| Literature DB >> 35222000 |
Zihan Chang1, Fen Xie1, Hualing Li1, Feilan Yuan1, Lina Zeng2, Lin Shi3, Shuzhen Zhu1, Xiaohe Lu2, Xiaobo Wei1, Qing Wang1.
Abstract
OBJECTIVE: This study intended to investigate whether retinal nerve fiber layer (RNFL) thickness could become a potential marker in patients with Parkinson's disease with cognitive impairment (PD-CI).Entities:
Keywords: Parkinson’s disease; cognitive impairment; indicator; optical coherence tomography; retinal nerve fiber layer
Year: 2022 PMID: 35222000 PMCID: PMC8867012 DOI: 10.3389/fnagi.2022.832768
Source DB: PubMed Journal: Front Aging Neurosci ISSN: 1663-4365 Impact factor: 5.750
FIGURE 1Diagrammatic map revealing the OCT examination of participants in the present study. (A) The appearance of the optic nerve. (B) Transverse image of RNFL. (C) Segmentation of RNFL. (D) RNFL thickness map.
Demographic and clinical characteristics of the study subjects.
| Variables [ | Controls ( | PD | |||
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| All ( | PD-NC ( | PD-CI ( | |||
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| Age, years | 61.42 ± 9.75 | 63.67 ± 9.27 | 60.52 ± 8.68 | 65.79 ± 9.18 | 0.059 |
| Male sex, No. (%) | 21 (46.7%) | 34 (59.6%) | 12 (52.2%) | 22 (64.7%) | 0.276 |
| Education, years | / | 9 (6) | 9 (3) | 6 (4) | 0.009 |
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| H&Y staging | / | 2.50 (0.5) | 2.00 (0.5) | 2.50 (1.0) | 0.325 |
| Disease duration, months | / | 36 (54) | 36 (36) | 48 (75) | 0.189 |
| LEDD, mg | / | 511.50 (242.75) | 436.50 (461.50) | 515.25 (177.00) | 0.083 |
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| 0.857 | ||||
| AR/PIGD subtype | 34 (59.6%) | 14 (60.9%) | 20 (58.8%) | / | |
| TD subtype | 7 (12.3%) | 2 (8.7%) | 5 (14.7%) | / | |
| Mixed subtype | 16 (28.1%) | 7 (30.4%) | 9 (26.5%) | / | |
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| / | 46.0 (26.0) | 37.0 (26.0) | 49.5 (29.0) | 0.016 |
| UPDRS-I | / | 4.0 (3.0) | 3.0 (3.0) | 4.0 (3.0) | 0.137 |
| UPDRS-II | / | 15.0 (9.0) | 13.0 (8.0) | 16.0 (9.0) | 0.022 |
| UPDRS-III | / | 25.0 (16.0) | 22.0 (17.0) | 26.5 (19.0) | 0.037 |
| UPDRS-IV | / | 3.0 (4.0) | 3.0 (4.0) | 3.50 (5.0) | 0.094 |
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| / | 25.0 (4.0) | 28.0 (2.0) | 24.5 (3.0) | < 0.001 |
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| / | 22.5 (8.0) | 24.5 (2.0) | 19.5 (7.0) | < 0.001 |
FIGURE 2RNFL thickness in PD patients with different cognitive conditions and healthy subjects. The scatter plots accompanied by the mean ± SD present the peripapillary RNFL thickness in healthy controls, PD-NC and PD-CI patients in inferior (A), inferior (B), temporal (C), nasal (D), Ti (temporal-inferior, E) and Ni (nasal-inferior, F) sectors. **p < 0.01, ***p < 0.001.
