Considering brain structural alterations as neurodegenerative consequences of Parkinson's disease (PD), we sought to infer the progression of PD via the ordering of brain structural alterations from cross-sectional MRI observations. Having measured cortical thinning in gray matter (GM) regions and disintegrity in white matter (WM) regions as MRI markers of structural alterations for 130 patients with PD (69 ± 10 years, 72 men), stochastic simulation based on the probabilistic relationship between the brain regions was conducted to infer the ordering of structural alterations across all brain regions and the staging of structural alterations according to changes in clinical status. The ordering of structural alterations represented WM disintegrity tending to occur earlier than cortical thinning. The staging of structural alterations indicated structural alterations happening mostly before major disease complications such as postural instability and dementia. Later disease states predicted by the sequence of structural alterations were significantly related to more severe clinical symptoms. The relevance of the ordering of brain structural alterations to the severity of clinical symptoms suggests the clinical feasibility of predicting PD progression states.

考虑到大脑结构改变是帕金森病 (PD) 的神经退行性后果，我们试图通过从横截面 MRI 观察中对大脑结构改变的排序来推断 PD 的进展。测量了 130 名 PD 患者（69 ± 10 岁，72 名男性）的灰质 (GM) 区域的皮质变薄和白质 (WM) 区域的不完整作为结构改变的 MRI 标志物，基于概率关系的随机模拟对大脑区域进行了推断，以推断所有大脑区域的结构改变的顺序，以及根据临床状态的变化对结构改变的分期。结构改变的顺序代表 WM 的崩解往往比皮质变薄更早发生。结构改变的分期表明结构改变主要发生在主要疾病并发症如姿势不稳和痴呆之前。通过结构改变序列预测的后期疾病状态与更严重的临床症状显着相关。脑结构改变顺序与临床症状严重程度的相关性表明预测 PD 进展状态的临床可行性。