Program of Brain and Cognitive Engineering, Korea Advanced Institute of Science and Technology, Daejeon, South Korea; KI for Health Science and Technology, Korea Advanced Institute of Science and Technology, Daejeon, South Korea.
Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea; Department of Physiology, Yonsei University College of Medicine, Seoul, South Korea.
Parkinsonism Relat Disord. 2022 Sep;102:108-114. doi: 10.1016/j.parkreldis.2022.08.005. Epub 2022 Aug 12.
Motor reserve refers to the individual capacity to cope with nigrostriatal dopamine depletion in Parkinson's disease (PD). This study aimed to explore the white matter structural network associated with motor reserve in patients with newly diagnosed PD.
A total of 238 patients with early-stage drug-naïve PD who underwent F-FP-CIT PET and brain MRI scans at initial assessment were enrolled. We estimated individual motor reserve based on the Unified Parkinson's Disease Rating Scale Part III (UPDRS-III) scores and dopamine transporter availability in the posterior putamen using a residual model. Then, we performed threshold-free network-based statistics (TFNBS) analysis to identify the structural brain network associated with the estimated motor reserve. We also assessed the effect of the network connectivity strength on the longitudinal increase in levodopa-equivalent dose (LED).
The mean age at PD symptom onset was 69.10 ± 9.03 years and the mean UPDRS-III score at the time of PD diagnosis was 22.44 ± 9.72. TFNBS analysis identified a motor reserve-associated structural network whose nodes were mainly in the frontal region and cerebellum. Higher network strength (i.e., greater motor reserve) was associated with a slower longitudinal increase in LED during a 3-year follow-up period.
The structural brain network is associated with motor reserve in patients with PD. Connectivity strength within the identified network indicates the individual's capacity to tolerate PD-related pathologies, which is maintained with disease progression and affects the long-term motor prognosis of PD.
运动储备是指个体在帕金森病（PD）中应对黑质纹状体多巴胺耗竭的能力。本研究旨在探讨与新诊断的 PD 患者运动储备相关的白质结构网络。
共纳入 238 例初诊、未经药物治疗的早期 PD 患者，在初始评估时进行 F-FP-CIT PET 和脑 MRI 扫描。我们根据统一帕金森病评定量表第三部分（UPDRS-III）评分和后壳核中的多巴胺转运体可用性，使用残差模型估计个体运动储备。然后，我们进行无阈值网络基础统计分析（TFNBS），以识别与估计运动储备相关的结构脑网络。我们还评估了网络连接强度对左旋多巴等效剂量（LED）纵向增加的影响。
PD 症状发作的平均年龄为 69.10±9.03 岁，PD 诊断时的平均 UPDRS-III 评分为 22.44±9.72。TFNBS 分析确定了一个与运动储备相关的结构网络，其节点主要位于额叶和小脑。较高的网络强度（即更大的运动储备）与 3 年随访期间 LED 的纵向增加较慢相关。
结构脑网络与 PD 患者的运动储备相关。所确定网络内的连接强度表明个体对 PD 相关病变的耐受能力，这种能力随着疾病的进展而保持，并影响 PD 的长期运动预后。
