多巴胺能与帕金森病局部脑血流相关

IF 7.4 1区医学 Q1 CLINICAL NEUROLOGY Movement Disorders Pub Date : 2022-03-14 DOI:10.1002/mds.28981

Yoshikazu Nakano MD, PhD, Shigeki Hirano MD, PhD, Kazuho Kojima MD, PhD, Honglinag Li MD, PhD, Toru Sakurai MD, PhD, Masahide Suzuki MD, Hong Tai MD, PhD, Shogo Furukawa MD, PhD, Atsuhiko Sugiyama MD, PhD, Yoshitaka Yamanaka MD, PhD, Tatsuya Yamamoto MD, PhD, Takashi Iimori RT, Hajime Yokota MD, PhD, Hiroki Mukai MD, PhD, Takuro Horikoshi MD, PhD, Takashi Uno MD, PhD, Satoshi Kuwabara MD, PhD

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引用次数: 4

摘要

脑血流(CBF)和多巴胺转运蛋白(DAT)图像在临床上用于帕金森病的鉴别诊断。本研究旨在探讨帕金森病(PD)和非典型帕金森综合征(APS)患者CBF与纹状体DAT的相关性，并通过机器学习评估每种成像方式单独或联合使用DAT相关的CBF对PD的诊断能力。方法对58例PD患者和71例APS患者(多系统萎缩24例，进行性核上性麻痹21例，皮质基底综合征26例)行123I-IMP和123I-FP-CIT单光子发射计算机断层扫描。对各组脑血流和纹状体数据结合进行多元回归分析。通过机器学习和受者工作特征曲线预测PD概率。结果PD组纹状体DAT结合与同侧前额叶灌注正相关，与双侧小脑灌注负相关。在皮质基底综合征中，纹状体DAT结合与同侧前额叶灌注正相关，与对侧中央前灌注负相关。在理查德森综合征中，纹状体DAT结合与同侧中央前皮质和基底神经节灌注正相关。机器学习表明，CBF和DAT联合使用比单独使用CBF(0.67)或DAT(0.50)更能从APS中描绘PD(曲线下面积[AUC] = 0.87)。结论PD和四重脑病患者前额叶灌注与同侧黑质纹状体多巴胺能功能有关。这种双示踪剂额纹状体关系可能有效地用作描绘PD和APS的诊断工具。©2022国际帕金森和运动障碍学会

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Dopaminergic Correlates of Regional Cerebral Blood Flow in Parkinsonian Disorders

Background

Cerebral blood flow (CBF) and dopamine transporter (DAT) images are clinically used for the differential diagnosis of parkinsonian disorders.

Objectives

This study aimed to examine the correlation of CBF with striatal DAT in patients with Parkinson's disease (PD) and atypical parkinsonian syndromes (APS) and evaluate the diagnostic power of DAT-correlated CBF in PD through machine learning with each imaging modality alone or in combination.

Methods

Fifty-eight patients with PD and 71 with APS (24 with multiple system atrophy, 21 with progressive supranuclear palsy, and 26 with corticobasal syndrome) underwent ¹²³I-IMP and ¹²³I-FP-CIT single-photon emission computed tomography. Multiple regression analyses for CBF and striatal DAT binding were conducted on each group. PD probability was predicted by machine learning and receiver operating characteristic curves.

Results

The PD group showed more affected striatal DAT binding positively correlated with the ipsilateral prefrontal perfusion and negatively with the bilateral cerebellar perfusion. In corticobasal syndrome, striatal DAT binding positively correlated with the ipsilateral prefrontal perfusion and negatively with the contralateral precentral perfusion. In Richardson's syndrome, striatal DAT binding positively correlated with perfusion in the ipsilateral precentral cortex and basal ganglia. Machine learning showed that the combination of CBF and DAT was better for delineating PD from APS (area under the curve [AUC] = 0.87) than either CBF (0.67) or DAT (0.50) alone.

Conclusions

In PD and four-repeat tauopathy, prefrontal perfusion was related to ipsilateral nigrostriatal dopaminergic function. This dual-tracer frontostriatal relationship may be effectively used as a diagnostic tool for delineating PD from APS. © 2022 International Parkinson and Movement Disorder Society

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来源期刊

Movement Disorders 医学-临床神经学

CiteScore

13.30

自引率

8.10%

发文量

371

审稿时长

12 months

期刊介绍： Movement Disorders publishes a variety of content types including Reviews, Viewpoints, Full Length Articles, Historical Reports, Brief Reports, and Letters. The journal considers original manuscripts on topics related to the diagnosis, therapeutics, pharmacology, biochemistry, physiology, etiology, genetics, and epidemiology of movement disorders. Appropriate topics include Parkinsonism, Chorea, Tremors, Dystonia, Myoclonus, Tics, Tardive Dyskinesia, Spasticity, and Ataxia.