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进行性核上性麻痹中胼胝体的节段性改变:一项多参数磁共振成像研究

Segmental Alterations of the Corpus Callosum in Progressive Supranuclear Palsy: A Multiparametric Magnetic Resonance Imaging Study.

作者信息

Bârlescu Lavinia A, Müller Hans-Peter, Uttner Ingo, Ludolph Albert C, Pinkhardt Elmar H, Huppertz Hans-Jürgen, Kassubek Jan

机构信息

Department of Neurology, University of Ulm, Ulm, Germany.

German Center for Neurodegenerative Diseases (DZNE), Ulm, Germany.

出版信息

Front Aging Neurosci. 2021 Nov 19;13:720634. doi: 10.3389/fnagi.2021.720634. eCollection 2021.

Abstract

The regional distribution of the widespread cerebral morphological alterations in progressive supranuclear palsy (PSP) is considered to include segmental parts of the corpus callosum (CC). The study was designed to investigate the regional white matter (WM) of the CC by T1 weighted magnetic resonance imaging (T1w MRI) data combined with diffusion tensor imaging (DTI) data in PSP patients, differentiated in the variants Richardson syndrome and PSP-parkinsonism, and to compare them with Parkinson's Disease (PD) patients and healthy controls, in order to identify macro- and micro-structural alterations . MRI-based WM mapping was used to perform an operator-independent segmentation for the different CC segments in 66 PSP patients vs. 66 PD patients vs. 44 matched healthy controls. The segmentation was followed by both planimetric and texture analysis of the separated CC areas for the comparison of the three groups. Results were complemented by a DTI-based tract-of-interest analysis of the associated callosal tracts. Significant alterations of the parameters and compared to controls were observed for PSP as well as for PD for the CC areas I, II, and III. The inhomogeneity in area II in the PSP cohort was the highest and differed significantly from PD. A combined score was defined as a potential marker for the different types of neurodegenerative parkinsonism; receiver operating characteristics (ROC) curves were calculated with areas under the curve values of 0.86 for PSP vs. controls, 0.72 for PD vs. controls, and 0.69 for PSP vs. PD, respectively. The multiparametric MRI texture and DTI analysis demonstrated extensive alterations of the frontal CC in neurodegenerative parkinsonism, whereas regional CC atrophy cannot be regarded as a constant neuroimaging feature of PSP. Specifically, the comparison PSP vs. PD revealed significant alterations in callosal area II. The combination of the texture and the DTI parameters might contribute as a neuroimaging marker for the assessment of the CC in PSP, including the differentiation vs. PD.

摘要

进行性核上性麻痹(PSP)中广泛存在的脑形态学改变的区域分布被认为包括胼胝体(CC)的节段部分。本研究旨在通过T1加权磁共振成像(T1w MRI)数据结合扩散张量成像(DTI)数据,对PSP患者(分为理查森综合征和PSP帕金森综合征亚型)的CC区域白质(WM)进行研究,并将其与帕金森病(PD)患者和健康对照进行比较,以识别宏观和微观结构改变。基于MRI的WM映射用于对66例PSP患者、66例PD患者和44例匹配的健康对照的不同CC节段进行独立于操作者的分割。分割后对分离出的CC区域进行平面测量和纹理分析,以比较三组。结果通过对相关胼胝体束的基于DTI的感兴趣区分析得到补充。与对照组相比,PSP和PD患者的CC区域I、II和III的参数和均有显著改变。PSP队列中区域II的不均匀性最高,与PD有显著差异。定义了一个综合评分作为不同类型神经退行性帕金森病的潜在标志物;计算了受试者操作特征(ROC)曲线,PSP与对照组的曲线下面积值为0.86,PD与对照组为0.72,PSP与PD为0.69。多参数MRI纹理和DTI分析表明,神经退行性帕金森病中额叶CC有广泛改变,而区域CC萎缩不能被视为PSP的恒定神经影像学特征。具体而言,PSP与PD的比较显示胼胝体区域II有显著改变。纹理和DTI参数的组合可能作为一种神经影像学标志物,用于评估PSP中的CC,包括与PD的鉴别。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cff/8640496/f87f44e68449/fnagi-13-720634-g001.jpg

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