Case control study of diffusion tensor imaging in Parkinson's disease
Case control study of diffusion tensor imaging in Parkinson's disease
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DOI：
10.1136/jnnp.2007.121525
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发表时间：
2007-12-01
影响因子：
11
通讯作者：
Tan, E-K
中科院分区：
文献类型：
--
作者：
Chan, L-L;Rumpel, H.;Tan, E-K
背景资料：初步研究表明，弥散张量MRI（diffusion tensor MRI，DTI）可能有助于帕金森病（Parkinson's disease，PD）的诊断。目的：我们进行了一项大型、前瞻性、病例对照研究，以确定：（1）PD患者和健康对照者基底节和黑质的弥散张量各向异性分数（fractional anisotropy，FA）和表观弥散系数（apparent diffusion coefficient，ADC）值是否存在差异;方法：对PD患者和正常对照者进行DTI成像，并对DTI成像结果进行统计学分析。使用弥散张量任务卡从DTI扫描的各种脑结构获得FA和ADC值。研究的结构为：尾状核、壳核、苍白球、丘脑和黑质。结果：研究了151名受试者（73名PD患者，41名男性，32名女性;平均年龄63.6岁）和78名年龄和性别匹配的对照受试者。PD患者的黑质FA值低于对照组（0.403 vs 0.415; p = 0.001）。然而，其他结构的FA或ADC值无显著差异。多因素回归分析显示，PD患者的临床严重程度与黑质FA值呈负相关（回归系数20.019）。没有一个单一的FA值都有很高的阳性和阴性预测能力PD.Conclusions：我们证明了在一个大型的，前瞻性的病例对照研究，FA值在黑质的DTI是较低的PD与健康对照组相比，与PD的临床严重程度呈负相关。进一步的纵向研究将有助于评估黑质连续FA测量在客观量化疾病进展和监测治疗反应方面的临床效用。
Background: Preliminary work has shown that diffusion tensor MRI (DTI) may contribute to the diagnosis of Parkinson's disease (PD).Objectives: We conducted a large, prospective, case control study to determine: (1) if fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values on DTI in the basal ganglia and substantia nigra are different between patients with PD and healthy controls; and (2) the predictive value of these parameters and their clinical utility.Methods: DTI imaging was carried out in patients with PD and controls. FA and ADC values were obtained from various brain structures on the DTI scan using the diffusion tensor taskcard. The structures studied were: caudate, putamen, globus pallidus, thalamus and substantia nigra.Results: 151 subjects (73 PD patients, 41 men, 32 women; mean age 63.6 years) and 78 age and sex matched control subjects were studied. The FA value of the substantia nigra in patients with PD was lower compared with controls (0.403 vs 0.415; p = 0.001). However, no significant differences were demonstrated for FA or ADC values of other structures. Multiple regression analysis revealed that the clinical severity of PD correlated inversely with the FA value in the substantia nigra in patients with PD (regression coefficient 20.019). No single FA value had both a high positive and negative predictive power for PD.Conclusions: We demonstrated in a large, prospective, case control study that the FA value in the substantia nigra on DTI was lower in PD compared with healthy controls, and correlated inversely with the clinical severity of PD. Further longitudinal studies would be helpful to assess the clinical utility of serial FA measurements of the substantia nigra in objective quantification of disease progression and monitoring of the therapeutic response.