Diabetes mellitus is independently associated with more severe cognitive impairment in Parkinson disease |
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| Affiliation: | 1. Department of Radiology, University of Michigan, Ann Arbor, MI, USA;2. Department of Neurology, University of Michigan, Ann Arbor, MI, USA;3. Neurology Service and GRECC, VAAAHS, Ann Arbor, MI, USA;4. Michigan Alzheimer Disease Center, Ann Arbor, MI, USA;1. Department of Psychiatry, University of Pittsburgh, Pittsburgh PA, USA;2. Department of Neurology, University of Pittsburgh, Pittsburgh PA, USA;3. Department of Psychology, University of Pittsburgh, Pittsburgh PA, USA;4. Department of Medicine, University of Pittsburgh, Pittsburgh PA, USA;5. Department of Biostatistics, University of Pittsburgh, Pittsburgh PA, USA;6. Department of Epidemiology, University of Pittsburgh, Pittsburgh PA, USA;1. Departments of Psychiatry and Preventive Medicine, Mount Sinai School of Medicine, New York, NY, USA;2. Departments of Preventive Medicine, Mount Sinai School of Medicine, New York, NY, USA;3. Department of Psychiatry, Sheba Medical Center, The Joseph Sagol Neuroscience Center, Tel-Aviv, Israel;4. Maccabi Healthcare Services, Israel;1. Department of Radiology, Washington University School of Medicine, 510 South Kingshighway Blvd., St. Louis, MO 63110, USA;2. Department of Neurology, Washington University School of Medicine, 510 South Kingshighway Blvd., St. Louis, MO 63110, USA;3. Department of Chemistry and Biochemistry, University of California, Santa Barbara, CA 93106, USA;1. College of Pharmacy, Yeungnam University, 280 Daehak-Ro, Gyeongsan, Gyeongbuk 38541, Republic of Korea;2. College of Pharmacy, Keimyung University, 1095 Dalgubeol-daero, Daegu 42601, Republic of Korea;1. Unitat d’Insuficiència Cardiaca, Servei de Cardiologia, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain;2. Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain |
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| Abstract: | BackgroundThere is increasing interest in interactions between metabolic syndromes and neurodegeneration. Diabetes mellitus (DM) contributes to cognitive impairment in the elderly but its effect in Parkinson disease (PD) is not well studied.ObjectiveTo investigate effects of comorbid DM on cognition in PD independent from PD-specific primary neurodegenerations.MethodsCross-sectional study. Patients with PD (n = 148); age 65.6 ± 7.4 years, Hoehn and Yahr stage 2.4 ± 0.6, with (n = 15) and without (n = 133) comorbid type II DM, underwent [11C]methyl-4-piperidinyl propionate (PMP) acetylcholinesterase (AChE) PET imaging to assess cortical cholinergic denervation, [11C]dihydrotetrabenazine (DTBZ) PET imaging to assess nigrostriatal denervation, and neuropsychological assessments. A global cognitive Z-score was calculated based on normative data. Analysis of covariance was performed to determine cognitive differences between subjects with and without DM while controlling for nigrostriatal denervation, cortical cholinergic denervation, levodopa equivalent dose and education covariates.ResultsThere were no significant differences in age, gender, Hoehn and Yahr stage or duration of disease between diabetic and non-diabetic PD subjects. There was a non-significant trend toward lower years of education in the diabetic PD subjects compared with non-diabetic PD subjects. PD diabetics had significantly lower mean (±SD) global cognitive Z-scores (−0.98 ± 1.01) compared to the non-diabetics (−0.36 ± 0.91; F = 7.78, P = 0.006) when controlling for covariate effects of education, striatal dopaminergic denervation, and cortical cholinergic denervation (total model F = 8.39, P < 0.0001).ConclusionDiabetes mellitus is independently associated with more severe cognitive impairment in PD likely through mechanisms other than disease-specific neurodegenerations. |
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| Keywords: | Acetylcholine Cognitive impairment Diabetes mellitus Dopamine Parkinson disease PET AChE" },{" #name" :" keyword" ," $" :{" id" :" kwrd0045" }," $$" :[{" #name" :" text" ," _" :" acetylcholinesterase DM" },{" #name" :" keyword" ," $" :{" id" :" kwrd0055" }," $$" :[{" #name" :" text" ," _" :" diabetes mellitus DTBZ" },{" #name" :" keyword" ," $" :{" id" :" kwrd0065" }," $$" :[{" #name" :" text" ," _" :" dihydrotetrabenazine LED" },{" #name" :" keyword" ," $" :{" id" :" kwrd0075" }," $$" :[{" #name" :" text" ," _" :" levodopa equivalent dose PD" },{" #name" :" keyword" ," $" :{" id" :" kwrd0085" }," $$" :[{" #name" :" text" ," _" :" Parkinson disease PET" },{" #name" :" keyword" ," $" :{" id" :" kwrd0095" }," $$" :[{" #name" :" text" ," _" :" positron emission tomography PMP" },{" #name" :" keyword" ," $" :{" id" :" kwrd0105" }," $$" :[{" #name" :" text" ," _" :" methyl-4-piperidinyl propionate VMAT2" },{" #name" :" keyword" ," $" :{" id" :" kwrd0115" }," $$" :[{" #name" :" text" ," _" :" vesicular monoamine transporter type 2 |
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