Lee Yang Hyun, Chung Seok Jong, Yoo Han Soo, Lee Yoonju, Sohn Young H, Cha Jungho, Lee Phil Hyu
Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea.
Memory and Aging Center, Department of Neurology, University of California San Francisco, San Francisco, CA, USA; Nash Family Center for Advanced Circuit Therapeutics, Ichan School of Medicine at Mount Sinai, New York, NY, USA.
Parkinsonism Relat Disord. 2020 Jun;75:41-47. doi: 10.1016/j.parkreldis.2020.05.012. Epub 2020 May 14.
To investigate the potential protective influence of serum uric acid (UA) level on white matter (WM) microstructural changes in de novo Parkinson's disease (PD).
We enrolled a total of 184 patients with drug-naïve de novo PD and 59 age and gender-matched controls that underwent diffusion tensor imaging (DTI). Based on the distribution, serum UA levels were stratified into tertiles in PD patients by gender. Using tract-based spatial statistics (TBSS) analysis, fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were used to compare WM integrity between the groups.
Interaction analysis showed that interaction effect on FA values between gender and UA levels in PD was significant in widespread WM areas, including frontal-parieto-temporal, corpus callosum, bilateral internal and external capsule, and thalamic regions. Multiple regression analysis revealed that FA values had a significantly positive correlation with UA levels across widespread WM areas in male patients. However, there was no significant correlation between DTI measures and UA levels in female patients. In a group comparison in male patients, PD with the lowest UA level (PD-L-UA) group showed significantly lower FA and higher MD and RD values in frontal-parieto-temporal WM regions than PD with the highest UA level (PD-H-UA) group. However, female patients did not show significant difference of DTI measures between PD-L-UA and PD-H-UA groups.
The present study demonstrated that the serum UA levels may have the potentially gender-specific close relationship with WM integrity in the early stage of PD.
探讨血清尿酸（UA）水平对初发帕金森病（PD）患者白质（WM）微观结构变化的潜在保护作用。
我们共纳入了184例初发、未用药的PD患者以及59例年龄和性别匹配的对照者，这些患者均接受了扩散张量成像（DTI）检查。根据分布情况，按性别将PD患者的血清UA水平分为三个三分位数。采用基于纤维束的空间统计学（TBSS）分析，利用分数各向异性（FA）、平均扩散率（MD）、轴向扩散率（AD）和径向扩散率（RD）来比较两组之间的WM完整性。
交互分析显示，在包括额顶颞叶、胼胝体、双侧内囊和外囊以及丘脑区域在内的广泛WM区域，PD患者中性别与UA水平对FA值的交互作用显著。多元回归分析显示，男性患者广泛WM区域的FA值与UA水平呈显著正相关。然而，女性患者的DTI测量值与UA水平之间无显著相关性。在男性患者的组间比较中，UA水平最低的PD组（PD-L-UA）在额顶颞叶WM区域的FA值显著低于UA水平最高的PD组（PD-H-UA），而MD和RD值则更高。然而，女性患者的PD-L-UA组和PD-H-UA组之间的DTI测量值无显著差异。
本研究表明，血清UA水平在PD早期可能与WM完整性存在潜在的性别特异性密切关系。
