Zheng Jin Hua, Sun Wen Hua, Ma Jian Jun, Wang Zhi Dong, Chang Qing Qing, Dong Lin Rui, Shi Xiao Xue, Li Ming Jian, Gu Qi, Chen Si Yuan, Li Dong Sheng
Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China.
Department of Neurology, People's Hospital of Zhengzhou University, Zhengzhou, China.
Front Neurosci. 2022 Jul 22;16:905709. doi: 10.3389/fnins.2022.905709. eCollection 2022.
The "postural instability/gait difficulty" (PIGD) and "tremor-dominant" (TD) motor subtypes of Parkinson's disease (PD) differ in their clinical manifestations. The neurological basis of these differences is unclear.
We performed voxel-based morphometric analysis and measured amplitudes of low-frequency fluctuation (ALFF) on 87 PIGD patients and 51 TD patients. We complemented this neuroanatomical comparison with seed-to-voxel analysis to explore differences in functional connectivity.
The PIGD group showed significantly smaller gray matter volume in the medial frontal gyrus (mainly on the right side) than the TD group. Across all patients, gray matter volume in the medial frontal gyrus correlated negatively with severity of PIGD symptoms after controlling for age ( = -0.250, = 0.003), but this correlation was not observed in separate analyses of only PIGD or TD patients. The PIGD group showed greater functional connectivity of the right superior frontal gyrus with the left lingual gyrus, right lateral occipital cortex, and right lingual gyrus. ALFF did not differ significantly between the two groups.
Postural instability/gait difficulty may be associated with smaller gray matter volume in medial frontal gyrus than TD, as well as with greater functional connectivity between the right superior frontal gyrus and occipital cortex. These results may help explain the clinical differences between the two motor subtypes of PD.
帕金森病（PD）的“姿势不稳/步态障碍”（PIGD）和“震颤为主”（TD）运动亚型在临床表现上有所不同。这些差异的神经学基础尚不清楚。
我们对87例PIGD患者和51例TD患者进行了基于体素的形态学分析，并测量了低频波动幅度（ALFF）。我们通过种子点到体素分析对这种神经解剖学比较进行补充，以探索功能连接的差异。
PIGD组在内侧前额叶皮质（主要在右侧）的灰质体积明显小于TD组。在所有患者中，控制年龄后，内侧前额叶皮质的灰质体积与PIGD症状严重程度呈负相关（r = -0.250，P = 0.003），但在仅对PIGD或TD患者进行的单独分析中未观察到这种相关性。PIGD组右侧额上回与左侧舌回、右侧枕外侧皮质和右侧舌回之间的功能连接更强。两组之间的ALFF没有显著差异。
姿势不稳/步态障碍可能与内侧前额叶皮质的灰质体积小于TD组有关，也与右侧额上回和枕叶皮质之间更强的功能连接有关。这些结果可能有助于解释PD两种运动亚型之间的临床差异。
