Cognitive Performance is Associated with Altered Cerebral Hemodynamics Assessed by Transcranial Ultrasound in Parkinson's Disease

Yi-Lun Ge; Si-Yi Gong; Pu-Zhi Wang; Jia-Hui Yan; Wen Li; Jin-Ru Zhang; Hong Jin; Sheng Zhuang; Lei Hu; Chang-Wei Ding; Ya-Ping Yang; Fen Wang; Dan Li; Jing Chen; Cheng-Jie Mao; Ying-Chun Zhang; Kai Li; Chun-Feng Liu

doi:10.2147/NDT.S358150

Cognitive Performance is Associated with Altered Cerebral Hemodynamics Assessed by Transcranial Ultrasound in Parkinson's Disease

Neuropsychiatr Dis Treat. 2022 Jul 12:18:1421-1431. doi: 10.2147/NDT.S358150. eCollection 2022.

Authors

Yi-Lun Ge^#¹, Si-Yi Gong^#¹, Pu-Zhi Wang¹, Jia-Hui Yan¹, Wen Li¹, Jin-Ru Zhang¹, Hong Jin¹, Sheng Zhuang¹, Lei Hu², Chang-Wei Ding², Ya-Ping Yang¹, Fen Wang³, Dan Li⁴, Jing Chen¹, Cheng-Jie Mao^{1

4}, Ying-Chun Zhang², Kai Li¹, Chun-Feng Liu^{1

3

4}

Affiliations

¹ Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China.
² Department of Ultrasound, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China.
³ Institute of Neuroscience, Soochow University, Suzhou, Jiangsu, People's Republic of China.
⁴ Department of Neurology, Suqian First Hospital, Suqian, People's Republic of China.

^# Contributed equally.

Abstract

Purpose: Cognitive impairment (CI) is a common but debilitating non-motor symptom in Parkinson's disease (PD). Although cerebrovascular functions are related to cognitive performance in healthy individuals, such a relation in PD remains elusive. This study aims to assess the association between cerebrovascular function and cognitive performance in PD individuals.

Patients and methods: Two-hundred-and-one PD individuals were retrospectively included. They were subsequently divided into two groups: PD with normal cognition (PD-NC) and PD with CI (PD-CI). Cerebral hemodynamic characteristics of the middle cerebral arteries were assessed by transcranial ultrasound. The association between scores in each cognitive domain and cerebral hemodynamic parameters was further analyzed using regression analyses. Additionally, a binary logistic regression model with backward stepwise procedure was applied to build the model for discriminating CI in PD individuals. An independent dataset of additional 46 PD individuals was used further.

Results: The PD-CI group showed a relatively lower end-diastolic blood flow velocity (EDV, p < 0.05) and a higher resistive index (RI, p < 0.05) compared to the PD-NC group. RI showed significant associations with the memory item score of Montreal Cognitive Assessment (p < 0.05). A model combining clinical and hemodynamic variables was established with optimal efficiency (area under the curve, AUC = 0.651). Further replication of the model in an independent dataset yielded a great consistency (AUC = 0.704).

Conclusion: In our study, cerebrovascular functions were significantly associated with the cognitive performance in PD individuals, especially with the memory task. The established model was effective in identifying CI in PD individuals, which might be a potentially useful tool to screen the cognitive decline in PD individuals at an early stage of the disease. Further studies with larger sample sizes in different populations are warranted.

Keywords: Parkinson’s disease; cognitive impairment; resistive index; transcranial ultrasound.

Grants and funding

This work was supported by the Jiangsu Provincial Key R&D Program (BE2018658), Jiangsu Provincial Medical Key Discipline Project (ZDXKB2016022), Discipline Construction Program of the Second Affiliated Hospital Soochow University (XKTJ-XK202001), National Natural Science Foundation of China (81801258), National Natural Science Foundation of China (81801120), talent support project for science and teaching of the Second Affiliated Hospital of Soochow University (XKTJ-RC202004), pre-research project for doctors of the Second Affiliated Hospital of Soochow University (SDFEYBS1702) and pre-research project for doctors of the Second Affiliated Hospital of Soochow University (SDFEYBS2014).