Diffusion Kurtosis Imaging Study Of Brain Microstructurechange In Gray Matter Nucleus Ontremor Dominant Of Parkinson’s Disease

Objective: The purpose of this study was to explore the value of diffusion kurtosis imaging(DKI)quantifing parameters for evaluating the microstructure changes of brain in patients with tremor dominant(TD)-type Parkinson’s disease(PD).Methods: 45 TD-type PD patients and 40 healthy controls were recruited in this study.Clinical data was collected and motor and cognitive symptoms were assessed.Conventional and DKI sequences MRI scanning were performed for all subjects.The maps and data of seven DKI parameters including fractional anisotropy(FA),mean diffusivity(MD),axial diffusivity(Da),radial diffusivity(Dr),mean kurtosis(MK),axial kurtosis(KA)and radial kurtosis(Dr)and data were obtained by software after postprocessing,and the values of the eight DKI parameters of grey nucleus in both hemispheres of different brain regions were measured and compared.Results:(1)FA values: The FA values of red nucleus at symptomatic side and the contralateral side in TD group showed statistically significant differences when compared with those at contralateral side in control group(P<0.05);the FA values of the caudate nucleus at symptomatic side and the contralateral side in TD group were statistically significant different with those at the corresponding location of both side in control group(P<0.05).(2)MD,Da and Dr values: The values of the three DKI parameters of every grey nucleus at the symptomatic side and the contralateral side in TD group were statistically significant different from those in the control group(P<0.05).(3)Ka values:The Ka values ofred core,putamen,substantia nigra dense zone,substantia nigra reticulum,pale globule,thalamus,and caudate nucleus at the symptomatic side and the contralateral side in TD group were statistically significant different from those in the control group(P<0.05).;The Ka values of the dentate nucleus at the symptomatic side in TD group were statistically significant at the symptomatic side in the control group(P<0.05)(4)MK values: The MK values of the substantia nigra reticulum and substantia nigra dense band at the symptomatic side in TD group were statistically significant different from those at the contralateral side in the control group(P<0.05).The MK values of putamen at symptomatic side and contralateral side in TD group were statistically significant when compared with those at both sides in the control group(P<0.05);The MK values of pale side at both sides in TD group and those in the control group were statistically significant(P<0.05);(5)Kr values: The Kr values of caudate nucleus at both sides in TD group were statistically significant when compared with those at the both the sides in control group(P<0.05);The Kr values of the dentate nucleus at the symptomatic side in TD group were statistically significant at the symptomatic side in the control group(P<0.05).Conclusion: DKI can detect changes in the microstructure of each gray matter nucleus in the subclinical stage of TD-type PD patients.