Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan City, Shandong Province, China.
Department of Radiology, Qilu Hospital of Shandong University, Jinan City, Shandong Province, China.
BMC Neurol. 2023 Aug 14;23(1):301. doi: 10.1186/s12883-023-03350-z.
Loss of neuromelanin in the midbrain is known in Parkinson's disease(PD), which can now be directly detected by neuromelanin-sensitive MRI(NM-MRI). This case-control study was to investigate the distribution of neuromelanin in the substantia nigra(SN) and the locus coeruleus(LC) using NM-MRI technique and evaluate its potential as a diagnostic marker for PD. 10 early PD patients(H&Y stage I, II), 11 progressive PD patients(H&Y stage III-V), and 10 healthy controls matched in age and gender were recruited. All participants completed clinical and psychometric assessments as well as NM-MRI scans. Neuromelanin signal intensities in SN and LC were measured by contrast-to-noise ratios(CNRs) derived from NM-MRI scans. There were significant decreases of CNRs in SNpc(including anterior, central, and posterior) and LC in PD patients compared to controls. There were also significant differences of CNR between the left and right sides. CNR in LC had a negative correlation with the Non-Motor Symptoms Scale(NMSS) score in PD patients(|R|=0.49), whereas CNR in SNpc did not correlate with Unified Parkinson Disease Rating Scale(UPDRS) score(|R|<0.3). The receiver operating characteristic(ROC) curves revealed that the CNR in LC had a high diagnostic specificity of 90.1% in progressive patients. This study provides new evidence for the asymmetric distribution of neuromelanin in SN and the LC of patients with PD. The neuromelanin loss is bilateral and more predominately in LC than that in SN. This distinct neuromelanin distribution pattern may offer a potential diagnostic marker and a potential neuropharmacological intervention target for PD patients.
中脑的神经黑色素丢失在帕金森病（PD）中是已知的，现在可以通过神经黑色素敏感 MRI（NM-MRI）直接检测到。这项病例对照研究旨在使用 NM-MRI 技术研究黑质（SN）和蓝斑（LC）中神经黑色素的分布，并评估其作为 PD 诊断标志物的潜力。招募了 10 名早期 PD 患者（H&Y 分期 I、II）、11 名进展性 PD 患者（H&Y 分期 III-V）和 10 名年龄和性别匹配的健康对照者。所有参与者都完成了临床和心理测量评估以及 NM-MRI 扫描。通过 NM-MRI 扫描得出的对比噪声比（CNR）来测量 SN 和 LC 中的神经黑色素信号强度。与对照组相比，PD 患者的 SNpc（包括前、中、后）和 LC 的 CNR 显著降低。左右侧之间也存在 CNR 的差异。LC 的 CNR 与 PD 患者的非运动症状量表（NMSS）评分呈负相关（|R|=0.49），而 SNpc 的 CNR 与统一帕金森病评定量表（UPDRS）评分不相关（|R|<0.3）。受试者工作特征（ROC）曲线显示，LC 的 CNR 在进展性患者中具有 90.1%的高诊断特异性。这项研究为 PD 患者 SN 和 LC 中神经黑色素的不对称分布提供了新的证据。神经黑色素的丢失是双侧的，LC 比 SN 更明显。这种独特的神经黑色素分布模式可能为 PD 患者提供潜在的诊断标志物和潜在的神经药理学干预靶点。
