期刊
QUANTITATIVE IMAGING IN MEDICINE AND SURGERY
卷 -, 期 -, 页码 -出版社
AME PUBLISHING COMPANY
DOI: 10.21037/qims-22-1403
关键词
Tremor-dominant Parkinson's disease; magnetic resonance imaging-guided focused ultrasound (MRgFUS); voxel-based morphometry (VBM); gray matter; cerebellum
Gray matter volume (GMV) can be used as a clinical marker to assess the effectiveness of magnetic resonance imaging-guided focused ultrasound (MRgFUS) thalamotomy in treating tremor-dominant Parkinson's disease (TDPD). The study found that there were significant changes in GMV after MRgFUS thalamotomy, which were closely related to tremor improvement. This discovery helps to better understand the remote effects of MRgFUS thalamotomy and the role of GMV in tremor control.
Background: Regional differences in gray matter volume (GMV) have been reported to be a reliable marker for diagnosing Parkinson's disease (PD). This study aimed to explore the clinical value of GMV to assess magnetic resonance imaging-guided focused ultrasound (MRgFUS) thalamotomy as a treatment for tremor-dominant PD (TDPD).Methods: Nine TDPD patients with MRgFUS thalamotomy were recruited for structural magnetic resonance image (MRI) scanning and clinical score evaluation. GMV was calculated. To investigate changes after treatment, voxel-and region of interest (ROI)-wise GMV analyses were performed. Then, GMV with significant differences was extracted from patients to investigate its dynamic alterations by one-way repeated-measures analysis of variance (ANOVA). The nonparametric Spearman rank correlation analysis was used to evaluate the relationship between GMV alterations and tremor improvement after thalamotomy.Results: Tremors were significantly relieved after MRgFUS thalamotomy in nine patients (P<0.05). The treated hand tremor scores improved 74.82% on average in patients from pre-operation to 12 months post-operation. Voxel-wise analysis at the cluster level showed a significant decrease in GMV in the left middle occipital gyrus (MOG) [t=11.81, voxel-level P<0.001, cluster-level Pfamily-wise error (FWE) <0.05] and an increase in GMV in the left precentral gyrus (PreCG) (t=7.99, voxel-level P<0.001, cluster-level PFWE <0.05) in TDPD patients from preoperative to 12 months post-operation, which was significantly correlated with tremor scores (rho =0.346-0.439, P<0.05). ROI-wise analysis showed that GMV related to MRgFUS thalamotomy was associated with long-term structural alterations (P<0.05 with Bonferroni correction), including specific basal ganglia and related nuclei and cerebellum subregions.Conclusions: GMV can be used to reflect tremor improvement after MRgFUS thalamotomy and be helpful to better understand the distant effect of MRgFUS thalamotomy and the involvement of GMV in tremor control in TDPD.Trial Registration: ClinicalTrials.gov identifier: NCT04570046.
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