Qi Weimin, Niu Xiaoyan, Zhan Xiuping, Ren Yazhou, He Jianhang, Li Jianxia, Hou Xiaolin, Li Haining
Neurology Department, General Hospital of Ningxia Medical University, Yinchuan 750004, China.
IBRO Neurosci Rep. 2025 Jan 6;18:180-190. doi: 10.1016/j.ibneur.2025.01.003. eCollection 2025 Jun.
This study aims to investigate the diagnostic value of multi-modal magnetic resonance imaging (MRI) utilizing arterial spin labeling (ASL), quantitative susceptibility mapping (QSM), and 3D T1-weighted imaging (3DT1WI) in patients with Parkinson's disease (PD). Additionally, it evaluates the relationship between MRI findings and non-motor symptoms associated with PD.
ASL, QSM, and 3DT1WI scans were performed on 48 PD patients and 46 healthy controls (HC). We extracted and analyzed differences in regional cerebral blood flow (rCBF), magnetic susceptibility, and gray matter density parameters between the two groups. These MRI parameters were correlated with clinical scale scores assessing non-motor symptoms, including cognitive function, sleep quality, olfaction, autonomic function, anxiety, depression, and fatigue. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic accuracy of each imaging modality in distinguishing PD from HC.
The areas under the ROC curve (AUC) for rCBF, magnetic susceptibility, and gray matter density were 0.941, 0.979, and 0.624, respectively. In PD patients, a negative correlation was found between Unified Parkinson's Disease Rating Scale Part II (UPDRS II) scores and rCBF in the bilateral precuneus. The Pittsburgh Sleep Quality Index (PSQI) scores negatively correlated with rCBF in the left middle temporal gyrus and right middle occipital gyrus. Hamilton Depression Rating Scale (HAMD) scores positively correlated with QSM values in the right supplementary motor area, while scores on the Argentine Smell Identification Test (AHRS) negatively correlated with QSM values in the same area. Disease duration showed a positive correlation with QSM values in the right middle cingulate gyrus. Additionally, PSQI scores positively correlated with QSM values in the left middle cingulate gyrus, and fatigue severity scale (FSS) scores also positively correlated with QSM values in the left middle cingulate gyrus. Gray matter atrophy in the left inferior temporal gyrus was associated with cognitive impairment in PD.
Occipital hypoperfusion and cortical atrophy in the left inferior temporal gyrus may serve as novel imaging biomarkers for PD and are associated with sleep disturbances and cognitive impairment in PD patients. Extensive iron deposition in the bilateral cerebral cortex of PD patients may be a contributing factor to non-motor symptoms such as sleep disturbances and fatigue. Multimodal imaging techniques, including ASL, QSM, and 3DT1WI, can enhance the diagnostic accuracy for PD.
本研究旨在探讨利用动脉自旋标记（ASL）、定量磁化率图谱（QSM）和三维T1加权成像（3DT1WI）的多模态磁共振成像（MRI）在帕金森病（PD）患者中的诊断价值。此外，评估MRI表现与PD相关非运动症状之间的关系。
对48例PD患者和46例健康对照者（HC）进行ASL、QSM和3DT1WI扫描。我们提取并分析了两组之间局部脑血流量（rCBF）、磁化率和灰质密度参数的差异。这些MRI参数与评估非运动症状的临床量表评分相关，包括认知功能、睡眠质量、嗅觉、自主神经功能、焦虑、抑郁和疲劳。采用受试者操作特征（ROC）曲线评估每种成像方式区分PD与HC的诊断准确性。
rCBF、磁化率和灰质密度的ROC曲线下面积（AUC）分别为0.941、0.979和0.624。在PD患者中，统一帕金森病评定量表第二部分（UPDRS II）评分与双侧楔前叶的rCBF呈负相关。匹兹堡睡眠质量指数（PSQI）评分与左侧颞中回和右侧枕中回的rCBF呈负相关。汉密尔顿抑郁评定量表（HAMD）评分与右侧辅助运动区的QSM值呈正相关，而阿根廷嗅觉识别测试（AHRS）评分与同一区域的QSM值呈负相关。病程与右侧扣带中回的QSM值呈正相关。此外，PSQI评分与左侧扣带中回的QSM值呈正相关，疲劳严重程度量表（FSS）评分也与左侧扣带中回的QSM值呈正相关。左侧颞下回的灰质萎缩与PD患者的认知障碍有关。
枕叶灌注不足和左侧颞下回皮质萎缩可能是PD的新型影像学生物标志物，并与PD患者的睡眠障碍和认知障碍有关。PD患者双侧大脑皮质广泛的铁沉积可能是睡眠障碍和疲劳等非运动症状的一个促成因素。包括ASL、QSM和3DT1WI在内的多模态成像技术可提高PD的诊断准确性。
