System for analyzing double-task cost and brain micro-injury of Parkinson type multi-system atrophy patient

Abstract

The invention discloses a system for analyzing double-task cost and brain micro-injury of a Parkinson type multi-system atrophy patient, and relates to the technical field of medical diagnosis, and the system comprises a gait collection module which is used for collecting single-task and double-task gait data of a participant, and processing the gait data to obtain gait feature data of the participant; the gait analysis module is used for analyzing the difference of the participants in the single-task gait aspect and the double-task gait aspect according to the gait feature data and calculating the double-task cost; the nuclear magnetic resonance imaging module is used for collecting nuclear magnetic resonance imaging data of participants; the morphological analysis module is used for performing voxel-based morphological analysis on the nuclear magnetic resonance imaging data and analyzing the correlation between the double-task cost of the participant and the grey matter under the brain curtain; and the diffusion tensor imaging analysis module is used for performing diffusion tensor imaging analysis on the nuclear magnetic resonance imaging data and analyzing the correlation between the double-task cost of the participant and the white matter under the brain screen.

Description

Technical Field

[0001] The present invention relates to the field of medical diagnosis technology, and more specifically to a system for analyzing dual-task costs and brain micro-lesions in patients with Parkinson's type multiple system atrophy. Background Art

[0002] Multiple system atrophy (MSA) is a fatal atypical parkinsonian syndrome that includes two main subtypes: MSA with parkinsonism (MSA-P) and MSA with cerebellar (MSA-C). MSA-P is mainly characterized by parkinsonian symptoms and mild cerebellar manifestations, while MSA-C is mainly characterized by ataxic manifestations. MSA-P patients have a wide range of stance and inward-outward instability, and always fail the tandem gait test.

[0003] Using diffusion-weighted imaging, MSA-P exhibits distinct infratentorial structural changes compared with healthy individuals and patients with Parkinson's disease (PD), including atrophy of the pons, cerebellum, and middle cerebellar peduncles, as well as increased diffusivity in the middle cerebellar peduncles. Furthermore, in addition to its diagnostic utility, cerebellar white matter (WM) deficits correlate with the overall severity of MSA.

[0004] Dual-task gait involves performing additional tasks simultaneously while walking, which simulates the multifaceted challenges encountered in daily life. Compared with single-task gait (STG), dual-task gait is affected by additional cognitive load, resulting in poorer performance on gait metrics. This difference is quantified as dual-task cost. A large number of studies have explored the impact of dual-task on gait performance in patients with PD and progressive supranuclear palsy. The dual-task cost of patients with Parkinson's syndrome is significantly higher than that of healthy elderly people, highlighting the usefulness of dual-task gait performance as a marker to distinguish between Parkinson's syndrome and normal populations. In addition, given the decreased dual-task gait performance observed in patients with Parkinson's syndrome, dual-task training has been used to improve gait disorders, enhance cognitive function, and reduce adverse events in daily activities. These findings highlight the importance of dual-task gait in the diagnosis and treatment of Parkinson's syndrome. However, there are currently few studies on dual-task gait performance and dual-task cost in MSA. In addition, the clinical application of dual-task in MSA patients lacks a solid research foundation.

[0005] Prior art has highlighted the important role of infratentorial structures in dual-task costs in healthy individuals and patients with PD. Given that changes in infratentorial structures are specific to MSA-P and distinguish them from healthy controls and other types of parkinsonism, a system for analyzing dual-task costs and brain microlesions in patients with multiple system atrophy with parkinsonism is urgently needed to examine whether dual-task costs are also associated with infratentorial structures in MSA-P. Summary of the invention

[0006] In order to overcome the defects in the above-mentioned prior art, the present invention discloses a system for analyzing dual-task costs and brain micro-lesions in patients with Parkinson's disease. Through the present invention, on the one hand, the differences in single-task and dual-task gait between MSA-P and healthy controls (HC) can be obtained, and on the other hand, the relationship between dual-task costs and infratentorial structures can be obtained. The present invention can describe the basic characteristics of dual-task gait performance of MSA-P patients and clarify the potential neural mechanism of dual-task costs.

