School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China.
Functional Magnetic Resonance and Molecular Imaging Key Laboratory of Henan Province, Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, China.
Eur J Radiol. 2023 Oct;167:111030. doi: 10.1016/j.ejrad.2023.111030. Epub 2023 Aug 9.
Abnormalities in free water (FW) and susceptibility values exist in the substantia nigra (SN) of patients with Parkinson's disease (PD), but their role in characterizing the disease processes remains uncertain. This study investigated these values at various SN locations and stages of PD, and their relationship with clinical symptoms.
FW and quantitative susceptibility mapping (QSM) values were evaluated in the anterior and posterior SN, along with swallow-tail-sign (STS) ratings, in patients with PD (early-stage: n = 39; middle-to-advanced-stage: n = 97) and healthy controls (n = 82). The correlation between these indices and motor and non-motor symptoms, and their capability to distinguish PD from healthy controls, were also examined.
Increased FW in the anterior and posterior SN and increased QSM values in the posterior SN were observed in both early-stage and middle-to-advanced-stage PD patients (p < 0.05). However, there was no significant difference in FW, QSM values, or STS ratings among patients at different stages. FW and QSM values correlated with motor symptoms in middle-to-advanced-stage patients (p < 0.05), while STS ratings were associated with non-motor symptoms (p < 0.05). Additionally, combining FW and QSM values in the posterior SN with STS ratings in logistic regression showed better performance in distinguishing PD (area under curve = 0.931) compared to using STS ratings alone (area under curve = 0.880).
Findings suggest elevated FW and iron content in PD at different stages, with dissociation in SN location between the two indices. Elevated signals are related to the motor symptom severity in middle-to-advanced-stage patients, and may have the potential for PD diagnosis and symptom assessment.
帕金森病（PD）患者的黑质（SN）中存在自由水（FW）和磁化率值异常，但它们在表征疾病过程中的作用仍不确定。本研究探讨了不同 SN 位置和 PD 阶段的这些值及其与临床症状的关系。
在 PD 患者（早期阶段：n=39；中晚期阶段：n=97）和健康对照组（n=82）中评估了 SN 前、后部位的 FW 和定量磁化率映射（QSM）值，以及吞咽尾征（STS）评分。还检查了这些指标与运动和非运动症状的相关性，以及它们将 PD 与健康对照组区分开的能力。
早期和中晚期 PD 患者的 SN 前、后部位 FW 增加，SN 后部位 QSM 值增加（p<0.05）。然而，不同阶段的患者之间的 FW、QSM 值或 STS 评分没有显著差异。FW 和 QSM 值与中晚期患者的运动症状相关（p<0.05），而 STS 评分与非运动症状相关（p<0.05）。此外，在逻辑回归中，将 SN 后部位的 FW 和 QSM 值与 STS 评分相结合，在区分 PD 方面的表现优于单独使用 STS 评分（曲线下面积=0.931 与 0.880）。
研究结果表明，不同阶段的 PD 患者的 FW 和铁含量升高，两个指标在 SN 位置上存在分离。升高的信号与中晚期患者的运动症状严重程度相关，可能具有 PD 诊断和症状评估的潜力。
