Neuroimaging uncovers distinct relationships of glymphatic dysfunction and motor symptoms in Parkinson’s disease
Neuroimaging uncovers distinct relationships of glymphatic dysfunction and motor symptoms in Parkinson’s disease
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DOI：
10.1007/s00415-023-11594-5
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发表时间：
2023-03
影响因子：
6
通讯作者：
Yan Qin;Runcheng He;Juan Chen;Xiaoxia Zhou;Xun Zhou;Zhenhua Liu;Qian Xu;Ji-feng Guo;Xinxiang Yan;Nana Jiang;W. Liao;T. Taoka;Dongcui Wang;B. Tang
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文献类型：
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作者：
Yan Qin;Runcheng He;Juan Chen;Xiaoxia Zhou;Xun Zhou;Zhenhua Liu;Qian Xu;Ji-feng Guo;Xinxiang Yan;Nana Jiang;W. Liao;T. Taoka;Dongcui Wang;B. Tang
背景近年来，有关帕金森病(PD)患者淋巴功能障碍的研究引起了人们的广泛关注。然而，淋巴功能障碍与临床症状之间的关系尚不清楚。目的确定沿血管周围间隙的扩散张量图像分析(DTI-ALPS)是否影响PD患者运动和非运动症状的严重程度和类型。方法从国际多中心帕金森进展标记物倡议(PPMI)队列中检索接受DTI和123I-DaTcan单光子发射计算机断层扫描(SPECT)的初诊PD患者和对照组。采用DTI-Alps对淋巴系统进行评估。运动症状采用运动障碍协会统一帕金森氏病评定量表III(MDS-UPDRS-III)进行评定。结果共纳入PD患者15 3例(平均年龄60.97 ± 9.47岁；男性99例)和正常对照组67例(平均年龄6 0.10 ± 10.562岁；男性43例)。PD组DTI-ALPS指数显著低于正常对照组(Z= − 2.160，p= 0.031)。MDS-UPDRS III评分(r= − 0.213，p= 0.008)和僵直亚分(r= − 0.177，p= 0.029)与DTI-ALPS指数呈负相关。在调整壳核多巴胺转运体的可用性和临床因素后，DTI-ALPS指数与MDS-UPDRS-III评分(β= − 0.160，p= 0.048)和僵直评分(β= − 0.170，p= 0.041)显著相关。结论我们的结果显示，淋巴功能障碍与PD运动症状的严重程度和类型有明显的相关性，提示DTI-ALPS指数有可能成为PD运动症状的生物标志物。
BackgroundStudies of glymphatic dysfunction in Parkinson’s disease (PD) patients have attracted much attention in recent years. However, the relationships between glymphatic dysfunction and clinical symptoms remains unclear.ObjectivesTo determine whether the diffusion tensor image analysis along the perivascular space (DTI-ALPS) affect the severity and types of motor and non-motor symptoms in PD patients.MethodsDe novo PD patients and controls who performed both DTI and123I-DaTscan single photon emission computed tomography (SPECT) scanning were retrieved from the international multicenter Parkinson’s Progression Marker Initiative (PPMI) cohort. Glymphatic system was evaluated by the DTI-ALPS. Motor symptoms were assessed by Movement Disorders Society Unified Parkinson’s Disease Rating Scale III (MDS-UPDRS-III). The influence of glymphatic activity on motor and non-motor symptoms was explored by multivariate linear regression models.ResultsA total of 153 PD patients (mean age 60.97 ± 9.47 years; 99 male) and 67 normal controls (mean age 60.10 ± 10.562 years; 43 male) were included. The DTI-ALPS index of PD patients was significantly lower than normal controls (Z= − 2.160,p= 0.031). MDS-UPDRS III score (r= − 0.213,p= 0.008) and subscore for rigidity (r= − 0.177,p= 0.029) were negatively correlated with DTI-ALPS index. The DTI-ALPS index was significantly associated with MDS-UPDRS-III score (β= − 0.160,p= 0.048) and subscore for rigidity (β= − 0.170,p= 0.041) after adjusting for putamen dopamine transporter availability and clinical factors.ConclusionsOur results showed distinct relationships between glymphatic dysfunction and the severity and types of PD motor symptoms, suggesting the potential of DTI-ALPS index as a biomarker for PD motor symptoms.