[0007] In order to achieve the above objectives, the technical solution adopted by the present invention is: Analysis of dual-task costs and brain micro-lesion systems in patients with Parkinson's disease, including: A gait collection module is used to collect the single-task and dual-task gait data of the participant and process the gait data to obtain the gait feature data of the participant; a gait analysis module, connected to the gait acquisition module, for analyzing the differences between the single-task and dual-task gaits of the participants and calculating the dual-task cost based on the gait feature data; an MRI module for collecting MRI data of participants; A morphological analysis module, connected to the magnetic resonance imaging module and the gait analysis module, for performing voxel-based morphological analysis on the magnetic resonance imaging data to analyze the correlation between the participants' dual-task costs and the subtentorial gray matter of the brain; The diffusion tensor imaging analysis module is connected to the magnetic resonance imaging module and the gait analysis module, and is used to perform diffusion tensor imaging analysis on the magnetic resonance imaging data to analyze the correlation between the dual-task cost of the participants and the subtentorial white matter of the brain.

[0008] 1. Gait Collection Module Preferably, the participants include patients with Parkinson's disease and healthy subjects.

[0009] Preferably, the gait acquisition module includes a video gait measurement system, which includes a camera and a processing terminal. The camera collects image data of the participant in a single-task gait, a dual-task gait with reverse counting, and a dual-task gait with spontaneous animal naming, and sends the collected image data to the processing terminal. The processing terminal processes the image data to obtain gait feature data, and evaluates the severity of the participant's disease and overall cognitive function based on the gait feature data.

[0010] Preferably, in the gait acquisition module, the single-task gait includes: the participant walks back and forth three times on a 3-meter walkway at a fixed distance from the camera; The reverse counting dual-task gait includes: participants perform an additional task of counting backwards from 100 while walking in front of a camera; The spontaneous animal naming dual-task gait includes an additional task in which participants spontaneously name non-repeated animals while walking in front of a camera.

[0011] Preferably, in the gait acquisition module, the gait characteristic data include: swing period, double support period, stride, step height, step frequency, step speed, stride speed, swing speed and turning duration.

[0012] The swing cycle is the period from the heel of one side touching the ground to the toe of the other side leaving the ground. The double support cycle is the period from when the heel of one side touches the ground to when the toe of the other side leaves the ground. This is called the double support cycle. Stride length is: the distance between two foot strikes; Step height is: the highest distance from the ground during foot swing; Cadence is the frequency of footsteps, calculated as: 60 / step duration; Pace is: distance / time between the start and end points; Stride speed is: left or right foot stride distance / stride time; Swing speed is: foot swing distance / swing time; The duration of a turn is the time from the start to the end of the turn.

[0013] Preferably, in the gait collection module, the unified multiple system atrophy assessment method is used to assess the severity of the participants' disease, and the Montreal cognitive assessment method is used to assess the participants' overall cognitive function.

[0014] In the present invention, the purpose of evaluating the severity of the participant's disease is to clarify the patient's disease stage and ensure the generalizability of the system; the purpose of evaluating the participant's overall cognitive function is to eliminate the patient's cognitive impairment and ensure that the patient has basic cognitive ability to understand instructions.

[0015] 2. Gait Analysis Module In the present invention, the gait analysis module is used to analyze the differences in single-task and dual-task gait between patients with Parkinson's disease and healthy subjects, so as to calculate the dual-task cost.

[0016] Preferably, in the gait analysis module, for the turning duration and the double support period, the dual-task cost is: the dual-task gait index minus the single-task gait index; For swing period, stride length, step height, step frequency, step speed, stride velocity, and swing velocity, the dual-task cost is: the single-task gait index minus the dual-task gait index.

[0017] In the present invention, dual-task cost refers to the additional cognitive and motor control costs that patients need to pay when performing dual tasks compared to single tasks, which is reflected in the decline in performance in dual tasks. After unified calculation, the larger the value, the higher the dual-task cost.

