苍白球多巴胺能神经末梢变性与早期帕金森病的静止性震颤：PPMI 队列分析。
Pallidal dopaminergic denervation and rest tremor in early Parkinson's disease: PPMI cohort analysis.
机构信息
Division of Brain Sciences, Neurology Imaging Unit, Imperial College London, Hammersmith Campus, UK; Department of Neurology, Seoul National University Boramae Hospital, South Korea.
Division of Brain Sciences, Neurology Imaging Unit, Imperial College London, Hammersmith Campus, UK.
出版信息
Parkinsonism Relat Disord. 2018 Jun;51:101-104. doi: 10.1016/j.parkreldis.2018.02.039. Epub 2018 Feb 24.
BACKGROUND
s: Over recent years there have been some conflicting reports upon the role of pallidal dopaminergic denervation in rest tremor in Parkinson's disease.
OBJECTIVES
To clarify this issue we analyzed the clinical and 123I-FP-CIT SPECT data of a large cohort of early Parkinson's disease patients enrolled in the PPMI study.
METHODS
Pallidal and striatal dopamine transporter uptake ratios were calculated in 382 patients (120 no-tremor, 60 tremor-dominant, and 202 indeterminate) and 150 controls. A region of interest (ROI) approach was used to estimate DAT uptake ratios from 123I-FP-CIT SPECT scans in the caudate nucleus, putamen, and globus pallidus after normalization to a DAT template. DAT uptake ratios for each region were compared between subgroups using ANCOVA and linear regression analyses were performed to evaluate the relationship between severity of rest tremor and regional DAT uptake ratios.
RESULTS
PD patients had significantly lower DAT uptake ratios in the pallidum, putamen and caudate as compared to healthy controls (p < 0.001). ANCOVA showed inter-PD subgroup differences in DAT uptake ratios in the putamen and pallidum (p < 0.05) after adjustment for age and disease duration, with post-hoc comparisons revealing significantly higher DAT uptake ratios for the tremor-dominant subgroup as compared to non-tremor and indeterminate subgroups (p < 0.016). There was no significant relationship between rest tremor severity and pallidal DAT either in the tremor-dominant subgroup or in the total PD population.
CONCLUSIONS
Pallidal dopaminergic denervation appears unrelated to rest tremor severity in early Parkinson's disease.
背景
近年来，关于苍白球多巴胺能神经变性在帕金森病静止性震颤中的作用存在一些相互矛盾的报告。
目的
为了澄清这一问题，我们分析了 PPMI 研究中纳入的一大组早期帕金森病患者的临床和 123I-FP-CIT SPECT 数据。
方法
在 382 名患者（120 名无震颤、60 名震颤为主和 202 名不确定）和 150 名对照中计算了苍白球和纹状体多巴胺转运体摄取比值。使用感兴趣区（ROI）方法，通过将 123I-FP-CIT SPECT 扫描中的 DAT 摄取比值归一化为 DAT 模板，来估计尾状核、壳核和苍白球中的 DAT 摄取比值。使用方差分析（ANCOVA）比较亚组之间的 DAT 摄取比值，并进行线性回归分析，以评估静止性震颤严重程度与区域 DAT 摄取比值之间的关系。
结果
与健康对照组相比，PD 患者的苍白球、壳核和尾状核中的 DAT 摄取比值显著降低（p<0.001）。在调整年龄和疾病持续时间后，ANCOVA 显示 PD 亚组之间在壳核和苍白球中的 DAT 摄取比值存在差异（p<0.05），事后比较显示震颤为主亚组的 DAT 摄取比值明显高于无震颤和不确定亚组（p<0.016）。在震颤为主亚组或总 PD 人群中，静止性震颤严重程度与苍白球 DAT 之间均无显著关系。
结论
在早期帕金森病中，苍白球多巴胺能神经变性与静止性震颤严重程度无关。
Zotero 插件