Klietz Martin, Elaman M Handan, Mahmoudi Nima, Nösel Patrick, Ahlswede Mareike, Wegner Florian, Höglinger Günter U, Lanfermann Heinrich, Ding Xiao-Qi
Department of Neurology, Hannover Medical School, Hanover, Germany.
Institute of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hanover, Germany.
Front Aging Neurosci. 2021 Nov 1;13:763331. doi: 10.3389/fnagi.2021.763331. eCollection 2021.
Parkinson's disease (PD) is the second most common neurodegenerative disease in the elderly. In early stages of PD, patients typically display normal brain magnet resonance imaging (MRI) in routine screening. Advanced imaging approaches are necessary to discriminate early PD patients from healthy controls. In this study, microstructural changes in relevant brain regions of early PD patients were investigated by using quantitative MRI methods. Cerebral MRI at 3T was performed on 20 PD patients in early stages and 20 age and sex matched healthy controls. Brain relative proton density, T1, T2, and T2' relaxation times were measured in 14 regions of interest (ROIs) in each hemisphere and compared between patients and controls to estimate PD related alterations. In comparison to matched healthy controls, the PD patients revealed decreased relative proton density in contralateral prefrontal subcortical area, upper and lower pons, in ipsilateral globus pallidus, and bilaterally in splenium corporis callosi, caudate nucleus, putamen, thalamus, and mesencephalon. The T1 relaxation time was increased in contralateral prefrontal subcortical area and centrum semiovale, putamen, nucleus caudatus and mesencephalon, whereas T2 relaxation time was elevated in upper pons bilaterally and in centrum semiovale ipsilaterally. T2' relaxation time did not show significant changes. Early Parkinson's disease is associated with a distinct profile of brain microstructural changes which may relate to clinical symptoms. The quantitative MR method used in this study may be useful in early diagnosis of Parkinson's disease. Limitations of this study include a small sample size and manual selection of the ROIs. Atlas-based or statistical mapping methods would be an alternative for an objective evaluation. More studies are necessary to validate the measurement methods for clinical use in diagnostics of early Parkinson's disease.
帕金森病（PD）是老年人中第二常见的神经退行性疾病。在PD的早期阶段，患者在常规筛查中通常显示脑磁共振成像（MRI）正常。需要先进的成像方法来区分早期PD患者和健康对照。在本研究中，使用定量MRI方法研究了早期PD患者相关脑区的微观结构变化。对20例早期PD患者和20例年龄及性别匹配的健康对照进行了3T脑MRI检查。在每个半球的14个感兴趣区域（ROI）测量脑相对质子密度、T1、T2和T2'弛豫时间，并在患者和对照之间进行比较，以评估与PD相关的改变。与匹配的健康对照相比，PD患者在对侧前额叶皮质下区域、脑桥上下部、同侧苍白球以及双侧胼胝体压部、尾状核、壳核、丘脑和中脑的相对质子密度降低。对侧前额叶皮质下区域、半卵圆中心、壳核、尾状核和中脑的T1弛豫时间增加，而双侧脑桥上部和同侧半卵圆中心的T2弛豫时间升高。T2'弛豫时间未显示出显著变化。早期帕金森病与脑微观结构变化的独特特征相关，这可能与临床症状有关。本研究中使用的定量MR方法可能有助于帕金森病的早期诊断。本研究的局限性包括样本量小和ROI的手动选择。基于图谱或统计映射方法将是进行客观评估的替代方法。需要更多研究来验证这些测量方法在早期帕金森病诊断临床应用中的有效性。
