Pietracupa S, Ojha A, Belvisi D, Piervincenzi C, Tommasin S, Petsas N, De Bartolo M I, Costanzo M, Fabbrini A, Conte A, Berardelli A, Pantano P
IRCCS Neuromed, Pozzilli, IS, Italy.
Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy.
NPJ Parkinsons Dis. 2024 Jun 19;10(1):119. doi: 10.1038/s41531-024-00727-w.
Increasing evidence suggests that the cerebellum may have a role in the pathophysiology of Parkinson's disease (PD). Hence, the scope of this study was to investigate whether there are structural and functional alterations of the cerebellum and whether they correlate with motor and non-motor symptoms in early PD patients. Seventy-six patients with early PD and thirty-one age and sex-matched healthy subjects (HS) were enrolled and underwent a 3 T magnetic resonance imaging (MRI) protocol. The following MRI analyses were performed: (1) volumes of 5 cerebellar regions of interest (sensorimotor and cognitive cerebellum, dentate, interposed, and fastigial nuclei); (2) microstructural integrity of the cerebellar white matter connections (inferior, middle, and superior cerebellar peduncles); (3) functional connectivity at rest of the 5 regions of interest already described in point 1 with the rest of brain. Compared to controls, early PD patients showed a significant decrease in gray matter volume of the dentate, interposed and fastigial nuclei, bilaterally. They also showed abnormal, bilateral white matter microstructural integrity in all 3 cerebellar peduncles. Functional connectivity of the 5 cerebellar regions of interest with several areas in the midbrain, basal ganglia and cerebral cortex was altered. Finally, there was a positive correlation between abnormal functional connectivity of the fastigial nucleus with the volume of the nucleus itself and a negative correlation with axial symptoms severity. Our results showed that structural and functional alterations of the cerebellum are present in PD patients and these changes contribute to the pathophysiology of PD in the early phase.
越来越多的证据表明，小脑可能在帕金森病（PD）的病理生理学中发挥作用。因此，本研究的目的是调查早期PD患者的小脑是否存在结构和功能改变，以及这些改变是否与运动和非运动症状相关。纳入了76例早期PD患者和31例年龄和性别匹配的健康受试者（HS），并对他们进行了3T磁共振成像（MRI）检查。进行了以下MRI分析：（1）5个小脑感兴趣区域（感觉运动和认知小脑、齿状核、间位核和顶核）的体积；（2）小脑白质连接（小脑下脚、中脚和上脚）的微观结构完整性；（3）第1点中已描述的5个感兴趣区域与大脑其他部分在静息状态下的功能连接。与对照组相比，早期PD患者双侧齿状核、间位核和顶核的灰质体积显著减少。他们还在所有3个小脑脚中表现出双侧白质微观结构完整性异常。5个小脑感兴趣区域与中脑、基底神经节和大脑皮层的几个区域之间的功能连接发生了改变。最后，顶核异常功能连接与其自身体积之间存在正相关，与轴向症状严重程度之间存在负相关。我们的结果表明，PD患者存在小脑的结构和功能改变，这些变化在疾病早期对PD的病理生理学有影响。
