进行性核上性麻痹伴帕金森病为主型的白质损伤进展。
Progression of white matter damage in progressive supranuclear palsy with predominant parkinsonism.
机构信息
Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy; Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
出版信息
Parkinsonism Relat Disord. 2018 Apr;49:95-99. doi: 10.1016/j.parkreldis.2018.01.001. Epub 2018 Jan 4.
INTRODUCTION
Progressive supranuclear palsy with predominant parkinsonism (PSP-P) accounts for 14-35% of all PSP cases. A few cross-sectional MRI studies in PSP-P showed a remarkable white matter (WM) damage. Progression of brain structural damage in these patients remains unknown.
METHODS
Longitudinal clinical, cognitive and diffusion tensor (DT) MRI data were obtained over a mean 1.6 year follow up in 10 PSP-P patients. At study entry, patients were compared with 36 healthy controls. Voxelwise statistical analysis of white matter DT MRI data (mean, axial and radial diffusivity, and fractional anisotropy) was carried out using tract-based spatial statistics.
RESULTS
During the 1.6 year follow up, PSP-P patients showed significant decline of motor, cognitive and mood disturbances. DT MRI analysis revealed at baseline a widespread pattern of WM alterations. Over time, PSP-P patients exhibited progression of WM damage in supratentorial tracts compared to baseline. No WM changes were detected in cerebellar WM.
CONCLUSIONS
In PSP-P patients, WM damage significantly progressed over time. Longitudinal DT MRI measures are a potential in vivo marker of disease progression in PSP-P.
简介
以帕金森病为主的进行性核上性麻痹（PSP-P）占所有 PSP 病例的 14-35%。少数 PSP-P 的横断面 MRI 研究显示出明显的白质（WM）损伤。这些患者的脑结构损伤进展情况尚不清楚。
方法
对 10 名 PSP-P 患者进行了平均 1.6 年的纵向临床、认知和弥散张量（DT）MRI 数据采集。在研究开始时，将患者与 36 名健康对照进行比较。使用基于束的空间统计学对弥散张量 MRI 数据（平均、轴向和径向弥散度和各向异性分数）进行了基于体素的统计分析。
结果
在 1.6 年的随访期间，PSP-P 患者表现出明显的运动、认知和情绪障碍恶化。DT MRI 分析显示在基线时有广泛的 WM 改变。随着时间的推移，与基线相比，PSP-P 患者的大脑皮质 WM tract 中 WM 损伤有进展。小脑 WM 中未检测到 WM 变化。
结论
在 PSP-P 患者中，WM 损伤随时间显著进展。纵向 DT MRI 测量可能是 PSP-P 疾病进展的体内标志物。
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