Department of Clinical Neurosciences, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India; Department of Neurology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India.
Department of Neuroimaging & Interventional Radiology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India.
Parkinsonism Relat Disord. 2018 Aug;53:28-32. doi: 10.1016/j.parkreldis.2018.04.022. Epub 2018 Apr 24.
The onset of motor symptoms in Parkinson's disease (PD) is characteristically asymmetric and correlates with dopaminergic deficit of contralateral basal ganglia. This study explored the concordance between motor asymmetry and changes of substantia nigra pars compacta (SNc) using neuromelanin-sensitive imaging.
Forty-four subjects with PD and fifteen healthy controls were included in this study. Clinical laterality (CL) was based on the motor sub scores of the Unified Parkinson's Disease Rating Scale-Part III. All subjects underwent neuromelanin-sensitive imaging and imaging laterality (IL) was based on the differences between contrast ratios of the right and left lateral SNc. Concordance was evaluated by correlating CL and IL.
Motor asymmetry at disease onset was reported in 97.72% of subjects with PD, of which 65.90% reported right-sided onset. Forty-three subjects were right-handed and 68.18% reported onset of symptoms on dominant side. Right CL was observed in 59.09%, left CL in 40.90%, right IL in 11.36% and left IL in 88.63%. Concordance was established in 61.36%, majority of whom had a combination of right CL and left IL. In healthy controls, a significantly lower contrast ratio of the left lateral SNc was also noted.
Handedness may correlate with motor asymmetry and left hemisphere may have a predilection for neurodegeneration. The finding of significant neuronal loss of left SNc in controls warrants further evaluation for better understanding of motor asymmetry in PD. Neuromelanin sensitive imaging can be a useful tool to study the relationship between motor asymmetry and nigrostriatal dysfunction.
帕金森病（PD）运动症状的发作具有明显的不对称性，与对侧基底节多巴胺能缺失相关。本研究通过神经黑色素敏感成像探索运动不对称与黑质致密部（SNc）变化的一致性。
本研究纳入 44 例 PD 患者和 15 名健康对照者。临床侧性（CL）基于统一帕金森病评定量表第三部分的运动子评分。所有受试者均行神经黑色素敏感成像，根据左右侧 SNc 对比率的差异进行成像侧性（IL）评估。通过 CL 和 IL 相关性评估一致性。
97.72%的 PD 患者在疾病发作时出现运动不对称，其中 65.90%报告右侧起病。43 名受试者为右利手，68.18%报告症状首发于优势侧。右侧 CL 为 59.09%，左侧 CL 为 40.90%，右侧 IL 为 11.36%，左侧 IL 为 88.63%。建立了一致性 61.36%，其中大多数患者具有右侧 CL 和左侧 IL 的组合。健康对照组也观察到左侧 SNc 对比率显著降低。
利手性可能与运动不对称相关，左侧半球可能存在神经退行性变的倾向。对照组 SNc 左侧出现明显神经元丢失，需要进一步评估，以更好地理解 PD 中的运动不对称。神经黑色素敏感成像可以作为研究运动不对称与黑质纹状体功能障碍关系的有用工具。
