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Regional analysis of cerebral hemodynamic changes during the head-up tilt test in Parkinson’s disease patients with orthostatic intolerance
Neurophotonics ( IF 5.3 ) Pub Date : 2020-10-01 , DOI: 10.1117/1.nph.7.4.045006
Zephaniah Phillips 1 , Jung Bin Kim 2 , Seung-Ho Paik 1 , Shin-Young Kang 1 , Nam-Joon Jeon 3 , Beop-Min Kim 1 , Byung-Jo Kim 2
Affiliation  

Significance: Cerebral oxygenation changes in the superior, middle, and medial gyri were used to elucidate spatial impairments of autonomic hemodynamic recovery during the head-up tilt table test (HUTT) in Parkinson’s disease (PD) patients with orthostatic intolerance (OI) symptoms. Aim: To analyze dynamic oxygenation changes during the HUTT and classify PD patients with OI symptoms using clinical and oxygenation features. Approach: Thirty-nine PD patients with OI symptoms [10: orthostatic hypotension (PD-OH); 29: normal HUTT results (PD-NOR)] and seven healthy controls (HCs) were recruited. Prefrontal oxyhemoglobin (HbO) changes during the HUTT were reconstructed with diffuse optical tomography and segmented using the automated anatomical labeling system. Decision trees were used for classification. Results: HCs and PD-NOR patients with positive rates of HbO change (PD-POS) showed the greatest HbO recovery in the superior frontal gyrus (SFG) during tilt. PD-OH and PD-NOR patients with negative rates of HbO change (PD-NEG) showed asymmetric reoxygenation. The classification accuracy was 89.4% for PD-POS versus PD-NEG, 71% for PD-NOR versus PD-OH, and 55.8% for PD-POS versus PD-NEG versus PD-OH. The oxygenation features were more discriminative than the clinical features. Conclusions: PD-OH showed decreased right SFG function, which may be associated with impaired compensatory autonomic responses to orthostatic stress.

中文翻译:

直立性不耐受的帕金森氏病患者抬头向上倾斜测试期间脑血流动力学变化的区域分析

意义:上,中和内侧回旋中的脑氧合变化被用于阐明在具有立位不耐症(OI)症状的帕金森病(PD)患者的抬头倾斜台试验(HUTT)过程中自主血流动力学恢复的空间障碍。目的:分析HUTT期间的动态氧合变化,并使用临床和氧合功能对PD患者的OI症状进行分类。方法:三十九名患有OI症状的PD患者[10:体位性低血压(PD-OH);29:HUTT结果正常(PD-NOR)]和7名健康对照(HCs)被招募。HUTT过程中前额叶氧合血红蛋白(HbO)的变化通过漫射光学层析成像技术进行重建,并使用自动解剖标记系统进行分割。决策树用于分类。结果:HbO变化阳性率(PD-POS)的HCs和PD-NOR患者在倾斜过程中在上额回(SFG)中显示出最大的HbO回收率。HbO变化率为负的PD-OH和PD-NOR患者(PD-NEG)显示不对称的复氧。PD-POS对PD-NEG的分类准确度为89.4%,PD-NOR对PD-OH的分类准确度为71%,PD-POS对PD-NEG对PD-OH的分类准确度为55.8%。氧合特征比临床特征更具区分性。结论:PD-OH的右SFG功能降低,这可能与对体位压力的代偿性自主神经反应受损有关。PD-POS对PD-NEG的分类准确度为89.4%,PD-NOR对PD-OH的分类准确度为71%,PD-POS对PD-NEG对PD-OH的分类准确度为55.8%。氧合特征比临床特征更具区分性。结论:PD-OH的右SFG功能降低,这可能与对体位压力的代偿性自主神经反应受损有关。PD-POS对PD-NEG的分类准确度为89.4%,PD-NOR对PD-OH的分类准确度为71%,PD-POS对PD-NEG对PD-OH的分类准确度为55.8%。氧合特征比临床特征更具区分性。结论:PD-OH的右SFG功能降低,这可能与对体位压力的代偿性自主神经反应受损有关。
更新日期:2020-10-30
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