帕金森病的临床和成像特征与负的α-synuclein种子放大试验
Sarah M Brooker1, Jacopo Pasquini2,3, Seung Ho Choi4
1Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
概括
偶发性帕金森病 (sPD) 对大脑脊髓液 (CSF) 中的α-synuclein种子负的个体显示出较少的缺血症,但更多的脑缩. 很大一部分这些人后来得到了不同的诊断.
科学领域:
- 神经学 神经学
- 生物标志物 生物标志物
- 神经退行发生神经退行.
背景情况:
- 大脑脊髓液α-synuclein种子放大试验 (CSFasynSAA) 在90%以上的零星帕金森病 (sPD) 病例中确定了α-synuclein聚合.
- 阴性CSFasynSAA的sPD的临床特征仍然不太清楚.
研究的目的:
- 在帕金森氏症进展标志物倡议 (PPMI) 队列中,划出患有阴性CSFasynSAA (SAA-) 的sPD个体的临床和神经成像特征.
- 为了比较SAA-个体与那些测试阳性的人 (SAA+).
主要方法:
- 从PPMI中识别的sPD参与者在基线时具有阴性 (n=80) 或阳性 (n=856) CSFasynSAA.
- 为了进行比较分析,使用了倾向性得分匹配的子集 (n=79 SAA-, n=237 SAA+).
- 分析了临床参数,多巴胺载体单光子发射计算机断层扫描 (DAT-SPECT) 和MRI脑体积测量.
主要成果:
- 在SAA和SAA+组中,基线运动 (MDS-UPDRS-III) 和认知 (MoCA) 性能相似.
- 在SAA- (12%) 与SAA+ (73%) 个体 (P < 0.001) 中,严重的低血的发生率明显较低.
- 患有SAA的个体表现出较大的皮下缩 (例如,黑色物质) 和更高的诊断变化率 (14.3%与0.9%相比).
结论:
- 在基线时,阴性CSFasynSAA的sPD个体已经减少了低血,但在其他方面临床上与SAA+个体相似.
- 然而,SAA个体表现出更多的皮下脑缩和后续诊断重新分类的显着率.
- 这些发现突出了不同的神经生物学基础和潜在的诊断轨迹在sPD的子集.
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