Zheng Qianshi, Yuan Weijin, Wen Jiaqi, Qin Jianmei, Wu Chenqing, Wu Haoting, Duanmu Xiaojie, Tan Sijia, Guo Tao, Zhou Cheng, Wu Jingjing, Chen Jingwen, Zeng Qingze, Fang Yuelin, Zhu Bingting, Yan Yaping, Tian Jun, Zhang Baorong, Zhang Minming, Guan Xiaojun, Xu Xiaojun
Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310009 Hangzhou, China; Joint Laboratory of Clinical Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310009 Hangzhou, China.
Neuroimage Clin. 2025 Apr 4;46:103776. doi: 10.1016/j.nicl.2025.103776.
Identifying intrinsic pattern of Parkinson's disease (PD) helps to better understand of PD and provide insights to disease identification and treatment monitoring. Here we confirmed the PD-related covariance pattern (PDRP) by using arterial spin labelling technology (ASL-PDRP) and explore its potential for predicting motor progression and levodopa (L-DOPA) reactivity reduction.
Data from an original cohort of 179 PD and 62 normal controls (NC) and a validation cohort including 36 PD and 19 NC to construct and validate the ASL-PDRP. The correlations between the pattern and motor symptoms were analyzed cross-sectionally and longitudinally (71 PD owned longitudinal data) with hierarchical linear regression analysis. Kaplan-Meier analysis was conducted in 54 L-DOPA-managed PD patients to predict the levodopa reactivity reduction.
The first principal component was predominantly recognized as the ASL-PDRP, with its expression being higher in PD than NC in both sets (original: P = 0.017, AUC = 0.598; validation: P = 0.024, AUC = 0.661). The pattern expression was associated with UPDRS III (P = 0.006) and sub-symptoms (axial: P < 0.001; rigidity: P = 0.003; bradykinesia: P = 0.015) at baseline. The ASL-PDRP could predict the progression of UPDRS III (P = 0.021, β = 4.930). Higher expression of the pattern had slower rate of levodopa reactivity reduction in PD patients with axial symptom (P = 0.031).
The identified ASL-PDRP may have potential for characterizing PD with the ability to predict motor progression and L-DOPA reactivity reduction.
识别帕金森病（PD）的内在模式有助于更好地理解PD，并为疾病识别和治疗监测提供见解。在此，我们通过动脉自旋标记技术（ASL-PDRP）确认了与PD相关的协方差模式，并探讨其预测运动进展和左旋多巴（L-DOPA）反应性降低的潜力。
来自179例PD患者和62例正常对照（NC）的原始队列数据以及包括36例PD患者和19例NC的验证队列数据，用于构建和验证ASL-PDRP。采用分层线性回归分析，对该模式与运动症状之间的相关性进行横断面和纵向分析（71例PD患者拥有纵向数据）。对54例接受L-DOPA治疗的PD患者进行Kaplan-Meier分析，以预测左旋多巴反应性降低情况。
第一主成分主要被识别为ASL-PDRP，在两组中其在PD患者中的表达均高于NC（原始队列：P = 0.017，AUC = 0.598；验证队列：P = 0.024，AUC = 0.661）。在基线时，该模式表达与统一帕金森病评定量表第三部分（UPDRS III）及各亚症状相关（轴向症状：P < 0.001；僵硬：P = 0.003；运动迟缓：P = 0.015）。ASL-PDRP可预测UPDRS III的进展（P = 0.021，β = 4.930）。在有轴向症状的PD患者中，该模式的较高表达与左旋多巴反应性降低的速率较慢相关（P = 0.031）。
所识别的ASL-PDRP可能具有表征PD的潜力，具备预测运动进展和L-DOPA反应性降低的能力。
