Title | Substantia Nigra Volume Dissociates Bradykinesia and Rigidity from Tremor in Parkinson's Disease: A 7 Tesla Imaging Study. |
Publication Type | Journal Article |
Year of Publication | 2020 |
Authors | Poston KL, Cruadhlaoich MAIUa, Santoso LF, Bernstein JD, Liu T, Wang Y, Rutt B, Kerchner GA, Zeineh MM |
Journal | J Parkinsons Dis |
Volume | 10 |
Issue | 2 |
Pagination | 591-604 |
Date Published | 2020 |
ISSN | 1877-718X |
Keywords | Aged, Autopsy, Female, Gait Disorders, Neurologic, Humans, Hypokinesia, Magnetic Resonance Imaging, Male, Middle Aged, Muscle Rigidity, Parkinson Disease, Postural Balance, Red Nucleus, Severity of Illness Index, Substantia Nigra, Subthalamic Nucleus, Time Factors, Tremor |
Abstract | BACKGROUND: In postmortem analysis of late stage Parkinson's disease (PD) neuronal loss in the substantial nigra (SN) correlates with the antemortem severity of bradykinesia and rigidity, but not tremor. OBJECTIVE: To investigate the relationship between midbrain nuclei volume as an in vivo biomarker for surviving neurons in mild-to-moderate patients using 7.0 Tesla MRI. METHODS: We performed ultra-high resolution quantitative susceptibility mapping (QSM) on the midbrain in 32 PD participants with less than 10 years duration and 8 healthy controls. Following blinded manual segmentation, the individual volumes of the SN, subthalamic nucleus, and red nucleus were measured. We then determined the associations between the midbrain nuclei and clinical metrics (age, disease duration, MDS-UPDRS motor score, and subscores for bradykinesia/rigidity, tremor, and postural instability/gait difficulty). RESULTS: We found that smaller SN correlated with longer disease duration (r = -0.49, p = 0.004), more severe MDS-UPDRS motor score (r = -0.42, p = 0.016), and more severe bradykinesia-rigidity subscore (r = -0.47, p = 0.007), but not tremor or postural instability/gait difficulty subscores. In a hemi-body analysis, bradykinesia-rigidity severity only correlated with SN contralateral to the less-affected hemi-body, and not contralateral to the more-affected hemi-body, possibly reflecting the greatest change in dopamine neuron loss early in disease. Multivariate generalized estimating equation model confirmed that bradykinesia-rigidity severity, age, and disease duration, but not tremor severity, predicted SN volume. CONCLUSIONS: In mild-to-moderate PD, SN volume relates to motor manifestations in a motor domain-specific and laterality-dependent manner. Non-invasive in vivo 7.0 Tesla QSM may serve as a biomarker in longitudinal studies of SN atrophy and in studies of people at risk for developing PD. |
DOI | 10.3233/JPD-191890 |
Alternate Journal | J Parkinsons Dis |
PubMed ID | 32250317 |
PubMed Central ID | PMC7242837 |
Grant List | K23 NS075097 / NS / NINDS NIH HHS / United States P50 AG047366 / AG / NIA NIH HHS / United States P41 EB015891 / EB / NIBIB NIH HHS / United States S10 RR026351 / RR / NCRR NIH HHS / United States |
Related Institute:
MRI Research Institute (MRIRI)