Zhu Zihao, Wen Jiaqi, Duanmu Xiaojie, Yuan Weijin, Zheng Qianshi, Guo Tao, Wu Chenqing, Wu Haoting, Zhou Cheng, Zeng Qingze, Qin Jianmei, Wu Jingjing, Chen Jingwen, 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, Hangzhou, China.
Joint Laboratory of Clinical Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
NPJ Parkinsons Dis. 2025 Apr 25;11(1):93. doi: 10.1038/s41531-025-00975-4.
Parkinson's disease (PD) is a highly heterogeneous neurodegenerative disorder. This study aimed to identify different patterns of early brain degeneration in PD patients and investigate their clinical relevance. 179 early-stage PD patients and 115 healthy controls were included. We assessed cortical morphology, white matter microstructure, and subcortical iron metabolism using multimodal magnetic resonance imaging and employed clustering techniques to identify subtypes. Two subtypes were identified: the early-deterioration subtype, characterized by fronto-temporal atrophy, parietal thickening, widespread reductions in fractional anisotropy (FA) values, and increased subcortical iron content, which exhibited more severe baseline symptoms and a trend of faster memory decline; and the early-compensatory subtype, characterized by rostral middle frontal atrophy, parietal-occipital thickening, increased FA values, and normal iron content, which exhibited milder symptoms initially but experienced faster progression of both motor and non-motor symptoms. These discoveries provided new insights into disease heterogeneity and facilitated the exploration of early neurodegenerative mechanisms.
帕金森病（PD）是一种高度异质性的神经退行性疾病。本研究旨在识别帕金森病患者早期脑退化的不同模式，并探讨其临床相关性。研究纳入了179例早期帕金森病患者和115例健康对照者。我们使用多模态磁共振成像评估了皮质形态、白质微观结构和皮质下铁代谢，并采用聚类技术来识别亚型。确定了两种亚型：早期恶化亚型，其特征为额颞叶萎缩、顶叶增厚、各向异性分数（FA）值广泛降低以及皮质下铁含量增加，该亚型表现出更严重的基线症状和记忆衰退更快的趋势；早期代偿亚型，其特征为额中回前部萎缩、顶枕叶增厚、FA值增加以及铁含量正常，该亚型最初症状较轻，但运动和非运动症状进展更快。这些发现为疾病的异质性提供了新的见解，并有助于探索早期神经退行性机制。
