NODDI用于不同亚型帕金森患者脑细微结构的定量研究

Quantitative Study of NODDI in the Subtle Structure of Brain in Patients with Different Subtypes of Parkinson's Disease

目的通过神经突方向离散度与密度成像(NODDI)的定量分析探索帕金森病(PD)患者不同亚型的脑灰质核团细微结构的变化。方法选择29例就诊于该院的PD患者并根据统一帕金森病评定量表(UPDRS)将其分为震颤为主型(n=18)和僵直迟缓为主型(n=11),行常规磁共振平扫及NODDI检查;测量双侧基底节灰质核团的神经突内体积分数值(VIC)、神经突方向离散度值(ODI),并取平均值;采用独立样本t检验比较两组核团参数值差异;通过受试者工作特征曲线(ROC)评估不同核团VIC及ODI值的诊断效能;多因素Logistic回归分析确定不同亚型PD的独立预测因子。结果僵直迟缓型PD患者的尾状核、壳核、内侧苍白背侧、内侧苍白腹侧、丘脑中的VIC和ODI及苍白球VIC低于震颤型患者(P<0.05)。在ROC分析中,右侧苍白球VIC显示最佳诊断效能。多因素Logistic分析显示,右侧苍白球VIC是最佳的独立预测因子。结论NODDI能够定量反映不同亚型患者细微结构变化,为临床精准治疗提供参考价值。

Objective This study aimed to explore the changes in the microstructure of gray matter nuclei in different clinical subtypes of Parkinson's disease(PD)by quantitatively analyzing the neurite orientation dispersion and density imaging(NODDI).Methods A total of 29 PD patients who visited our hospital were selected and divided into tremor-dominant subtype(n=18)and rigidity-bradykinesia-dominant subtype(n=11)according to the Unified Parkinson's Disease Rating Scale(UPDRS).Routine magnetic resonance imaging(MRI)and NODDI examinations were performed.The volume fraction of intracellular volume(VIC)and orientation dispersion index(ODI)of bilateral basal ganglia nuclei were measured and averaged.Independent samples t-test was used to compare the differences in the parameters of the nuclei between the two groups.The diagnostic performance of different VIC and ODI values in the nuclei was evaluated using receiver operating characteristic(ROC)curve analysis.Multivariate logistic regression analysis was conducted to determine the independent predictors of PD.Results The VIC and ODI values of the caudate nucleus,putamen,posterior pallidum,anterior pallidum,and thalamus in the rigidity-bradykinesia-dominant PD patients were lower than those in the tremor-dominant patients(P<0.05).In the ROC analysis,the VIC of the right pallidum showed the best diagnostic performance.Multivariate logistic regression analysis revealed that the VIC of the right pallidum was the best independent predictor.Conclusion NODDI can quantitatively reflect the microstructural changes in different clinical subtypes of PD,providing valuable reference for precise clinical treatment.