Cao Xingyue, Gan Caiting, Zhang Heng, Yuan Yongsheng, Sun Huimin, Zhang Li, Wang Lina, Zhang Lian, Zhang Kezhong
Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
NPJ Parkinsons Dis. 2024 Mar 28;10(1):71. doi: 10.1038/s41531-024-00688-0.
Dilated perivascular spaces (PVS) have emerged as a pathological hallmark in various neurological conditions, including Parkinson's disease (PD). Levodopa-induced dyskinesia (LID), an intractable motor complication of PD, remains enigmatic regarding the distribution patterns of PVS. Our objective was to scrutinize the percent PVS (pPVS) changes within PD patients with LID (PD-LID). In total, 132 individuals were enrolled, including PD-LID (n = 42), PD patients without LID (PD-nLID, n = 45), and healthy controls (HCs, n = 45). Employing an automated approach for PVS quantification based on structural magnetic resonance imaging, we comprehensively evaluated total pPVS in subcortical white matter globally and regionally. A significant increase in global pPVS was observed in PD patients versus HCs, particularly evident in PD-LID relative to HCs. Within the PD-LID group, elevated pPVS was discerned in the right inferior frontal gyrus region (rIFG) (pars opercularis), contrasting with PD-nLID and HCs. Moreover, PD patients exhibited increased pPVS in bilateral superior temporal regions compared to HCs. Notably, pPVS in the rIFG positively correlated with dyskinetic symptoms and could well identify LID. Our findings unveiled PVS alternations in subcortical white matter in PD-LID at both global and regional levels, highlighting the increased pPVS in rIFG as a prospective imaging marker for LID.
血管周围间隙增宽（PVS）已成为包括帕金森病（PD）在内的各种神经系统疾病的病理标志。左旋多巴诱导的异动症（LID）是PD难以治疗的运动并发症，其PVS的分布模式仍不清楚。我们的目的是仔细研究LID的PD患者（PD-LID）的PVS百分比（pPVS）变化。总共招募了132名个体，包括PD-LID患者（n = 42）、无LID的PD患者（PD-nLID，n = 45）和健康对照者（HCs，n = 45）。我们采用基于结构磁共振成像的自动方法对PVS进行定量，全面评估了皮质下白质整体和局部的总pPVS。与HCs相比，PD患者的整体pPVS显著增加，在PD-LID患者中相对于HCs尤为明显。在PD-LID组中，右侧额下回区域（rIFG）（岛盖部）的pPVS升高，这与PD-nLID和HCs形成对比。此外，与HCs相比，PD患者双侧颞上区域的pPVS增加。值得注意的是，rIFG中的pPVS与异动症状呈正相关，并且能够很好地识别LID。我们的研究结果揭示了PD-LID患者皮质下白质在整体和区域水平上的PVS改变，突出了rIFG中pPVS增加作为LID的一种潜在影像学标志物。
