Parkinson’s Disease:Diffusion Kurtosis Imaging Of Deep Brain Nucleus And The Correlation With Clinical Manifestations

Purpose: Using magnetic resonance diffusion kurtosis imaging(DKI) to evaluate the microstructure changes of deep brain nucleus in Parkinson’s disease(PD) as well as the correlation with clinical manifestations.Materials and Methods: 32 PD patients were recruited into this study. 20 gender and age matched healthy subjects served as the control group. All participants underwent MRI examinations, including T1 weighted imaging(T1WI), T2 weighted imaging(T2WI), diffusion weighted imaging(DWI), 3DT1 weighted imaging(3DT1WI), susceptibility weighted imaging(SWI) and DKI. The disease duration(month), Unified Parkinson’s Disease Rating Scale(UDPRS-Ⅲ) score, H-Y(Hoehn-Yahr) staging, mini-mental state examination(MMSE) score, and montreal cognitive assessment(Mo CA) score were recorded for each PD patients. The original DKI imaging data were processed offline to calculate three parametric maps, including mean kurtosis(MK) value, fractional anisotropy(FA) value, and mean diffusivity(MD) value, which represented water molecule diffusion states intissue, by the software including MRIConvert, MRIcro N and DKE. Three DKI parameters measured from head of caudate nucleus, putamen, globus pallidus and substantia nigra were compared between the two groups using t-test or Mann-Whitney U test according to data distribution. The correlations between the three DKI parameters in substantia nigra of PD patients both with the disease duration and clinical scales were tested by Spearmen or Pearson analysis according to data distribution. The receiver operating characteristic(ROC) curve was used to evaluate the PD diagnostic efficacy of MK value in substantia nigra.Results: There was no significant difference in FA values measured from all deep brain nucleuses between the two groups. The MD values in PD group’s globus pallidus(0.824(0.782, 0.861)) and substantia nigra(0.955 ± 0.062) were both significant higher than those in the control group(0.787 ± 0.077, 0.915 ± 0.067)(U = 185.000, P = 0.011; t = 2.191, P = 0.033). MK value in PD group’s substantia nigra(1.293 ± 0.054) was significant higher than that in the control group(1.257 ± 0.058)(t = 2.241, P = 0.029). Spearmen correlation analysis revealed that there was no significant association between three DKI parameters in substantia nigra of PD patients with the disease duration and clinical scales. The area under the ROC curve(AUC) was 0.689 for the MK value in PD group’s substantia nigra.Conclusion: MR DKI of deep brain nucleuses can be useful for the diagnosis of PD, but it is not suitable to evaluate the extent of PD clinical symptoms.