A Preliminary Study Of Amide Proton Transfer Imaging In Parkinson’s Disease With Freezing Of Gait

Objective:To explore Parkinson’s disease with freezing gait by amide proton transfer(APT)magnetic resonance technique,Characteristics of APT signal in substantia nigra of Parkinson’s disease without freezing of gait(PD-FOG)and Parkinson’s disease without freezing gait(PD-NFOG),and compared with healthy control(HC)group,and compared the statistical differences of APT indexes among the three groups.To preliminarily study the changes of protein metabolism in substantia nigra of Parkinson’s disease patients with frozen gait,so as to further explore the possible mechanism of frozen gait and provide a possible theoretical basis for the diagnosis and treatment of frozen gait.Methods:A total of 33 patients with Parkinson’s disease(PD)in our hospital were included as the case group,including 15 cases in the PD-FOG group,18 cases in the PD-NFOG group and 20 healthy volunteers as the control group.MRI scans were performed in all three groups,obtaining APT images and related parameters,and the inter-group differences in parameters of the region of interest of the three groups were compared.Then,we compared the parameter values of the ROI on the affected side and the healthy side in the PD-FOG group with unilateral symptoms.The correlation between the parameter values and a series of scale scores correlated with the motor symptoms of Parkinson’s disease was analyzed.To evaluate the diagnostic efficacy of APT parameter values in the substantia nigra in the diagnosis of PD-FOG by ROC curve.Results:APTw values in the substantia nigra of the PD-FOG group were significantly lower than those of the PD-NFOG group and the HC group,while there was no significant difference between the PD-NFOG group and the NC group.APTw values in the substantia nigra on the affected side were significantly lower than those on the healthy side in PD-FOG patients with unilateral symptoms.APTw values in the substantia nigra of the PD-FOG group were correlated with scale scores related to motor symptoms of Parkinson’s disease in patients.The results of ROC curve analysis showed that the area under the APTw curve of the substantia nigra was 0.766.Conclusion:Amide proton transfer imaging can reflect the protein metabolic changes in the substantia nigra of patients with Parkinson’s disease and frozen gait,and is significantly correlated with the severity and course of the disease,which is expected to provide an important objective basis for the diagnosis and monitoring of PD-FOG,as well as help for the treatment and intervention of PD.