Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea.
Department of Physical Medicine and Rehabilitation, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea.
Parkinsonism Relat Disord. 2020 Dec;81:165-172. doi: 10.1016/j.parkreldis.2020.10.044. Epub 2020 Nov 4.
This study aimed to investigate the alterations in thalamic nuclei volumes and the intrinsic thalamic structural network in patients with de novo Parkinson's disease (PD) based on their predominant symptoms.
We enrolled 65 patients with de novo PD (44 patients with tremor-dominant [TD] subtype and 21 patients with postural instability and gait disturbance [PIGD] subtype) and 20 healthy controls. All subjects underwent three-dimensional T1-weighted magnetic resonance imaging. The thalamic nuclei were segmented using the FreeSurfer program.
We obtained volumetric differences in the thalamic nuclei of each subtype of PD in comparison of healthy control. Volumes of the right and left suprageniculate nuclei were significantly increased, whereas that of the left parafascicular nucleus was decreased in patients with the TD subtype. Volumes of the right and left suprageniculate nuclei and right ventromedial nucleus were significantly increased, whereas those of the right and left parafascicular nuclei volumes were decreased in patients with the PIGD subtype. The measures of the intrinsic thalamic global network were not different between patients with TD PD and healthy controls. However, in patients with the PIGD subtype, the global and local efficiencies were significantly increased compared to healthy controls. Moreover, although there were no differences in thalamic volume and intrinsic thalamic global network between patients with the TD and PIGD variants, we identified significant differences in the intrinsic thalamic local network between the two groups.
Alterations in thalamic nuclei volumes and the intrinsic thalamic network in patients with PD differed based on their predominant symptoms. These findings might be related to the underlying pathogenesis and suggest that PD is a heterogeneous syndrome.
本研究旨在探讨基于主要症状的新发帕金森病（PD）患者丘脑核体积变化和固有丘脑结构网络。
我们纳入了 65 名新发 PD 患者（44 名震颤为主型[TD]亚型和 21 名姿势不稳和步态障碍型[PIGD]亚型）和 20 名健康对照者。所有受试者均行三维 T1 加权磁共振成像。使用 FreeSurfer 程序对丘脑核进行分割。
我们比较了健康对照组，得出了每种 PD 亚型的丘脑核容积差异。TD 亚型患者右侧和左侧上丘脑核体积显著增加，而左侧旁中央核体积减少。PIGD 亚型患者右侧和左侧上丘脑核及右侧腹内侧核体积显著增加，而右侧和左侧旁中央核体积减少。TD PD 患者与健康对照组的固有丘脑全局网络测量值无差异。然而，在 PIGD 亚型患者中，全局和局部效率与健康对照组相比显著增加。此外，虽然 TD 和 PIGD 变体患者的丘脑体积和固有丘脑全局网络没有差异，但我们发现两组之间固有丘脑局部网络存在显著差异。
PD 患者丘脑核体积和固有丘脑网络的改变与其主要症状有关。这些发现可能与潜在的发病机制有关，并表明 PD 是一种异质性综合征。
