Application of diffusion tensor imaging of the basal ganglia circuit in patients with prodromal Parkinson's disease

doi:10.3877/cma.j.issn.1674-0785.2023.09.011

Abstract

Abstract:

Objective

To assess the value of diffusion-tensor imaging (DTI) of the basal ganglia circuit in the diagnosis and assessment of prodromal Parkinson's disease (pPD).

Methods

A total of 21 pPD patients at the Department of Neurology of the Second People's Hospital of Lianyungang City from January 2020 to December 2022 were collected. Meanwhile, 30 healthy people (control group, HC group) and 28 patients with Parkinson's disease (PD group) were also included. All subjects underwent plain MRI scanning and DTI. DSI studio software was used to post-process DTI images of all subjects, and parameters [fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD)] of basal ganglia nuclei were automatically extracted. Statistical comparison and analysis were carried out among PD, pPD, and HC groups, and correlation analysis was carried out between parameters of each group and UPDRS III Scale score.

Results

There were statistical differences in basal ganglia nuclei and parameters among the PD, pPD, and HC groups (P<0.05). Putamen AD=1.28×10^-3 mm²/s was the best diagnostic cut-off point for pPD and HC; the area under the curve was 0.805, the sensitivity was 61.9%, the specificity was 90.0%, and the diagnostic efficiency was the highest. In the pPD group, there were correlations between basal ganglia nuclei and UPDRS III Scale score (P<0.05), and the AD value of the subthalamic nucleus (r=0.763, P<0.001) had the highest correlation coefficient.

Conclusion

The lesions of basal ganglia nuclei in pPD patients are extensive and different in severity. AD value in the putamen is valuable for quantitative diagnosis of pPD. AD value in the subthalamic nucleus can be used as a characteristic sensitive index of disease severity in pPD patients. Multiple parameters of DTI in basal ganglia nuclei provide valuable reference for early diagnosis and intervention of pPD.

Key words: Prodromal Parkinson's disease, Diffusion tensor imaging, Basal ganglia, UPDRS III Scale score

Lei Geng, Zhaoting Zhang, Lei Xu, Hai Huang, Yi Sun, Fumeng Yang, Kai Xu, Chunfeng Hu. Application of diffusion tensor imaging of the basal ganglia circuit in patients with prodromal Parkinson's disease[J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(09): 995-1003.

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References 13

1	中华医学会神经病学分会帕金森病及运动障碍学组. 中国帕金森病治疗指南(第四版) [J]. 中华神经科杂志, 2020, 53(12): 973-986.
2	中华医学会神经病学分会帕金森病及运动障碍学组. 帕金森病前驱期诊断研究标准中国专家共识 [J]. 中华老年医学杂志, 2019, 38(8): 825-831.
3	张玉柱, 徐露露, 周洁, 等. 中脑和基底节神经核团MR扩散张量成像在帕金森病诊断中的作用 [J]. 分子影像学杂志, 2021, 44(2): 327-331.
4	Marrero-González P, Iranzo A, Bedoya D, et al. Prodromal Parkinson disease in patients with idiopathic hyposmia [J]. J Neurol, 2020, 267(12): 3673-3682.
5	Du J, Zhou X, Liang Y, et al. Levodopa responsiveness and white matter alterations in Parkinson's disease: A DTI-based study and brain network analysis: A cross-sectional study [J]. Brain and behavior, 2022, 12(12): e2825.
6	夏敏, 陈光斌, 敖锋. 基于扩散张量的灰质核团在帕金森病早期诊断研究 [J]. 临床放射学杂志, 2023, 42(1): 26-31.
7	Shah V, Alugolu R, Arora A, et al. 3T MRI-SWI based volumetric analysis of the subthalamic and red nuclei in advanced Parkinson's disease [J]. J Neurosurg Sci, 2023, 67(1): 108-112.
8	Hope TR, Selnes P, Rektorová I, et al. Diffusion tensor and restriction spectrum imaging reflect different aspects of neurodegeneration in Parkinson's disease [J]. PLoS One, 2019, 14(5): e0217922.
9	Terkelsen MH, Klaestrup IH, Hvingelby V, et al. Neuroinflammation and immune changes in prodromal Parkinson's disease and other synucleinopathies [J]. J Parkinsons Dis, 2022, 12(s1): S149-S163.
10	张红迁, 李伟霞, 吴有森, 等. DKI参数联合DTI在老年帕金森病患者脑深部核团微观变化评估中的应用[J]. 中国老年学杂志, 2022, 42(11): 2734-2737.
11	Farmen K, Nissen SK, Stokholm MG, et al. Monocyte markers correlate with immune and neuronal brain changes in REM sleep behavior disorder [J]. Proc Natl Acad Sci USA, 2021, 118(10): e2020858118.
12	Hasan SM, Alshafie S, Hasabo EA, et al. Efficacy of dance for Parkinson's disease: a pooled analysis of 372 patients [J]. J Neurol, 2022, 269(3): 1195-1208.
13	Basile GA, Quartu M, Bertino S, et al. Red nucleus structure and function: from anatomy to clinical neurosciences [J]. Brain Struct Funct, 2021, 226(1): 69-91.

