Sterling N W, Lewis M M, Du G, Huang X
Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA.
Department of Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA.
J Parkinsons Dis. 2016 May 27;6(3):557-67. doi: 10.3233/JPD-160824.
Parkinson's disease (PD) is a progressive age-related neurodegenerative disorder. Although the pathological hallmark of PD is dopaminergic cell death in the substantia nigra pars compacta, widespread neurodegenerative changes occur throughout the brain as disease progresses. Postmortem studies, for example, have demonstrated the presence of Lewy pathology, apoptosis, and loss of neurotransmitters and interneurons in both cortical and subcortical regions of PD patients. Many in vivo structural imaging studies have attempted to gauge PD-related pathology, particularly in gray matter, with the hope of identifying an imaging biomarker. Reports of brain atrophy in PD, however, have been inconsistent, most likely due to differences in the studied populations (i.e. different disease stages and/or clinical subtypes), experimental designs (i.e. cross-sectional vs. longitudinal), and image analysis methodologies (i.e. automatic vs. manual segmentation). This review attempts to summarize the current state of gray matter structural imaging research in PD in relationship to disease progression, reconciling some of the differences in reported results, and to identify challenges and future avenues.
帕金森病（PD）是一种与年龄相关的进行性神经退行性疾病。尽管PD的病理标志是黑质致密部多巴胺能细胞死亡，但随着疾病进展，大脑中会出现广泛的神经退行性变化。例如，尸检研究表明，PD患者的皮质和皮质下区域均存在路易体病理、细胞凋亡以及神经递质和中间神经元的丧失。许多活体结构成像研究试图评估与PD相关的病理变化，尤其是在灰质中，以期找到一种成像生物标志物。然而，关于PD患者脑萎缩的报道并不一致，这很可能是由于研究人群的差异（即不同的疾病阶段和/或临床亚型）、实验设计（即横断面研究与纵向研究）以及图像分析方法（即自动分割与手动分割）所致。本综述旨在总结PD灰质结构成像研究的现状及其与疾病进展的关系，调和报道结果中的一些差异，并确定挑战和未来研究方向。
