Abstract：
Due to a high degree of symptom overlap in the early stages, with movement disorders predominating, Parkinson\'s disease (PD) and multiple system atrophy (MSA) may exhibit a similar decline in motor areas, yet they differ in their spread throughout the brain, ultimately resulting in two distinct diseases. Drawing upon neuroimaging analyses and altered motor cortex excitability, potential diffusion mechanisms were delved into, and comparisons of correlations across distinct disease groups were conducted in a bid to uncover significant pathological disparities. We recruited thirty-five PD, thirty-seven MSA, and twenty-eight matched controls to conduct clinical assessments, electromyographic recording, and magnetic resonance imaging scanning during the \"on medication\" state. Patients with neurodegeneration displayed a widespread decrease in electrophysiology in bilateral M1. Brain function in early PD was still in the self-compensatory phase and there was no significant change. MSA patients demonstrated an increase in intra-hemispheric function coupled with a decrease in diffusivity, indicating a reduction in the spread of neural signals. The level of resting motor threshold in healthy aged showed broad correlations with both clinical manifestations and brain circuits related to left M1, which was absent in disease states. Besides, ICF exhibited distinct correlations with functional connections between right M1 and left middle temporal gyrus in all groups. The present study identified subtle differences in the functioning of PD and MSA related to bilateral M1. By combining clinical information, cortical excitability, and neuroimaging intuitively, we attempt to bring light on the potential mechanisms that may underlie the development of neurodegenerative disease.
摘要：
由于早期症状高度重叠，以运动障碍为主，帕金森病（PD）和多系统萎缩（MSA）可能表现出类似的运动区域下降，然而它们在整个大脑中的传播不同，最终导致两种不同的疾病。利用神经影像学分析和运动皮层兴奋性改变，对潜在扩散机制进行了深入研究，并对不同疾病组的相关性进行了比较，以揭示显著的病理学差异。我们招募了35名警局,37MSA，和28个匹配的对照进行临床评估，肌电图记录,在“用药”状态下进行磁共振成像扫描。神经变性患者的双侧M1电生理表现出广泛的下降。早期PD脑功能仍处于自我代偿期，无明显变化。MSA患者表现出半球内功能增加，扩散率降低，表明神经信号的传播减少。健康老年人的静息运动阈值水平与临床表现和与左侧M1相关的脑回路均显示出广泛的相关性，而在疾病状态下则不存在。此外,在所有组中，ICF与右M1和左颞中回之间的功能连接均表现出明显的相关性。本研究确定了与双侧M1相关的PD和MSA功能的细微差异。通过结合临床信息，皮质兴奋性,和直观的神经成像，我们试图揭示神经退行性疾病发展的潜在机制。
