Departement des neurosciences cliniques, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland.
Curr Opin Neurol. 2010 Aug;23(4):413-9. doi: 10.1097/WCO.0b013e32833bc59c.
An overview of recent advances in structural neuroimaging and their impact on movement disorders research is presented.
Novel developments in computational neuroanatomy and improvements in magnetic resonance image quality have brought further insight into the pathophysiology of movement disorders. Sophisticated automated techniques allow for sensitive and reliable in-vivo differentiation of phenotype/genotype related traits and their interaction even at presymptomatic stages of disease.
Voxel-based morphometry consistently demonstrates well defined patterns of brain structure changes in movement disorders. Advanced stages of idiopathic Parkinson's disease are characterized by grey matter volume decreases in basal ganglia. Depending on the presence of cognitive impairment, volume changes are reported in widespread cortical and limbic areas. Atypical Parkinsonian syndromes still pose a challenge for accurate morphometry-based classification, especially in early stages of disease progression. Essential tremor has been mainly associated with thalamic and cerebellar changes. Studies on preclinical Huntington's disease show progressive loss of tissue in the caudate and cortical thinning related to distinct motor and cognitive phenotypes. Basal ganglia volume in primary dystonia reveals an interaction between genotype and phenotype such that brain structure changes are modulated by the presence of symptoms under the influence of genetic factors. Tics in Tourette's syndrome correlate with brain structure changes in limbic, motor and associative fronto-striato-parietal circuits. Computational neuroanatomy provides useful tools for in-vivo assessment of brain structure in movement disorders, allowing for accurate classification in early clinical stages as well as for monitoring therapy effects and/or disease progression.
本文介绍了结构神经影像学的最新进展及其对运动障碍研究的影响。
计算神经解剖学的新发展和磁共振成像质量的提高，使我们对运动障碍的病理生理学有了更深入的了解。复杂的自动化技术可以敏感、可靠地在疾病的无症状阶段对表型/基因型相关特征及其相互作用进行体内区分。
体素形态计量学一致显示出运动障碍患者大脑结构变化的明确模式。特发性帕金森病的晚期表现为基底节灰质体积减少。根据认知障碍的存在，报告了广泛的皮质和边缘区域的体积变化。非典型帕金森综合征仍然是基于形态计量学的准确分类的挑战，尤其是在疾病进展的早期阶段。特发性震颤主要与丘脑和小脑变化有关。对临床前亨廷顿病的研究表明，纹状体和皮质变薄与特定的运动和认知表型有关，这与组织逐渐丧失有关。原发性肌张力障碍的基底节体积显示基因型和表型之间的相互作用，即脑结构变化受遗传因素影响下症状存在的调节。图雷特综合征的抽搐与边缘、运动和联想额顶叶皮质回路中的脑结构变化相关。计算神经解剖学为运动障碍的大脑结构提供了有用的体内评估工具，允许在早期临床阶段进行准确的分类，以及监测治疗效果和/或疾病进展。
