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Study of the relationship between onset lateralization and hemispheric white matter asymmetry in Parkinson's disease

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Abstract

Background

Parkinson's disease (PD) is characterized by a lateralized onset, but its cause and mechanism are still unclear.

Methods

Obtaining diffusion tensor imaging (DTI) data from the Parkinson’s Progression Markers Initiative (PPMI). Tract-based spatial statistics analysis and region-of-interest-based analysis were performed to evaluate the white matter (WM) asymmetry using original DTI parameters, Z Score normalized parameters, or the asymmetry index (AI). Hierarchical cluster analysis and least absolute shrinkage and selection operator regression were performed to construct predictive models for predicting the PD onset side. DTI data from The Second Affiliated Hospital of Chongqing Medical University were obtained for external validation of the prediction model.

Results

118 PD patients and 69 healthy controls (HC) from PPMI were included. Right-onset PD patients presented more asymmetric areas than left-onset PD patients. The inferior cerebellar peduncle (ICP), superior cerebellar peduncle (SCP), external capsule (EC), cingulate gyrus (CG), superior fronto-occipital fasciculus (SFO), uncinate fasciculus (UNC), and tapetum (TAP) showed significant asymmetry in left-onset and right-onset PD patients. An onset-side-specific pattern of WM alterations exists in PD patients, and a prediction model was constructed. The predicting models based on AI and ΔZ Score presented favorable efficacy in predicting PD onset side by external validation in 26 PD patients and 16 HCs from our hospital.

Conclusions

Right-onset PD patients may have more severe WM damage than left-onset PD patients. WM asymmetry in ICP, SCP, EC, CG, SFO, UNC, and TAP may predict PD onset side. Imbalances in the WM network may underlie the mechanism of lateralized onset in PD.

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Data availability

The data that support the findings of this study are available from the corresponding authors.

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Acknowledgements

Data used in the preparation of this article were obtained from the Parkinson’s Progression Markers Initiative database (www.ppmi-info.org/data). For up-to-date information on the study, visit http://www.ppmi-info.org. PPMI, a public-private partnership, is funded by the Michael J. Fox Foundation for Parkinson’s Research and funding partners, including , including 4D Pharma; AbbVie Inc.; AcureX Therapeutics; Allergan; Amathus Therapeutics; Aligning Science Across Parkinson’s (ASAP); Avid Radiopharmaceuticals; Bial Biotech; Biogen; BioLegend; Bristol Myers Squibb; Calico Life Sciences LLC; Celgene Corporation; DaCapo Brainscience; Denali Therapeutics; the Edmond J. Safra Foundation; Eli Lilly and Company; GE Healthcare; GlaxoSmithKline; Golub Capital; Handl Therapeutics; Insitro; Janssen Pharmaceuticals; Lundbeck; Merck & Co., Inc.; Meso Scale Diagnostics, LLC; Neurocrine Biosciences; Pfizer Inc.; Piramal Imaging; Prevail Therapeutics; F. Hoffmann-La Roche Ltd and its affiliated company Genentech Inc.; Sanofi Genzyme; Servier; Takeda Pharmaceutical Company; Teva Neuroscience, Inc.; UCB, Vanqua Bio; Verily Life Sciences; Voyager Therapeutics, Inc.; and Yumanity Therapeutics, Inc (http://www.ppmi-info.org/fundingpartners).

Funding

This study was supported by National Natural Science Foundation of China (grant number: 82001367, receiver: Xi Liu), Natural Science Foundation of Chongqing (grant number: cstc2021jcyj-msxmX0180, receiver: Xi Liu), Kuanren Talent Program of The Second Affiliated Hospital of Chongqing Medical University (receiver: Xi Liu), and Scientific and Technological Research Program of Chongqing Municipal Education Commission (grant number: KJQN202200417, receiver: Changhong Tan).

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Authors and Affiliations

  1. Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, 74 Linjiang Road, Yuzhong District, Chongqing, 400010, China

    Yuxia Zhu, Sichen Li, Xiaohui Da, Hongyu Lai, Changhong Tan, Xi Liu, Fen Deng & Lifen Chen

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  1. Yuxia Zhu
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  2. Sichen Li
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Contributions

YZ: Data Curation (lead); Formal Analysis (lead); Investigation (lead); Methodology (lead); Software (lead); Validation (lead); Visualization (lead); Writing—Original Draft Preparation (equal). SL: Data Curation (supporting); Investigation (supporting); Validation (supporting). XD: Data Curation (supporting); Investigation (supporting); Validation (supporting). HL: Data Curation (supporting); Investigation (supporting); Validation (supporting). CT: Formal Analysis (supporting); Funding Acquisition (supporting). XL: Conceptualization (lead); Formal Analysis (supporting); Funding Acquisition (lead); Methodology (supporting); Software (supporting); Supervision (equal); Visualization (supporting); Writing—Original Draft Preparation (equal); Writing—Review & Editing (equal). FD: Conceptualization (supporting); Project Administration (equal); Resources (equal); Supervision (equal); Writing—Review & Editing (equal). LC: Project Administration (equal); Resources (equal); Supervision (equal). All authors read and approved the fnal manuscript.

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Correspondence to Xi Liu or Fen Deng.

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The PPMI study has been approved by the respective institutional review boards of all participating sites, and written informed consents were obtained from each participant. This study was also approved by the Ethics Committee of The Second Affiliated Hospital of Chongqing Medical University (2022–759), written consents were also obtained from each participant.

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Zhu, Y., Li, S., Da, X. et al. Study of the relationship between onset lateralization and hemispheric white matter asymmetry in Parkinson's disease. J Neurol 270, 5004–5016 (2023). https://doi.org/10.1007/s00415-023-11849-1

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