Wieler Marguerite, Gee Myrlene, Martin W R Wayne
Division of Neurology, University of Alberta, Edmonton, Alberta, Canada.
Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada.
Parkinsonism Relat Disord. 2015 Mar;21(3):179-83. doi: 10.1016/j.parkreldis.2014.11.017. Epub 2014 Nov 29.
To determine whether, in patients with early Parkinson's disease (PD), longitudinal changes in midbrain iron content are associated with declining motor function over a period of three years.
Nineteen untreated subjects with early PD and 13 age- and sex-matched controls were followed clinically for 36 months. MRI with a 3 T magnet was performed at baseline, 18 months and 36 months with a multiple gradient echo sequence designed for rapid single-scan mapping of the proton transverse relaxation rate R2*. R2* was calculated for midbrain and forebrain basal ganglia regions.
A difference in R2* between patients and controls was observed at baseline (p = 0.035) but not at 18 or 36 months in the lateral substantia nigra pars compacta (SNc). Linear regression indicated significant correlations between the change in R2* in the lateral SNc and the change score in UPDRS III (p = 0.008) and the PDQ-39 -mobility sub-score (p = 0.03) from baseline to 36 months. R2* tended to increase in those with more advanced disease and to decrease in those with milder disease.
High field MRI demonstrates lateral SNc abnormalities that progress over 3 years in early PD consistent with increased iron content in those with more advanced disease, corresponding to the known distribution of neuronal loss occurring in this disorder, and correlating with motor symptomatology. Larger and longer investigations with more precise mapping of iron-containing midbrain structures are needed to fully evaluate the potential of R2* as a biomarker of disease progression in PD.
确定早期帕金森病（PD）患者中脑铁含量的纵向变化是否与三年期间运动功能下降相关。
对19名未经治疗的早期PD患者和13名年龄及性别匹配的对照者进行了36个月的临床随访。在基线、18个月和36个月时，使用3T磁共振成像仪，采用一种多梯度回波序列进行检查，该序列设计用于快速单扫描质子横向弛豫率R2的映射。计算中脑和前脑基底神经节区域的R2。
在黑质致密部外侧，患者与对照者在基线时R2存在差异（p = 0.035），但在18个月或36个月时无差异。线性回归表明，从基线到36个月，黑质致密部外侧R2的变化与统一帕金森病评定量表第三部分（UPDRS III）的变化评分（p = 0.008）以及帕金森病问卷-39运动亚评分（p = 0.03）之间存在显著相关性。R2*在病情较重者中倾向于升高，在病情较轻者中倾向于降低。
高场磁共振成像显示早期PD患者黑质致密部外侧异常在3年内进展，与病情较重者铁含量增加一致，这与该疾病中已知的神经元丢失分布相对应，并与运动症状学相关。需要进行更大规模、更长时间且对含铁血脑结构进行更精确映射的研究，以充分评估R2*作为PD疾病进展生物标志物的潜力。
