Department of Radiology, Shaoxing people's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing, China.
Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Eur J Radiol. 2022 Sep;154:110441. doi: 10.1016/j.ejrad.2022.110441. Epub 2022 Jul 21.
Cerebral small vessel disease (SVD) related brain changes have been found associated with various clinical symptoms of Parkinson disease (PD). On the other hand, PD pathology and treatment may also accelerate SVD progression.
The aim of this study is to explore the interplay between SVD and PD pathology using longitudinal dataset.
We screened 66 healthy controls (HCs) and 114 patients from the Parkinson Progression Markers Initiative (PPMI) database. The peak width of skeletonized mean diffusivity (PSMD) was quantified from diffusion tensor images to reflect vascular pathologies at baseline and 24 months follow-up, and dopamine transporter (DAT) imaging data was used to represent the extent of dopaminergic neuronal degeneration at the same point time. We compared the PSMD between PD patients and HCs, and analyzed whether PSMD and DAT availability could predict each other's progression using multiple regression analyses in PD patients.
PSMD at baseline had no significant difference between the HCs and patients with PD (P = 0.169). Higher baseline PSMD was associated with less DAT reduction in the caudate (β = 0.216, P = 0.029), but not the putamen (β = 0.058, P = 0.552) in PD patients. Baseline caudate and putamen DAT availability had no significant association with PSMD progression (β = -0.006, P = 0.950; β = 0.017, P = 0.860, respectively).
Mild SVD might slow down PD pathology progression, while the effect of PD pathology on the progression of SVD was not significant.
脑小血管病（SVD）相关的脑改变与帕金森病（PD）的各种临床症状有关。另一方面，PD 病理和治疗也可能加速 SVD 的进展。
本研究旨在利用纵向数据集探讨 SVD 和 PD 病理之间的相互作用。
我们从帕金森进展标志物倡议（PPMI）数据库中筛选了 66 名健康对照（HC）和 114 名 PD 患者。在基线和 24 个月随访时，通过弥散张量成像量化骨架化平均弥散度（PSMD）峰值宽度，以反映血管病变；并在同一时间点使用多巴胺转运蛋白（DAT）成像数据来代表多巴胺能神经元变性的程度。我们比较了 PD 患者和 HC 之间的 PSMD，并在 PD 患者中使用多元回归分析分析了 PSMD 和 DAT 可用性是否可以相互预测。
基线时，HC 和 PD 患者之间的 PSMD 没有显著差异（P=0.169）。较高的基线 PSMD 与尾状核中 DAT 减少量较少相关（β=0.216，P=0.029），但与壳核中 DAT 减少量无关（β=0.058，P=0.552）。PD 患者基线尾状核和壳核 DAT 可用性与 PSMD 进展无显著相关性（β=-0.006，P=0.950；β=0.017，P=0.860）。
轻度 SVD 可能会减缓 PD 病理的进展，而 PD 病理对 SVD 进展的影响并不显著。
