Park Chang-Hyun, Shin Na-Young, Yoo Sang-Won, Seo Haeseok, Yoon Uicheul, Yoo Ji-Yeon, Ahn Kookjin, Kim Joong-Seok
Department of Radiology, College of Medicine, Catholic University of Korea, Seoul, Korea.
Center for Neuroprosthetics and Brain Mind Institute, Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland.
NPJ Parkinsons Dis. 2022 Jun 28;8(1):86. doi: 10.1038/s41531-022-00349-0.
Considering brain structural alterations as neurodegenerative consequences of Parkinson's disease (PD), we sought to infer the progression of PD via the ordering of brain structural alterations from cross-sectional MRI observations. Having measured cortical thinning in gray matter (GM) regions and disintegrity in white matter (WM) regions as MRI markers of structural alterations for 130 patients with PD (69 ± 10 years, 72 men), stochastic simulation based on the probabilistic relationship between the brain regions was conducted to infer the ordering of structural alterations across all brain regions and the staging of structural alterations according to changes in clinical status. The ordering of structural alterations represented WM disintegrity tending to occur earlier than cortical thinning. The staging of structural alterations indicated structural alterations happening mostly before major disease complications such as postural instability and dementia. Later disease states predicted by the sequence of structural alterations were significantly related to more severe clinical symptoms. The relevance of the ordering of brain structural alterations to the severity of clinical symptoms suggests the clinical feasibility of predicting PD progression states.
考虑到脑结构改变是帕金森病（PD）的神经退行性后果，我们试图通过横断面MRI观察结果中脑结构改变的排序来推断PD的进展情况。我们测量了130例PD患者（69±10岁，72名男性）灰质（GM）区域的皮质变薄和白质（WM）区域的完整性破坏，以此作为结构改变的MRI标记物，并基于脑区之间的概率关系进行随机模拟，以推断所有脑区结构改变的排序以及根据临床状态变化进行结构改变的分期。结构改变的排序表明WM完整性破坏往往比皮质变薄更早发生。结构改变的分期表明结构改变大多发生在诸如姿势不稳和痴呆等主要疾病并发症之前。由结构改变序列预测的疾病后期状态与更严重的临床症状显著相关。脑结构改变排序与临床症状严重程度的相关性表明预测PD进展状态具有临床可行性。
