Department of Neurology, Charité - University Medicine Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.
Neuroimage Clin. 2013 Sep 20;3:381-7. doi: 10.1016/j.nicl.2013.09.006. eCollection 2013.
Detection and discrimination of neurodegenerative Parkinson syndromes are challenging clinical tasks and the use of standard T1- and T2-weighted cerebral magnetic resonance (MR) imaging is limited to exclude symptomatic Parkinsonism. We used a quantitative structural MR-based technique, MR-elastography (MRE), to assess viscoelastic properties of the brain, providing insights into altered tissue architecture in neurodegenerative diseases on a macroscopic level. We measured single-slice multifrequency MRE (MMRE) and three-dimensional MRE (3DMRE) in two neurodegenerative disorders with overlapping clinical presentation but different neuropathology - progressive supranuclear palsy (PSP: N = 16) and idiopathic Parkinson's disease (PD: N = 18) as well as in controls (N = 18). In PSP, both MMRE (Δμ = - 28.8%, Δα = - 4.9%) and 3DMRE (Δ|G*|: - 10.6%, Δφ: - 34.6%) were significantly reduced compared to controls, with a pronounced reduction within the lentiform nucleus (Δμ = - 34.6%, Δα = - 8.1%; Δ|G*|: - 7.8%, Δφ: - 44.8%). MRE in PD showed a comparable pattern, but overall reduction in brain elasticity was less severe reaching significance only in the lentiform nucleus (Δμ n.s., Δα = - 7.4%; Δ|G*|: - 6.9%, Δφ: n.s.). Beyond that, patients showed a close negative correlation between MRE constants and clinical severity. Our data indicate that brain viscoelasticity in PSP and PD is differently affected by the underlying neurodegeneration; whereas in PSP all MRE constants are reduced and changes in brain softness (reduced μ and |G*|) predominate those of viscosity (α and φ) in PD.
检测和区分神经退行性帕金森综合征是具有挑战性的临床任务,标准的 T1 和 T2 加权脑磁共振(MR)成像的应用仅限于排除有症状的帕金森病。我们使用一种基于定量结构的磁共振技术,即磁共振弹性成像(MRE),来评估大脑的粘弹性特性,从宏观层面上深入了解神经退行性疾病中组织结构的改变。我们在两种具有重叠临床表现但不同神经病理学的神经退行性疾病中测量了单层面多频 MRE(MMRE)和三维 MRE(3DMRE):进行性核上性麻痹(PSP:N=16)和特发性帕金森病(PD:N=18)以及对照组(N=18)。在 PSP 中,与对照组相比,MMRE(Δμ=-28.8%,Δα=-4.9%)和 3DMRE(Δ|G*|: -10.6%,Δφ=-34.6%)均显著降低,其中豆状核内的降低更为明显(Δμ=-34.6%,Δα=-8.1%;Δ|G*|: -7.8%,Δφ=-44.8%)。PD 的 MRE 表现出类似的模式,但脑弹性的整体降低程度较轻,仅在豆状核内具有统计学意义(Δμ n.s.,Δα=-7.4%;Δ|G*|: -6.9%,Δφ n.s.)。除此之外,患者的 MRE 常数与临床严重程度呈密切负相关。我们的数据表明,PSP 和 PD 中的脑粘弹性受到潜在神经退行性变的不同影响;而在 PSP 中,所有 MRE 常数都降低,脑柔软度(降低 μ 和 |G*|)的变化比 PD 中粘度(α和φ)的变化更为明显。