Value of fiber density imaging in white matter changes in early Parkinson's disease
Objective To apply high angular resolution diffusion imaging(HARDI)to generate track density imaging(TDI),and to explore its value in the microstructural changes in white matter fiber bundles in patients with early Parkinson's disease(PD).Methods From March 2023 to March 2024,41 early PD patients(PD group)were diagnosed and treated in Henan Provincial People's Hospital,and another 39 healthy subjects(control group)received physical examination.Both groups underwent whole-brain tractography using HARDI to generate TDI.Spatial normalization was performed to obtain high-resolution TDI images,using both linear and nonlinear methods.Fiber density values were compared between two groups,with voxels of corrected P values(PFWE)＜0.05 and cluster sizes＞50 as significant differences.The Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale(MDS-UPDRS)Ⅰ-Ⅲ scores,Hoehn-Yahr stage(H-Y stage),Parkinson's Disease Sleep Scale(PDSS),and Epworth Sleepiness Score(ESS)were recorded in the PD group.Pearson correlation analysis was conducted to evaluate the relationships of significantly different fiber density values with MDS-UPDRS Ⅲ score,H-Y stages,PDSS and ESS.Results In the PD group,the MDS-UPDRS Ⅰ,Ⅱ and Ⅲ scores were 6.60±5.59,8.27±7.15 and 25.35±12.60,the H-Y stage was 1.61±0.48,the PDSS was 118.21±37.10,and the ESS was 5.59±5.05.The fiber density values of the left and right anterior thalamic radiation(389.63±34.85,372.18±33.74),corticospinal tract(504.33±54.41,488.09±45.04),inferior fronto-occipital fasciculus(533.04±71.74,585.50±68.22),inferior longitudinal fasciculus(478.69±47.00,575.16±52.57),and uncinate fasciculus(367.42±43.49,354.29±34.59)in the PD group were lower than those in the control group(437.61±49.67,425.92±50.91;568.19±68.12,555.33±72.40;632.05±87.58,687.49±94.63;544.47±66.00,647.87±72.91;435.66±87.78,397.19±65.15)(t=2.937-4.577,all PFWE values＜0.05).The fiber density values of the right anterior thalamic radiation,left corticospinal tract,left inferior fronto-occipital fasciculus,and left inferior longitudinal fasciculus were negatively correlated with MDS-UPDRS Ⅲ score(r=-0.346,P=0.029;r=-0.331,P=0.037;r=-0.362,P=0.022;r=-0.359,P=0.023),and the fiber density values of the contralateral ones were positively correlated with PDSS(r=0.343,P=0.032;r=0.371,P=0.020;r=0.383,P=0.016;r=0.362,P=0.023).Conclusion TDI can comprehensively and precisely detect the microstructural changes in the white matter fiber bundles of early PD patients,and the changes in fiber density in anterior thalamic radiation,corticospinal tract,inferior longitudinal fasciculus,and inferior fronto-occipital fasciculus are closely associated with both motor and non-motor symptoms.
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