The Research Of The Structural Changes Of Cerebellar Tissue In Tremor Dominant Parkinson's Disease Based On DKI

Objectives:Using Diffusion Kurtosis Imaging(DKI)to observe the histopathological changes of the cerebellum in patients with Tremor-Dominant Parkinson Disease(TD-PD),and to provide a new idea for the diagnosis and treatment of PD.Materials and Methods : 1.A total of 36 patients on the basis of clinical symptoms have been confirmed to primary PD called PD group.All of them have been satisfied of the UK brain bank diagnostic criteria for PD.On the side,select randomly10 healthy people as Normal Control group,whose age,gender were matching with selected PD patients.2.According to the clinical manifestations of subjects,PD patients were divided into Tremor Dominant PD group(TD)and Postural Instability Gait Difficulty PD group(PIGD).3.All of the PD patients would need to accomplish the Hoehn-Yahr(H-Y)stages,aim to analyse the disease severity.All of TD patients would need to accomplish the Tremor Score,aim to analyse the severity of tremor.4.All of subjects need to examine head by 3.0T superconducting MRI,and complete conventional MRI sequences and DKI scan.The original imaging using Functool software for post-processing:On the color pictures,to draw manually the region of interest(ROI)for each subject.Mean Kurtosis(MK),Mean Diffusion(MD),and Fractional Anisotropy(FA)were measured in bilateral cerebellar white matter and bilateral dentate nucleus.5.All of the results and datas was analysed by SPSS 23.0.All of the samples were in line with the normal distribution,comparison of counting datas were used by ?2 test,such as the analysis of gender of the general information.The comparison of measurement datas with each other was used t test,such as themeasured value analysis at every measuring position.The relation analysis between measured value with tremor scores would use the linear regression analysis study.Result:1.General data analysis:the data of TD group,PIGD group and NC group were compared with each other in age,gender and the data of TD group and PIGD group in H-Y stage.The difference was not statistically significant(P>0.05).2.Compared with Normal Control group,the MK value of the white matter in bilateral cerebellum,the MK value of the dentate nucleus of bilateral cerebellum,the FA value of the white matter in left cerebellum in tremor-type PD group were significantly increased,the MD value of the white matter in bilateral cerebellum in tremor-type PD group were decreased.The difference was statistically significant(P<0.05).3.Compared with Normal Control group,the MK value of the white matter in bilateral cerebellum,the MK value of the dentate nucleus of bilateral cerebellum,the FA value of the white matter in left cerebellum in non-tremor type PD group were significantly increased.The difference was statistically significant(P<0.05).4.Compared with non-tremor type PD group,the MK value of the white matter in bilateral cerebellar,the MK value of the dentate nucleus of bilateral cerebellum,the FA value of the white matter in left ventricular,the FA value of the dentate nucleus of left cerebellum in tremor-type PD group were significantly increased.The difference was statistically significant(P <0.05).5.Liner regression analysis was preformed between the measured MK value of TD and the tremor scores.There was no correlation between them.Conclusion:1.The white matter and dentate nucleus of cerebellum in the patients with Parkinson's disease occur structural changes,which may play a compensatory role in the course of the occurrence and development of the disease.2.The cerebellar structure of patients with rest tremor in Parkinson's disease occur changes,so as to verify the changes to the cerebellum of compensatory function,and the compensatory effect is mediated through the cerebellar-thalamic-cortex loop.3.Compared with the FA and MD value,the sensitivity of MK value is relatively high,and DKI technology can be more sensitive to the subtle changes of organizational structure.