Klinik und Poliklinik für Neurologie, Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg, Germany.
Cerebellum. 2024 Apr;23(2):355-362. doi: 10.1007/s12311-023-01532-6. Epub 2023 Feb 20.
Alterations in the cerebellum's morphology in Parkinson's disease (PD) point to its pathophysiological involvement in this movement disorder. Such abnormalities have previously been attributed to different PD motor subtypes. The aim of the study was to relate volumes of specific cerebellar lobules to motor symptom severity, in particular tremor (TR), bradykinesia/rigidity (BR), and postural instability and gait disorders (PIGD) in PD. We performed a volumetric analysis based on T1-weighted MRI images of 55 participants with PD (22 females, median age 65 years, Hoehn and Yahr stage 2). Multiple regression models were fitted to investigate associations between volumes of cerebellar lobules with clinical symptom severity based on MDS-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) part III score and sub-scores for TR, BR, and PIGD; adjusted for age, sex, disease duration, and intercranial volume as cofactors. Smaller volume of lobule VIIb was associated with higher tremor severity (P = 0.004). No structure-function relationships were detected for other lobules or other motor symptoms. This distinct structural association denotes the involvement of the cerebellum in PD tremor. Characterizing morphological features of the cerebellum leads to a better understanding of its role in the spectrum of motor symptoms in PD and contributes further to identifying potential biological markers.
帕金森病（PD）患者小脑形态的改变表明其在这种运动障碍中的病理生理参与。这些异常以前归因于不同的 PD 运动亚型。本研究的目的是将特定小脑小叶的体积与运动症状的严重程度相关联，特别是在 PD 中震颤（TR）、运动迟缓/僵硬（BR）和姿势不稳与步态障碍（PIGD）。我们对 55 名 PD 患者（22 名女性，中位年龄 65 岁，Hoehn 和 Yahr 分期 2）的 T1 加权 MRI 图像进行了体积分析。基于 MDS-统一帕金森病评定量表（MDS-UPDRS）第三部分评分和 TR、BR 和 PIGD 的亚评分，建立多元回归模型，以研究小脑小叶体积与临床症状严重程度之间的关系；调整年龄、性别、疾病持续时间和颅内体积作为协变量。小叶 VIIb 的体积较小与震颤严重程度较高相关（P=0.004）。其他小叶或其他运动症状未检测到结构-功能关系。这种明显的结构关联表明小脑参与了 PD 震颤。对小脑形态特征的描述有助于更好地理解其在 PD 运动症状谱中的作用，并有助于进一步确定潜在的生物学标志物。
