Zekai Chen , Die Cai , Jichun Yuan , Jiakuan Chen , Xi Zhou , Wenjie He , Jun Xia
{"title":"Value of MRI-visible perivascular spaces in predicting levodopa responsiveness of patients with Parkinson’s disease","authors":"Zekai Chen , Die Cai , Jichun Yuan , Jiakuan Chen , Xi Zhou , Wenjie He , Jun Xia","doi":"10.1016/j.ejrad.2024.111844","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>Inter-individual difference in levodopa responsiveness is a challenge for physicians to administer personalized treatment for patients with Parkinson’s disease (PD). Previous studies demonstrated that magnetic resonance imaging (MRI)-visible perivascular spaces (PVS) might lead to an incomplete response to levodopa. This study aimed to investigate the association between MRI-visible PVS and levodopa responsiveness in patients with PD.</div></div><div><h3>Methods</h3><div>This cross-sectional study enrolled a total of 327 patients with PD (median age 64.0[57.0–68.0] years, 180 male) who had undergone high-resolution T2-weighted structural MRI at our hospital between 2019 and 2023. An acute levodopa challenge test was performed to evaluate levodopa responsiveness. The patients were divided into two groups: levodopa responsive (MDS-UPDRS-III reduction ≥ 33 %, n = 274) and irresponsive groups (MDS-UPDRS-III reduction < 33 %, n = 53). We employed quantitative and semi-quantitative methods to evaluate MRI-visible PVS in patients with PD, including PVS number, volume fraction, and visual score. Additionally, the imaging features of the levodopa-responsive and irresponsive groups were compared.</div></div><div><h3>Results</h3><div>There were no significant differences in PVS number, volume fraction, and visual score between the levodopa-responsive and −irresponsive groups. The indicators from quantitative and semi-quantitative analyses of PVS were not found to be independent predictors of levodopa responsiveness. None of the indicators from the quantitative or semi-quantitative analyses of PVS were significantly associated with poor responsiveness to levodopa treatment.</div></div><div><h3>Conclusions</h3><div>MRI-visible PVS are not independently associated with levodopa responsiveness, and their value in predicting levodopa responsiveness in patients with PD is limited.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"182 ","pages":"Article 111844"},"PeriodicalIF":3.2000,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Radiology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0720048X24005606","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose
Inter-individual difference in levodopa responsiveness is a challenge for physicians to administer personalized treatment for patients with Parkinson’s disease (PD). Previous studies demonstrated that magnetic resonance imaging (MRI)-visible perivascular spaces (PVS) might lead to an incomplete response to levodopa. This study aimed to investigate the association between MRI-visible PVS and levodopa responsiveness in patients with PD.
Methods
This cross-sectional study enrolled a total of 327 patients with PD (median age 64.0[57.0–68.0] years, 180 male) who had undergone high-resolution T2-weighted structural MRI at our hospital between 2019 and 2023. An acute levodopa challenge test was performed to evaluate levodopa responsiveness. The patients were divided into two groups: levodopa responsive (MDS-UPDRS-III reduction ≥ 33 %, n = 274) and irresponsive groups (MDS-UPDRS-III reduction < 33 %, n = 53). We employed quantitative and semi-quantitative methods to evaluate MRI-visible PVS in patients with PD, including PVS number, volume fraction, and visual score. Additionally, the imaging features of the levodopa-responsive and irresponsive groups were compared.
Results
There were no significant differences in PVS number, volume fraction, and visual score between the levodopa-responsive and −irresponsive groups. The indicators from quantitative and semi-quantitative analyses of PVS were not found to be independent predictors of levodopa responsiveness. None of the indicators from the quantitative or semi-quantitative analyses of PVS were significantly associated with poor responsiveness to levodopa treatment.
Conclusions
MRI-visible PVS are not independently associated with levodopa responsiveness, and their value in predicting levodopa responsiveness in patients with PD is limited.
期刊介绍:
European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field.
Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.