Integrated Brain Imaging Center, Radiology, University of Washington Medical Center, Seattle, WA, USA.
Integrated Brain Imaging Center, Radiology, University of Washington Medical Center, Seattle, WA, USA.
Parkinsonism Relat Disord. 2020 Jul;76:21-28. doi: 10.1016/j.parkreldis.2020.05.014. Epub 2020 May 11.
Imaging neurovascular disturbances in Parkinson's disease (PD) is an excellent measure of disease severity. Indeed, a disease-specific regional pattern of abnormal metabolism has been identified using positron emission tomography. Only a handful of studies, however, have applied perfusion MRI to detect this disease pattern. Our goal was to replicate the evaluation of a PD-related perfusion pattern using scaled subprofile modeling/principal component analysis (SSM-PCA).
We applied arterial spin labeling (ASL) MRI for this purpose. Uniquely, we assessed this pattern separately in PD individuals ON and OFF dopamine medications. We further compared the existence of these patterns and their strength in each individual with their Movement Disorder Society-Unified Parkinson's Disease Rating Scale motor (MDS-UPDRS) scores, cholinergic tone as indexed by short-term afferent inhibition (SAI), and other neuropsychiatric tests.
We observed a PD-related perfusion pattern that was similar to previous studies. The patterns were observed in both ON and OFF states but only the pattern in the OFF condition could significantly (AUC=0.72) differentiate between PD and healthy subjects. In the ON condition, PD subjects were similar to controls from a CBF standpoint (AUC=0.45). The OFF pattern prominently included the posterior cingulate, precentral region, precuneus, and the subcallosal cortex. Individual principal components from the ON and OFF states were strongly associated with MDS-UPDRS scores, SAI amplitude and latency.
Using ASL, our study identified patterns of abnormal perfusion in PD and were associated with disease symptoms.
在帕金森病（PD）中，对神经血管紊乱进行成像，是评估疾病严重程度的一个极好指标。事实上，使用正电子发射断层扫描（PET）已经确定了一种特定于疾病的区域代谢异常模式。然而，只有少数研究应用灌注磁共振成像（MRI）来检测这种疾病模式。我们的目标是使用比例子空间模型/主成分分析（SSM-PCA）复制对 PD 相关灌注模式的评估。
为此，我们应用动脉自旋标记（ASL）MRI。独特的是，我们分别评估了 PD 患者在多巴胺药物开和关时的这种模式。我们进一步比较了在每个个体中，这些模式及其强度的存在情况，并与他们的运动障碍协会统一帕金森病评定量表（MDS-UPDRS）运动评分、以短期传入抑制（SAI）为指标的胆碱能张力，以及其他神经心理学测试进行了比较。
我们观察到了与之前研究相似的 PD 相关灌注模式。这些模式在开和关状态下都有观察到，但只有在关状态下的模式才能显著（AUC=0.72）区分 PD 和健康受试者。在开状态下，从 CBF 的角度来看，PD 患者与对照组相似（AUC=0.45）。关状态下的模式主要包括后扣带回、中央前区、楔前叶和胼胝体下区。来自开和关状态的个体主成分与 MDS-UPDRS 评分、SAI 幅度和潜伏期密切相关。
使用 ASL，我们的研究在 PD 中识别出了异常灌注模式，并与疾病症状相关。
