ABSTRACT

Objective

To explore the whole cerebral perfusion and microstructure alteration patterns in Parkinson’s disease (PD) and the associations of these patterns with clinical features.

Methods

Forty-one subjects [20 PD patients and 21 healthy controls (HCs)] underwent arterial spin labeling (ASL), diffusion tensor imaging (DTI) and 3D T1-weighted imaging (T1WI) MRI. The cerebral blood flow (CBF) of the whole brain and the fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD) and mean diffusivity (MD) of subcortical and cerebellar regions were measured and compared between groups. Pearson’s correlation was calculated between MRI measurements and clinical features [Unified Parkinson’s Disease Rating Scale (UPDRS), UPDRS III, Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA) and olfactory test scores].

Results

Compared to HCs, PD patients showed lower CBF in the frontal, parietal and temporal lobes but higher CBF in bilateral hippocampi, red nuclei, right substantia nigra, thalamus and most cerebellar regions. The MD in the right thalamus and several regions in the cerebellum increased in PD compared to HCs. In PD patients, the total UPDRS, UPDRS III, MoCA, MMSE and olfactory test scores were related to FA or CBF in cerebellum. (all p < 0.05)

Conclusion

Hypoperfusion in cortical regions, together with hyperperfusion in subcortical and cerebellar regions may be the characteristic perfusion pattern in advanced PD patients. The microstructures of the right thalamus and cerebellum were changed in PD patients. The cognitive, motor and olfactory performance of PD patients is closely related to the perfusion and microstructure of the brain, especially the cerebellum.

中文翻译：

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晚期帕金森病的脑灌注和微结构改变及其与临床特征的关联

摘要

客观的

探讨帕金森病 (PD) 的全脑灌注和微结构改变模式以及这些模式与临床特征的关联。

方法

41 名受试者 [20 名 PD 患者和 21 名健康对照 (HC)] 接受了动脉自旋标记 (ASL)、扩散张量成像 (DTI) 和 3D T1 加权成像 (T1WI) MRI。测量全脑脑血流量（CBF）和各组间各向异性分数（FA）、轴向弥散率（AD）、径向弥散率（RD）和平均弥散率（MD），并进行组间比较。Pearson 的相关性计算在 MRI 测量值和临床特征 [统一帕金森病评定量表 (UPDRS)、UPDRS III、简易精神状态检查 (MMSE)、蒙特利尔认知评估 (MoCA) 和嗅觉测试分数] 之间。

结果

与 HC 相比，PD 患者额叶、顶叶和颞叶的 CBF 较低，但双侧海马、红核、右侧黑质、丘脑和大部分小脑区域的 CBF 较高。与 HC 相比，PD 中右侧丘脑和小脑几个区域的 MD 增加。在 PD 患者中，UPDRS、UPDRS III、MoCA、MMSE 和嗅觉测试总分与小脑 FA 或 CBF 相关。（所有 p < 0.05）

结论

皮质区域的低灌注以及皮质下和小脑区域的高灌注可能是晚期 PD 患者的特征性灌注模式。PD患者右侧丘脑和小脑的微观结构发生了改变。PD患者的认知、运动和嗅觉表现与大脑特别是小脑的灌注和微观结构密切相关。