Movement Disorders Unit, Neurology Service, Department of Internal Medicine, Hospital de Clínicas, Federal University of Paraná, Curitiba, Paraná, Brazil.
Movement Disorders Unit, Neurology Service, Department of Internal Medicine, Hospital de Clínicas, Federal University of Paraná, Curitiba, Paraná, Brazil.
Parkinsonism Relat Disord. 2020 Sep;78:73-78. doi: 10.1016/j.parkreldis.2020.06.460. Epub 2020 Jul 27.
There is a dearth of studies of spinocerebellar ataxias (SCAs) and diffusion tensor magnetic resonance imaging (DTI).
To analyze changes observed in DTI parameters and correlate these to clinical findings in SCA3 and SCA10 patients.
SCA3 (n = 19) and SCA10 (n = 18) patients were compared with a similar number of controls and assessed clinically and with the scale for the assessment and rating of ataxia (SARA) before undergoing the same MRI protocol. TRACULA (TRActs Constrained by UnderLying Anatomy) software was used to analyze the DTI metrics FA, AD, RD and MD.
More white matter fiber tracts with changes in diffusivity were found in SCA3 patients than in SCA10 patients. There was a reduction in AD in altered fiber tracts in SCA3 and a greater increase in RD in SCA10. In the SCA3 patients, FA was reduced in the corticospinal tract (CST) and inferior longitudinal fasciculus (ILF), but this was not observed in the SCA10 patients. SARA score was correlated with DTI findings in SCA3 but not in SCA10.
Changes were observed in DTI for both SCA3 and SCA10 but were more widespread in SCA3. Our finding of myelin-sheath changes in SCA10 and secondary axonal changes in SCA3 may reflect the more rapid, aggressive clinical course of SCA3.
目前对于脊髓小脑性共济失调（SCA）和弥散张量磁共振成像（DTI）的研究较少。
分析 SCA3 和 SCA10 患者 DTI 参数的变化，并将这些变化与临床发现相关联。
将 SCA3（n=19）和 SCA10（n=18）患者与数量相似的对照组进行比较，所有患者在接受相同的 MRI 方案之前均进行了临床评估和共济失调评估量表（SARA）评分。使用 TRACULA（基于解剖结构约束的轨迹）软件分析 DTI 指标 FA、AD、RD 和 MD。
与 SCA10 患者相比，SCA3 患者的更多白质纤维束出现弥散改变。在改变的纤维束中 SCA3 的 AD 减少，而 SCA10 的 RD 增加更多。在 SCA3 患者中，FA 在皮质脊髓束（CST）和下纵束（ILF）中降低，但在 SCA10 患者中未观察到这种情况。SARA 评分与 SCA3 的 DTI 发现相关，但与 SCA10 无关。
在 SCA3 和 SCA10 中均观察到 DTI 的变化，但 SCA3 的变化更为广泛。我们在 SCA10 中发现的髓鞘变化和 SCA3 中的继发轴索变化可能反映了 SCA3 更快速、更具侵袭性的临床病程。
