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深部脑刺激治疗帕金森病后运动改善与黑质和丘脑底核的微观结构完整性的关系。

The connection of motor improvement after deep brain stimulation in Parkinson's disease and microstructural integrity of the substantia nigra and subthalamic nucleus.

机构信息

Department of Stereotactic and Functional Neurosurgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.

Department of Neurology and Clinical Neuroscience, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.

出版信息

Neuroimage Clin. 2024;42:103607. doi: 10.1016/j.nicl.2024.103607. Epub 2024 Apr 18.

DOI:10.1016/j.nicl.2024.103607
PMID:38643635
原文链接:
https://pmc.ncbi.nlm.nih.gov/articles/PMC11046219/
Abstract

BACKGROUND

Nigrostriatal microstructural integrity has been suggested as a biomarker for levodopa response in Parkinson's disease (PD), which is a strong predictor for motor response to deep brain stimulation (DBS) of the subthalamic nucleus (STN). This study aimed to explore the impact of microstructural integrity of the substantia nigra (SN), STN, and putamen on motor response to STN-DBS using diffusion microstructure imaging.

METHODS

Data was collected from 23 PD patients (mean age 63 ± 7, 6 females) who underwent STN-DBS, had preoperative 3 T diffusion magnetic resonance imaging including multishell diffusion-weighted MRI with b-values of 1000 and 2000 s/mm and records of motor improvement available.

RESULTS

The association between a poorer DBS-response and increased free interstitial fluid showed notable effect sizes (rho > |0.4|) in SN and STN, but not in putamen. However, this did not reach significance after Bonferroni correction and controlling for sex and age.

CONCLUSION

Microstructural integrity of SN and STN are potential biomarkers for the prediction of therapy efficacy following STN-DBS, but further studies are required to confirm these associations.

摘要

背景

黑质纹状体的微观结构完整性已被认为是帕金森病(PD)中左旋多巴反应的生物标志物,它是预测丘脑底核(STN)深部脑刺激(DBS)对运动反应的一个强有力的预测因子。本研究旨在使用扩散微观成像技术探索黑质(SN)、STN 和壳核微观结构完整性对 STN-DBS 运动反应的影响。

方法

从 23 名接受 STN-DBS 的 PD 患者(平均年龄 63 ± 7 岁,6 名女性)中收集数据,这些患者在术前进行了 3T 扩散磁共振成像,包括多壳扩散加权 MRI,b 值为 1000 和 2000 s/mm,并且有运动改善的记录。

结果

较差的 DBS 反应与增加的自由间质液之间的关联在 SN 和 STN 中表现出显著的效应大小(rho > |0.4|),但在壳核中没有。然而,在经过 Bonferroni 校正和控制性别和年龄后,这并没有达到显著水平。

结论

SN 和 STN 的微观结构完整性是预测 STN-DBS 治疗效果的潜在生物标志物,但需要进一步的研究来证实这些关联。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/be76/11046219/a29736e244ae/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/be76/11046219/a29736e244ae/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/be76/11046219/a29736e244ae/gr1.jpg

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引用本文的文献

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Neuroimaging in advanced Parkinson's disease: insights into pathophysiology, biomarkers, and personalized therapies.晚期帕金森病的神经影像学:对病理生理学、生物标志物和个性化治疗的见解。
J Neural Transm (Vienna). 2025 May 12. doi: 10.1007/s00702-025-02942-y.
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Microstructure is associated with motor outcomes following Deep Brain Stimulation in Parkinson's disease.
帕金森病患者接受脑深部电刺激后的微观结构与运动结果相关。
NPJ Parkinsons Dis. 2025 Apr 21;11(1):81. doi: 10.1038/s41531-025-00930-3.