[0018] 3. Magnetic Resonance Imaging Module Preferably, the nuclear magnetic resonance imaging module is a nuclear magnetic resonance imaging scanner, and the nuclear magnetic resonance imaging scanner is equipped with a 32-channel head coil, which uses a volumetric three-dimensional spoiled gradient recall sequence to acquire t1-weighted images, and the parameters are: repetition time TR = 2300 ms, echo time TE = 2.01 ms, inversion angle FA = 8°, field of view FOV = 256 × 256 mm², layer thickness = 1 mm, no layer gap, voxel size = 1.0 × 1.0 × 1.0 mm³, number of layers = 192; The MRI data were acquired using an echo planar imaging sequence with the following parameters: repetition time TR = 5100 ms, echo time TE = 72 ms, field of view FOV = 256 × 256 mm², diffusion-sensitive gradient field parameter b values ​​of 0 and 1000 s / mm², voxel size = 2 × 2 × 2 mm³, diffusion direction = 64, slice thickness = 2 mm, no slice gap, and number of slices = 76.

[0019] In the present invention, both the Parkinson's disease patients and healthy subjects need to undergo magnetic resonance imaging. After the subjects perform single-task and dual-task gait, magnetic resonance imaging is performed immediately to facilitate subsequent analysis of the correlation between dual-task cost and brain micro-lesions.

[0020] 4. Morphological Analysis Module Preferably, the morphological analysis of the morphological analysis module comprises the following steps: A1, orient the T1-weighted image in the MRI data in the LPI direction, and set the image origin to the anterior commissure; A2, visual inspection of MRI data for artifacts, followed by separation of cerebellum and brainstem structures from surrounding tissue; A3. Visual inspection and calibration of the separated cerebellum and brainstem structures; A4. Perform spatial normalization and slicing on the corrected cerebellum and brainstem structures to obtain map slices and generate cerebellum and brainstem gray matter probability maps, by modulating the normalized volume changes using the retention option during generation; A5. Set the map slices to the Montreal Neurological Institute space and use a slight smoothing kernel to maintain the spatial accuracy of the infratentorial area to obtain the registered gray matter probability map.

[0021] In the present invention, step A4 is to obtain a unique picture of each brain (each person's head is big or small); step A5 is to register all brains to the same standard brain through mathematical methods to ensure that the brains can be directly compared.

[0022] Preferably, the morphological analysis of the morphological analysis module includes: The gray matter volumes of the patients with multiple system atrophy with parkinsonism and the healthy control group were compared using the registered gray matter probability maps with gender and age as covariates using two-sample t-tests; Voxel-wise linear regression model I was used to analyze the relationship between cerebellar and brainstem infratentorial gray matter volumes and dual-task cost in patients with multiple system atrophy with parkinsonism after adjusting for gender and age.

[0023] In the present invention, the purpose of performing voxel-based morphometric analysis is to analyze the brain gray matter volume damage associated with dual-task cost.

[0024] Preferably, in the morphological analysis of the morphological analysis module, the gray matter volume of the Parkinson's type multiple system atrophy patient group is reduced compared with the healthy control group.

[0025] 5. Diffusion Tensor Imaging Analysis Module Preferably, the diffusion tensor imaging analysis of the diffusion tensor imaging analysis module includes: The dual-task cost of counter-counting dual-task gait was analyzed using diffusion tensor imaging and correlated with infratentorial white matter structures in the cerebellum and brainstem; Dual-task costs of spontaneous animal-named dual-task gaits were correlated with infratentorial white matter structures in the cerebellum and brainstem using diffusion tensor imaging.

[0026] Preferably, the diffusion tensor imaging (DTI) analysis of the diffusion tensor imaging analysis module comprises the following steps: B1. Preprocessing: The MRI data were corrected for head motion and eddy current using the eddy correct command, and each diffusion-weighted image was aligned with the first b=0 image using the anisotropic alignment method; B2. Feature extraction: A linear model is used to calculate the diffusion tensor of the preprocessed MRI data to generate the whole-brain fractional anisotropy, axial diffusion coefficient, mean diffusion coefficient, and radial diffusion coefficient white matter feature maps; B3, Normalization to the infratentorial template: The whole brain atlas is registered to the T1-weighted image of each individual, and the cerebellum and brainstem are separated, spatially normalized, and re-sliced ​​to the SUIT template to obtain the white matter feature map of the infratentorial structure of the cerebellum and brainstem; B4. Correlation between dual-task cost and white matter features of infratentorial structures: A voxel-based linear regression model II was constructed, and the white matter feature maps of the infratentorial structures of the cerebellum and brainstem and the dual-task cost were input into the linear regression model II to calculate the association between the infratentorial white matter of the cerebellum and brainstem and the dual-task cost; In linear regression model II, the threshold was set at voxel-level p1<0.001, and the standard SUIT atlas was used as a mask for cluster-level FWE correction, with a threshold of p2<0.05 after correction; Duvernoy's human brainstem and cerebellum atlas was used to determine the location of the significantly different clusters on the SUIT brainstem template.

