Ghazi Sherbaf Farzaneh, Rahmani Farzaneh, Jooyandeh Sommayeh Mohammadi, Aarabi Mohammad Hadi
Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.
Acta Neurol Belg. 2018 Sep;118(3):415-421. doi: 10.1007/s13760-018-0896-x. Epub 2018 Feb 13.
Search for Parkinson's disease (PD) progression biomarkers has led to the identification of both motor and non-motor symptoms relevant of prodromal PD that could be eye-opening to the spreading underlying Lewy body pathogenesis. One most robust predictor of PD is the REM sleep behavior disorder (RBD), and one most common early non-motor symptom of PD is depression. With RBD, frequently coexisting with clinical depression and both predicting dopamine transmission dysfunction, we aimed to survey structural associates of depressive symptoms in early PD patients with comorbid RBD. Through diffusion MRI connectometry, we tracked fiber differences comparing DWI images obtained from 14 patients with depressive symptoms and 18 without depression from a group with comorbid RBD and PD. DWI images and patients were recruited from the Parkinson's Progression Markers Initiative database. PD-RBD patients with depressive symptoms showed pathways with significantly reduced connectivity in the right cingulum, left and right fornix, left inferior longitudinal fasciculus, right corticospinal tract, left middle cerebellar peduncle and genu of corpus callosum (FDR = 0.0228). Diffusivity alteration of the mentioned fibers in depressed, early PD patients with RBD might reflect underlying PD pathology and serve as common structural DWI signatures for early PD diagnosis.
对帕金森病（PD）进展生物标志物的研究已导致识别出与前驱期PD相关的运动和非运动症状，这可能为潜在的路易体发病机制的传播带来新的认识。PD最可靠的预测指标之一是快速眼动睡眠行为障碍（RBD），PD最常见的早期非运动症状之一是抑郁。由于RBD常与临床抑郁共存，且两者都预示着多巴胺传递功能障碍，我们旨在调查合并RBD的早期PD患者抑郁症状的结构关联。通过扩散磁共振成像连接ometry，我们追踪了纤维差异，比较了从一组合并RBD和PD的患者中获得的14例有抑郁症状患者和18例无抑郁症状患者的弥散加权成像（DWI）图像。DWI图像和患者来自帕金森病进展标志物倡议数据库。有抑郁症状的PD-RBD患者在右侧扣带、左右穹窿、左侧下纵束、右侧皮质脊髓束、左侧小脑中脚和胼胝体膝部显示出连接性显著降低的通路（错误发现率=FDR=0.0228）。合并RBD的抑郁早期PD患者上述纤维的扩散率改变可能反映了潜在的PD病理，并可作为早期PD诊断的常见结构DWI特征。
