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早期治疗苯丙酮尿症患者的代谢控制与基底节形态计量学和功能的关系。

The relationship between metabolic control and basal ganglia morphometry and function in individuals with early-treated phenylketonuria.

机构信息

Department of Psychological Sciences, University of Missouri, Columbia, MO, USA.

Department of Psychological Sciences, University of Missouri, Columbia, MO, USA.

出版信息

Mol Genet Metab. 2022 Nov;137(3):249-256. doi: 10.1016/j.ymgme.2022.09.006. Epub 2022 Sep 24.

Abstract

Abnormalities of the cortical white matter are the most prominent and widely-reported neurological findings in individuals with early-treated phenylketonuria (ETPKU). Much less is known regarding the effects of ETPKU on gray matter structures in the brain such as the basal ganglia. Previous findings on basal ganglia in ETPKU have been mixed. The current study was designed to further elucidate the effects of ETPKU and elevated phe levels on the morphometry of basal ganglia structures (i.e., putamen, caudate nucleus, nucleus accumbens, and globus pallidus). High resolution magnetic resonance imaging (MRI) data was collected from a sample of 37 adults with ETPKU and a demographically-matched comparison group of 33 individuals without PKU. No overall group differences (ETPKU vs. non-PKU) in basal ganglia volumes were observed. However, within the ETPKU group, poorer metabolic control (as reflected by higher blood phenylalanine levels) was associated with larger putamen volume. Vertex-wise shape analysis revealed that the volume increase was accompanied by shape changes in the middle left putamen. Consistent with this area's role in motor control, a significant correlation between left putamen volume and motor performance was also observed. Additional research is needed to fully understand the cellular level processes underlying this effect as well as to better understand the clinical impact of these morphometric changes and their potential relation to treatment response.

摘要

皮质白质异常是早期治疗苯丙酮尿症(ETPKU)个体中最显著和广泛报道的神经学发现。对于 ETPKU 对大脑灰质结构(如基底节)的影响,人们知之甚少。以前关于 ETPKU 基底节的研究结果喜忧参半。本研究旨在进一步阐明 ETPKU 和升高的 phe 水平对基底节结构(即壳核、尾状核、伏隔核和苍白球)形态的影响。从 37 名 ETPKU 成年患者和 33 名无 PKU 的匹配对照组中收集了高分辨率磁共振成像(MRI)数据。未观察到基底节体积的总体组间差异(ETPKU 与非 PKU)。然而,在 ETPKU 组中,代谢控制较差(反映为血液苯丙氨酸水平较高)与壳核体积增大有关。顶点形状分析显示,体积增加伴随着左壳核中部形状的变化。与该区域在运动控制中的作用一致,还观察到左壳核体积与运动表现之间存在显著相关性。需要进一步研究,以充分了解这一效应背后的细胞水平过程,并更好地了解这些形态变化的临床影响及其与治疗反应的潜在关系。

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