[0027] In the present invention, the purpose of performing correlation analysis using the diffusion tensor imaging analysis module is to analyze white matter damage associated with dual-task costs.

[0028] Preferably, in the diffusion tensor imaging analysis of the diffusion tensor imaging analysis module, the dual-task cost of DTI analysis DTG-BC is: Increased MD in the left MLR and SCP was associated with increased dual-task costs during the right sway cycle; Increased MD, AD, and RD in left lobules IV and V were associated with higher dual-task costs of turn duration; The MD of right lobule IV, lobule V, lobule VI, right SCP, right ECu, and right MRt were associated with increased dual-task cost of left sway speed; Increased MD in right lobule IV, lobule V, lobule VI, right SCP, right ECu, and right MRt was associated with increased dual-task cost of right sway speed; In the diffusion tensor imaging analysis of the diffusion tensor imaging analysis module, the dual-task cost of DTG-SAN for DTI analysis is: Increased MD in right lobule IV, lobule V, lobule VI, right SCP, right ECu, and right MRt was associated with increased dual-task costs of left sway velocity; Increased MD in right lobule IV, lobule V, lobule VI, right SCP, right Ecu, and right MRt was associated with increased dual-task costs of right sway velocity; where MSA-P: multiple system atrophy with parkinsonism; DTI: diffusion tensor imaging; DTG-BC: dual-task gait with count-backwards; DTG-SAN: dual-task gait with spontaneous animal naming; MNI: Montreal Neurological Institute space; MD: mean diffusivity; RD: radial diffusivity; AD: axial diffusivity; MLR: midbrain motor area; SCP: superior cerebellar peduncle; ECu: lateral cuneate nucleus; MRt: medullary reticular formation.

[0029] Beneficial effects of the present invention: 1. The system of the present invention can be used to obtain the differences in single-task and dual-task gait between patients with Parkinson's type multiple system atrophy and healthy controls, and the relationship between dual-task cost and infratentorial structure, including the correlation between dual-task cost and microscopic damage to the white matter and gray matter of the brain in patients with Parkinson's type multiple system atrophy, which is helpful for medical staff to explore the infratentorial structure of the brain and fills the gap in previous technologies.

[0030] 2. The system of the present invention can be used to describe the basic characteristics of dual-task gait performance in patients with Parkinson's disease and to elucidate the potential neural mechanisms of dual-task cost. BRIEF DESCRIPTION OF THE DRAWINGS

[0031] Figure 1 Schematic diagram of the system for analyzing dual-task costs and brain micro-lesions in patients with Parkinson's disease and multiple system atrophy in the present invention; Figure 2 This is a picture after morphological analysis in an embodiment of the present invention; Figure 3 This is a DTI analysis image of the dual-task cost of the reverse counting dual-task gait in MSA-P of an embodiment of the present invention; Figure 4 This is a DTI analysis image of the dual-task cost of the dual-task gait spontaneously named by animals in MSA-P according to an embodiment of the present invention. DETAILED DESCRIPTION

[0032] The concept, specific structure and technical effects of the present invention will be clearly and completely described below in conjunction with the embodiments and drawings to fully understand the purpose, characteristics and effects of the present invention.

