White matter microstructure damage in tremor-dominant Parkinson's disease patients
White matter microstructure damage in tremor-dominant Parkinson's disease patients
复制标题
震颤为主的帕金森病患者白质微结构损伤
DOI：
10.1007/s00234-017-1846-7
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发表时间：
2017-07-01
期刊：
影响因子：
2.8
通讯作者：
Shang, Hui-Fang
中科院分区：
文献类型：
--
作者：
Luo, ChunYan;Song, Wei;Shang, Hui-Fang
静止性震颤是帕金森病（PD）的主要运动特征之一。一些证据表明，静止性震颤可能具有与运动迟缓和僵硬不同的潜在病理生理过程。本研究的目的是确定白色物质的微结构异常与静息震颤的PD。我们招募了60例PD患者（30例震颤显性PD和30例非震颤显性PD）和26名正常对照。所有参与者均接受了临床评估和扩散张量MRI。我们使用基于束的空间统计学研究了整个白色束骨骼的白色物质完整性，与健康对照组和非震颤显性PD患者相比，震颤显性PD患者的特征是沿着多个白色束的平均扩散率（MD）和轴向扩散率（AD）增加，主要涉及小脑-丘脑-皮质（CTC）通路。在震颤型PD患者中，有显著性差异的聚类中的平均AD值与静息震颤评分相关。非震颤显性PD患者与对照组之间无显著差异。我们的研究结果支持了这样一种观点，即PD的静息震颤是一种独特的情况，其中存在显著的微结构白色物质变化，并为CTC参与PD的震颤发生提供了证据。
Resting tremor is one of the cardinal motor features of Parkinson's disease (PD). Several lines of evidence suggest resting tremor may have different underlying pathophysiological processes from those of bradykinesia and rigidity. The current study aims to identify white matter microstructural abnormalities associated with resting tremor in PD.We recruited 60 patients with PD (30 with tremor-dominant PD and 30 with nontremor-dominant PD) and 26 normal controls. All participants underwent clinical assessment and diffusion tensor MRI. We used tract-based spatial statistics to investigate white matter integrity across the entire white matter tract skeleton.Compared with both healthy controls and the nontremor-dominant PD patients, the tremor-dominant PD patients were characterized by increased mean diffusivity (MD) and axial diffusivity (AD) along multiple white matter tracts, mainly involving the cerebello-thalamo-cortical (CTC) pathway. The mean AD value in clusters with significant difference was correlated with resting tremor score in the tremor-dominant PD patients. There was no significant difference between the nontremor-dominant PD patients and controls.Our results support the notion that resting tremor in PD is a distinct condition in which significant microstructural white matter changes exist and provide evidence for the involvement of the CTC in tremor genesis of PD.