A Multi-sequence MRI Study in Parkinson's Disease: Association Between Rigidity and Myelin

Jiayue Cai; Jowon L Kim; Tobias R Baumeister; Maria Zhu; Yuheng Wang; Aiping Liu; Soojin Lee; Martin J McKeown

doi:10.1002/jmri.27853

A Multi-sequence MRI Study in Parkinson's Disease: Association Between Rigidity and Myelin

J Magn Reson Imaging. 2022 Feb;55(2):451-462. doi: 10.1002/jmri.27853. Epub 2021 Aug 9.

Authors

Jiayue Cai^{1

2}, Jowon L Kim², Tobias R Baumeister³, Maria Zhu², Yuheng Wang³, Aiping Liu⁴, Soojin Lee^{3

5}, Martin J McKeown²

Affiliations

¹ School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China.
² Department of Medicine, Division of Neurology, The University of British Columbia, Vancouver, British Columbia, Canada.
³ School of Biomedical Engineering, The University of British Columbia, Vancouver, British Columbia, Canada.
⁴ Department of Electronic Science and Technology, University of Science and Technology of China, Hefei, China.
⁵ Centre for Functional MRI of the Brain (FMRIB), Wellcome Centre for Integrative Neuroimaging, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.

PMID: 34374158
DOI: 10.1002/jmri.27853

Abstract

Background: The pathophysiology of rigidity in Parkinson's disease (PD) is poorly understood. Multi-sequence functional and structural brain MRI may further clarify the origin of this clinical characteristic.

Purpose: To examine both joint and unique relationships of MRI-based functional and structural imaging modalities to rigidity and other clinical features of PD.

Study type: Retrospective cross-sectional study.

Population: 31 PD subjects (aged 68.0 ± 5.9 years, 21 males) with average disease duration 9.3 ± 5.4 years.

Field strength/sequence: Multi-echo GRASE, diffusion-weighted echo planar imaging (EPI), and blood oxygen level dependent contrast EPI T2*-weighted sequences on a 3T scanner.

Assessment: Myelin water fraction (MWF) and fractional anisotropy (FA) of 20 white-matter regions of interest (ROIs), and functional connectivity derived from resting-state fMRI among 56 ROIs were assessed. The Unified Parkinson's Disease Rating Scale-Part III, Montreal Cognitive Assessment, Beck Depression Index, and Apathy Rating Scales were used to assess motor and non-motor symptoms.

Statistical tests: Multiset canonical correlation analysis (MCCA) and canonical correlation analysis (CCA) were utilized to examine the joint and unique relationships of multiple imaging measures with clinical symptoms of PD. A permutation test was used to determine statistical significance (P < 0.05).

Results: MCCA revealed a single significant component jointly linking MWF, FA, and functional connectivity to age, bradykinesia, and leg agility, non-motor symptoms of cognition, depression, and apathy, but not rigidity (P = 0.77), tremor (P = 0.50 and 0.67 on the left and right side), or sex (P = 0.54). After controlling for this joint component, CCA found a unique significant association between MWF and rigidity, but no other associations were detected, including with FA (P = 0.87).

Data conclusion: MWF, FA, and functional connectivity can serve as multi-sequence imaging markers to characterize many PD symptoms. However, rigidity in PD is additionally associated with widespread myelin changes.

Evidence level: 4 TECHNICAL EFFICACY: Stage 3.

Keywords: Parkinson's disease; clinical characteristics; data fusion; multi-sequence; myelin water fraction.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Canonical Correlation Analysis
Cross-Sectional Studies
Humans
Magnetic Resonance Imaging
Male
Myelin Sheath* / metabolism
Oxygen Saturation
Parkinson Disease* / diagnostic imaging
Retrospective Studies