■在这项研究中,我们试图研究特发性肌张力障碍患者在皮质和皮质下水平的结构影像学改变.肌张力障碍两种亚型的共同和特异性变化,宫颈肌张力障碍(CD)和广泛性肌张力障碍(GD),他们打算被探索。此外,我们试图确定可能与患者临床特征有关的形态测量,从而提供了更多的线索,涉及特发性肌张力障碍的机制的特定脑区。
■对56例特发性肌张力障碍患者和30例健康对照(HC)进行了3DT1加权MRI扫描。患者分为CD或GD,根据不同的症状分布。使用计算解剖学工具箱(CAT12)估算了30CD和26GD的皮质厚度(CT),并将其与HC进行了比较。而皮质下结构的体积及其形状改变(29CD,25GD,和27HC)通过FSL软件进行分析。Further,我们对上述有显著性差异的影像学测量值与患者临床特征进行了相关性分析.
■两组患者与HCs之间的比较结果高度一致,显示双侧中央后的CT增加,上顶叶,前额叶/前额叶,枕回,等。,双侧扣带回的CT降低,脑岛,entorhinal,和梭状回(集群水平PFWE<0.005)。在CD中,发现疾病严重程度与CT改变之间存在负相关趋势,主要位于中央前/后,前额叶中段,上顶叶,和上边缘区域。此外,双侧壳核体积,尾状,两组患者的丘脑明显减少,而与HC相比,GD中的苍白球体积也有所减少。尾状体积减少与GD的疾病严重程度增加有相关性的趋势。最后,形状分析直接显示了双侧丘脑和尾状部的区域表面变化,位于尾状部头部的萎缩与GD的发病年龄有相关性的趋势。
■我们的研究表明,CT的形态变化广泛,皮质下体积,和特发性肌张力障碍的形状。CD和GD表现出相似的形态异常,表明两种不同疾病形式的共同潜在机制。尤其是,多个脑区的CT与疾病严重程度的临床关联,CD和GD中尾状体积/形状随疾病严重程度/发病年龄的改变可能作为进一步疾病探索的潜在生物标志物。
UNASSIGNED: In this study, we sought to investigate structural imaging alterations of patients with idiopathic dystonia at the cortical and subcortical levels. The common and specific changes in two subtypes of dystonia, cervical dystonia (CD) and generalized dystonia (GD), were intended to be explored. Additionally, we sought to identify the morphometric measurements which might be related to patients\' clinical characteristics, thus providing more clues of specific brain regions involved in the mechanism of idiopathic dystonia.
UNASSIGNED: 3D T1-weighted MRI scans were acquired from 56 patients with idiopathic dystonia and 30 healthy controls (HC). Patients were classified as CD or GD, according to the distinct symptom distributions. Cortical thickness (CT) of 30 CD and 26 GD were estimated and compared to HCs using Computational Anatomy Toolbox (CAT12), while volumes of subcortical structures and their shape alterations (29 CD, 25 GD, and 27 HCs) were analyzed via FSL software. Further, we applied correlation analyses between the above imaging measurements with significant differences and patients\' clinical characteristics.
UNASSIGNED: The results of comparisons between the two patient groups and HCs were highly consistent, demonstrating increased CT of bilateral postcentral, superiorparietal, superiorfrontal/rostralmiddlefrontal, occipital gyrus, etc., and decreased CT of bilateral cingulate, insula, entorhinal, and fusiform gyrus (PFWE < 0.005 at the cluster level). In CD, trends of negative correlations were found between disease severity and CT alterations mostly located in pre/postcentral, rostralmiddlefrontal, superiorparietal, and supramarginal regions. Besides, volumes of bilateral putamen, caudate, and thalamus were significantly reduced in both patient groups, while pallidum volume reduction was also presented in GD compared to HCs. Caudate volume reduction had a trend of correlation to increasing disease severity in GD. Last, shape analysis directly demonstrated regional surface alterations in bilateral thalamus and caudate, where the atrophy located in the head of caudate had a trend of correlation to earlier ages of onset in GD.
UNASSIGNED: Our study demonstrates wide-spread morphometric changes of CT, subcortical volumes, and shapes in idiopathic dystonia. CD and GD presented similar patterns of morphometric abnormalities, indicating shared underlying mechanisms in two different disease forms. Especially, the clinical associations of CT of multiple brain regions with disease severity, and altered volume/shape of caudate with disease severity/age of onset separately in CD and GD might serve as potential biomarkers for further disease exploration.