Nathoo Nabeela, Gee Myrlene, Nelles Krista, Burt Jacqueline, Sun Hongfu, Seres Peter, Wilman Alan H, Beaulieu Christian, Ba Fang, Camicioli Richard
Department of Medicine (Neurology), University of Alberta, Edmonton, Alberta, Canada.
School of Information Technology and Electrical Engineering, University of Queensland, Brisbane, Australia.
Can J Neurol Sci. 2023 Nov;50(6):853-860. doi: 10.1017/cjn.2022.316. Epub 2022 Nov 10.
Quantitative susceptibility mapping (QSM) demonstrates elevated iron content in Parkinson's disease (PD) patients within the basal ganglia, though it has infrequently been studied in relation to gait difficulties including freezing of gait (FOG). Our purpose was to relate QSM of basal ganglia and extra-basal ganglia structures with qualitative and quantitative gait measures in PD.
This case-control study included PD and cognitively unimpaired (CU) participants from the Comprehensive Assessment of Neurodegeneration and Dementia study. Whole brain QSM was acquired at 3T. Region of interests (ROIs) were drawn blinded manually in the caudate nucleus, putamen, globus pallidus, pulvinar nucleus of the thalamus, red nucleus, substantia nigra, and dentate nucleus. Susceptibilities of ROIs were compared between PD and CU. Items from the FOG questionnaire and quantitative gait measures from PD participants were compared to susceptibilities.
Twenty-nine participants with PD and 27 CU participants were included. There was no difference in susceptibility values in any ROI when comparing CU versus PD ( > 0.05 for all). PD participants with gait impairment ( = 23) had significantly higher susceptibility in the putamen ( = 0.008), red nucleus ( = 0.01), and caudate nucleus ( = 0.03) compared to those without gait impairment ( = 6). PD participants with FOG ( = 12) had significantly higher susceptibility in the globus pallidus ( = 0.03) compared to those without FOG ( = 17). Among quantitative gait measures, only stride time variability was significantly different between those with and without FOG ( = 0.04).
Susceptibilities in basal ganglia and extra-basal ganglia structures are related to qualitative measures of gait impairment and FOG in PD.
定量磁化率成像（QSM）显示帕金森病（PD）患者基底神经节内铁含量升高，不过针对包括步态冻结（FOG）在内的步态困难的相关研究较少。我们的目的是研究基底神经节和基底神经节外结构的QSM与PD患者的定性和定量步态指标之间的关系。
本病例对照研究纳入了来自神经退行性变和痴呆综合评估研究中的PD患者和认知未受损（CU）参与者。在3T条件下获取全脑QSM。在尾状核、壳核、苍白球、丘脑枕核、红核、黑质和齿状核中手动绘制感兴趣区域（ROI），绘制过程中设盲。比较PD组和CU组ROI的磁化率。将PD参与者的FOG问卷项目和定量步态指标与磁化率进行比较。
纳入了29名PD参与者和27名CU参与者。比较CU组和PD组时，任何ROI的磁化率值均无差异（所有P值均＞0.05）。与无步态障碍的PD参与者（n = 6）相比，有步态障碍的PD参与者（n = 23）在壳核（P = 0.008）、红核（P = 0.01）和尾状核（P = 0.03）中的磁化率显著更高。与无FOG的PD参与者（n = 17）相比，有FOG的PD参与者（n = 12）在苍白球中的磁化率显著更高（P = 0.03）。在定量步态指标中，有FOG和无FOG的参与者之间只有步幅时间变异性存在显著差异（P = 0.04）。
基底神经节和基底神经节外结构的磁化率与PD患者的步态障碍定性指标和FOG相关。
