Diffusion tensor imaging of the cortico-ponto-cerebellar pathway in patients with adult-onset ataxic neurodegenerative disease
Diffusion tensor imaging of the cortico-ponto-cerebellar pathway in patients with adult-onset ataxic neurodegenerative disease
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DOI：
10.1007/s00234-007-0351-9
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发表时间：
2008-04-01
期刊：
影响因子：
2.8
通讯作者：
Inoue, Yuichi
中科院分区：
文献类型：
--
作者：
Kitamura, Kaeko;Nakayama, Keiko;Inoue, Yuichi
引言我们试图确定是否扩散张量成像（DTI）可以检测在体内的皮质桥脑小脑通路的成年型共济失调性神经退行性疾病患者的轴突损伤。方法常规MRI和DTI进行了18例成年型共济失调性神经退行性疾病和28个年龄匹配的对照组。测量脑桥腹侧、中央和背侧、小脑中脚（MCP）和内囊的各向异性分数（FA）和平均扩散率（MD），以评估皮质脑桥小脑投射。比较患者和对照组之间FA和MD值的变化。根据国际共济失调评定量表（ICARS）评估临床残疾。研究了DTI测量值与ICARS的关系。结果正常对照组脑桥腹侧、中央部、MCP和内囊FA值均明显低于正常对照组（P < 0.05），FA值越低，ICARS越差（r >-0.57，P < 0.05）。MD值在这些区域升高，但差异小于FA值。MD和ICARS之间没有观察到关系。5例随访患者中，MCP和内囊FA值较随访前明显降低（P < 0.05）。结论DTI可显示患者存在皮质桥脑小脑通路的变性，FA值与共济失调的严重程度相关。DTI可以作为监测疾病进展的定量替代标记物，是临床上有用的工具。
Introduction We sought to determine whether diffusion-tensor imaging (DTI) can detect in vivo axonal damage in the corticopontocerebellar pathway of patients with adult-onset ataxic neurodegenerative disease.Methods Conventional MRI and DTI were performed on 18 patients with adult-onset ataxic neurodegenerative disease and 28 age-matched control subjects. Fractional anisotropy (FA) and the mean diffusivity (MD) were measured in the ventral, central, and dorsal pons, middle cerebellar peduncle (MCP) and internal capsule to evaluate corticopontocerebellar projection. Changes in FA and MD values were compared between patients and controls. Clinical disability was assessed according to the International Cooperative Ataxia Rating Scale (ICARS). The relationship between DTI measurements and ICARS was studied. Follow-up MRI was performed in five patients approximately 1 year later.Results FA values were significantly lower in the ventral and central portions of the pons, MCP, and internal capsules than in these areas in control subjects (P < 0.05) with the lower FA values correlating with poorer ICARS (r >-0.57, P < 0.05). MD values were elevated in these areas, but the differences were smaller than for the FA values. No relationship was observed between the MD and ICARS. In the five patients who underwent the follow-up study, there were significant decreases between the initial study and the follow-up DTI study for FA in the MCP and internal capsule (P < 0.05).Conclusion DTI can demonstrate a degenerated corticopontocerebellar pathway in patients, and FA values can be correlated with ataxia severity. DTI may be a clinically useful tool as a quantitative surrogate marker for monitoring disease progression.