The Differential Diagnosis and Prognosis of Idiopathic and Atypical Parkinson Disease by Using Diffusion MRI
The hypothesis is that the differential extent of microstructural damages in the affected brain regions can be specific to the disease of interest and could reflect the clinical severity. Therefore, we propose that the whole brain parcellation of diffusion MRI can be used to improve the diagnosis and prediction of clinical outcomes in Parkinson's Disease.
- A regression model between clinical severity and two-year clinical outcomes and diffusion properties from multiple parcellated regions will be developed.
- Blind validation will be performed.
研究概览
地位
条件
详细说明
Parkinson's disease (PD) is a common progressive neurodegenerative disorder characterized by resting tremor, bradykinesia, restricted mobility, and postural instability. Early diagnosis of PD would be paramount for further treatment and prognosis. The most common neurodegenerative parkinsonian syndrome is known as Parkinson's disease (PD) or idiopathic Parkinson syndrome, if it occurs sporadically (not familial) and its lead clinical symptom is a movement disorder after brainstem-predominant α-synuclein deposition. To distinguish them from Parkinson's disease, other sporadic entities have been named atypical parkinsonian syndromes or atypical parkinsonism. The present review article describes current standards for the diagnosis and treatment of the most important disease entities in this latter group: dementia with Lewy bodies (DLB), multiple system atrophy (MSA), progressive supranuclear palsy (PSP), and corticobasal degeneration (CBD).
PD is diagnosed mainly by neurologists, based on clinical symptoms. However, there are no objective criteria available for their diagnosis. Although magnetic resonance imaging (MRI) is often employed in conjunction with clinical judgment, the images are mostly used to eliminate other diseases, rather than to confirm the diagnosis. Other imaging methods, such as Positron Emission Tomography or Computed Tomography, may help in the diagnosis of PD but have harmful effects on the human body. MRI image of patients with Parkinson's disease is usually normal. Previous studies have also indicated that brain-related areas, such as the atrophy of basal ganglia, are not observed until a period of disease progression. However, the shrinkage of brain tissue cannot be used as a criterion for the diagnosis of Parkinson's disease, because many other diseases are accompanied by atrophy of brain tissue as well. Furthermore, because human brain cells cannot regenerate, It is too late to diagnose or treat when a large number of nerve cells are apoptotic. Since we expect the function of the diseased cells to change first, therefore, if you can detect changes in the patient's brain microenvironment, it is possible to achieve early detection of Parkinson's disease. Magnetic resonance imaging can detect functional images and display functional changes, thus providing an opportunity to detect abnormalities and diagnose diseases early. One of the key technologies in the measurement of functional images is diffusion magnetic resonance imaging.
Diffusion MRI has been widely utilized to investigate the patterns of neural connectivity. Mean diffusivity (MD) and the directionality (fractional anisotropy (FA)) have been studied in epilepsy, multiple sclerosis, and noticeably in Parkinson's Disease. Owing to their paramount pathogenetic role in Parkinson's disease, the basal ganglia in general and the substantia nigra pars compacta, in particular, have been the subject of intense MRI investigation.
The plan uses standard anatomic labeling (AAL) to perform whole-brain diffusion MRI to obtain diffusion data for the whole brain parcellation. We will use statistical methods to identify the areas affected by each PD's subtype, we will also identify areas that are likely to be related to the severity of the disease, and then combine these areas for linear regression analysis. We anticipate that diffusion magnetic resonance imaging can be used as a differential diagnosis, as well as to define areas of high correlation with clinical severity, and to be used for accurate disease prediction and future development, and to provide physicians and patients with clinically important information.
The program uses diffusion magnetic resonance imaging to assess clinical status and prognosis for Parkinson's disease. Our research goal is
- Establish objective and clear imaging diagnostic criteria of diffusion MRI for idiopathic and atypical Parkinson's disease.
- Establish objective and clear clinical severity and the prognosis prediction mode of diffusion MRI for idiopathic and atypical Parkinson's disease.
研究类型
注册 (实际的)
联系人和位置
学习地点
-
-
-
Taoyuan、台湾、333
- ChangGung Memorial Hospital, Linkou
-
-
参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
取样方法
研究人群
All subjects should meet the following criteria:
- Between 50-80 years old
- Right-handed
- Able to understand study requirements and give informed consent
- Agree to return for follow-up checks
- Able to suspend intake of medication for at least 12 hours
描述
Inclusion Criteria:
-
Exclusion Criteria:
- Cardiac pacemaker or defibrillator implantation Intracranial metal device implantation
- Other major systemic diseases, such as renal failure, heart failure, stroke, AMI/unstable angina, poorly controlled diabetes mellitus, poorly controlled hypertension
- Alcohol or drug abuse
- Moderate to severe dementia
- Severe movement disorders
- Imaging data is similar to a nuclear medical examination, exclusion criteria is any abnormality that may affect cognitive function as reflected in computer tomography or MRI records, such as hydrocephalus or encephalitis. Mild cortical atrophy is acceptable.
- History of intracranial surgery including thalamotomy, pallidotomy, and/or deep brain stimulation
- Major physical or neuropsychiatric disorders
- Structural abnormalities that may cause dementia, such as cortical infarction, tumour, or subdural hematoma
- Besides medication for Parkinson's Disease, taking other medication with substances that can pass through the blood-brain barrier
- Besides medication for Parkinson's Disease, taking other medication for more than 10 years
- Treatments or concurrent illnesses other than Alzheimer's Disease that could interfere with cognitive function
- Meet the criteria for dementia (DSM-IV)
- Head trauma with loss of consciousness greater than 10 minutes
- Severe loss of sensation
学习计划
研究是如何设计的?
设计细节
队列和干预
团体/队列 |
---|
Atypical Parkinson's Disease patients
This group consists of patients includes 35 patients with Progressive Supranuclear Paralysis (PSP), 35 patients with Multiple System Atrophy (MSA), and 35 patients with Cortico-Basal Degeneration (CBD).
|
Idiopathic Parkinson's Disease patients
This group consists of patients starting from 2012 to 2013 and includes 87 patients with typical Parkinson's Disease (PD)
|
Healthy volunteers
The 96 healthy volunteers should meet the following criteria:
|
研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
---|---|---|
帕金森病诊断、鉴别诊断和预后的客观图像证据
大体时间:第三年末
|
以下将测量弥散 MRI 的诊断性能:
|
第三年末
|
次要结果测量
结果测量 |
措施说明 |
大体时间 |
---|---|---|
differential diagnosis
大体时间:end of the second year
|
To differentiate patient of PD from PD + using diffusion MRI
|
end of the second year
|
prognosis
大体时间:end of the third year
|
To predict the outcome of patient with PD using the diffusion MRI at baseline
|
end of the third year
|
prognosis
大体时间:end of the third year
|
Methods for evaluation of worsening cognitive function in neurodegenerative disease
|
end of the third year
|
Imaging
大体时间:end of the third year
|
High-quality diffusion MRI and image data restoration
|
end of the third year
|
成像
大体时间:第三年末
|
高质量扩散 MRI 成像标准、分割方法和图像处理协议
|
第三年末
|
合作者和调查者
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.