Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
School of Biomedical Engineering, Korea University, 145, Anam-ro, Seongbuk-gu, Seoul, 02841, South Korea.
Sci Rep. 2022 Jul 25;12(1):12631. doi: 10.1038/s41598-022-16747-6.
Levodopa-induced dyskinesia (LID), a long-term motor complication in Parkinson's disease (PD), is attributable to both presynaptic and postsynaptic mechanisms. However, no studies have evaluated the baseline structural changes associated with LID at a subcortical level in PD. A total of 116 right-handed PD patients were recruited and based on the LID latency of 5 years, we classified patients into those vulnerable to LID (PD-vLID, n = 49) and those resistant to LID (PD-rLID, n = 67). After adjusting for covariates including dopamine transporter (DAT) availability of the posterior putamen, we compared the subcortical shape between the groups and investigated its association with the onset of LID. The PD-vLID group had lower DAT availability in the posterior putamen, higher parkinsonian motor deficits, and faster increment in levodopa equivalent dose than the PD-rLID group. The PD-vLID group had significant inward deformation in the right thalamus compared to the PD-rLID group. Inward deformation in the thalamus was associated with an earlier onset of LID at baseline. This study suggests that independent of presynaptic dopamine depletion, the thalamus is a major neural substrate for LID and that a contracted thalamic shape at baseline is closely associated with an early development of LID.
左旋多巴诱导的运动障碍（LID）是帕金森病（PD）的一种长期运动并发症，其与突触前和突触后机制均有关。然而，目前尚无研究评估 PD 患者在亚皮质水平与 LID 相关的基线结构变化。共招募了 116 名右利手 PD 患者，并根据 5 年的 LID 潜伏期，将患者分为易发生 LID 的患者（PD-vLID，n=49）和不易发生 LID 的患者（PD-rLID，n=67）。在调整包括后壳核多巴胺转运蛋白（DAT）可用性在内的协变量后，我们比较了两组之间的亚皮质形状，并探讨了其与 LID 发病的关系。与 PD-rLID 组相比，PD-vLID 组的后壳核 DAT 可用性较低，帕金森运动缺陷较高，左旋多巴等效剂量增加较快。与 PD-rLID 组相比，PD-vLID 组的右侧丘脑有明显的内向变形。丘脑的内向变形与基线时 LID 的早期发病有关。本研究表明，独立于突触前多巴胺耗竭，丘脑是 LID 的主要神经基质，基线时丘脑的收缩形状与 LID 的早期发展密切相关。
