Neuroscience Research Center, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy.
Institute of Neurology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy.
Parkinsonism Relat Disord. 2023 Aug;113:105768. doi: 10.1016/j.parkreldis.2023.105768. Epub 2023 Jul 18.
We aimed to identify the brain structures associated with postural instability (PI) in Progressive Supranuclear Palsy (PSP).
Forty-seven PSP patients and 45 control subjects were enrolled in this study. PI was assessed using the items 27 and 28 of the PSP rating scale (postural instability score, PIS). PSP patients were compared with controls using voxel-based morphometry (VBM). In PSP patients, LASSO regression model was used to investigate associations between VBM-based Region-Of-Interest grey matter (GM) volumes and different categories of the PSP rating scale. A whole-brain multi-regression analysis was also used to identify brain areas where GM volumes correlated with the PIS in PSP patients.
VBM analysis showed widespread GM atrophy (fronto-temporal-parietal-occipital regions, limbic lobes, insula, cerebellum, and basal ganglia) in PSP patients compared with control subjects. In PSP patients, LASSO regression analysis showed associations of the right cerebellar lobules IV-V with ocular motor category score, and the left Rolandic area with bulbar category score, while the right inferior frontal gyrus (IFG) was negatively correlated with the PIS. The whole-brain multi-regression analysis identified the right IFG as the only area significantly associated with the PIS.
In our study, two different approaches demonstrated that the IFG volume was associated with PIS in PSP patients, suggesting that this area may play a role in the pathophysiological mechanisms underlying PI. Our findings may have important implications for developing optimal Transcranial Magnetic Stimulation protocols targeting IFG in parkinsonism with postural disorders.
我们旨在确定与进行性核上性麻痹（PSP）中姿势不稳（PI）相关的脑结构。
本研究纳入了 47 名 PSP 患者和 45 名对照受试者。使用 PSP 评定量表的项目 27 和 28（姿势不稳评分，PIS）评估 PI。PSP 患者与对照组进行基于体素的形态计量学（VBM）比较。在 PSP 患者中，使用 LASSO 回归模型探讨 VBM 基于感兴趣区灰质（GM）体积与 PSP 评定量表不同类别的相关性。还使用全脑多元回归分析确定 GM 体积与 PSP 患者 PIS 相关的脑区。
VBM 分析显示，与对照组相比，PSP 患者存在广泛的 GM 萎缩（额颞顶枕叶区、边缘叶、岛叶、小脑和基底节）。在 PSP 患者中，LASSO 回归分析显示右侧小脑小叶 IV-V 与眼球运动分类评分相关，左侧 Rolandic 区与延髓分类评分相关，而右侧额下回（IFG）与 PIS 呈负相关。全脑多元回归分析确定右侧 IFG 是与 PIS 显著相关的唯一区域。
在我们的研究中，两种不同的方法均表明 IFG 体积与 PSP 患者的 PIS 相关，提示该区域可能在 PI 的病理生理机制中起作用。我们的发现可能对开发针对帕金森病伴姿势障碍的 IFG 的最佳经颅磁刺激方案具有重要意义。
