCI group than the PD-NC group. Specially, the left and right ventricle extension for the PD-MCI patients conspicuously had showed a quantitative linear relationship between the memory and the visuospatial function for the SNSB (r>0.5, p<0.05). Therefore, we were able to judge the diagnostic criteria of the PD-MCI through that can observe the volumetric variation of the specific cerebral ventricle by using Freesurfer in brain MRI, and to analyze the correlation between the SNSB.

본 연구는 경도인지장애가 동반된 파킨슨병 환자에 대하여 인지 기능 평가를 위한 서울신경심리검사와 뇌 자기공명 영상에서 영역별 뇌실에 대한 체적 변화를 분석하여 경도인지장애가 동반된 파킨슨병에 대한 진단적 기준을 판단할 수 있는 가이드라인을 제시하고자 하였다. 이를 위하여 파킨슨병으로 진단 받은 환자(경도인지장애군: 34명, 비인지장애군: 34명)를 대상으로 주의력, 언어, 기억력, 시공간, 그리고 전두엽 집행 기능에 대한 서울신경심리검사와 뇌 자기공명영상 검사를 시행하였다. 또한 영역별 뇌실에 대한 체적 변화를 비교하기 위하여 정상인 32명(정상 대조군)을 추가 선정하여 추가적으로 뇌 자기공명영상 검사를 시행하였으며 영역별 뇌실에 대한 체적 분석은 프리서퍼(Freesurfer Ver. 5.1, Boston MA, USA)를 통해 수행되었다. 결과적으로 경도인지장애군은 시공간 및 기억력에 대한 수행 능력이 비인지장애군과 비교하여 통계적으로 유의하게 감소되었다(p<0.05). 영역별 뇌실에 대한 체적 변화는 좌 우측뇌실, 좌 우하측뇌실, 제3뇌실에서 통계적으로 유의한 체적 변화를 나타내었으며 객관화된 비교를 위하여 정규화한 백분율을 적용한 체적의 변화는 비인지장애군보다 경도인도장애군에서 확장되어 나타났다. 특히 경도인지장애를 동반한 파킨슨병 환자의 좌 우측뇌실의 확장은 서울신경심리검사에서 시공간 및 기억력 영역에 대하여 뚜렷한 양적 선형관계를 보였다(r>0.5, p<0.05). 따라서 뇌 자기공명영상에서 프리서퍼를 이용하여 영역별 뇌실의 체적 변화를 관찰하고 서울 신경심리검사와 상관관계를 분석함으로써 경도인지장애를 동반한 파킨슨병 환자의 진단적 기준을 마련할 수 있을 것으로 판단되었다.

Keywords

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