High-resolution diffusion tensor imaging in the substantia nigra of de novo Parkinson disease
High-resolution diffusion tensor imaging in the substantia nigra of de novo Parkinson disease
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DOI：
10.1212/01.wnl.0000340982.01727.6e
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发表时间：
2009-04-21
期刊：
影响因子：
9.9
通讯作者：
Little, D. M.
中科院分区：
文献类型：
--
作者：
Vaillancourt, D. E.;Spraker, M. B.;Little, D. M.
背景：帕金森病(PD)患者中脑黑质腹外侧部和尾侧部的多巴胺能神经元选择性丢失。在帕金森病小鼠模型中，研究人员使用了1-甲基-4-苯基-1，2，3，6-四氢吡啶(MPTP)，发现扩散张量成像(DTI)的测量结果与中毒后丢失的多巴胺神经元的数量相关。方法：28名受试者(14名早期帕金森病患者和14名年龄和性别匹配的对照组)在3Tesla使用高分辨率DTI技术，使用8通道相位阵列线圈和并行成像研究SN中特定的变性节段。结果：PD患者SN的分数各向异性(FA)较对照组降低(p<；0.001)。事后分析发现，帕金森病患者的FA减少在尾侧比在吻侧感兴趣区更大(p<；0.00001)。尾侧SN的受试者特征分析显示，区分PD患者和健康人的敏感性和特异性均为100%。结论：这些发现为黑质高分辨率扩散张量成像区分早期帕金森病(PD)患者和健康人提供了证据，并有可能成为PD的无创性早期生物标志物。神经病学(R)2009；72：1378-1384
Background: In the midbrain of patients with Parkinson disease (PD), there is a selective loss of dopaminergic neurons in the ventrolateral and caudal substantia nigra (SN). In a mouse model of PD, investigators have administered 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) and found that measures derived using diffusion tensor imaging (DTI) were correlated with the number of dopamine neurons lost following intoxication.Methods: Twenty-eight subjects (14 with early stage, untreated PD and 14 age- and gender-matched controls) were studied with a high-resolution DTI protocol at 3 Tesla using an eight-channel phase array coil and parallel imaging to study specific segments of degeneration in the SN. Regions of interest were drawn in the rostral, middle, and caudal SN by two blinded and independent raters.Results: Fractional anisotropy (FA) was reduced in the SN of subjects with PD compared with controls (p < 0.001). Post hoc analysis identified that reduced FA for patients with PD was greater in the caudal compared with the rostral region of interest (p < 0.00001). A receiver operator characteristic analysis in the caudal SN revealed that sensitivity and specificity were 100% for distinguishing patients with PD from healthy subjects. Findings were consistent across both raters.Conclusions: These findings provide evidence that high resolution diffusion tensor imaging in the substantia nigra distinguishes early stage, de novo patients with Parkinson disease (PD) from healthy individuals on a patient by patient basis and has the potential to serve as a noninvasive early biomarker for PD. Neurology(R) 2009; 72: 1378-1384