Sung Young Hee, Lee Jongho, Nam Yoonho, Shin Hyeong-Geol, Noh Young, Shin Dong Hoon, Kim Eung Yeop
Department of Neurology, Gachon University Gil Medical Center, Incheon, South Korea.
Department of Electrical and Computer Engineering, Seoul National University, Seoul, Korea.
Hum Brain Mapp. 2018 Jan;39(1):542-553. doi: 10.1002/hbm.23863. Epub 2017 Oct 24.
In this study, the prevalence of abnormality in putative nigrosome 1 and nigrosome 4 (N1 and N4, respectively) was investigated in early versus late-stage idiopathic Parkinson's disease (IPD) patients. A total of 128 IPD patients (early stage[n = 89]; late stage[n = 39]) and 15 healthy subjects were scanned for high-resolution (0.5 × 0.5 × 1.0 mm ) multiecho gradient-recalled echo MRI and dopamine transporter PET imaging. The MRI data were processed for susceptibility map-weighted imaging (SMWI) to improve a contrast-to-noise ratio, and the images were resliced at 0.5 mm to define N1 and N4. When each side of N1 and N4 was assessed separately for the loss of hyperintensity by two independent reviewers, the consensus review results showed that in early-stage IPD (178 substantia nigras [SNs]), the loss of hyperintensity was observed more often in only the N1 region (65.2%) when compared to in both N1 and N4 regions (34.8%). In late-stage IPD (78 SNs), on the other hand, the loss in only the N1 region (25.6%) was less prevalent than in both N1 and N4 (74.4%) (P < 0.0001). Additionally, intact SNs (both in N1 and N4) were observed 17 SNs (9.6%) of the early-stage IPD patients, whereas it was not found in any SNs of the late-stage IPD patients (P = 0.005). Moreover, involvement of both N1 and N4 on both sides was found in 19.1% of the early-stage IPD patients, whereas its incidence was higher (61.5%) in the late-stage IPD patients (P < 0.0001), suggesting that the loss of hyperintensity in IPD progresses from N1 to N4 as the disease advances. Hum Brain Mapp 39:542-553, 2018. © 2017 Wiley Periodicals, Inc.
在本研究中，我们调查了早期和晚期特发性帕金森病（IPD）患者中假定的黑质小体1和黑质小体4（分别为N1和N4）异常的患病率。对总共128例IPD患者（早期[n = 89]；晚期[n = 39]）和15名健康受试者进行了高分辨率（0.5×0.5×1.0 mm）多回波梯度回波MRI和多巴胺转运体PET成像扫描。对MRI数据进行处理以获得磁化率图加权成像（SMWI），以提高对比度噪声比，并将图像重新切片至0.5 mm以定义N1和N4。当由两名独立的评估者分别评估N1和N4每一侧的高信号缺失情况时，一致性评估结果显示，在早期IPD（178个黑质[SNs]）中，与N1和N4区域均出现高信号缺失（34.8%）相比，仅在N1区域观察到高信号缺失的情况更常见（65.2%）。另一方面，在晚期IPD（78个SNs）中，仅在N1区域的高信号缺失（25.6%）比在N1和N4区域均出现高信号缺失（74.4%）的情况更少见（P < 0.0001）。此外，在17个（9.6%）早期IPD患者的SNs中观察到完整的SNs（N1和N4均完整），而在晚期IPD患者的任何SNs中均未发现（P = 0.005）。此外，在19.1%的早期IPD患者中发现双侧的N1和N4均受累，而在晚期IPD患者中的发生率更高（61.5%）（P < 0.0001），这表明随着疾病进展，IPD中高信号的缺失从N1发展至N4。《人类脑图谱》39:542 - 553，2018年。© 2017威利期刊公司。
