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Objective:To explore the correlation between high cholinergic pathway signaling and cognitive function in patients with Parkinson disease(PD) accompanied with sleep disorder.Methods:PD patients admitted from 2017 to 2022 were divided into PD with sleep disorder group (PD-SD group) ( n=56) and PD without sleep disorder group (PD-NSD group) ( n=41) according to the Parkinson's disease sleep scale (PDSS) score. All participants underwent magnetic resonance imaging examination.All patients were evaluated by the PDSS, Hoehn-Yahr (H-Y), Montreal cognitive assessment scale (MoCA), and cholinergic pathways hyper intensities scale (CHIPS). The difference of cognitive function between the two groups and the correlation between CHIPS and cognitive function were analyzed.Independent sample t-test, Spearman correlation analysis, and binary Logistic regression analysis were performed on the data by SPSS 26.0 statistical software. Results:(1)The MoCA score of the PD-SD group (22.00 (5.00)) was lower than that of the PD-NSD group (26.00 (5.00)) ( Z=-3.830, P<0.05). The total and all aspects scores of CHIPS in PD-SD group were higher than those in PD-NSD group(the total score of the low external capsule: 12.00(8.00), 0(8.00), the total score of the high external capsule: 12.00(2.00), 6.00(9.00), the total score of the radial crown: 8.00(0), 4.00(4.00), the total score of the centrum semiovale: 3.00(4.00), 0(2.00), the total score of the right side: 16.00(9.00), 5.00(10.00), the total score of the left side: 17.00(6.00), 7.00(9.00), the total score of CHIPS: 32.00(14.00), 14.00(20.00))( Z=-5.081, -5.873, -4.933, -3.211, -5.562, -6.232, -5.995, all P<0.05). (2)The correlation analysis between the score of CHIPS and cognitive function in the PD-SD group showed that, the total score of the low external capsule ( r=-0.286), the total score of the centrum semiovale ( r=-0.307), the total score of the right side ( r=-0.376), the total score of the left side ( r=-0.284) and the total score of CHIPS ( r=-0.349) were negatively correlated with MoCA(all P<0.05). (3)Binary Logistic regression analysis showed that white matter lesions in centrum semiovale, low inner capsule, right and left leukodystrophy were not influence factors for cognitive impairment (all P>0.05). Conclusion:PD patients with sleep disorders have lower cognitive function scores, higher CHIPS scores, and significant changes in white matter lesions compared to those without sleep disorders. In PD patients with sleep disorders, the higher the CHIPS score, the lower the cognitive function score, and the more significant the rate of cognitive impairment occurrence and development.
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Objective:To explore the characteristics of sleep disorders in patients with Parkinson's disease (PD) and its correlation with homocysteine.Methods:Totally 75 PD patients hospitalized in the department of neurology from January 2017 to June 2021 were selected and divided into sleep disorder group ( n=39) and non-sleep disorder group ( n=36)according to polysomnography, Parkinson's disease sleep scale(PDSS) and Epworth sleepiness scale(ESS). The basic clinical data, hematological examination results, scale evaluation data and polysomnography monitoring data of the above patients were collected during hospitalization to analyze the sleep characteristics of patients with Parkinson's disease and its correlation with homocysteine.SPSS 26.0 statistical analysis software was used for t test, Mann-Whitney U test, Pearson analysis, Spearman analysis and multivariate Logistic analysis. Results:The sleep efficiency (56.82±19.07)%, N2 phase ratio(48.67±17.70)%, N3 phase ratio(9.20%(19.00%)) and the leg movement micro-arousal index(0(1.20)) in the sleep disorder group were lower than those in the non-sleep disorder group (sleep efficiency (82.15±5.55)%, N2 phase ratio(57.02±2.80)%, N3 phase ratio(20.01%(3.93%)), the leg movement micro-arousal index(1.15(1.80)). The differences were statistically significant ( t/ Z=-6.087, -2.905, -3.773, -3.683, all P<0.05). The proportion of AHI (0.90(14.60)), N1 stage (19.50%(15.70%)), and periodic limb index (0(24.80)) in sleep disorder group were higher than those in non-sleep disorder group (AHI (0.60(0.30)), N1 stage (12.15%(3.15%)), and periodic limb index (0(0)). The difference was statistically significant ( Z=2.154, 5.250, 3.559, all P<0.05). The homocysteine (15.80(3.90) μmol/L), NMSS-insomnia correlation score (3.00(5.00)), MDS-UPDRS-Ⅰ(7.00 (10.00)), MDS-UPDRS-Ⅲ (23.00 (16.00)) in the sleep disorder group were