帕金森病脑血管反应模式:可行性研究

Harm Jan van der Horn, Andrei A Vakhtin, Kayla Julio, Stephanie Nitschke, Nicholas Shaff, Andrew B Dodd, Erik Erhardt, John P Phillips, Sarah Pirio Richardson, Amanda Deligtisch, Melanie Stewart, Gerson Suarez Cedeno, Sanne K Meles, Andrew R Mayer, Sephira G Ryman
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摘要

越来越多的研究表明,脑血管功能障碍是帕金森病(PD)病理生理学的一个基本要素。在当前的可行性研究中,使用血氧水平依赖性(BOLD)核磁共振成像测量了 26 名帕金森病患者和 16 名健康对照组(HC)对高碳酸血症反应的脑血管反应性(CVR),旨在发现帕金森病特有的多变量模式。研究人员计算了CVR振幅(即对二氧化碳的反应幅度)和潜伏期(即达到最大振幅的时间)的全脑图谱,并使用缩放子轮廓模型主成分分析(SSM-PCA)和留空交叉验证对其进行了进一步分析。根据 CVR 延迟时间确定了一种有意义的模式,并将其命名为 PD CVR 模式(PD-CVRP)。该模式的特点是,相对于 HC,基底节、感觉运动皮层、辅助运动区、丘脑和视觉皮层的潜伏期相对增加,而大脑白质的潜伏期则相对减少。虽然样本量可能限制了我们检测显著关联的能力,但与临床指标没有明显关联。总之,PD-CVRP 强调了脑血管功能障碍在帕金森病中的重要性,并可能成为未来临床研究和实践的潜在生物标志物。
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Parkinson’s disease cerebrovascular reactivity pattern: A feasibility study
A mounting body of research points to cerebrovascular dysfunction as a fundamental element in the pathophysiology of Parkinson’s disease (PD). In the current feasibility study, blood-oxygen-level-dependent (BOLD) MRI was used to measure cerebrovascular reactivity (CVR) in response to hypercapnia in 26 PD patients and 16 healthy controls (HC), and aimed to find a multivariate pattern specific to PD. Whole-brain maps of CVR amplitude (i.e., magnitude of response to CO2) and latency (i.e., time to reach maximum amplitude) were computed, which were further analyzed using scaled sub-profile model principal component analysis (SSM-PCA) with leave-one-out cross-validation. A meaningful pattern based on CVR latency was identified, which was named the PD CVR pattern (PD-CVRP). This pattern was characterized by relatively increased latency in basal ganglia, sensorimotor cortex, supplementary motor area, thalamus and visual cortex, as well as decreased latency in the cerebral white matter, relative to HC. There were no significant associations with clinical measures, though sample size may have limited our ability to detect significant associations. In summary, the PD-CVRP highlights the importance of cerebrovascular dysfunction in PD, and may be a potential biomarker for future clinical research and practice.
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