Longitudinal Study of Gray Matter Changes in Parkinson Disease
Longitudinal Study of Gray Matter Changes in Parkinson Disease
复制标题
帕金森病灰质变化的纵向研究
DOI：
10.3174/ajnr.a4447
复制
发表时间：
2015-12-01
影响因子：
3.5
通讯作者：
Li, K.
中科院分区：
文献类型：
--
作者：
Jia, X.;Liang, P.;Li, K.
背景与目的：帕金森病病理导致脑容量形态学改变。到目前为止，与对照组相比，帕金森病患者的脑灰质体积随时间的变化仍不清楚。我们的目的是研究帕金森病患者的灰质变化模式，并通过基于体素的形态学分析来探索帕金森病患者随着疾病进展所特有的进行性灰质体积变化。材料和方法：89名帕金森病患者（62名男性）和55名健康对照（33名男性）的纵向认知评估和结构磁共振成像来自帕金森进展标志物倡议数据库，包括初始基线和12个月的随访数据。采用SPM8软件中的Diffeomorphic anatomy Registration Through Exponentiated Lie Algebra工具，对年龄、性别、受教育年限、多中心影像资料、颅内总容积等协变量进行双向协方差分析。结果：帕金森病患者的灰质体积变化表现为额颞顶区和双侧尾状核灰质体积减少，双侧边缘/旁边缘区、内侧苍白球/壳核和右侧枕皮质灰质体积增加。帕金森病患者和健康对照者均发现双侧尾状核灰质体积进行性减少，这两组的尾状核体积与认知能力呈正相关。帕金森病患者特有的进行性灰质体积增加位于丘脑左侧腹侧核附近，在震颤为主的帕金森病患者亚组中，发现丘脑体积与震颤评分呈正相关。结论：观察到帕金森病灰质体积的进行性变化可能为神经退行性过程提供新的见解。目前的研究结果表明，尾状核体积的减少可能导致帕金森病患者的认知能力下降，而进行性丘脑增大可能与帕金森病患者的震颤严重程度有关。
BACKGROUND AND PURPOSE: The pathology of Parkinson disease leads to morphological brain volume changes. So far, the progressive gray matter volume change across time specific to patients with Parkinson disease compared controls remains unclear. Our aim was to investigate the pattern of gray matter changes in patients with Parkinson disease and to explore the progressive gray matter volume change specific to patients with Parkinson disease with disease progression by using voxel-based morphometry analysis. MATERIALS AND METHODS: Longitudinal cognitive assessment and structural MR imaging of 89 patients with Parkinson disease (62 men) and 55 healthy controls (33 men) were from the Parkinson's Progression Markers Initiative data base, including the initial baseline and 12-month follow-up data. Two-way analysis of covariance was performed with covariates of age, sex, years of education, imaging data from multiple centers, and total intracranial volume by using Diffeomorphic Anatomical Registration Through Exponentiated Lie Algebra tool from SPM8 software. RESULTS: Gray matter volume changes for patients with Parkinson disease were detected with decreased gray matter volume in the frontotemporoparietal areas and the bilateral caudate, with increased gray matter volume in the bilateral limbic/paralimbic areas, medial globus pallidus/putamen, and the right occipital cortex compared with healthy controls. Progressive gray matter volume decrease in the bilateral caudate was found for both patients with Parkinson disease and healthy controls, and this caudate volume was positively associated with cognitive ability for both groups. The progressive gray matter volume increase specific to the patients with Parkinson disease was identified close to the left ventral lateral nucleus of thalamus, and a positive relationship was found between the thalamic volume and the tremor scores in a subgroup with tremor-dominant patients with Parkinson disease. CONCLUSIONS: The observed progressive changes in gray matter volume in Parkinson disease may provide new insights into the neurodegenerative process. The current findings suggest that the caudate volume loss may contribute to cognitive decline in patients with Parkinson disease and the progressive thalamus enlargement may have relevance to tremor severity in Parkinson disease.