Department of Neurology, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea.
Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Samsung Medical Center, Gangnam-gu, Seoul, Republic of Korea.
Hum Brain Mapp. 2021 Jun 15;42(9):2823-2832. doi: 10.1002/hbm.25406. Epub 2021 Mar 10.
Previous pathologic studies evaluated the substantia nigra pars compacta (SNpc) of a limited number of idiopathic Parkinson's disease (IPD) patients with relatively longer disease durations. Therefore, it remains unknown which region of the SNpc is most significantly affected in early-stage IPD. We hypothesized that a voxelwise analysis of thin-section neuromelanin-sensitive MRI (NM-MRI) may help determine the significantly affected regions of the SNpc in early-stage IPD and localize these areas in each nigrosome on high-spatial-resolution susceptibility map-weighted imaging (SMwI). Ninety-six healthy subjects and 50 early-stage IPD patients underwent both a 0.8 × 0.8 × 0.8 mm NM-MRI and a 0.5 × 0.5 × 1.0 mm multi-echo gradient-recalled echo imaging for SMwI. Both NM-MRI and SMwI templates were created by using image data from the 96 healthy subjects. Permutation-based nonparametric tests were conducted to investigate spatial differences between the two groups in NM-MRI, and the results were displayed on both NM-MRI and SMwI templates. The posterolateral and anteromedial regions of the SNpc in NM-MRI were significantly different between the two groups, corresponding to the nigrosome 1 and nigrosome 2 regions, respectively, on the SMwI template. There were the areas of significant spatial difference in the hypointense SN on SMwI between early-stage IPD patients and healthy subjects. These areas on SMwI were slightly greater than those on NM-MRI, including the areas showing group difference on NM-MRI. Our voxelwise analysis of NM-MRI suggests that two regions (nigrosome 1 and nigrosome 2) of the SNpc are separately affected in early-stage IPD.
先前的病理学研究评估了数量有限的特发性帕金森病（IPD）患者的黑质致密部（SNpc），这些患者的疾病持续时间相对较长。因此，目前尚不清楚在早期 IPD 中 SNpc 的哪个区域受到的影响最大。我们假设，对薄层神经黑色素敏感 MRI（NM-MRI）进行体素分析，可能有助于确定早期 IPD 中 SNpc 受影响最严重的区域，并在高空间分辨率磁化率加权成像（SMwI）的每个黑质体定位这些区域。96 名健康受试者和 50 名早期 IPD 患者均接受了 0.8×0.8×0.8mm NM-MRI 和 0.5×0.5×1.0mm 多回波梯度回波成像的 SMwI。NM-MRI 和 SMwI 模板均使用 96 名健康受试者的图像数据创建。进行了基于置换的非参数检验，以研究 NM-MRI 中两组之间的空间差异，并在 NM-MRI 和 SMwI 模板上显示结果。NM-MRI 中 SN 的后外侧和前内侧区域在两组之间存在显著差异，分别对应于 SMwI 模板上的黑质体 1 和黑质体 2 区域。SMwI 上的 SN 低信号区存在显著的空间差异，早期 IPD 患者和健康受试者之间存在差异。这些 SMwI 上的区域略大于 NM-MRI 上的区域，包括 NM-MRI 上显示组间差异的区域。我们对 NM-MRI 的体素分析表明，SNpc 的两个区域（黑质体 1 和黑质体 2）在早期 IPD 中分别受到影响。
