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皮层和皮下区域的边界复杂性预测了帕金森病中大脑深度刺激的结果
Devin Schoen1,2, Skyler Deutsch1, Juhi Mehta1
1Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA.
Nature communications
|July 2, 2025
概括
对帕金森病 (PD) 的深度大脑刺激 (DBS) 结果可以通过使用碎形维度 (FD) 大脑成像来改善. 这种成像生物标志物预测DBS后的药物变化,增强治疗计划,以获得更好的患者结果.
科学领域:
- 神经科学是一个神经科学.
- 医疗成像医学成像
- 神经学 神经学
背景情况:
- 深度大脑刺激 (DBS) 对帕金森病 (PD) 有效,但患者结果的变化需要改进预后标准.
- 了解影响DBS反应的因素对于优化PD管理中的治疗策略至关重要.
研究的目的:
- 评估碎形维度 (FD) 的实用性,这是从T1加权MRI中获得的大脑结构复杂性的测量,用于预测PD患者在DBS后的药物变化.
- 评估是否结合FD成像特征,与单独的临床因素相比,改善了DBS结果的预测模型.
主要方法:
- 从231名PD患者的手术前T1加权MRI扫描中提取了区域FD测量.
- 通过将PD患者与健康对照进行比较,验证了FD作为PD进展生物标志物.
- 开发了回归和分类模型,将临床数据 (人口统计,DBS特征,勒沃多巴反应) 与FD特征相结合,以预测DBS后药物变化.
主要成果:
- 在PD患者和健康对照人群之间,在9个大脑区域中观察到FD的显著差异,支持FD作为PD标志物的作用.
- 在预测模型中包括FD测量解释了DBS后药物变化的额外13.6%的差异 (仅用于临床数据的R2=0.388与R2=0.252).
- 在将临床和成像特征与单独临床特征相结合时,超图形分类实现了更好的预测准确性 (AUC=0.76), (AUC=0.64).
结论:
- 与帕金森病相关的大脑形态的变化,由FD捕获,显著影响DBS治疗结果.
- 碎形维度显示出作为一个有价值的成像生物标志物来增强DBS候选人选择和优化帕金森病治疗计划的潜力.
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The cerebral cortex, the brain's outermost layer, is pivotal in processing complex cognitive tasks, emotions, and various sensory inputs and executing voluntary motor activities. This intricate structure is divided into three primary functional areas: the motor areas, sensory areas, and association areas.
Motor Areas
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The motor areas located in the frontal lobe are central to controlling voluntary movements. This region is further subdivided into the primary motor cortex and the premotor cortex.
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Association areas are regions of the cerebral cortex that do not have a specific sensory or motor function. Instead, they integrate and interpret information from various sources to enable higher cognitive processes such as memory, learning, and decision-making. Some key association areas include the following:
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