| ObjectivesThe objectives of this paper are to use diffusion tensor imaging for observation of Spinocerebellar Ataxia Type 3 patients’ white matter fiber bundle morphology and structural characteristics, to record associated changes from normal structure and pathology, to provide a functional anatomical basis for clinical diagnosis and research analysis, and to provide new ideas for differential diagnoses of SCA 3.MethodsThe Neurology Department chose 20 cases diagnosed by screening for gene mutations in hereditary Spinocerebellar Ataxia Type 3 patients from 2012 to 2014, selecting during the same period 20 cases of unrelated healthy individuals as a control group. These individuals were examined by brain diffusion tensor imaging, followed by data post-processing at a workstation utilizing the SPSS 19.0 statistical package for statistical analysis.Result(1) DTI examination reveals the white matter fiber bundles in the SCA 3 group, as compared with the healthy control group, show incomplete average diffusion, fractional anisotropy, with relative anisotropy values significantly lower than the control group (P<0.05);(2) For anterior thalamic radiation, corticospinal tract, cingulate cortex, cingulum (hippocampus), forceps major, inferior frontal-occipital fasciculus, inferior longitudinal fasciculus, sperior longitudinal fasciculus, uncinate fasciculus, superior longitudinal fasciculus (temporal part) total 10 white matter fibers performed diffusion tensor function test, the±S of MD values of the left and right sides of white matter fiber bundles in this patient group are decreased relative to the control group. Case and control groups on the left corticospinal tract, cingulum (hippocampus), inferior frontal-occipital fasciculus, inferior longitudinal fasciculus, sperior longitudinal fasciculus group between the MD value ANOVA P< 0.05:no homogeneity of variance, not statistically significant. The left anterior thalamic radiation, cingulate cortex, forceps major, uncinate fasciculus, the superior longitudinal fasciculus (temporal) MD value analysis of variance between groups P> 0.05:homogeneity of variance between groups, independent sample T-test, the left anterior thalamic radiation, forceps major, uncinate fasciculus, superior longitudinal fasciculus (temporal part) group MD values on P values> 0.05; differences between the groups were not significant; the left cingulate group MD values on P values< 0.05: there was a significant difference between the groups.Case and control groups’right anterior thalamic radiation, corticospinal tract, cingulate cortex, cingulum (hippocampus), forceps major, inferior fronto-occipital fasciculus, inferior longitudinal fasciculus, uncinate fasciculus, the superior longitudinal fasciculus (forehead) between groups MD value analysis of variance P> 0.05, homogeneity of variance between groups, independent samples T-test, the right anterior thalamic radiation, corticospinal tract, cingulum (hippocampus), forceps major, inferior fronto-occipital fasciculus group MD values on P values< 0.05:there was a significant difference between the groups; right side of the cingulate gyrus, inferior longitudinal fasciculus, uncinate fasciculus, the superior longitudinal fasciculus (forehead) group MD values on P values> 0.05:the difference between groups was not significant; on the right side of the superior longitudinal fasciculus group MD value ANOVA P< 0.05:no homogeneity of variance, not statistically significant.(3) The ± S of FA values of left and right sides of white matter fiber bundles in the patient group are decreased relative to the control group. Case and control groups on the left anterior thalamic radiation, corticospinal tract, cingulate cortex, cingulum (hippocampus), forceps major, inferior fronto-occipital fasciculus, superior longitudinal fasciculus, uncinate fasciculus, superior longitudinal fasciculus (temporal part) FA value analysis of variance P> 0.05 between the two groups, homogeneity of variance between groups, independent sample T-test, the left anterior thalamic radiation, corticospinal tract, cingulate cortex, cingulum (hippocampus), forceps major, inferior fronto-occipital fasciculus, superior longitudinal fasciculus, uncinate fasciculus FA values on P values< 0.05:the difference between groups was significant, superior longitudinal fasciculus (temporal) group FA values P> 0.05:the difference between groups was not significant; FA values of inferior longitudinal fasciculus group ANOVA P< 0.05:variance missing, was not statistically significant.Case and control groups on the right anterior thalamic radiation, cingulate cortex, forceps major, Inferior fronto-occipital fasciculus, superior longitudinal fasciculus, uncinate fasciculus superior longitudinal fasciculus (temporal part) FA values between groups ANOVA P> 0.05:homogeneity of variance between groups, independent samples T-test, right anterior thalamic radiation, forceps major, inferior fronto-occipital fasciculus, superior longitudinal fasciculus group FA values on P values< 0.05:the difference between groups was significant. Right side of the cingulate cortex, uncinate fasciculus, superior longitudinal fasciculus (temporal part) group FA values on P values> 0.05:the difference between groups was not significant; the right of the corticospinal tract, cingulum (hippocampus), inferior longitudinal fasciculus group FA values ANOVA P< 0.05:variance missing, was not statistically significant.(4) The ± S of RA values of left and right sides of white matter fiber bundles in the patient group are decreased relative to the control group. Case and control groups on the left anterior thalamic radiation, corticospinal tract, cingulate cortex, cingulum (hippocampus), forceps major, inferior fronto-occipital fasciculus, inferior longitudinal fasciculus, uncinate fasciculus, superior longitudinal fasciculus (temporal part) between the two groups RA value analysis of variance P> 0.05. Homogeneity of variance between groups, independent samples T-test, the left anterior thalamic radiation, corticospinal tract, cingulate cortex, forceps major, inferior fronto-occipital fasciculus, inferior longitudinal fasciculus group RA value P value< 0.05:there were significant differences between groups, left cingulum (hippocampus), uncinate fasciculus, superior longitudinal fasciculus (temporal part) group RA value P> 0.05: the difference between groups was not significant; on the left side of the superior longitudinal fasciculus group RA value ANOVA P< 0.05, non-homogeneity of variance, not statistically significant.Case and control groups on the right anterior thalamic radiation, corticospinal tract, cingulate cortex, cingulum (hippocampus), forceps major, inferior fronto-occipital fasciculus, inferior longitudinal fasciculus, superior longitudinal fasciculus, uncinate fasciculus, superior longitudinal fasciculus (temporal part) group RA values ANOVA P> 0.05:homogeneity of variance between groups, independent samples T-test, the right anterior thalamic radiation, corticospinal tract, cingulate cortex, cingulum (hippocampus), forceps major, inferior fronto-occipital fasciculus, inferior longitudinal fasciculus, superior longitudinal fasciculus group on RA value P values< 0.05:differences between the two groups are significant, right side of the uncinate fasciculus,superior longitudinal fasciculus (temporal part) group RA value P> 0.05:difference between groups was not significant.(5) Due to the small number of cases studied, with short follow-up time, no improvement was seen in the white matter fiber bundles damage in patients with clinical symptoms associated with the study, the research group will continue to complete this correlation study between SCAs functional imaging and clinical symptoms and signs.ConclusionThe cerebral white matter fiber bundle’s diffusion tensor imaging indices of SCA 3 patients were significantly different than the control (P< 0.05) groups, DTI examination found multiple white matter fibers atrophied in the brain in SCA 3 patients, providing a functional anatomical basis for clinical diagnosis and research, which may assist in the diagnosis and differential diagnosis of SCA 3 diseases, to provide new ideas and directions for future study of the impact on the brain damage of the fiber bundle and relevance of clinical manifestations of SCA 3. |
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