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Purpose <p>Emerging evidence indicates white matter (WM) alterations in Parkinson’s disease (PD), potentially manifesting before dopaminergic neuron loss in the substantia nigra pars compacta (SNc). Diffusion tensor imaging (DTI) is effective for mapping WM pathways, even in patients with PD who have deep brain stimulation (DBS) devices. This study evaluated DTI as a tool for assessing WM changes in post-DBS patients with PD.</p> Methods <p>We retrospectively collected data from 32 patients with PD. Among them, 27 patients underwent both DTI and T1-weighted imaging before and after undergoing DBS, while the remaining 5 patients received two DTI scans over time without undergoing DBS. Whole-brain and three predefined WM tracts were comparatively analyzed. Repeated-measures statistical analysis was conducted to compare DTI metrics before and after DBS, with statistical significance set at <i>p</i> &lt; 0.05. Clinical evaluations included the Unified Parkinson’s Disease Rating Scale, Hoehn and Yahr (H&amp;Y) staging, Mini-Mental State Examination (MMSE), and Levodopa Equivalent Daily Dose (LEDD).</p> Results <p>Following DBS, DTI metrics showed reduction in tract number, mean length, fractional anisotropy (FA), and normalized quantitative anisotropy (nQA). Conversely, mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) increased, while quantitative anisotropy (QA), isotropy (ISO), and restricted diffusion imaging (RDI) remained unchanged. No significant differences were found in five patients over 2.8 years without DBS.</p> Conclusions <p>DTI metrics showed a decrease in whole-brain FA after 12.5 months of DBS treatment compared to pre-DBS, while the Dentato-Rubro-Thalamic tracts (DRTT) remained relatively preserved. No significant changes were observed for patients with PD without DBS over 2.8 years. Further research is needed to clarify clinical relevance.</p>

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Diffusion tensor imaging for deep brain stimulation in patients with parkinson’s disease

  • 期刊论文

  • 发表日期：

    2025年7月25日

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  • Li-Chuan Huang,
  • Li-Guo Chen,
  • Sheng-Huang Lin,
  • Sheng-Tzung Tsai,
  • Ping-An Wu,
  • Shin-Yuan Chen

摘要

Purpose

Emerging evidence indicates white matter (WM) alterations in Parkinson’s disease (PD), potentially manifesting before dopaminergic neuron loss in the substantia nigra pars compacta (SNc). Diffusion tensor imaging (DTI) is effective for mapping WM pathways, even in patients with PD who have deep brain stimulation (DBS) devices. This study evaluated DTI as a tool for assessing WM changes in post-DBS patients with PD.

Methods

We retrospectively collected data from 32 patients with PD. Among them, 27 patients underwent both DTI and T1-weighted imaging before and after undergoing DBS, while the remaining 5 patients received two DTI scans over time without undergoing DBS. Whole-brain and three predefined WM tracts were comparatively analyzed. Repeated-measures statistical analysis was conducted to compare DTI metrics before and after DBS, with statistical significance set at p < 0.05. Clinical evaluations included the Unified Parkinson’s Disease Rating Scale, Hoehn and Yahr (H&Y) staging, Mini-Mental State Examination (MMSE), and Levodopa Equivalent Daily Dose (LEDD).

Results

Following DBS, DTI metrics showed reduction in tract number, mean length, fractional anisotropy (FA), and normalized quantitative anisotropy (nQA). Conversely, mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) increased, while quantitative anisotropy (QA), isotropy (ISO), and restricted diffusion imaging (RDI) remained unchanged. No significant differences were found in five patients over 2.8 years without DBS.

Conclusions

DTI metrics showed a decrease in whole-brain FA after 12.5 months of DBS treatment compared to pre-DBS, while the Dentato-Rubro-Thalamic tracts (DRTT) remained relatively preserved. No significant changes were observed for patients with PD without DBS over 2.8 years. Further research is needed to clarify clinical relevance.