分组	PD组	pPD组	HC组	统计值	P值
年龄（岁，）	65.50±6.68	64.24±8.47	62.2±5.7	F=1.707	0.188
性别[例（%）]				χ²=3.12	0.21
男性	12（42.9）	9（42.9）	19（63.3）
女性	16（57.1）	12（57.1）	11（36.7）
受教育程度（年，）	6.96±4.17	8.43±3.98	8.10±3.54	F=1.01	0.369
MMSE（分，）	23.43±2.36	27.90±1.67	-	t=-7.764	<0.001
病程（年，）	4.09±1.95	5.33±2.46	-	t=-1.975	0.054
UPDRS III（分，）	38.04±8.46	8.1±2.76	-	t=17.534	<0.001
H&Y分级（）	2.21±0.57	-	-	-	-

分组	PD组	pPD组	HC组	统计值	P值
年龄（岁，）	65.50±6.68	64.24±8.47	62.2±5.7	F=1.707	0.188
性别[例（%）]				χ²=3.12	0.21
男性	12（42.9）	9（42.9）	19（63.3）
女性	16（57.1）	12（57.1）	11（36.7）
受教育程度（年，）	6.96±4.17	8.43±3.98	8.10±3.54	F=1.01	0.369
MMSE（分，）	23.43±2.36	27.90±1.67	-	t=-7.764	<0.001
病程（年，）	4.09±1.95	5.33±2.46	-	t=-1.975	0.054
UPDRS III（分，）	38.04±8.46	8.1±2.76	-	t=17.534	<0.001
H&Y分级（）	2.21±0.57	-	-	-	-

ROI	PD组	pPD组	HC组	F值	P值	^aP值	^bP值	^cP值
尾状核	0.38±0.02	0.41±0.02	0.42±0.03	22.468	<0.001	<0.001	<0.001	0.073
壳核	0.43±0.02	0.45±0.03	0.47±0.03	14.894	<0.001	0.002	<0.001	0.075
苍白球内侧部	0.47±0.03	0.48±0.02	0.50±0.03	15.199	<0.001	0.01	<0.001	0.018
苍白球外侧部	0.44±0.03	0.46±0.02	0.48±0.03	16.577	<0.001	0.008	<0.001	0.033
丘脑下核	0.37±0.03	0.40±0.03	0.42±0.03	20.035	<0.001	0.001	<0.001	0.024
黑质	0.45±0.03	0.48±0.02	0.50±0.02	33.824	<0.00	<0.001	<0.001	0.005
红核	0.42±0.03	0.46±0.03	0.47±0.03	22.047	<0.001	<0.001	<0.001	0.212

ROI	PD组	pPD组	HC组	F值	P值	^aP值	^bP值	^cP值
尾状核	0.38±0.02	0.41±0.02	0.42±0.03	22.468	<0.001	<0.001	<0.001	0.073
壳核	0.43±0.02	0.45±0.03	0.47±0.03	14.894	<0.001	0.002	<0.001	0.075
苍白球内侧部	0.47±0.03	0.48±0.02	0.50±0.03	15.199	<0.001	0.01	<0.001	0.018
苍白球外侧部	0.44±0.03	0.46±0.02	0.48±0.03	16.577	<0.001	0.008	<0.001	0.033
丘脑下核	0.37±0.03	0.40±0.03	0.42±0.03	20.035	<0.001	0.001	<0.001	0.024
黑质	0.45±0.03	0.48±0.02	0.50±0.02	33.824	<0.00	<0.001	<0.001	0.005
红核	0.42±0.03	0.46±0.03	0.47±0.03	22.047	<0.001	<0.001	<0.001	0.212

ROI	PD组	pPD组	HC组	F值	P值	^aP值	^bP值	^cP值
尾状核	1.02±0.07	0.96±0.05	0.93±0.04	18.405	<0.001	0.006	<0.001	0.09
壳核	0.86±0.04	0.85±0.04	0.81±0.02	13.481	<0.001	0.483	<0.001	0.009
苍白球内侧部	0.88±0.05	0.84±0.04	0.82±0.04	13.067	<0.001	0.006	<0.001	0.075
苍白球外侧部	0.88±0.05	0.85±0.04	0.81±0.03	20.364	<0.001	0.006	<0.001	0.004
丘脑下核	1.05±0.10	0.94±0.06	0.89±0.03	36.598	<0.001	<0.001	<0.001	0.006
黑质	0.92±0.09	0.86±0.07	0.81±0.04	17.780	<0.001	0.033	<0.001	0.016
红核	1.0±0.09	0.93±0.07	0.91±0.06	10.405	<0.001	0.013	<0.001	0.773

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