Amygdala neurodegeneration differentiates brain-first and body-first Parkinson's disease: An MRI study

IF 3.4 3区医学 Q2 CLINICAL NEUROLOGY Parkinsonism & related disorders Pub Date : 2025-04-09 DOI:10.1016/j.parkreldis.2025.107827

Nils Schröter , Laura Matinpalo , Jonas A. Hosp , Marco Reisert , Lea Philpsen , Wolfgang H. Jost , Heinz Wiendl , Horst Urbach , Michel Rijntjes , Alexander Rau

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Abstract

Background

Two distinct patterns of alpha-synuclein spread in Parkinson's disease were proposed with a body-first and a brain-first subtype. The body-first subtype originates in the periphery, while the brain-first subtype initiates in the central nervous system, notably affecting the amygdala.

Objectives

This retrospective cross-sectional study compared the integrity of the substantia nigra and amygdala between body-first and brain-first Parkinson's disease subtypes.

Methods

We analyzed data from 30 Parkinson's disease patients, classified into body-first (n = 21) and brain-first (n = 9) subtypes based on REM sleep behavior disorder history. Microstructural integrity was assessed using diffusion microstructure MRI.

Results

No significant differences were found in the substantia nigra between subtypes. However, amygdala degeneration was significantly pronounced in the “brain-first” compared to the “body-first” group reflected by increased free interstitial fluid (p = 0.02, Cohen's d = −1.22).

Conclusions

The degeneration of amygdala is distinctively pronounced in “brain-first” Parkinson's disease, supporting differential disease progression patterns between subtypes.

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杏仁核神经变性可区分脑先性和体先性帕金森病：核磁共振成像研究

背景α -突触核蛋白在帕金森病中的传播有两种不同的模式，即身体优先亚型和大脑优先亚型。体优先亚型起源于外周神经系统，而脑优先亚型起源于中枢神经系统，主要影响杏仁核。目的：本回顾性横断面研究比较体优先和脑优先帕金森病亚型黑质和杏仁核的完整性。方法对30例帕金森病患者资料进行分析，根据其快速眼动睡眠行为障碍病史将其分为身体优先型（21例）和大脑优先型（9例）。采用扩散微结构MRI评估显微组织完整性。结果不同亚型间黑质差异无统计学意义。然而，与“体优先”组相比，“脑优先”组的杏仁核变性明显，表现为游离间质液增加（p = 0.02, Cohen’s d = - 1.22）。结论杏仁核变性在“脑优先”帕金森病中特别明显，支持不同亚型之间疾病进展模式的差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Parkinsonism & related disorders 医学-临床神经学

CiteScore

6.20

自引率

4.90%

发文量

292

审稿时长

39 days

期刊介绍： Parkinsonism & Related Disorders publishes the results of basic and clinical research contributing to the understanding, diagnosis and treatment of all neurodegenerative syndromes in which Parkinsonism, Essential Tremor or related movement disorders may be a feature. Regular features will include: Review Articles, Point of View articles, Full-length Articles, Short Communications, Case Reports and Letter to the Editor.