Landelle Caroline, Dahlberg Linda Solstrand, Lungu Ovidiu, Misic Bratislav, De Leener Benjamin, Doyon Julien
Department of Neurology and Neurosurgery, McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada.
Department of Computer Engineering and Software Engineering, Polytechnique Montreal, Montreal, Quebec, Canada.
Mov Disord. 2023 Apr;38(4):636-645. doi: 10.1002/mds.29354. Epub 2023 Feb 21.
Parkinson's disease (PD) has traditionally been viewed as an α-synucleinopathy brain pathology. Yet evidence based on postmortem human and animal experimental models indicates that the spinal cord may also be affected.
Functional magnetic resonance imaging (fMRI) seems to be a promising candidate to better characterize spinal cord functional organization in PD patients.
Resting-state spinal fMRI was performed in 70 PD patients and 24 age-matched healthy controls, the patients being divided into three groups based on their motor symptom severity: PD (n = 24), PD (n = 22), and PD (n = 24) groups. A combination of independent component analysis (ICA) and a seed-based approach was applied.
When pooling all participants, the ICA revealed distinct ventral and dorsal components distributed along the rostro-caudal axis. This organization was highly reproducible within subgroups of patients and controls. PD severity, assessed by Unified Parkinson's Disease Rating Scale (UPDRS) scores, was associated with a decrease in spinal functional connectivity (FC). Notably, we observed a reduced intersegmental correlation in PD as compared to controls, the latter being negatively associated with patients' upper-limb UPDRS scores (P = 0.0085). This negative association between FC and upper-limb UPDRS scores was significant between adjacent C4-C5 (P = 0.015) and C5-C6 (P = 0.20) cervical segments, levels associated with upper-limb functions.
The present study provides the first evidence of spinal cord FC changes in PD and opens new avenues for the effective diagnosis and therapeutic strategies in PD. This underscores how spinal cord fMRI can serve as a powerful tool to characterize, in vivo, spinal circuits for a variety of neurological diseases. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
帕金森病（PD）传统上被视为一种α-突触核蛋白病脑病理学。然而，基于人类尸检和动物实验模型的证据表明脊髓也可能受到影响。
功能磁共振成像（fMRI）似乎是更好地表征PD患者脊髓功能组织的一个有前景的方法。
对70例PD患者和24例年龄匹配的健康对照者进行静息态脊髓fMRI检查，根据运动症状严重程度将患者分为三组：PD（n = 24）组、PD（n = 22）组和PD（n = 24）组。应用独立成分分析（ICA）和基于种子点的方法相结合。
将所有参与者合并分析时，ICA显示沿头尾轴分布有明显的腹侧和背侧成分。这种组织在患者和对照组的亚组中具有高度可重复性。通过统一帕金森病评定量表（UPDRS）评分评估的PD严重程度与脊髓功能连接（FC）降低相关。值得注意的是，与对照组相比，我们观察到PD患者节段间相关性降低，后者与患者上肢UPDRS评分呈负相关（P = 0.0085）。FC与上肢UPDRS评分之间的这种负相关在相邻的C4 - C5（P = 0.015）和C5 - C6（P = 0.20）颈段之间显著，这些节段与上肢功能相关。
本研究首次提供了PD患者脊髓FC变化的证据，并为PD的有效诊断和治疗策略开辟了新途径。这强调了脊髓fMRI可作为一种强大的工具，在体内表征各种神经系统疾病的脊髓回路。© 2023作者。《运动障碍》由Wiley Periodicals LLC代表国际帕金森和运动障碍协会出版。
