Age at onset influences neurodegenerative processes underlying PD with levodopa-induced dyskinesias
Age at onset influences neurodegenerative processes underlying PD with levodopa-induced dyskinesias
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DOI：
10.1016/j.parkreldis.2013.05.015
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发表时间：
2013-10-01
影响因子：
4.1
通讯作者：
Quattrone, Aldo
中科院分区：
文献类型：
--
作者：
Cerasa, Antonio;Salsone, Maria;Quattrone, Aldo
目的：最近，我们证明，帕金森病患者与左旋多巴诱导的运动障碍的特点是神经解剖和功能的变化，涉及前额叶皮层。与非运动障碍型PD患者相比，运动障碍型PD患者表现出下额叶皮质体积增加，在运动任务中该区域与辅助运动区之间存在功能失调。在目前的研究中，我们调查了发病年龄对运动障碍患者神经解剖学特征的影响，因为众所周知，早发性PD患者通常比晚发性PD患者更早发生运动障碍。在运动障碍组（n = 33）进行了全脑灰质体积和皮质厚度的体素研究，非运动障碍PD患者（n = 33）和年龄性别匹配的健康对照（n = 40）。根据发病年龄（早、晚）分别进行神经影像学分析< 50 y >。独立于发病时的年龄，运动障碍PD患者表现出改变的形态，在下额叶皮层相比，非运动障碍患者。此外，与对照组相比，早发性和迟发性PD患者出现了额外的显著异常。事实上，早发性运动障碍患者显示中脑包括黑质和红核在内的大簇体积增加，而晚发性运动障碍患者的特征是辅助运动区的灰质异常增加。我们的研究结果表明，根据发病年龄，LID患者的大脑异常模式不同，突出了黑质病理学在早发性PD患者中的作用和皮质病理学在晚发性PD患者中的作用。(c)2013爱思唯尔有限公司保留所有权利。
Purpose: Recently, we demonstrated that PD patients with levodopa-induced dyskinesias are characterized by neuroanatomical and functional changes involving the prefrontal cortex. When compared with non-dyskinetic PD patients, dyskinetic PD patients showed increased volume of the inferior frontal cortex and a dysfunctional imbalance between this region and the supplementary motor area during motor task. In the current study, we investigated the impact of age at onset of the disease on the neuroanatomical characteristics of dyskinetic patients, because it is well known that early-onset PD patients usually develop dyskinesias sooner with respect to late-onset PD.Methods: Whole-brain voxel-wise investigations of gray matter volume and cortical thickness were carried out in dyskinetic (n = 33), non-dyskinetic PD patients (n = 33) and in age-sex-matched healthy controls (n = 40). Neuroimaging analyses were performed separately according to the age at onset (early < 50 y > late).Results: Independent of age at onset, dyskinetic PD patients showed altered morphology in the inferior frontal cortex when compared with non-dyskinetic patients. Moreover, additional significant abnormalities emerged in the early- and late-onset PD patients when compared to controls. In fact, early-onset dyskinetic patients showed increased volume in a large cluster of the midbrain encompassing substantia nigra and red nucleus, whereas late-onset dyskinetic patients were characterized by abnormal gray matter increase in the supplementary motor area.Discussion: Our findings demonstrate different patterns of brain abnormalities in patients with LID according to age at onset, highlighting the role of the nigral pathology in early-onset and of the cortical pathology in late-onset patients with PD. (c) 2013 Elsevier Ltd. All rights reserved.