MRI Multimodal Study Of Parkinson’s Disease Patients With Depressive Disorder

BackgroundParkinson’s disease（Parkinson ’s disease,PD）is a high incidence disease in the middle and old age population.The cause of disease is complex.Depression is the most common mental disorder in patients with Parkinson’s disease.The incidence rate of this disease can exceed 55%.Clinically,there are many diagnostic methods for PD and depression,such as transcranial ultrasound imaging and positron emission computed tomography（PET）,which are commonly used in PD diagnosis.The diagnostic and Statistical Manual of mental disorders（DSM-Ⅳ）published by American Psychological Association is often used for depression diagnosis.PD patients with depression clinical diagnosis of the lack of objective image data indicators.With the application of new magnetic resonance imaging technology,a variety of joint application of MRI technology can provide the multivariate data analysis,are likely to show slight changes in the structure of brain gray matter nuclei and pathological changes,is of great significance to enhance the accuracy in Parkinson’s disease with depression.ObjectiveTo explore the clinical significance of SWI,QSM,DTI,DKI,T1W-3D-TFE and FE-EPI in the diagnosis of PD with depression,so as to provide an objective basis for the diagnosis and prognosis of Parkinson’s patients with depression.MethodsTwenty patients with Parkinson’s disease and depression in Beijing Rehabilitation Hospital from April 2018 to December 2019 were selected as the case group;20 patients with Parkinson’s disease in Beijing Rehabilitation Hospital during the same period were selected as negative control（NC）,referred to as negative control;20 cases of Beijing Rehabilitation Hospital physical examination in the same period were selected as the control group.After admission,routine examinations were completed in both groups.SWI,DTI,DKI,QSM,T1W-3D-TFE and FE-EPI sequences of 3.0T MRI were used to analyze and compare the parameters（DKI、DTI and QSM）of each nucleus in DPD group and HC group,Philips post-processing workstation,MEDI,DKE,DPARSF and other software were used to obtain each parameter map.At least two MRI doctors read the image together,draw the ROI range in the map,and measure the relevant parameters.The parameters of each nucleus in the images of DKI in HC group were compared;The parameters of nuclei（DKI,DTI,QSM）in DPD group and HC group were compared;The Re Ho on the time series is evaluated,and the parameters are Kendall coefficient（KCC）.Finally,the standardized Re Ho diagram is made.At the same time.The data in this study were processed by SPSS 21.0 software.Results1.The results of Nigrosome-one were compared with the clinical diagnosis.The sensitivity,specificity,positive predictive value and negative predictive value of SWI sequence in diagnosing DPD were 70%,35%,51.9% and 53.8%,with a diagnostic coincidence rate of 52.5%.The sensitivity and specificity of QSM sequence for the diagnosis of DPD were 90%,60%,positive predictive value was 69.2%,negative predictive value was 85.7%,and diagnostic coincidence rate was 75.0%.2.There was no statistical difference in the parameters of interest region between DKI3 b and DKI5 b sequences in the normal group（P > 0.05）.3.The magnetic susceptibility of ROI region of substantia nigra,caudate nucleus head,red nucleus and putamen increased in patients with the disease and negative control group,and there was statistical significance（P < 0.05）.4.Compared with the non-affected group,the MK and MD values of the substantia nigra in the diseased group and the negative control group were increased,and there was a statistical difference（P<0.05）,and the diseased group was higher than the negative control group（P<0.05）.<0.05);the MD value of the head of the caudate nucleus in the basal ganglia increased with statistical significance（P<0.05）,and the diseased group was higher than the negative control group（P<0.05）.The MK value in the thalamus decreased with statistical significance（P<0.05）,and the diseased group was lower than the negative control group（P<0.05）.5.The brain regions with Re Ho value changes were mainly distributed in the right dorsolateral prefrontal lobe,right inferior parietal lobe and right talus fissure.Namely frontal,parietal,occipital cortex and limbic system.ConclusionCombined with QSM and DKI techniques,the MK and MD values of substantia nigra,MD values of caudate nucleus head and MK values of thalamus are beneficial for the diagnosis of Parkinson’s disease patients with mild depressive disorder.A variety of specific parameters can be applied to clinical auxiliary diagnosis.improve the accuracy of MRI in the diagnosis of DPD,and provide objective imaging indexes for clinical early diagnosis and early treatment.