Abstract：
OBJECTIVE: This study aimed to assess the glymphatic function and its correlation with clinical characteristics and the loss of dopaminergic neurons in Parkinson\'s disease (PD) using hybrid positron emission tomography (PET)-magnetic resonance imaging (MRI) combined with diffusion tensor image analysis along the perivascular space (DTI-ALPS), choroid plexus volume (CPV), and enlarged perivascular space (EPVS) volume.
METHODS: Twenty-five PD patients and thirty matched healthy controls (HC) participated in the study. All participants underwent 18F-fluorodopa (18F-DOPA) PET-MRI scanning. The striatal standardized uptake value ratio (SUVR), DTI-ALPS index, CPV, and EPVS volume were calculated. Furthermore, we also analysed the relationship between the DTI-ALPS index, CPV, EPVS volume and striatal SUVR as well as clinical characteristics of PD patients.
RESULTS: PD patients demonstrated significantly lower values in DTI-ALPS (t = 3.053, p = 0.004) and larger CPV (t = 2.743, p = 0.008) and EPVS volume (t = 2.807, p = 0.008) compared to HC. In PD group, the ALPS-index was negatively correlated with the Unified Parkinson\'s Disease Rating Scale III (UPDRS-III) scores (r = -0.730, p < 0.001), and positively correlated with the mean putaminal SUVR (r = 0.560, p = 0.007) and mean caudal SUVR (r = 0.459, p = 0.032). Moreover, the mean putaminal SUVR was negatively associated with the UPDRS-III scores (r = -0.544, p = 0.009).
CONCLUSIONS: DTI-ALPS has the potential to uncover glymphatic dysfunction in patients with PD, with this dysfunction correlating strongly with the severity of disease, together with the mean putaminal and caudal SUVR. PET- MRI can serve as a potential multimodal imaging biomarker for early-stage PD.
METHODS: Twenty-five PD patients and thirty matched healthy controls (HC) participated in the study. All participants underwent 18F-fluorodopa (18F-DOPA) PET-MRI scanning. The striatal standardized uptake value ratio (SUVR), DTI-ALPS index, CPV, and EPVS volume were calculated. Furthermore, we also analysed the relationship between the DTI-ALPS index, CPV, EPVS volume and striatal SUVR as well as clinical characteristics of PD patients.
RESULTS: PD patients demonstrated significantly lower values in DTI-ALPS (t = 3.053, p = 0.004) and larger CPV (t = 2.743, p = 0.008) and EPVS volume (t = 2.807, p = 0.008) compared to HC. In PD group, the ALPS-index was negatively correlated with the Unified Parkinson\'s Disease Rating Scale III (UPDRS-III) scores (r = -0.730, p < 0.001), and positively correlated with the mean putaminal SUVR (r = 0.560, p = 0.007) and mean caudal SUVR (r = 0.459, p = 0.032). Moreover, the mean putaminal SUVR was negatively associated with the UPDRS-III scores (r = -0.544, p = 0.009).
CONCLUSIONS: DTI-ALPS has the potential to uncover glymphatic dysfunction in patients with PD, with this dysfunction correlating strongly with the severity of disease, together with the mean putaminal and caudal SUVR. PET- MRI can serve as a potential multimodal imaging biomarker for early-stage PD.
摘要：
目的：本研究旨在使用混合正电子发射断层扫描（PET）-磁共振成像（MRI）结合沿血管周围间隙（DTI-ALPS）的弥散张量图像分析（DTI-ALPS）评估帕金森病（PD）的淋巴功能及其与临床特征和多巴胺能神经元丢失的相关性，脉络丛容积(CPV),血管周围间隙(EPVS)体积增大。
方法：25名PD患者和30名匹配的健康对照（HC）参与了研究。所有参与者均接受18F-氟多巴（18F-DOPA）PET-MRI扫描。纹状体标准化摄取值比率(SUVR)，DTI-ALPS指数,CPV,计算EPVS体积。此外，我们还分析了DTI-ALPS指数之间的关系，CPV,PD患者的EPVS体积和纹状体SUVR以及临床特征。
结果：与HC相比，PD患者的DTI-ALPS（t=3.053，p=0.004）和CPV（t=2.743，p=0.008）以及EPVS体积（t=2.807，p=0.008）明显较低。在PD组中，ALPS指数与帕金森病综合评定量表III(UPDRS-III)评分呈负相关(r=-0.730,p<0.001),并与平均肌体SUVR（r=0.560，p=0.007）和平均尾部SUVR（r=0.459，p=0.032）呈正相关。此外，平均putaminalSUVR与UPDRS-III评分呈负相关(r=-0.544,p=0.009).
结论：DTI-ALPS有可能发现PD患者的淋巴功能障碍，这种功能障碍与疾病的严重程度密切相关，以及平均羽状和尾部SUVR。PET-MRI可作为早期PD的潜在多模态成像生物标志物。
方法：25名PD患者和30名匹配的健康对照（HC）参与了研究。所有参与者均接受18F-氟多巴（18F-DOPA）PET-MRI扫描。纹状体标准化摄取值比率(SUVR)，DTI-ALPS指数,CPV,计算EPVS体积。此外，我们还分析了DTI-ALPS指数之间的关系，CPV,PD患者的EPVS体积和纹状体SUVR以及临床特征。
结果：与HC相比，PD患者的DTI-ALPS（t=3.053，p=0.004）和CPV（t=2.743，p=0.008）以及EPVS体积（t=2.807，p=0.008）明显较低。在PD组中，ALPS指数与帕金森病综合评定量表III(UPDRS-III)评分呈负相关(r=-0.730,p<0.001),并与平均肌体SUVR（r=0.560，p=0.007）和平均尾部SUVR（r=0.459，p=0.032）呈正相关。此外，平均putaminalSUVR与UPDRS-III评分呈负相关(r=-0.544,p=0.009).
结论：DTI-ALPS有可能发现PD患者的淋巴功能障碍，这种功能障碍与疾病的严重程度密切相关，以及平均羽状和尾部SUVR。PET-MRI可作为早期PD的潜在多模态成像生物标志物。
