Parkinson’s Disease Using Tract-Based Spatial Statistical Analysis

ObjectivesTo observe the patient’s white matter of early idiopathic Parkinsons disease (PD) using diffusion tensor imaging (DTI) based on the fiber bundle analysis tract-based spatial statistical (TBSS) analysis, and explore the differences of white matter fiber bundles between patients and normal people, also the differences between males and females with early PD, then provide a reference for early clinical diagnosis, research and analysis.MethodsChoosing Hoehn-Yahr staging ≤2.5 of 36 PD patients, the patients were divided into two groups by gender, with selection of 26 healthy volunteers as a control group. Both PD patients and healthy volunteers are subjected to complete diffusion tensor imaging. Using TBSS analysis parameters of DTI in the male group, female group and control group, including fractional anisotropy (FA) values, mean diffusivity (MD) values and comparison of statistical differences in FA values and MD values between test/control groups, male/female groups.Results1. Age, course of disease and other factors have no impact on FA values and MD values in test/control group, and male/female group.2. Between male group and female group, there are no white matter regions ofp< 0.05; FA values and MD values have no statistically significant differences.3. FA, MD values between the test group and control group:(1) In early PD patients’white matter, the regions’FA values are reduced from normal as follows:middle cerebellar peduncle, pontine crossing tract, genu of corpus callosum, body of corpus callosum, splenium of corpus callosum, fornix, medial lemniscus, bilateral inferior cerebellar peduncle, bilateral superior cerebellar peduncle, bilateral cerebral peduncle, bilateral anterior limb of internal capsule, bilateral posterior limb of internal capsule, bilateral anterior corona radiata, bilateral superior corona radiata, bilateral posterior corona radiata, bilateral posterior thalamic radiation, bilateral sagittal stratum, bilateral external capsule, bilateral cingulum, bilateral superior longitudinal fasciculus (p=0.001).(2) In early PD patients’ white matter, the regions of MD values are elevated in comparison to normal as follows:middle cerebellar peduncle, pontine crossing tract, genu of corpuscallosum, body of corpuscallosum, splenium of corpuscallosum, bilateral corticospinal tract, bilateral medial lemniscus, the left inferior cerebellar peduncle, the right superior cerebellar peduncle, bilateral superior cerebellar peduncle, the left anterior limb of internal capsule, bilateral posterior limb of internal capsule, bilateral posterior corona radiata, bilateral posterior thalamic radiation, the left external capsule (p=0.0001)Conclusions1. Early damaged microstructure in white matter of PD not only includes previous study of the substantia nigra and striatum extra pyramidal system, but also involves the white matter fiber bundle; 2. In early PD patients, white matter fiber bundle damage shows no difference between women and men; 3. In the study of early PD patients’ white matter fiber bundles micro structure, the FA values may be more sensitive than the MD; 4. Using DTI, combined tract-based spatial statistical analysis can more objectively show changes of the white matter fiber bundle micro structure in early PD, and provide an objective basis for clinical diagnosis and study of the white matter fiber bundles in early PD patients; this can provide new ideas and methods forresearching the relationship between damaged white matter fiber bundles and clinical features of PD patients.