Universidade Federal de Ciências da Saúde de Porto Alegre, UFCSPA, Porto Alegre, RS, Brazil.
Universidade Federal do Rio Grande do Sul, UFRGS, Porto Alegre, RS, Brazil.
Neuroradiology. 2024 Nov;66(11):1955-1966. doi: 10.1007/s00234-024-03452-6. Epub 2024 Aug 27.
Parkinson's disease (PD) is a neurodegenerative disorder characterized by dopaminergic neurons' degeneration of the substantia nigra, presenting with motor and non-motor symptoms. We hypothesized that altered diffusion metrics are associated with clinical symptoms in de novo PD patients.
Fractional Anisotropy (FA) and Mean (MD), Axial (AD), and Radial Diffusivity (RD) were assessed in 55 de novo PD patients (58.62 ± 9.85 years, 37 men) and 55 age-matched healthy controls (59.92 ± 11.25 years, 34 men). Diffusion-weighted images and clinical variables were collected from the Parkinson's Progression Markers Initiative study. Tract-based spatial statistics were used to identify white matter (WM) changes, and fiber tracts were localized using the JHU-WM tractography atlas. Motor and non-motor symptoms were evaluated in patients.
We observed higher FA values and lower RD values in patients than controls in various fiber tracts (p-TFCE < 0.05). No significant MD or AD difference was observed between groups. Diffusion metrics of several regions significantly correlated with non-motor (state and trait anxiety and daytime sleepiness) and axial motor symptoms in the de novo PD group. No correlations were observed between diffusion metrics and other clinical symptoms evaluated.
Our findings suggest microstructural changes in de novo PD fiber tracts; however, limited associations with clinical symptoms reveal the complexity of PD pathology. They may contribute to understanding the neurobiological changes underlying PD and have implications for developing targeted interventions. However, further longitudinal research with larger cohorts and consideration of confounding factors are necessary to elucidate the underlying mechanisms of these diffusion alterations in de novo PD.
帕金森病（PD）是一种神经退行性疾病，其特征是黑质多巴胺能神经元退化，表现为运动和非运动症状。我们假设，新诊断的 PD 患者的扩散指标改变与临床症状有关。
在 55 名新诊断的 PD 患者（58.62±9.85 岁，37 名男性）和 55 名年龄匹配的健康对照组（59.92±11.25 岁，34 名男性）中评估了分数各向异性（FA）和平均值（MD）、轴向扩散系数（AD）和径向扩散系数（RD）。从帕金森病进展标志物倡议研究中收集了扩散加权图像和临床变量。使用基于束的空间统计学来识别白质（WM）变化，并使用 JHU-WM 纤维束图谱定位纤维束。在患者中评估了运动和非运动症状。
我们观察到患者的 FA 值高于对照组，RD 值低于对照组，在各种纤维束中（p-TFCE<0.05）。两组之间 MD 或 AD 没有显著差异。新诊断 PD 组的几个区域的扩散指标与非运动（状态和特质焦虑和白天嗜睡）和轴向运动症状显著相关。在评估的其他临床症状中未观察到扩散指标之间的相关性。
我们的研究结果表明，新诊断 PD 患者的纤维束存在微观结构变化；然而，与临床症状的有限关联揭示了 PD 病理的复杂性。它们可能有助于理解 PD 神经生物学变化，并对开发靶向干预措施具有意义。然而，需要进一步进行有更大队列和考虑混杂因素的纵向研究，以阐明这些新诊断 PD 患者扩散改变的潜在机制。