Comparisons of retinal nerve fiber layer among different groups based on one-way ANOVA.
| RNFL (μ m) |
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| Group A | Group B | Group C | A | A | B | ||
| Global | 107.02 ± 6.55 | 104.48 ± 9.07 | 98.50 ± 9.95 | 0.719 | < 0.001 | 0.029 | |
| Superior | 134.82 ± 10.83 | 128.37 ± 16.81 | 129.57 ± 15.42 | 0.221 | 0.301 | 1.000 | |
| Inferior | 138.98 ± 13.31 | 139.33 ± 11.75 | 126.87 ± 12.53 | 1.000 | < 0.001 | 0.001 | |
| temporal | 82.31 ± 12.65 | 76.83 ± 12.01 | 70.78 ± 16.09 | 0.369 | 0.001 | 0.321 | |
| Nasal | 73.29 ± 12.14 | 73.63 ± 13.53 | 67.79 ± 14.62 | 1.000 | 0.217 | 0.323 | |
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| temporal-superior | 149.04 ± 17.13 | 142.07 ± 16.15 | 140.62 ± 20.64 | 0.412 | 0.132 | 1.000 | |
| nasal-superior | 121.33 ± 16.33 | 114.52 ± 20.09 | 117.85 ± 19.49 | 0.449 | 1.000 | 1.000 | |
| temporal-inferior | 158.22 ± 17.68 | 160.46 ± 14.94 | 140.79 ± 18.97 | 1.000 | < 0.001 | < 0.001 | |
| nasal-inferior | 120.14 ± 16.22 | 117.98 ± 20.69 | 113.01 ± 19.58 | 1.000 | 0.276 | 0.963 | |
* p < 0.05, ** p < 0.01, *** p < 0.001. RNFL: retinal nerve fiber layer; PD: Parkinson’s disease; PD-NC: PD with normal cognition; PD-CI: PD with cognitive impairment.
General linear model analysis in the RNFL levels in PD patients with different cognitive status.
| RNFL | Global RNFL (μ m) | Inferior RNFL (μ m) | ||||
| PD-NC | PD-CI | PD-NC | PD-CI | |||
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| Unadjusted | 104.48 ± 9.07 | 98.50 ± 9.95 | 0.025 | 139.33 ± 11.75 | 126.87 ± 12.53 | <0.001 |
| Adjusted | 103.16 ± 9.63 | 99.39 ± 9.48 | 0.166 | 138.03 ± 12.41 | 127.75 ± 12.22 | 0.005 |
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| Unadjusted | 160.46 ± 14.94 | 140.79 ± 18.97 | <0.001 | 117.98 ± 20.69 | 113.01 ± 19.58 | 0.363 |
| Adjusted | 159.64 ± 18.20 | 141.34 ± 17.92 | 0.001 | 116.20 ± 21.29 | 114.22 ± 20.96 | 0.740 |
Abbreviations: RNFL: retinal nerve fiber layer; PD: Parkinson’s disease; PD-NC: PD with normal cognition; PD-CI: PD with cognitive impairment.
Logistic regression analysis for the relation between RNFL and the impaired cognition in PD patients.
| Global RNFL | Cognitive Impairment (CI) | Inferior RNFL | Cognitive Impairment (CI) | ||||
| OR | 95% confidence intervals | OR | 95% confidence intervals | ||||
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| Unadjusted | 0.935 | 0.897 – 0.994 | 0.032 | Unadjusted | 0.922 | 0.877 – 0.970 | 0.002 |
| Adjusted | 0.962 | 0.893 – 1.037 | 0.314 | Adjusted | 0.923 | 0.865 – 0.984 | 0.014 |
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| Unadjusted | 0.932[ | 0.894 – 0.973 | 0.001 | Unadjusted | 0.987 | 0.961 – 1.015 | 0.358 |
| Adjusted | 0.923[ | 0.870 – 0.978 | 0.007 | Adjusted | 0.991 | 0.959 – 1.023 | 0.558 |
FIGURE 3ROC analysis to assess the validity of RNFL thickness or RNFL-involved models for differentiating PD patients with different cognitive conditions. (A) The ROC curves of RNFL thickness from different peripapillary sectors are shown. The AUCs of RNFL thickness in the inferior and temporal-inferior sectors were 0.77 (p = 0.001) and 0.78 (p < 0.001), respectively, for discriminating between PD-NC and PD-CI cases. (B) The RNFL-involved combined model for differentiating PD-CI from PD-NC patients comprised three variables, namely Ti (temporal-inferior) RNFL thickness, education level and UPDRS-III. The AUC was 0.85 for this model (p < 0.001). Note that the RNFL-involved combined model was generated from the logistic regression analysis in Supplementary Table 3.