Parkinson’s disease propagation using MRI biomarkers and partial least squares path modeling

Objectives: The classical Braak neuropathological staging model in Parkinson's disease (PD) suggests that brain lesions progress from the medulla oblongata to the cortex. An alternative model in which neurodegeneration first occurs in the cortex has also been proposed. These two models may correspond to different patient phenotypes. To test these two models and investigate if they were influenced by the presence of rapid eye movement sleep behavior disorder (RBD) we used multimodal MRI and Partial Least Squares Path-Modeling (PLS-PM) assuming that patients with RBD followed distinct neurodegeneration pattern.

Methods: Fifty-four patients with PD (thirty-four with RBD) and twenty-five healthy volunteers were scanned using T1-weighted, diffusion tensor and neuromelanin-sensitive imaging. Volume, signal, mean, axial and radial diffusivities were calculated in brainstem, basal forebrain and cortical regions. PLS-PM, estimating a network of causal relationships between blocks of variables...

研究目的：帕金森病（Parkinson's disease, PD）经典Braak神经病理分期模型提出，脑内病变从延髓向大脑皮层逐步进展。另有假说提出神经退行性变首先始发于皮层的替代模型。上述两种模型可能对应不同的患者表型。为验证这两种模型，并探究快速眼动睡眠行为障碍（rapid eye movement sleep behavior disorder, RBD）的存在是否会对神经退行性模式产生影响，本研究采用多模态磁共振成像（multimodal MRI）与偏最小二乘路径模型（Partial Least Squares Path-Modeling, PLS-PM），并假设伴RBD的PD患者遵循独特的神经退行性模式。

研究方法：本研究共纳入54例PD患者（其中34例伴RBD）及25名健康志愿者，采用T1加权成像、弥散张量成像与神经黑色素敏感成像完成扫描。研究人员在脑干、基底前脑及皮层区域计算了脑区体积、信号强度、平均弥散系数、轴向弥散系数与径向弥散系数。偏最小二乘路径模型用于估计多变量块间的因果关系网络……