Chen Zekai, Huang Sibo, Liang Yuefei, Cai Die, Zhou Xi, He Wenjie, Xia Jun
Department of Radiology, The First Affiliated Hospital of Shenzhen University, Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China.
Department of Radiology, South China Hospital, Medical School, Shenzhen University, Shenzhen, China.
Eur J Neurol. 2025 Jul;32(7):e70290. doi: 10.1111/ene.70290.
Inter-individual variability in levodopa responsiveness complicates personalized treatment of Parkinson's disease (PD). Previous studies have suggested that magnetic resonance imaging (MRI)-based indices of the perivascular space (PVS) and choroid plexus (CP) volume may be related to levodopa responsiveness. This study integrated multiple MRI indices, including CP volume, free water (FW) fraction, PVS volume fraction (PVSVF), and diffusion tensor imaging along the PVS (DTI-ALPS), to investigate their associations with levodopa responsiveness.
This retrospective study included 100 participants with PD (median age, 63.5 years; 53% females) who underwent 3T MRI between March 2023 and December 2024 and were grouped into good (n = 54) and poor (n = 46) responders based on the results of an acute levodopa challenge test. CP volume, FW fraction, PVSVF, and DTI-ALPS index were calculated. The Mann-Whitney U test and binary logistic regression were used for analysis.
Participants in the poor responder group had a higher CP volume (p = 0.048) and FW fraction (p < 0.01) than those in the good responder group. Higher CP volume (odds ratio [OR], 0.986; p = 0.038) and FW fraction (odds ratio [OR], 0.883; p < 0.01) were significantly associated with poor levodopa responsiveness, while higher PVS volume fraction, higher PVSVF-BG, higher PVSVF-WM, and lower DTI-ALPS were not.
Higher CP volume and FW fraction were independently associated with poor levodopa responsiveness. CP volume and FW fraction measurements may be valuable imaging biomarkers for predicting levodopa responsiveness.
左旋多巴反应的个体间差异使帕金森病（PD）的个性化治疗变得复杂。先前的研究表明，基于磁共振成像（MRI）的血管周围间隙（PVS）和脉络丛（CP）体积指标可能与左旋多巴反应有关。本研究整合了多个MRI指标，包括CP体积、自由水（FW）分数、PVS体积分数（PVSVF）以及沿PVS的扩散张量成像（DTI-ALPS），以研究它们与左旋多巴反应的关联。
这项回顾性研究纳入了100名PD患者（中位年龄63.5岁；53%为女性），他们在2023年3月至2024年12月期间接受了3T MRI检查，并根据急性左旋多巴激发试验的结果分为反应良好组（n = 54）和反应不佳组（n = 46）。计算CP体积、FW分数、PVSVF和DTI-ALPS指数。采用曼-惠特尼U检验和二元逻辑回归进行分析。
反应不佳组的参与者CP体积（p = 0.048）和FW分数（p < 0.01）高于反应良好组。较高的CP体积（比值比[OR]，0.986；p = 0.038）和FW分数（比值比[OR]，0.883；p < 0.01）与左旋多巴反应不佳显著相关，而较高的PVS体积分数、较高的PVSVF-BG、较高的PVSVF-WM和较低的DTI-ALPS则不然。
较高的CP体积和FW分数与左旋多巴反应不佳独立相关。CP体积和FW分数测量可能是预测左旋多巴反应的有价值的影像生物标志物。
