Sui He, Mo Zhanhao, Shi Feng, Zhou Qing, Yu Dan, Wang Jiaqi, Liu Lin
China-Japan Union Hospital of Jilin University, Changchun, China.
Shanghai United Imaging Intelligence Co., Ltd., Shanghai, China.
Front Aging Neurosci. 2025 Jul 16;17:1602245. doi: 10.3389/fnagi.2025.1602245. eCollection 2025.
Non-motor symptoms (NMS) in Parkinson's disease (PD) often precede motor manifestations and are challenging to detect with conventional MRI. This study investigates the use of the Multi-Flip-Angle and Multi-Echo Gradient Echo Sequence (MULTIPLEX) in MRI to detect previously undetectable microstructural changes in brain tissue associated with NMS in PD.
A prospective study was conducted on 37 patients diagnosed with PD. Anxiety and depression levels were assessed using the Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD), respectively. MRI techniques, including 3D T1-weighted imaging (3D T1WI) and MULTIPLEX - which encompasses T2*-mapping, T1-mapping, proton density-mapping, and quantitative susceptibility mapping (QSM)-were performed. Brain subregions were automatically segmented using deep learning, and their volume and quantitative parameters were correlated with NMS-related assessment scales using Spearman's rank correlation coefficient.
Correlations were observed between QSM and T2* values of certain subregions within the left frontal and bilateral temporal lobes and both anxiety and depression (absolute -values ranging from 0.358 to 0.480, < 0.05). Additionally, volume measurements of regions within the bilateral frontal, temporal, and insular lobes exhibited negative correlations with anxiety and depression (absolute -values ranging from 0.354 to 0.658, < 0.05). In T1-mapping and proton density-mapping, no specific brain regions were found to be significantly associated with the NMS of PD under investigation.
Quantitative parameters derived from MULTIPLEX MRI show significant associations with clinical evaluations of NMS in PD. Multiparametric MR neuroimaging may serve as a potential early diagnostic tool for PD.
帕金森病（PD）的非运动症状（NMS）通常先于运动表现出现，并且使用传统磁共振成像（MRI）检测具有挑战性。本研究调查了MRI中的多翻转角和多回波梯度回波序列（MULTIPLEX）在检测与PD中NMS相关的先前无法检测到的脑组织微观结构变化方面的应用。
对37例诊断为PD的患者进行了一项前瞻性研究。分别使用汉密尔顿焦虑量表（HAMA）和汉密尔顿抑郁量表（HAMD）评估焦虑和抑郁水平。进行了MRI技术检查，包括三维T1加权成像（3D T1WI）和MULTIPLEX，后者包括T2*映射、T1映射、质子密度映射和定量磁化率映射（QSM）。使用深度学习对脑亚区域进行自动分割，并使用斯皮尔曼等级相关系数将其体积和定量参数与NMS相关评估量表进行关联。
观察到左额叶和双侧颞叶内某些亚区域的QSM和T2*值与焦虑和抑郁之间存在相关性（绝对值范围为0.358至0.480，P<0.05）。此外，双侧额叶、颞叶和岛叶内区域的体积测量值与焦虑和抑郁呈负相关（绝对值范围为0.354至0.658，P<0.05）。在T1映射和质子密度映射中，未发现特定脑区与所研究的PD的NMS有显著关联。
从MULTIPLEX MRI获得的定量参数显示与PD中NMS的临床评估有显著关联。多参数磁共振神经成像可能作为PD的潜在早期诊断工具。
