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首页> 美国卫生研究院文献>Frontiers in Aging Neuroscience >Progressive Decline in Gray and White Matter Integrity in de novo Parkinson’s Disease: An Analysis of Longitudinal Parkinson Progression Markers Initiative Diffusion Tensor Imaging Data
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Progressive Decline in Gray and White Matter Integrity in de novo Parkinson’s Disease: An Analysis of Longitudinal Parkinson Progression Markers Initiative Diffusion Tensor Imaging Data

机译：新生帕金森氏病中灰色和白色物质完整性的逐步下降：纵向帕金森氏进展标记主动扩散张量成像数据的分析

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>Background: Progressive neuronal loss in neurodegenerative diseases such as Parkinson’s disease (PD) is associated with progressive degeneration of associated white matter tracts as measured by diffusion tensor imaging (DTI). These findings may have diagnostic and functional implications but their value in de novo PD remains unknown. Here we analyzed longitudinal DTI data from Parkinson’s Progression Markers Initiative de novo PD patients for changes over time relative to healthy control (HC) participants.>Methods: Baseline and 1-year follow-up DTI MRI data from 71 PD patients and 45 HC PPMI participants were included in the analyses. Whole-brain fractional anisotropy (FA) and mean diffusivity (MD) images were compared for baseline group differences and group–by–time interactions. Baseline and 1-year changes in DTI values were correlated with changes in DTI measures and symptom severity, respectively.>Results: At baseline, PD patients showed significantly increased FA in brainstem, cerebellar, anterior corpus callosal, inferior frontal and inferior fronto-occipital white matter and increased MD in primary sensorimotor and supplementary motor regions. Over 1 year PD patients showed a significantly stronger decline in FA compared to HC in the optic radiation and corpus callosum and parietal, occipital, posterior temporal, posterior thalamic, and vermis gray matter. Significant increases in MD were observed in white matter of the midbrain, optic radiation and corpus callosum, while gray matter of prefrontal, insular and posterior thalamic regions. Baseline brainstem FA white matter (WM) values predicted 1-year changes in FA white matter and MD gray matter values. White but not gray matter changes in both FA and MD were significantly associated with changes in symptom severity.>Conclusion: Significant gray and white matter DTI alterations are observable at the time of PD diagnosis and expand in the first year of de novo PD to other cortical and white matter regions. This pattern of DTI changes is in line with preclinical and neuroanatomical studies suggesting that the increased spatial spread of alpha-synuclein neuropathology is the key mechanism of PD progression. Taken together, these findings suggest that DTI may serve as a sensitive biomarker of disease progression in early-stage PD.
机译：>背景：通过扩散张量成像（DTI）测量，帕金森氏病（PD）等神经退行性疾病中的进行性神经元丧失与相关白质束的进行性退化有关。这些发现可能具有诊断和功能意义，但它们在从头PD中的价值仍然未知。在这里，我们分析了帕金森氏病进展性PD倡议患者的纵向DTI数据相对于健康对照（HC）参与者随时间的变化。>方法：来自71位患者的基线和1年随访DTI MRI数据分析中包括PD患者和45位HC PPMI参与者。比较了全脑分数各向异性（FA）和平均扩散率（MD）图像的基线组差异和组-时间相互作用。 >结果：在基线时，PD患者的脑干，小脑，前体call体，下位的FA显着增加，分别与DTI值的基线和1年变化相关。额叶和额枕下白质和初级感觉运动和辅助运动区域的MD增加。在1年以上的时间里，PD患者在视辐射和and体以及顶叶，枕叶，颞后叶，丘脑后叶和ver骨灰质方面，与HC相比，FA的下降明显更强。在中脑白质，视辐射和体中发现了MD的显着增加，而在额叶前，岛状和丘脑后区域则出现了灰质。基线脑干FA白质（WM）值预测FA白质和MD灰质值出现1年变化。 FA和MD的白色而非灰色物质变化与症状严重程度显着相关。>结论：在PD诊断时可观察到显着的灰色和白色物质DTI改变，并在第一年扩大。从头到尾的PD到其他皮质和白质区域。 DTI变化的这种模式与临床前和神经解剖学研究一致，表明α-突触核蛋白神经病理学的空间扩散增加是PD进展的关键机制。综上所述，这些发现表明DTI可以作为早期PD中疾病进展的敏感生物标志物。

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