Yang Hong-Qi, Xin Ran, Che Ning-Ning, Jiang Qiu-Huan, Chen Shuai, Chen Si-Yuan, Sun Zhi-Kun, Yang Wei-Min, Li Xue, Ma Jian-Jun, Zhang Jie-Wen, Malik Rayaz A
Department of Neurology, People's Hospital of Zhengzhou University, School of Clinical Medicine, Zhengzhou University, Zhengzhou, China.
Department of Neurology, Henan Provincial People's Hospital, School of Clinical Medicine, Henan University, Zhengzhou, China.
NPJ Parkinsons Dis. 2025 May 6;11(1):112. doi: 10.1038/s41531-025-00969-2.
Parkinson's disease (PD) is characterized by progressive degeneration of dopaminergic neurons in the substantia nigra, while secondary parkinsonism (SP) may be due to drugs, vascular, infectious, inflammatory, or even paraneoplastic etiologies. There is currently no biomarker that accurately distinguishes SP from PD. Corneal confocal microscopy (CCM) identifies corneal nerve loss which is associated with motor, cognitive and autonomic dysfunction in PD patients. This study enrolled participants with PD (n = 45) and SP (n = 25). A subset of patients underwent L-6-F-fluoro-3,4-dihydroxyphenylalanine (F-DOPA) positron emission tomography (PET) scan which showed bilateral decreased dopamine uptake in the putamen and caudate of patients with PD, but not in those with SP. Corneal nerve fiber density (CNFD) (P < 0.001) was lower and corneal nerve branch density (CNBD) (P = 0.007) was higher in the PD group compared to the SP group. The receiver operating characteristic (ROC) analysis revealed that combined CNFD and CNBD showed excellent discrimination between SP and PD, with an area under the curve (AUC) of 0.924. CCM may have clinical utility in differentiating patients with SP from PD.
帕金森病（PD）的特征是黑质中多巴胺能神经元进行性退化，而继发性帕金森综合征（SP）可能由药物、血管、感染、炎症甚至副肿瘤病因引起。目前尚无能够准确区分SP与PD的生物标志物。角膜共焦显微镜检查（CCM）可识别角膜神经损伤，这与PD患者的运动、认知和自主神经功能障碍有关。本研究纳入了PD患者（n = 45）和SP患者（n = 25）。一部分患者接受了L-6-F-氟-3,4-二羟基苯丙氨酸（F-DOPA）正电子发射断层扫描（PET），结果显示PD患者壳核和尾状核的多巴胺摄取双侧降低，而SP患者则未出现这种情况。与SP组相比，PD组的角膜神经纤维密度（CNFD）更低（P < 0.001），角膜神经分支密度（CNBD）更高（P = 0.007）。受试者工作特征（ROC）分析显示，联合CNFD和CNBD在区分SP和PD方面表现出色，曲线下面积（AUC）为0.924。CCM在鉴别SP患者和PD患者方面可能具有临床应用价值。
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