From the Department of Health Promotion (Y.L.), Severance Check-up, Yonsei University Health System, Seoul; Department of Neurology (Y.L.), Yonsei University College of Medicine, Seoul; Department of Neurology (J.K., J.Y.H.), Yonsei University Wonju College of Medicine, Wonju; Department of Nuclear Medicine (Y.E.C., J.S.O., J.S.K.), Asan Medical Center, University of Ulsan College of Medicine, Seoul; INFINITT Healthcare (Y.E.C.), Seoul; Department of Neurology (M.K.S.), Bundang Jesaeng General Hospital, Seongnam; Department of Neurology (J.H.Y.), Ajou University School of Medicine, Suwon; and Department of Neurology (S.Y.K.), Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, South Korea.
Neurology. 2020 Jul 21;95(3):e291-e298. doi: 10.1212/WNL.0000000000009890. Epub 2020 Jun 23.
To determine whether deep white matter and periventricular hyperintensities affect the motor symptoms of Parkinson disease (PD) differently, we analyzed MRI and dopamine transporter imaging.
We analyzed the medical records of patients with de novo PD who underwent dopamine transporter PET scanning and MRI at their first visit. Deep white matter and periventricular hyperintensities were scored with a visual rating scale, and motor symptoms were assessed by Unified Parkinson's Disease Rating Scale motor score and tremor, rigidity, bradykinesia, and axial symptom subscores. The influence of white matter hyperintensity on motor symptoms was explored using multivariable linear regression models.
A total of 93 patients (mean age, 67.2 ± 9.9 years; 44 male) were included and the mean motor score was 25.0 ± 10.8. Subscores for bradykinesia and axial symptoms were correlated with both deep white matter and periventricular hyperintensities scores. Multivariable linear regression models revealed that deep white matter hyperintensities score was significantly associated with subscore for bradykinesia and periventricular hyperintensities score was associated with subscores for bradykinesia and axial symptoms after adjusting for putaminal dopamine transporter availability and clinical factors.
These results demonstrate that deep white matter hyperintensities are associated with bradykinesia and periventricular hyperintensities are associated with bradykinesia and axial symptoms in patients with PD independently of the severity of dopaminergic depletion.
通过分析磁共振成像(MRI)和多巴胺转运体成像,确定深部白质和脑室周围高信号是否会对帕金森病(PD)的运动症状产生不同影响。
我们分析了首次就诊时接受多巴胺转运体正电子发射断层扫描(PET)和 MRI 的新发 PD 患者的病历。深部白质和脑室周围高信号采用视觉评分量表进行评分,运动症状采用统一帕金森病评定量表(UPDRS)运动评分和震颤、僵直、运动迟缓和轴性症状子评分进行评估。使用多变量线性回归模型探讨白质高信号对运动症状的影响。
共纳入 93 例患者(平均年龄 67.2±9.9 岁,44 例男性),平均运动评分 25.0±10.8。运动迟缓和轴性症状子评分与深部白质和脑室周围高信号评分均相关。多变量线性回归模型显示,深部白质高信号评分与运动迟缓和轴性症状子评分显著相关,而脑室周围高信号评分与运动迟缓和轴性症状子评分相关,校正苍白球多巴胺转运体摄取和临床因素后仍有统计学意义。
这些结果表明,深部白质高信号与运动迟缓有关,脑室周围高信号与运动迟缓及轴性症状有关,与多巴胺能神经递质耗竭的严重程度无关。