Clinical, cognitive, and behavioural correlates of white matter damage in progressive supranuclear palsy
Clinical, cognitive, and behavioural correlates of white matter damage in progressive supranuclear palsy
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DOI：
10.1007/s00415-014-7301-3
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发表时间：
2014-05-01
影响因子：
6
通讯作者：
Filippi, Massimo
中科院分区：
文献类型：
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作者：
Agosta, Federica;Galantucci, Sebastiano;Filippi, Massimo
对进行性核上性麻痹（PSP）患者与健康对照组和特发性帕金森病（PD）患者的白色束（WM）改变进行了评估，以探讨WM束损伤与临床疾病严重程度、认知测试表现和冷漠的关系。37名PSP患者、41名PD患者和34名健康对照者接受了MRI扫描和临床测试，以评估身体残疾、认知障碍和冷漠。在PSP中，使用随机森林分析评估WM束损伤对整体疾病严重程度以及认知和行为障碍的贡献。与对照组相比，PSP患者显示胼胝体、上级小脑脚（SCP）、双侧扣带和钩束以及右下纵束的扩散张量（DT）MRI异常。胼胝体和SCP DT MRI测量区分PSP与PD患者的准确性很高（曲线下面积范围为0.89至0.72）。在PSP中，胼胝体和上级小脑脚的DT MRI指标是总体疾病严重程度量表评分的最佳预测因子。胼胝体、右侧上级纵束和下纵束以及左侧钩椎的DT MRI指标是执行功能障碍的最佳预测指标。在PSP中，情感淡漠的严重程度与胼胝体、右侧上级纵束和钩束的损伤有关。总之，WM束损伤有助于PSP的运动，认知和行为缺陷。DT MRI为PSP诊断、评估和监测提供了标记物。
White matter (WM) tract alterations were assessed in patients with progressive supranuclear palsy (PSP) relative to healthy controls and patients with idiopathic Parkinson's disease (PD) to explore the relationship of WM tract damage with clinical disease severity, performance on cognitive tests, and apathy. 37 PSP patients, 41 PD patients, and 34 healthy controls underwent an MRI scan and clinical testing to evaluate physical disability, cognitive impairment, and apathy. In PSP, the contribution of WM tract damage to global disease severity and cognitive and behavioural disturbances was assessed using Random Forest analysis. Relative to controls, PSP patients showed diffusion tensor (DT) MRI abnormalities of the corpus callosum, superior cerebellar peduncle (SCP), cingulum and uncinate fasciculus bilaterally, and right inferior longitudinal fasciculus. Corpus callosum and SCP DT MRI measures distinguished PSP from PD patients with high accuracy (area under the curve ranging from 0.89 to 0.72). In PSP, DT MRI metrics of the corpus callosum and superior cerebellar peduncles were the best predictors of global disease severity scale scores. DT MRI metrics of the corpus callosum, right superior longitudinal and inferior longitudinal fasciculus, and left uncinate were the best predictors of executive dysfunction. In PSP, apathy severity was related to the damage to the corpus callosum, right superior longitudinal, and uncinate fasciculi. In conclusion, WM tract damage contributes to the motor, cognitive, and behavioural deficits in PSP. DT MRI offers markers for PSP diagnosis, assessment, and monitoring.