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使用多壳自由水扩散张量成像(DTI)和神经突方向离散与密度成像(NODDI)研究帕金森病中的白质改变:对神经退行性变和左旋多巴效应的见解

Investigating white matter alterations in Parkinson's disease using multi-shell free-water DTI and NODDI: insights into neurodegeneration and levodopa effects.

作者信息

Bergamino Maurizio, Zhu Shuyi, Shill Holly A, Stokes Ashley M

机构信息

Barrow Neuroimaging Innovation Center, Barrow Neurological Institute, Phoenix, AZ, United States.

School of Life Sciences, Arizona State University, Tempe, AZ, United States.

出版信息

Front Neurol. 2025 Jul 9;16:1605753. doi: 10.3389/fneur.2025.1605753. eCollection 2025.


DOI:10.3389/fneur.2025.1605753
PMID:40703778
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12283281/
Abstract

INTRODUCTION: Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by motor and non-motor symptoms. Levodopa remains the primary treatment, temporarily restoring dopamine levels and improving motor symptoms. Advanced diffusion MRI techniques, such as free-water corrected diffusion tensor imaging (fw-DTI) and neurite orientation dispersion and density imaging (NODDI), provide insights into PD-related microstructural changes beyond conventional DTI. METHODS: This study investigates white matter alterations in PD using multi-shell fw-DTI and NODDI to compare voxel-wise differences between PD patients both OFF and ON levodopa, with comparison to healthy controls (HC). Effect sizes and receiver operating characteristic (ROC) analyses assessed the discriminative power of imaging metrics. RESULTS: PD (OFF) exhibited increased free-water, reduced neurite density (NDI), and altered orientation dispersion (ODI) in key motor pathways in comparison to HC, while fw-FA offered robust group discrimination (AUC=0.956). Levodopa (ON state) increased NDI and NODDI-FWF, suggesting acute microstructural plasticity, though this finding contrasted with minimal fw-DTI FW changes. Additionally, voxel-based correlation analyses linked free-water and neurite integrity metrics with disease severity. DISCUSSION: Our findings suggest that fw-DTI and NODDI provide complementary information on PD-related neurodegeneration and the transient effects of levodopa. These results underscore the potential of advanced diffusion MRI techniques as biomarkers for tracking PD progression and treatment response.

摘要

引言:帕金森病(PD)是一种以运动和非运动症状为特征的进行性神经退行性疾病。左旋多巴仍然是主要治疗方法,可暂时恢复多巴胺水平并改善运动症状。先进的扩散磁共振成像(MRI)技术,如自由水校正扩散张量成像(fw-DTI)和神经突方向离散度与密度成像(NODDI),能够揭示常规DTI之外与PD相关的微观结构变化。 方法:本研究使用多壳层fw-DTI和NODDI研究PD患者的白质改变,比较左旋多巴停药和服药状态下PD患者与健康对照(HC)之间的体素差异。效应量和受试者工作特征(ROC)分析评估了成像指标的辨别能力。 结果:与HC相比,PD(停药状态)在关键运动通路中表现出自由水增加、神经突密度(NDI)降低和方向离散度(ODI)改变,而fw-FA提供了强大的组间辨别能力(AUC = 0.956)。左旋多巴(服药状态)增加了NDI和NODDI-FWF,表明存在急性微观结构可塑性,尽管这一发现与fw-DTI的自由水变化极小形成对比。此外,基于体素的相关性分析将自由水和神经突完整性指标与疾病严重程度联系起来。 讨论:我们的研究结果表明,fw-DTI和NODDI提供了与PD相关神经退行性变以及左旋多巴短暂效应的补充信息。这些结果强调了先进扩散MRI技术作为追踪PD进展和治疗反应生物标志物的潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f3c/12283281/958ad2e7b33b/fneur-16-1605753-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f3c/12283281/049b4f2d96ad/fneur-16-1605753-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f3c/12283281/fd1e69e11530/fneur-16-1605753-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f3c/12283281/202085646878/fneur-16-1605753-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f3c/12283281/2ff568ff093c/fneur-16-1605753-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f3c/12283281/b5addd5d18d3/fneur-16-1605753-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f3c/12283281/78d032809049/fneur-16-1605753-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f3c/12283281/958ad2e7b33b/fneur-16-1605753-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f3c/12283281/049b4f2d96ad/fneur-16-1605753-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f3c/12283281/fd1e69e11530/fneur-16-1605753-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f3c/12283281/202085646878/fneur-16-1605753-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f3c/12283281/2ff568ff093c/fneur-16-1605753-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f3c/12283281/b5addd5d18d3/fneur-16-1605753-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f3c/12283281/78d032809049/fneur-16-1605753-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f3c/12283281/958ad2e7b33b/fneur-16-1605753-g007.jpg

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本文引用的文献

[1]
Gait impairment-related axonal degeneration in Parkinson's disease by neurite orientation dispersion and density imaging.

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A biological definition of neuronal α-synuclein disease: towards an integrated staging system for research.

Lancet Neurol. 2024-2

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Sex Differences in Alzheimer's Disease Revealed by Free-Water Diffusion Tensor Imaging and Voxel-Based Morphometry.

J Alzheimers Dis. 2022

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Neuroimage. 2019-8-29

[10]
Neurite orientation dispersion and density imaging (NODDI) and free-water imaging in Parkinsonism.

Hum Brain Mapp. 2019-8-12

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