Table_1_Corticospinal Tract Impairment of Patients With Parkinson’s Disease: Triple Stimulation Technique Findings.docx

BackgroundCorticospinal tract impairment is no longer an absolute exclusion in the updated Movement Disorder Society Parkinson’s disease criteria. Triple stimulation technique (TST) is an accurate method to quantitatively assess the integrity and impairment of corticospinal pathway in a variety of neurological diseases. This study aims to evaluate the corticospinal tract impairment in Parkinson’s disease (PD) patients using TST.
MethodsTen PD patients, 19 multiple-system atrophy parkinsonian variant (MSA-P) patients, and 12 healthy controls (HC) were sequentially recruited in this study. Information of age, disease duration, pyramidal signs, and Hoehn and Yahr (H&Y) stage was obtained from all patients. The TST was assessed at right abductor digiti minimi for HCs and both sides for patients. The Chi-square test was used for categorical variables, and variance analysis was performed for continuous variables in comparing the difference among PD, MSA-P, and HC, plus the post hoc tests for pairwise comparisons.
ResultsAll subjects were age and gender matched. There was no significant difference in disease duration (p = 0.855), H-Y stage (p = 0.067), and the percentage of pyramidal signs present (p = 0.581) between MSA-P and PD patients. The mean TST ratio was 55.5 ± 32.2%, 81.7 ± 19.8%, and 96.8 ± 3.0% for PD, MSA-P, and HCs, correspondingly. PD patients had a significant lower TST amplitude ratio than MSA-P and HCs. The TST ratio of MSA-P was lower than HCs, but there was no significant difference (p = 0.160). Additionally, it was significantly higher in percentage of abnormal TST ratio between PD patients and MSA-P (p = 0.010).
ConclusionCorticospinal tract impairment is not a rare manifestation in PD and can be quantitatively evaluated with TST. The result needs to be verified in amplified sample.

【背景】在最新版运动障碍学会（Movement Disorder Society）帕金森病诊断标准中，皮质脊髓束（corticospinal tract）损伤已不再是绝对排除项。三重刺激技术（Triple stimulation technique, TST）是一种可精准定量评估多种神经系统疾病中皮质脊髓通路完整性与损伤程度的方法。本研究旨在通过TST评估帕金森病（Parkinson’s disease, PD）患者的皮质脊髓束损伤情况。
【方法】本研究依次纳入了10例帕金森病患者、19例多系统萎缩帕金森型（multiple-system atrophy parkinsonian variant, MSA-P）患者以及12例健康对照（healthy controls, HC）。收集所有受试者的年龄、病程、锥体束征及Hoehn-Yahr（H&Y）分期信息。健康对照仅于右侧小指展肌处进行TST检测，患者则检测双侧肢体。组间比较时，针对分类变量采用卡方检验，针对连续变量采用方差分析，并进行事后两两比较检验。
【结果】所有受试者在年龄与性别上均匹配。多系统萎缩帕金森型患者与帕金森病患者在病程（p=0.855）、H-Y分期（p=0.067）及锥体束征阳性率（p=0.581）方面均无显著差异。帕金森病、多系统萎缩帕金森型及健康对照的平均TST比值分别为55.5±32.2%、81.7±19.8%及96.8±3.0%。帕金森病患者的TST振幅比值显著低于多系统萎缩帕金森型患者与健康对照；多系统萎缩帕金森型患者的TST比值虽低于健康对照，但差异无统计学意义（p=0.160）。此外，帕金森病患者的异常TST比值占比显著高于多系统萎缩帕金森型患者（p=0.010）。
【结论】皮质脊髓束损伤并非帕金森病的罕见表现，可通过TST进行定量评估。本研究结果尚需扩大样本量进一步验证。