Sun Hui-Min, Wang Li-Na, Ji Min, Gan Cai-Ting, Yuan Yong-Sheng, Cao Xing-Yue, Zhang Heng, Zhang Ke-Zhong
Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Quant Imaging Med Surg. 2022 Jun;12(6):3264-3275. doi: 10.21037/qims-21-1018.
Brain-derived neurotrophic factor () gene rs6265 single-nucleotide polymorphism (SNP) is thought to be involved in neuroplasticity and influence the development of levodopa-induced dyskinesia (LID) in Parkinson's disease (PD). This study aimed to determine how the rs6265 SNP regulates cortical thickness and to investigate the association between and the pathological mechanisms of LID in PD.
This cross-sectional study recruited 75 patients with PD, including 37 patients with LID and 38 patients without LID, and 33 healthy controls. All the participants underwent T1-weighted magnetic resonance imaging (MRI) scans, clinical evaluations, and rs6265 genotyping. Two-way factorial analysis of covariance (ANCOVA) was used to explore the primary effects of disease status, rs6265 genotype, and their interactions on cortical thickness. Associations between cortical thickness in the regions of the brain affected by disease status-genotype interactions and clinical symptoms were detected using Spearman's rank-order correlation. Receiver operating characteristic (ROC) curve analysis was used to test cortical thickness measurements as an indicator of LID.
The main effects of disease status were observed in the right pars orbitalis (F=4.229, P=0.017), medial orbitofrontal cortex (F=3.639, P=0.030), and left banks superior temporal sulcus (F=3.172, P=0.046). The left pars orbitalis (F=4.541, P=0.036) and lingual gyrus (F=4.307, P=0.041) were thicker in carriers of the CC genotype than in carriers of the TC/TT genotype. Interaction between disease status and genotype showed that in the LID group, carriers of the CC genotype had a thicker left postcentral gyrus (mean difference =0.103, 95% confidence interval, 0.036 to 0.107, Bonferroni-corrected P<0.005) than did carriers of the TC/TT genotype, whereas no difference was found in the non-LID and healthy control (HC) groups. In carriers of the CC genotype, the cortical thickness of the left postcentral gyrus could identify whether patients with PD had LID, with an area under the receiver operating curve (AUC) of 0.757 (P=0.033, optimal cut-off =2.102). The cortical thickness of the left postcentral gyrus was also positively correlated with the Unified Dyskinesia Rating Scale (UDysRS) score in the LID-CC subgroup (r=0.825, P=0.001).
The rs6265 SNP might be associated with dyskinesia symptoms in patients with PD and LID through its regulation of cortical thickness in the left postcentral gyrus.
脑源性神经营养因子(BDNF)基因rs6265单核苷酸多态性(SNP)被认为与神经可塑性有关,并影响帕金森病(PD)中左旋多巴诱导的异动症(LID)的发生发展。本研究旨在确定BDNF rs6265 SNP如何调节皮层厚度,并探讨其与PD中LID病理机制的关联。
这项横断面研究招募了75例PD患者,其中37例有LID,38例无LID,以及33名健康对照者。所有参与者均接受了T1加权磁共振成像(MRI)扫描、临床评估和BDNF rs6265基因分型。采用双向协方差分析(ANCOVA)探讨疾病状态、rs6265基因型及其相互作用对皮层厚度的主要影响。使用Spearman等级相关分析疾病状态-基因型相互作用影响的脑区皮层厚度与临床症状之间的关联。采用受试者工作特征(ROC)曲线分析来检验皮层厚度测量值作为LID指标的效能。
在右侧眶部(F = 4.229,P = 0.017)、内侧眶额皮质(F = 3.639,P = 0.030)和左侧颞上沟岸(F = 3.172,P = 0.046)观察到疾病状态的主要影响。CC基因型携带者的左侧眶部(F = 4.541,P = 0.036)和舌回(F = 4.307,P = 0.041)比TC/TT基因型携带者更厚。疾病状态与基因型之间的相互作用表明,在LID组中,CC基因型携带者的左侧中央后回比TC/TT基因型携带者更厚(平均差异 = 0.103,95%置信区间,0.036至0.107,Bonferroni校正P<0.005),而在非LID组和健康对照组(HC)中未发现差异。在CC基因型携带者中,左侧中央后回的皮层厚度可用于识别PD患者是否患有LID,受试者工作曲线下面积(AUC)为0.757(P = 0.033, 最佳截断值 = 2.102)。在LID-CC亚组中,左侧中央后回的皮层厚度也与统一异动症评分量表(UDysRS)评分呈正相关(r = 0.825,P = 0.001)。
BDNF rs6265 SNP可能通过调节左侧中央后回的皮层厚度与PD伴LID患者的异动症症状相关。