higher than those in the non-sleep disorder group (homocysteine (14.10 (4.20)μmol/L), NMSS-insomnia correlation score (0(1.00)), MDS-UPDRS-Ⅰ(3.00 (2.00)), MDS-UPDRS-Ⅲ (17.00 (4.00)), and the differences were statistically significant( Z=2.557, 4.487, 2.952, 2.180, all P<0.05). The NMSS-olfactory correlation scores (2.00(4.00)) and PDSS (99.00 (40.00)) were lower than those in the non-sleep disorder group (NMSS-olfactory correlation scores (4.50 (7.00)) and PDSS (122.00 (28.00)), and the differences were statistically significant ( Z=2.450, 4.126, both P<0.05). Hcy was positively correlated with sleep disorder in PD patients ( r=0.297, P<0.05). Binariate logistic regression analysis showed that elevated homocysteine level might be a risk factor for sleep disorder in PD patients ( β=0.193, OR=1.213, 95% CI=1.029-1.430). Conclusion:Parkinson's disease patients with sleep disorder have the characteristics of sleep structure disorder, often accompanied by more serious motor disorders, and the olfactory function impairment is relatively mild. Elevated homocysteine levels may be a risk factor for sleep disorder in Parkinson's disease.
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Objective To explore the pathological features of Aβ1-42 deposition and its correlation with Apolipoprotein E in brain of streptozotocin (STZ)-induced type Ⅱ diabetic rats.Methods High fat diet combined with small dose of STZ induced diabetic rats were adopted as experiment rats,and randomly divided into 3 months old diabetes mellitus group and 6 months old diabetes mellitus group (n=15).Healthy Wistar rats were adopted as control rats,and divided 3 months old control group and 6 months old control group (n=15).The Aβ1-42 and ApoE location and expressions were detected by immtmohistochemistry.Real-time fluorogenic quantitative-PCR and Westem blotting were used to detect the mRNA and protein levels of ApoE in each group.Results Immunohistochemical results showed that Aβ1-42 in the brain of the diabetic rats gathered around the vessel wall and blood vessel.The number of Aβ1-42 and ApoE positively-stained cells and positively-stained vessels was significantly larger and the ApoE mRNA and protein expressions were significantly increased in the 6 months old diabetes mellitus group as compared with those in the 3 months old diabetes mellitus group (P＜0.05).The number of Aβ1-42 and ApoE positively-stained cells and positively-stained vessels was significantly larger and the ApoE mRNA and protein expressions were significantly increased in the 6 months old control groupas compared with those in the 3 months old control group (P＜0.05).As compared with that in the 6 months old control group,the number of Aβ11-42 and ApoE positively-stained cells and positively-stained vessels was significantly larger and the ApoE mRNA and protein expressions were significantly increased in the 6 months old diabetes mellitus group (P＜0.05).As compared with that in the 3 months old control group,the number of Aβ1-42 and ApoE positively-stained cells and positively-stained vessels was significantly larger and the ApoE mRNA and protein expressions was significantly increased in the 3 months old diabetes mellitus group (P＜0.05).Person correlation coefficient indicated that the number of positively-stained cells of Aβ-42 was positively correlated to ApoE protein expression level (r=0.9755,P=0.000).Conclusions Aβ1-42 in the brain of type Ⅱ diabetic rats expresses both in blood vessel wall and around blood vessel.Age and duration of diabetes can increase the deposition of A3 and ApoE in brain tissues,and there is a positive correlation between them.
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Objective To study the tortuosity coefficient (TC) values of basilar arteries in the adult,and its change in cerebral basilar artery infarction.Methods TC values of basilar arteries was prospectively analyzed using the magnetic resonance angiography images of 135 controls(19-80 years of age,male 90,female 45)and 42 patients with cerebral infarction(5l-70 years of age,male 28,female 14).The relationship between TC values and posterior circulation infarction was statistically evaluated.Results Differences of TC between age groups were statistically significant except group B (31-50 years)and C(51-70 years)(F=10.31,P<0.01).The infarction group had greater TC value(2.497±1.200)than the control group(1.939±0.850,t=2.39,P=0.0195).Conclusions (1)Basilar artery tortuosity is positively related to age,reflecting the degree of arteriosclerosis;(2)Basilar artery tortuosity increases in patients with posterior circulation infarction.