Potential separation of multiple system atrophy and Parkinson’s disease by susceptibility-derived components

IF 4.5 2区医学 Q1 NEUROIMAGING

NeuroImage Pub Date : 2025-09-01 DOI:10.1016/j.neuroimage.2025.121241

Su Yan , Jun Lu , Bingfang Duan , Shun Zhang , Dong Liu , Yuanyuan Qin , Alexey V. Dimov , Junghun Cho , Yuanhao Li , Wenzhen Zhu , Yi Wang

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引用次数: 0

Abstract

Background

Substantial evidence emphasizes the dysregulation of iron homeostasis, demyelination and oxidative stress in the neurodegenerative process of multiple system atrophy (MSA) and Parkinson’s disease (PD), although its clinical implications remain unclear. Recent MRI post-processing techniques leveraging magnetic susceptibility properties provide a noninvasive means to characterize iron, myelin content and oxygen metabolism alterations. This study aims to investigate subcortical alterations of susceptibility-derived metrics in these two synucleinopathies.

Methods

A cohort comprising 180 patients (122 with PD and 58 with MSA) and 77 healthy controls (HCs) underwent clinical evaluation and multi-echo gradient echo MRI scans. Susceptibility source separation, susceptibility-based oxygen extraction fraction (OEF) mapping and semiautomatic subcortical nuclei segmentation were utilized to derive parametric values of deep gray matter in all subjects.

Results

MSA patients showed markedly elevated paramagnetic susceptibility values in the putamen, globus pallidus (GP) and thalamus; increased diamagnetic susceptibility values in the putamen and dentate nucleus; and reduced OEF values across all nuclei compared with PD patients and HCs. Whereas PD exhibited increased positive susceptibility values in the substantia nigra and enhancing negative values in the GP, similar to MSA. Notably, age-related reductions in OEF were evident in HCs, which was altered by the MSA pathology. Paramagnetic susceptibility was correlated with disease severity. Moreover, the susceptibility-derived metrics of striatum and midbrain nuclei proved to be effective predictors to distinguish PD from MSA (AUC = 0.833).

Conclusion

Susceptibility-derived metrics could detect pathological involvement distinct to each disease, offering significant potential for differentiating between MSA and PD in clinical settings.

查看原文本刊更多论文

多系统萎缩和帕金森病的敏感性衍生成分的潜在分离。

背景：尽管其临床意义尚不清楚，但大量证据强调在多系统萎缩（MSA）和帕金森病（PD）的神经退行性过程中铁稳态失调、脱髓鞘和氧化应激。最近利用磁化率特性的MRI后处理技术提供了一种无创手段来表征铁、髓磷脂含量和氧代谢的变化。本研究旨在探讨这两种突触核蛋白病中易感性衍生指标的皮质下改变。方法：对180例PD患者（122例PD， 58例MSA）和77例健康对照（hc）进行临床评估和多回声梯度回声MRI扫描。利用敏感性源分离、基于敏感性的氧萃取分数（OEF）作图和半自动皮质下核分割等方法，得到所有受试者的深部灰质参数值。结果：MSA患者壳核、苍白球（GP）和丘脑的顺磁化率值明显升高；壳核和齿状核抗磁化率升高；与PD患者和hc患者相比，所有核的OEF值都降低了。而PD在黑质中表现出增加的阳性敏感性值，在GP中表现出增强的阴性敏感性值，与MSA相似。值得注意的是，年龄相关的OEF减少在hcc中很明显，这被MSA病理改变了。顺磁敏感性与疾病严重程度相关。此外，纹状体和中脑核的敏感性指标被证明是区分PD和MSA的有效预测指标（AUC = 0.833）。结论：敏感性衍生指标可以检测不同疾病的病理累及，为临床区分MSA和PD提供了重要的潜力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

NeuroImage 医学-核医学

CiteScore

11.30

自引率

10.50%

发文量

809

审稿时长

63 days

期刊介绍： NeuroImage, a Journal of Brain Function provides a vehicle for communicating important advances in acquiring, analyzing, and modelling neuroimaging data and in applying these techniques to the study of structure-function and brain-behavior relationships. Though the emphasis is on the macroscopic level of human brain organization, meso-and microscopic neuroimaging across all species will be considered if informative for understanding the aforementioned relationships.