Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea.
Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea.
Parkinsonism Relat Disord. 2023 Sep;114:105767. doi: 10.1016/j.parkreldis.2023.105767. Epub 2023 Jul 26.
Glymphatic dysfunction can contribute to α-synucleinopathies. We examined glymphatic function in idiopathic Parkinson's disease (PD) utilizing Diffusion Tensor Image Analysis aLong the Perivascular Space (DTI-ALPS).
This study enrolled consecutive patients diagnosed with de novo PD between June 2017 and March 2019 who underwent brain DTI with concurrent I-2β-carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl)-nortropane (I-FP-CIT) SPECT, and age- and sex-matched controls. From DTI-ALPS, the ALPS-index was calculated as a ratio of diffusivities along the x-axis in the region of neural fibers passing vertically to the diffusivities perpendicular to them, which reflected perivascular water motion at the lateral ventricular body level. The ALPS-index of the PD and control groups was compared using Student's t-test; its correlations with clinical scores for motor and cognition (UPDRS-III, MMSE, and MoCA) and striatal dopamine transporter uptake measured by I-FP-CIT specific binding ratios (SBRs) were examined using a correlation coefficient.
In all, 54 patients in the de novo PD group (31 women, 23 men; mean age, 68.9 ± 9.4 years) and 54 in the control group (mean age, 69.0 ± 10.5 years) were included. The ALPS-index was lower in the PD group than in the controls (1.51 ± 0.22 versus 1.66 ± 0.20; P < 0.001). In the PD group, the ALPS-index negatively correlated with the UPDRS-III score (r = -0.526), and positively correlated with the MMSE (r = 0.377) and MoCA scores (r = 0.382) (all, P < 0.05). No correlation was observed between the ALPS-index and striatal I-FP-CIT SBRs (P > 0.05).
DTI-ALPS can reveal glymphatic dysfunction in patients with PD, whose severity correlated with motor and cognitive dysfunction, but not striatal dopamine transporter uptake.
糖液功能障碍可导致α-突触核蛋白病。我们利用沿血管周围空间的扩散张量图像分析（DTI-ALPS）检查了特发性帕金森病（PD）中的糖液功能。
本研究纳入了 2017 年 6 月至 2019 年 3 月期间连续诊断为新发 PD 的患者，并进行了脑 DTI 检查，同时进行 I-2β-羧甲氧基-3β-（4-碘苯基）-N-（3-氟丙基）-去甲托烷（I-FP-CIT）SPECT。并匹配年龄和性别相匹配的对照组。从 DTI-ALPS 中，ALPS 指数作为垂直穿过神经纤维区域的 x 轴方向扩散率与垂直于它们的扩散率之比来计算，这反映了侧脑室体水平的血管周围水运动。使用学生 t 检验比较 PD 组和对照组的 ALPS 指数；使用相关系数检查 ALPS 指数与运动和认知评分（UPDRS-III、MMSE 和 MoCA）以及 I-FP-CIT 特异性结合比（SBR）测量的纹状体多巴胺转运体摄取之间的相关性。
总共纳入了 54 例新发 PD 组患者（31 名女性，23 名男性；平均年龄 68.9±9.4 岁）和 54 例对照组患者（平均年龄 69.0±10.5 岁）。PD 组的 ALPS 指数低于对照组（1.51±0.22 与 1.66±0.20；P<0.001）。在 PD 组中，ALPS 指数与 UPDRS-III 评分呈负相关（r=-0.526），与 MMSE（r=0.377）和 MoCA 评分（r=0.382）呈正相关（均 P<0.05）。ALPS 指数与纹状体 I-FP-CIT SBR 之间未见相关性（P>0.05）。
DTI-ALPS 可以显示 PD 患者的糖液功能障碍，其严重程度与运动和认知功能障碍相关，但与纹状体多巴胺转运体摄取无关。
