Department of Neurology, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey.
Department of Neurology, Bezmialem Foundation University Faculty of Medicine, Istanbul, Turkey.
Medicine (Baltimore). 2024 Mar 22;103(12):e37538. doi: 10.1097/MD.0000000000037538.
In the elderly population, Parkinson's Disease (PD) is the second most common neurodegenerative disorder and is associated with morphological changes in the basal ganglia, especially the substantia nigra (SN). This study aimed to evaluate the volume and signal intensity (SI) of SN using Magnetic Resonance Imaging (MRI) to detect structural changes and investigate the relationship between the onset side and disease severity of PD. Clinical features and imaging data of 58 patients with PD were retrospectively analyzed from their medical records. Axial T2-weighted fluid-attenuated inversion recovery (FLAIR) sequences of 3 Tesla (T) MRIs were used for the measurements. The right and left SN volumes and SI measurements were calculated in duplicate by 2 blinded and qualified neuroradiologists. The side of disease onset, disease duration, levodopa equivalent daily dose, Movement Disorder Society-sponsored Unified Parkinson Disease Rating Scale (MDS-UPDRS III) motor score, and modified Hoehn and Yahr (H&Y) scale scores were recorded and compared with SN volume and SI measurements. No statistically significant difference was found between the disease onset side and contralateral SN volume or SI measurements (P > .05). Despite high inter- and intra-rater reliability rates, there was no significant difference in the volume and SI of the contralateral SN according to H&Y stages (P > .05). Furthermore, SN volume and SI measurements were not significantly correlated with disease duration and MDS-UPDRS III motor score (P > .05). SN volume and SI values measured using axial FLAIR 3T MRI are not correlated with the side of onset or disease severity in PD. New imaging methods are required to detect preclinical or early-stage PD.
在老年人群中,帕金森病(PD)是第二常见的神经退行性疾病,与基底节,尤其是黑质(SN)的形态变化有关。本研究旨在通过磁共振成像(MRI)评估 SN 的体积和信号强度(SI),以检测结构变化,并探讨 PD 发病侧与疾病严重程度之间的关系。我们回顾性分析了 58 例 PD 患者的病历资料,获取其临床特征和影像学数据。使用 3 特斯拉(T)MRI 的轴向 T2 加权液体衰减反转恢复(FLAIR)序列进行测量。由 2 位盲法且合格的神经放射科医生重复测量双侧 SN 的体积和 SI。记录疾病发病侧、病程、左旋多巴等效日剂量、运动障碍协会赞助的统一帕金森病评定量表(MDS-UPDRS III)运动评分和改良 Hoehn 和 Yahr(H&Y)量表评分,并与 SN 体积和 SI 测量值进行比较。疾病发病侧与对侧 SN 体积或 SI 测量值之间无统计学差异(P>.05)。尽管组内和组间观察者的可靠性较高,但根据 H&Y 分期,对侧 SN 的体积和 SI 无显著差异(P>.05)。此外,SN 体积和 SI 测量值与病程和 MDS-UPDRS III 运动评分无显著相关性(P>.05)。使用轴向 FLAIR 3T MRI 测量的 SN 体积和 SI 值与 PD 的发病侧或疾病严重程度无关。需要新的成像方法来检测临床前或早期 PD。