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首页> 外文期刊>The Canadian Journal of Neurological Sciences: le Journal Canadien des Sciences Neurologiques >P.087 The influence of disease lateralization in Parkinson’s Disease on tractography in DBS patients
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P.087 The influence of disease lateralization in Parkinson’s Disease on tractography in DBS patients

机译：P.087疾病横向化在DBS患者牵引术中疾病的影响

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Background: Asymmetric motor symptoms are typical in Parkinson’s disease (PD), with potential implications on disease course. Imaging modalities have demonstrated asymmetry, including thinning of motor-related cortex in the contralateral hemisphere of symptomatic side. The objective is to assess correlation between lateralized symptoms and Diffusion Tensor Imaging (DTI) characteristics of pyramidal tract. Methods: 34 PD patients and 30 controls were evaluated. Disease dominance was assessed using UDPRS III. DTI was performed with 60-directional 3Tesla MRI protocol. A 1cm3 subcortical region of interest was positioned underneath motor cortex. Primary outcome was the difference in fibers between disease-dominant and non disease-dominant cortex. Results: There was a significantly higher number of fibers in the hemisphere corresponding to disease dominance (p=0.0031). The same was true for seed number (p=0.0032) and fractional anisotropy (p=0.0427). Based on 23 patients operated on, the threshold for stimulation-induced side effects on the left side was inversely correlated with number of fibers in left ROI (Spearman -0.497, p=0.0158). Conclusions: Based on current literature we expected a reduction of fibers in the contralateral hemisphere to symptom dominant side. Surprisingly, DTI analysis showed an inverse correlation. The underlying pathophysiology remains unclear with the possibility of a compensatory mechanism or compacting of fibers underneath a shrinking motor cortex.
机译：背景：帕金森病（Pd）的不对称电机症状是典型的，对疾病课程潜在影响。成像方式已经证明了不对称性，包括在症状侧对侧半球的电动机相关皮层稀释。该目的是评估盲症状和扩散张量成像（DTI）特征的锥体斑块的相关性。方法：评估34例PD患者和30例对照。使用UDPRS III评估疾病优势。用60个方向3TESLA MRI协议进行DTI。 1cm3的感兴趣区域位于马达皮质下方。主要结果是疾病 - 占状和非疾病占优势皮质之间的纤维差异。结果：对应于疾病优势的半球中有较高数量的纤维（P = 0.0031）。种子数（p = 0.0032）和分数各向异性也是如此（p = 0.0427）。基于23名患者进行操作，左侧刺激诱导的副作用的阈值与左ROI的纤维数与左侧纤维（SPEARMAN -0.497，P = 0.0158）相关。结论：基于目前文献，我们预计对侧半球中的纤维降低到症状主导侧。令人惊讶的是，DTI分析显示了逆相关性。潜在的病理物理学仍然不清楚，在收缩的电机皮质下方的纤维的补偿机制或压实的可能性仍然不清楚。

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