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Abstract：
OBJECTIVE: To assess whether diffusion tensor imaging (DTI) and generalized q-sampling imaging (GQI) metrics could preoperatively predict the clinical outcome of deep brain stimulation (DBS) in patients with Parkinson\'s disease (PD).
METHODS: In this single-center retrospective study, from September 2021 to March 2023, preoperative DTI and GQI examinations of 44 patients who underwent DBS surgery, were analyzed. To evaluate motor functions, the Unified Parkinson\'s Disease Rating Scale (UPDRS) during on- and off-medication and Parkinson\'s Disease Questionnaire-39 (PDQ-39) scales were used before and three months after DBS surgery. The study population was divided into two groups according to the improvement rate of scales: ≥ 50% and < 50%. Five target regions, reported to be affected in PD, were investigated. The parameters having statistically significant difference were subjected to a receiver operating characteristic (ROC) analysis.
RESULTS: Quantitative anisotropy (qa) values from globus pallidus externus, globus pallidus internus (qa_Gpi), and substantia nigra exhibited significant distributional difference between groups in terms of the improvement rate of UPDRS-3 scale during on-medication (p = 0.003, p = 0.0003, and p = 0.0008, respectively). In ROC analysis, the best parameter in predicting DBS response included qa_Gpi with a cut-off value of 0.01370 achieved an area under the ROC curve, accuracy, sensitivity, and specificity of 0.810, 73%, 62.5%, and 85%, respectively. Optimal cut-off values of ≥ 0.01864 and ≤ 0.01162 yielded a sensitivity and specificity of 100%, respectively.
CONCLUSIONS: The imaging parameters acquired from GQI, particularly qa_Gpi, may have the ability to non-invasively predict the clinical outcome of DBS surgery.
METHODS: In this single-center retrospective study, from September 2021 to March 2023, preoperative DTI and GQI examinations of 44 patients who underwent DBS surgery, were analyzed. To evaluate motor functions, the Unified Parkinson\'s Disease Rating Scale (UPDRS) during on- and off-medication and Parkinson\'s Disease Questionnaire-39 (PDQ-39) scales were used before and three months after DBS surgery. The study population was divided into two groups according to the improvement rate of scales: ≥ 50% and < 50%. Five target regions, reported to be affected in PD, were investigated. The parameters having statistically significant difference were subjected to a receiver operating characteristic (ROC) analysis.
RESULTS: Quantitative anisotropy (qa) values from globus pallidus externus, globus pallidus internus (qa_Gpi), and substantia nigra exhibited significant distributional difference between groups in terms of the improvement rate of UPDRS-3 scale during on-medication (p = 0.003, p = 0.0003, and p = 0.0008, respectively). In ROC analysis, the best parameter in predicting DBS response included qa_Gpi with a cut-off value of 0.01370 achieved an area under the ROC curve, accuracy, sensitivity, and specificity of 0.810, 73%, 62.5%, and 85%, respectively. Optimal cut-off values of ≥ 0.01864 and ≤ 0.01162 yielded a sensitivity and specificity of 100%, respectively.
CONCLUSIONS: The imaging parameters acquired from GQI, particularly qa_Gpi, may have the ability to non-invasively predict the clinical outcome of DBS surgery.
摘要：
目的：评估弥散张量成像（DTI）和广义q采样成像（GQI）指标是否可以预测帕金森病（PD）患者术前深部脑刺激（DBS）的临床结果。
方法：在这项单中心回顾性研究中，2021年9月至2023年3月，对44例接受DBS手术的患者进行术前DTI和GQI检查，进行了分析。为了评估运动功能，在DBS手术前和术后3个月使用统一的帕金森病评定量表(UPDRS)和帕金森病问卷-39(PDQ-39)。根据量表的改善率将研究人群分为两组：≥50％和<50％。五个目标区域,据报道在PD中受到影响，被调查了。对具有统计学显著性差异的参数进行接收器工作特性(ROC)分析。
结果：来自苍白球的定量各向异性（qa）值，苍白球（qa_Gpi），在用药期间，就UPDRS-3量表的改善率而言，黑质和黑质在组间表现出显着分布差异（分别为p=0.003，p=0.0003和p=0.0008）。在ROC分析中，预测DBS反应的最佳参数包括截断值为0.01370的qa_Gpi，获得ROC曲线下面积，准确度,灵敏度,特异性为0.810，73%，62.5%,85%,分别。最佳临界值≥0.01864和≤0.01162产生100%的灵敏度和特异性,分别。
结论：从GQI获取的成像参数，特别是qa_Gpi，可能具有非侵入性预测DBS手术的临床结果的能力。
方法：在这项单中心回顾性研究中，2021年9月至2023年3月，对44例接受DBS手术的患者进行术前DTI和GQI检查，进行了分析。为了评估运动功能，在DBS手术前和术后3个月使用统一的帕金森病评定量表(UPDRS)和帕金森病问卷-39(PDQ-39)。根据量表的改善率将研究人群分为两组：≥50％和<50％。五个目标区域,据报道在PD中受到影响，被调查了。对具有统计学显著性差异的参数进行接收器工作特性(ROC)分析。
结果：来自苍白球的定量各向异性（qa）值，苍白球（qa_Gpi），在用药期间，就UPDRS-3量表的改善率而言，黑质和黑质在组间表现出显着分布差异（分别为p=0.003，p=0.0003和p=0.0008）。在ROC分析中，预测DBS反应的最佳参数包括截断值为0.01370的qa_Gpi，获得ROC曲线下面积，准确度,灵敏度,特异性为0.810，73%，62.5%,85%,分别。最佳临界值≥0.01864和≤0.01162产生100%的灵敏度和特异性,分别。
结论：从GQI获取的成像参数，特别是qa_Gpi，可能具有非侵入性预测DBS手术的临床结果的能力。
