Diffusion Tensor Imaging Reveals Deep Brain Structure Changes in Early Parkinson's Disease Patients with Various...

Area of Science:

• Neuroscience
• Neurology
• Radiology

Background:

• Parkinson's disease (PD) is a neurodegenerative disorder characterized by dopaminergic neuron loss.
• Sleep disorders (SDs) are frequently observed in PD patients, impacting disease progression and clinical presentation.
• Diffusion tensor imaging (DTI) offers insights into cerebral microstructural integrity in neurodegenerative conditions.

Purpose of the Study:

• To investigate the prevalence and clinical characteristics of various sleep disorders in early Parkinson's disease.
• To explore the association between sleep disorders and neuroimaging markers (DTI-based fractional anisotropy) in the substantia nigra, thalamus, and hypothalamus.
• To determine the utility of analyzing sleep disorders and neuroimaging features for early PD diagnosis and intervention.

Main Methods:

• Recruited 36 early PD patients (31 with SDs) and 22 healthy controls.
• Assessed sleep disorders using validated questionnaires (RBDQ-HK, ESS, ILRS, PDSS-2).
• Performed DTI-based region-of-interest analysis on substantia nigra, thalamus, and hypothalamus.

Main Results:

• SDs were highly prevalent (86.11%) in early PD patients compared to controls (27.27%).
• Nighttime problems (NPs), excessive daytime sleepiness (EDS), and restless legs syndrome (RLS) correlated with longer PD duration and advanced Hoehn and Yahr stages.
• Patients with probable rapid eye movement sleep behavior disorder (pRBD) exhibited more severe PD symptoms and progression.
• Increased types of SDs were associated with greater damage in the substantia nigra and hypothalamus.

Conclusions:

• Sleep disorders are a significant clinical feature in early Parkinson's disease, associated with disease severity and progression.
• DTI reveals microstructural alterations in key brain regions (substantia nigra, thalamus, hypothalamus) linked to specific sleep disorders in early PD.
• Characterizing sleep disorders and associated neuroimaging changes is crucial for early diagnosis and therapeutic strategies in Parkinson's disease.