ABSTRACT
Objective:To explore the value of magnetic resonance diffusion kurtosis imaging (DKI) in the early diagnosis of Parkinson′s disease (PD).Methods:Thirty patients with early PD who were admitted to the Fujian Medical University Union Hospital From December 2016 to September 2017 were selected as case group, and 20 healthy persons in the same period were selected as healthy control group. 3.0 T GE magnetic resonance DKI was used to analyze olfactory related brain regions of the case group and the control group, the statistical differences were compared between the two groups in fractional anisotropy (FA), mean diffusion (MD), mean kurtosis (MK) values of olfactory cortex, and the correlation between MK values of olfactory cortex of the case group and age, disease course, Hoehn-Yahr (H-Y) stage, olfactory test, cognitive function evaluation was analyzed. Receiver operating characteristic (ROC) curve was used to determine the best diagnostic cutoff value of olfactory cortical MK in PD.Results:The left amygdala MK between the PD group (0.595±0.037) and the control group (0.647±0.091) showed statistically significant difference ( t=-2.183, P=0.037). ROC curve was drawn according to the MK value of the left amygdala of the PD group: the best diagnostic cutoff value was 0.597, the sensitivity was 65.0%, and the specificity was 52.2%. There was a statistically significant difference between the PD group and the control group in Montreal Cognitive Assessment (MoCA; 21.03±3.71 vs 24.25±1.65, t=-3.636, P=0.001) and Frontal Assessment Battery (FAB) scores (13.93±1.36 vs 15.00±1.25, t=-2.086, P=0.042), and there was negative correlation between MoCA, FAB scores and H-Y stage ( r=-0.548, P=0.007; r=-0.465, P=0.025). There was a positive correlation between MK value of the right direct gyrus of the PD group and MoCA evaluation results ( r=0.447, P=0.032). Conclusions:The left amygdala DKI can be used as a biomarker of PD in the early stage, which is helpful for the early diagnosis of PD. MoCA and FAB scales can be used as tools to monitor the progress of PD cognitive impairment. PD cognitive dysfunction may be related to impairment of frontal lobe function.
ABSTRACT
Objective To investigate the diagnostic value of quantitative detection of α-synuclein and DJ-1 protein in saliva for Parkinson Disease. Methods Twenty seven patients diagnosed with primary Parkinson's disease and 27 healthy controls were studied.The clinical data of all subjects were collected.Each participant received a disease evaluation including Hohn-Yahr stage, unified Parkinson Disease Rating Scale (UPDRS)-Ⅱ / Ⅲ, 12 Item odor identification test from Sniffin'Sticks (SS-12), Montreal cognitive assessment (MoCA), Mini Mental State Examination (MMSE).α-syn and DJ-1 protein in saliva were examined by using enzyme linked immunosorbent assay (ELISA). The statistical analysis was used to test the difference in these two protein levels between patient and control groups and the correlation with age, gender and course of disease. Results There were significant changes in mean concentration of salivary α-syn (1269.02±16.09 pg/mL、1350.51±25.79 pg/mL,P=0.010) and DJ-1 protein (6.07±3.23 ng/mL、8.43±4.33 ng/mL,P=0.027) between patient and control groups. The sensitivity of α-syn and DJ-1 protein levels in PD diagnosis was 55.56% and 77.8%,and the specificity was 89.19% and 55.6%.The area under the ROC curve in finding the PD of α-syn and DJ-1 was 0.671 and 0.649, respectively. In Parkinson disease group, age, gender, UPDRS-Ⅱ / Ⅲ, Hohn-Yahr stage, SS-12, MMSE and MoCA of Parkinson's disease group were not related to the concentration of α-syn and DJ-1 protein in saliva (P>0.05). Conclusion The detection of α-syn and DJ-1 protein levels in saliva may be an auxiliary tool for diagnosis of PD.