Multimodal Magnetic Resonance Imaging Quantification of Brain Changes in Progressive Supranuclear Palsy
Multimodal Magnetic Resonance Imaging Quantification of Brain Changes in Progressive Supranuclear Palsy
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DOI：
10.1002/mds.27877
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发表时间：
2019-11-11
影响因子：
8.6
通讯作者：
Lehericy, Stephane
中科院分区：
文献类型：
--
作者：
Pyatigorskaya, Nadya;Yahia-Cherif, Lydia;Lehericy, Stephane
背景进行性核上性麻痹（PSP）是一种神经退行性疾病，临床表现多样，正式诊断是基于死后的脑组织学检查。目的利用多模式MRI定量技术对PSP的神经退行性变进行精确的体内分期。还评价了MRI生物标志物区分PSP与PD的能力。方法将11例PSP患者与26例年龄匹配的健康对照组和51例PD患者进行比较。在3特斯拉（三维T-1加权、扩散张量和神经黑素敏感图像）和7特斯拉（三维T-2* 图像）下采集图像。感兴趣的区域包括皮质区、海马、杏仁核、基底神经节、基底前脑、脑干核、齿状核和小脑。测量了介电常数、平均扩散率和各向异性分数。在每个区域，计算组分类的阈值，并确定四个等级的变化（0-3）。结果PSP患者中脑、黑质、苍白球、基底前脑、蓝斑、桥脚核、齿状核等核团体积和弥散改变广泛，与病理学改变程度一致。分离PSP和健康对照的预测因素依次为：基于神经黑素的SN体积;中脑各向异性分数;中脑、苍白球和壳核的体积;蓝斑各向异性分数。分离PSP PD的最佳预测因子是SN中基于神经黑素的体积、脑桥中的各向异性分数、中脑和苍白球的体积以及基底前脑中的各向异性分数。结论这些结果表明，它是可能的，以评估脑神经退行性变的PSP无创性，即使在小脑干核，在密切的协议与以前发表的组织学数据。(c)2019国际帕金森和运动障碍协会
Background Progressive supranuclear palsy (PSP) is a neurodegenerative clinically heterogeneous disorder, formal diagnosis being based on postmortem histological brain examination. Objective We aimed to perform a precise in vivo staging of neurodegeneration in PSP using quantitative multimodal MRI. The ability of MRI biomarkers to differentiate PSP from PD was also evaluated. Methods Eleven PSP patients were compared to 26 age-matched healthy controls and 51 PD patients. Images were acquired at 3 Tesla (three-dimensional T-1-weighted, diffusion tensor, and neuromelanin-sensitive images) and 7 Tesla (three-dimensional-T-2* images). Regions of interest included the cortical areas, hippocampus, amygdala, basal ganglia, basal forebrain, brainstem nuclei, dentate nucleus, and cerebellum. Volumes, mean diffusivity, and fractional anisotropy were measured. In each region, a threshold value for group categorization was calculated, and four grades of change (0-3) were determined. Results PSP patients showed extensive volume decreases and diffusion changes in the midbrain, SN, STN, globus pallidus, basal forebrain, locus coeruleus, pedunculopontine nucleus, and dentate nucleus, in close agreement with the degrees of impairment in histological analyses. The predictive factors for the separation of PSP and healthy controls were, in descending order, the neuromelanin-based SN volume; midbrain fractional anisotropy; volumes of the midbrain, globus pallidus, and putamen; and fractional anisotropy in the locus coeruleus. The best predictors for separating PSP from PD were the neuromelanin-based volume in the SN, fractional anisotropy in the pons, volumes of the midbrain and globus pallidus, and fractional anisotropy in the basal forebrain. Conclusions These results suggest that it is possible to evaluate brain neurodegeneration in PSP noninvasively, even in small brainstem nuclei, in close agreement with previously published histological data. (c) 2019 International Parkinson and Movement Disorder Society