Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
China National Clinical Research Center for Neurological Diseases, Beijing, China.
Eur J Neurol. 2024 Feb;31(2):e16147. doi: 10.1111/ene.16147. Epub 2023 Nov 17.
The ventral pallidum (VP) regulates involuntary movements, but it is unclear whether the VP regulates the abnormal involuntary movements in Parkinson's disease (PD) patients who have levodopa-induced dyskinesia (LID). To further understand the role of the VP in PD patients with LID (PD-LID), we explored the structural and functional characteristics of the VP in such patients using multimodal magnetic resonance imaging (MRI).
Thirty-one PD-LID patients, 39 PD patients without LID (PD-nLID), and 28 healthy controls (HCs) underwent T1-weighted MRI, quantitative susceptibility mapping, multi-shell diffusion MRI, and resting-state functional MRI (rs-fMRI). Different measures characterizing the VP were obtained using a region-of-interest-based approach.
The left VP in the PD-LID group showed significantly higher intracellular volume fraction (ICVF) and isotropic volume fraction (IsoVF) compared with the PD-nLID and HC groups. Rs-MRI revealed that, compared with the PD-nLID group, the PD-LID group in the medication 'off' state had higher functional connectivity (FC) between the left VP and the left anterior caudate, left middle frontal gyrus and left precentral gyrus, as well as between the right VP and the right posterior ventral putamen and right mediodorsal thalamus. In addition, the ICVF values of the left VP, the FC between the left VP and the left anterior caudate and left middle frontal gyrus were positively correlated with Unified Dyskinesia Rating Scale scores.
Our multimodal imaging findings show that the microstructural changes of the VP (i.e., the higher ICVF and IsoVF) and the functional change in the ventral striatum-VP-mediodorsal thalamus-cortex network may be associated with pathophysiological mechanisms of PD-LID.
腹侧苍白球（VP）调节不自主运动，但尚不清楚 VP 是否调节患有左旋多巴诱导性运动障碍（LID）的帕金森病（PD）患者的异常不自主运动。为了进一步了解 PD 伴 LID 患者（PD-LID）中 VP 的作用，我们使用多模态磁共振成像（MRI）探索了此类患者 VP 的结构和功能特征。
31 例 PD-LID 患者、39 例无 LID 的 PD 患者（PD-nLID）和 28 例健康对照者（HC）接受了 T1 加权 MRI、定量磁化率映射、多壳扩散 MRI 和静息状态功能 MRI（rs-fMRI）检查。使用基于感兴趣区的方法获得了不同的 VP 特征测量值。
与 PD-nLID 组和 HC 组相比，PD-LID 组的左侧 VP 细胞内容积分数（ICVF）和各向同性容积分数（IsoVF）显著升高。rs-fMRI 显示，与 PD-nLID 组相比，PD-LID 组在药物“关”状态下，左侧 VP 与左侧前尾状核、左侧额中回和左侧中央前回之间以及右侧 VP 与右侧后腹侧苍白球和右侧中脑背内侧核之间的功能连接（FC）更高。此外，左侧 VP 的 ICVF 值、左侧 VP 与左侧前尾状核和左侧额中回之间的 FC 与统一运动障碍评分量表（Unified Dyskinesia Rating Scale，UDysRS）评分呈正相关。
我们的多模态影像学研究结果表明，VP 的微观结构变化（即更高的 ICVF 和 IsoVF）以及腹侧纹状体-VP-中脑背内侧核-皮质网络的功能变化可能与 PD-LID 的病理生理机制有关。
