Abstract
We aimed to evaluate microscale changes in the bilateral red nucleus and substantia nigra of patients with Parkinson's disease (PD) using diffusion kurtosis imaging (DKI). Twenty-six patients with PD [mean age, 62.5 ± 8.7 years; Hoehn-Yahr stage, 0–4.0; Unified Parkinson's Disease Rating Scale (UPDRS) scores, 8–43] and 15 healthy controls (mean age, 59.5 ± 9.4 years) underwent DKI of the substantia nigra and red nucleus. Imaging was performed using a General Electric (GE) Signa 3.0-T MRI system. Patients with PD were divided into two groups consisting of 12 patients with UPDRS scores ≥ 30 and 14 patients with UPDRS scores < 30. All DKI data processing operations were performed with commercial workstations (GE, ADW 4.6) using Functool software to generate color-coded and parametric maps of mean kurtosis (MK), fractional anisotropy (FA), and mean diffusivity (MD). MK values in the bilateral substantia nigra were significantly lower in patients with early- and advanced-stage PD than in controls. Moreover, MK values in the left substantia nigra were significantly lower in patients with advanced-stage PD than in those with early-stage PD. Patients with advanced-stage PD also exhibited significant decreases in MK values in the bilateral red nucleus relative to controls. No significant differences in FA or MD values were observed between the PD and control groups. There were no significant correlations between MK, FA, or MD values and UPDRS scores. Our findings suggest that decreased MK values in the substantia nigra may aid in determining the severity of PD and help provide early diagnoses.
Highlights
Parkinson’s disease (PD) is a progressive neurodegenerative disease caused by the degeneration of nigrostriatal dopaminergic neurons
mean kurtosis (MK) values in the substantia nigra were significantly lower in patients with early- and advanced-stage PD than in controls (Figure 1, Table 1)
MK values in the bilateral red nucleus were significantly lower in patients with advanced-stage PD than in controls (Figure 3, Table 2)
Summary
Parkinson’s disease (PD) is a progressive neurodegenerative disease caused by the degeneration of nigrostriatal dopaminergic neurons. Diffusion Kurtosis Imaging for Parkinson’s such as bradykinesia, resting tremor, postural instability, gait disorder, and muscular rigidity, all of which become evident only after an 80% loss of dopaminergic neurons in the striatum [1, 2]. Many laboratory tests (e.g., cerebrospinal fluid analysis, blood tests) have been used to provide excellent support for the early prediction of PD. Use of these biomarkers alone is not sufficient for diagnosis, as PD is not a disease with a single characteristic; specific biomarkers for motor and non-motor dysfunction would lead to more precise and individualized treatment for patients with PD. More sensitive diagnostic methods are required to ensure timely and appropriate treatment
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