Voxel-based analysis of tremor-dominant Parkinson's disease:a study on brain magnetic resonance diffusion tensor imaging

FAN Min; DENG Jie; LI Qian; YUAN Yizhi; AO Yongsheng; JIANG Ling; QIU Lihua

doi:10.12173/j.issn.1004-5511.202412093

Abstract：Objective To investigate the diagnostic value of diffusion tensor imaging(DTI)technology in tremor-dominant Parkinson's disease(TD-PD).Methods Prospectively included TD-PD patients diagnosed in the Department of Neurology in the Yibin Second People's Hospital from December 2019 to March 2023,along with healthy volunteers as the control group.3D-T1WI and DTI sequences were scanned for both the TD-PD group and the control group.The FSL software was utilized to calculate whole-brain white matter fractional anisotropy(FA),mean diffusivity(MD),axial diffusivity(AD),and radial diffusivity(RD).Group differences in whole-brain white matter FA,MD,AD,and RD were compared using the voxel-based analysis(VBA)method.Furthermore,the correlations between DTI parameters in the TD-PD group and Montreal Cognitive Assessment(MoCA),Hoehn-Yahr staging,and Movement Disorder Society Unified Parkinson's Disease Rating Scale(MDS-UPDRS)scores were analyzed.Results A total of 50 subjects were included,comprising 31 cases in the case group and 19 controls in the control group.Compared with the control group,patients in the TD-PD group exhibited decreased FA in the corpus callosum body(voxel-wise P<0.001,uncorrected,cluster-wise P<0.05,FWE-corrected),while MD,AD,and RD increased in the leftanterior cerebellar lobe,and MD and AD increased in the right frontal lobe(voxel-level P<0.001,cluster-level P<0.05,uncorrected).Correlation analysis revealed a positive association between MD in the left anterior cerebellar lobe and Hoehn-Yahr staging(r=0.417,P=0.020).Conclusion TD-PD patients have more extensive cerebral white matter microstructural changes,in which corpus callosum degeneration may be the pathophysiological basis of TD-PD.The structural changes in the leftcerebellar anterior lobe may contribute to the development of tremor symptoms in PD patients.