Abstract：
OBJECTIVE: This study aimed to examine the structural alterations of the deep gray matter (DGM) in the basal ganglia circuitry of Parkinson\'s disease (PD) patients with freezing of gait (FOG) using quantitative susceptibility mapping (QSM) and neuromelanin-sensitive magnetic resonance imaging (NM-MRI).
METHODS: Twenty-five (25) PD patients with FOG (PD-FOG), 22 PD patients without FOG (PD-nFOG), and 30 age- and sex-matched healthy controls (HCs) underwent 3-dimensional multi-echo gradient recalled echo and NM-MRI scanning. The mean volume and susceptibility of the DGM on QSM data and the relative contrast (NMRC-SNpc) and volume (NMvolume-SNpc) of the substantia nigra pars compacta on NM-MRI were analyzed among groups. A multiple linear regression analysis was performed to explore the associations of FOG severity with MRI measurements and disease stage.
RESULTS: The PD-FOG group showed higher susceptibility in the bilateral caudal substantia nigra (SN) compared to the HC group. Both the PD-FOG and PD-nFOG groups showed lower volumes than the HC group in the bilateral caudate and putamen as determined from the QSM data. The NMvolume-SNpc on NM-MRI in the PD-FOG group was significantly lower than in the HC and PD-nFOG groups. Both the PD-FOG and PD-nFOG groups showed significantly decreased NMRC-SNpc.
CONCLUSIONS: The PD-FOG patients showed abnormal neostriatum atrophy, increases in iron deposition in the SN, and lower NMvolume-SNpc. The structural alterations of the DGM in the basal ganglia circuits could lead to the abnormal output of the basal ganglia circuit to trigger the FOG in PD patients.
METHODS: Twenty-five (25) PD patients with FOG (PD-FOG), 22 PD patients without FOG (PD-nFOG), and 30 age- and sex-matched healthy controls (HCs) underwent 3-dimensional multi-echo gradient recalled echo and NM-MRI scanning. The mean volume and susceptibility of the DGM on QSM data and the relative contrast (NMRC-SNpc) and volume (NMvolume-SNpc) of the substantia nigra pars compacta on NM-MRI were analyzed among groups. A multiple linear regression analysis was performed to explore the associations of FOG severity with MRI measurements and disease stage.
RESULTS: The PD-FOG group showed higher susceptibility in the bilateral caudal substantia nigra (SN) compared to the HC group. Both the PD-FOG and PD-nFOG groups showed lower volumes than the HC group in the bilateral caudate and putamen as determined from the QSM data. The NMvolume-SNpc on NM-MRI in the PD-FOG group was significantly lower than in the HC and PD-nFOG groups. Both the PD-FOG and PD-nFOG groups showed significantly decreased NMRC-SNpc.
CONCLUSIONS: The PD-FOG patients showed abnormal neostriatum atrophy, increases in iron deposition in the SN, and lower NMvolume-SNpc. The structural alterations of the DGM in the basal ganglia circuits could lead to the abnormal output of the basal ganglia circuit to trigger the FOG in PD patients.
摘要：
目的：本研究旨在使用定量磁敏感图（QSM）和神经黑色素敏感磁共振成像（NM-MRI）检查伴有步态冻结（FOG）的帕金森病（PD）患者的基底神经节回路深灰质（DGM）的结构改变。
方法：二十五（25）例PD伴FOG（PD-FOG）患者，22例无FOG的PD患者（PD-nFOG），30名年龄和性别匹配的健康对照（HCs）接受了3维多回波梯度回忆回波和NM-MRI扫描。各组分析QSM数据上DGM的平均体积和敏感性以及NM-MRI上黑质致密部的相对对比（NMRC-SNpc）和体积（NMvolume-SNpc）。进行了多元线性回归分析，以探讨FOG严重程度与MRI测量值和疾病分期的关系。
结果：与HC组相比，PD-FOG组显示出更高的双侧尾黑质（SN）易感性。根据QSM数据确定，PD-FOG和PD-nFOG组在双侧尾状核和壳核中均显示出比HC组低的体积。PD-FOG组NM-MRI上的NMvolume-SNpc明显低于HC和PD-nFOG组。PD-FOG和PD-nFOG组均显示NMRC-SNpc显著降低。
结论：PD-FOG患者表现出异常的新纹状体萎缩，SN中铁沉积的增加，和较低的NMvolume-SNpc。基底神经节回路中DGM的结构改变可能导致基底神经节回路的异常输出，从而触发PD患者的FOG。
方法：二十五（25）例PD伴FOG（PD-FOG）患者，22例无FOG的PD患者（PD-nFOG），30名年龄和性别匹配的健康对照（HCs）接受了3维多回波梯度回忆回波和NM-MRI扫描。各组分析QSM数据上DGM的平均体积和敏感性以及NM-MRI上黑质致密部的相对对比（NMRC-SNpc）和体积（NMvolume-SNpc）。进行了多元线性回归分析，以探讨FOG严重程度与MRI测量值和疾病分期的关系。
结果：与HC组相比，PD-FOG组显示出更高的双侧尾黑质（SN）易感性。根据QSM数据确定，PD-FOG和PD-nFOG组在双侧尾状核和壳核中均显示出比HC组低的体积。PD-FOG组NM-MRI上的NMvolume-SNpc明显低于HC和PD-nFOG组。PD-FOG和PD-nFOG组均显示NMRC-SNpc显著降低。
结论：PD-FOG患者表现出异常的新纹状体萎缩，SN中铁沉积的增加，和较低的NMvolume-SNpc。基底神经节回路中DGM的结构改变可能导致基底神经节回路的异常输出，从而触发PD患者的FOG。
