Clinical Correlates of White Matter Tract Degeneration in Progressive Supranuclear Palsy
Clinical Correlates of White Matter Tract Degeneration in Progressive Supranuclear Palsy
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DOI：
10.1001/archneurol.2011.107
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发表时间：
2011-06-01
影响因子：
--
通讯作者：
Josephs, Keith A.
中科院分区：
文献类型：
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作者：
Whitwell, Jennifer L.;Master, Ankit V.;Josephs, Keith A.
目的：使用扩散张量成像评估进行性核上性麻痹（PSP）的白色白质束变性，并探讨束完整性和临床measures.Design之间的相关性：病例对照研究。设置：三级医疗中心。患者/参与者：20例可能的PSP患者和20名年龄和性别匹配的健康对照。所有PSP患者均接受标准化临床测试，包括评估行为变化的额叶行为量表和额叶评估组合，测量疾病严重程度的PSP评定量表，运动障碍协会赞助的统一帕金森病评定量表修订版，（部分II和III）测量运动功能，以及PSP扫视损害量表测量眼球运动异常。分数各向异性和平均扩散率进行了测量，使用感兴趣的分析和基于道的空间statistics.Results：与对照组相比，异常扩散率主要观察在上级小脑脚，胼胝体，下纵束，和上级纵束的PSP患者。上级小脑脚的各向异性分数值与疾病严重程度相关（r=-0.59，P =.006），下纵束与运动功能相关（r=-0.51，P =.02），而上级纵束与扫视障碍的严重程度相关结论：本研究结果表明PSP与脑干、联合和连合纤维的变性有关，这种变性可能在临床功能障碍中起重要作用。
Objectives: To use diffusion tensor imaging to assess white matter tract degeneration in progressive supranuclear palsy (PSP) and to investigate correlates between tract integrity and clinical measures.Design: Case-control study.Setting: Tertiary care medical center.Patients/Participants: Twenty patients with probable PSP and 20 age-and sex-matched healthy controls were enrolled. All patients with PSP underwent standardized clinical testing, including the Frontal Behavioral Inventory and Frontal Assessment Battery to assess behavioral change, the PSP Rating Scale to measure disease severity, the Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (parts II and III) to measure motor function, and the PSP Saccadic Impairment Scale to measure eye movement abnormalities.Methods: Fractional anisotropy and mean diffusivity were measured using region of interest analysis and tract-based spatial statistics.Results: Compared with controls, abnormal diffusivity was observed predominantly in the superior cerebellar peduncles, body of the corpus callosum, inferior longitudinal fasciculus, and superior longitudinal fasciculus in patients with PSP. Fractional anisotropy values in the superior cerebellar peduncles correlated with disease severity (r=-0.59, P=.006), inferior longitudinal fasciculus correlated with motor function (r=-0.51, P=.02), and superior longitudinal fasciculus correlated with severity of saccadic impairments (r=-0.45, P=.047).Conclusions: The results of this study demonstrate that PSP is associated with degeneration of the brainstem, association, and commissural fibers and that this degeneration likely plays an important role in clinical dysfunction.