[0033] Example 1 Analysis of dual-task costs and brain microlesions in patients with Parkinson's disease Figure 1 As shown, including: A gait collection module is used to collect the single-task and dual-task gait data of the participant and process the gait data to obtain the gait feature data of the participant; a gait analysis module, connected to the gait acquisition module, for analyzing the differences between the single-task and dual-task gaits of the participants and calculating the dual-task cost based on the gait feature data; an MRI module for collecting MRI data of participants; A morphological analysis module, connected to the magnetic resonance imaging module and the gait analysis module, for performing voxel-based morphological analysis on the magnetic resonance imaging data to analyze the correlation between the participants' dual-task costs and the subtentorial gray matter of the brain; The diffusion tensor imaging analysis module is connected to the magnetic resonance imaging module and the gait analysis module, and is used to perform diffusion tensor imaging analysis on the magnetic resonance imaging data to analyze the correlation between the dual-task cost of the participants and the subtentorial white matter of the brain.

[0034] In the present invention, modules such as the gait acquisition module, gait analysis module, magnetic resonance imaging module, morphological analysis module, diffusion tensor imaging analysis module, etc. can all be executed using computers and other devices, so the system of the present invention can be applied in industry.

[0035] For example, the gait acquisition module can use the ReadyGo video gait measurement system developed by Beijing Chinese Academy of Sciences Ruiyi Information Technology Co., Ltd. to perform gait measurement and calculation. The gait analysis module can use statistical analysis software or data analysis platform for analysis. The magnetic resonance imaging module can use MRI scanners. The morphological analysis module can use statistical parametric mapping software version 12, MRIcron software, and statistical analysis software. The diffusion tensor imaging analysis module can use FMRIB diffusion toolbox and PANDA toolbox.

[0036] Example 2 This embodiment further explains the gait collection module based on the embodiment 1.

[0037] The gait acquisition module includes a video gait measurement system, which includes a camera and a processing terminal. The camera collects image data of the participant in single-task gait, dual-task gait with reverse counting, and dual-task gait with spontaneous animal naming, and sends the collected image data to the processing terminal. The processing terminal processes the image data to obtain gait feature data, and evaluates the disease severity and overall cognitive function of the participant based on the gait feature data.

[0038] In this example, in single-task gait (STG), participants walked back and forth three times on a 3-meter walkway at a fixed distance from the camera. In dual-task gait with backward counting (DTG-BC), participants performed an additional task of counting backward from 100 while walking. In dual-task gait with spontaneous animal naming (DTG-SAN), participants spontaneously named non-repeated animals while walking.

[0039] This embodiment uses the following indicators to represent gait characteristics: swing cycle, double support cycle, stride, step height, step frequency, pace, stride speed, swing speed and turn duration. Compared with the single-task gait, the turn duration and double support cycle of the dual-task gait are longer, the swing cycle, stride and step height are shorter, and the stride speed, step frequency, step speed and swing speed are lower, indicating that the dual-task cost is higher. In order to facilitate understanding and calculation, for the turn duration and double support cycle, the dual-task gait indicator is used to deduct the single-task gait indicator to represent the dual-task cost, and for the swing cycle, stride, stride speed, step frequency, pace, swing speed and step height, the single-task gait indicator is used to deduct the dual-task gait indicator to represent the dual-task cost, so the larger the final calculated value is, the higher the dual-task cost is.

[0040] In this embodiment, the unified multiple system atrophy rating scale is used to evaluate the severity of the disease. The Montreal cognitive assessment scale is used to evaluate the overall cognitive function.

[0041] Example 3 This embodiment further explains the gait analysis module based on the embodiment 2.

[0042] This example included 20 patients with MSA-P and 10 healthy controls matched by age, gender, and education. The average age of MSA-P patients was 57.65 years, and the average disease duration was 1.75 years. The average score of the Unified Multiple System Atrophy Rating Scale Part II for MSA-P was 11.90 points, and the average score of the Montreal Cognitive Assessment Scale was 22.35 points. There were 3 cases with normal gait, 16 cases with mild gait disorder, and 1 case with moderate gait disorder.

[0043] Compared with healthy controls, MSA-P patients showed no differences in STG performance but showed significantly reduced right stride length in DTG-BC and DTG-SAN, and increased turn duration in DTG-BC. In addition, MSA-P patients showed higher dual-task costs in DTG-BC, as evidenced by changes in right swing period and turn duration in DTG-BC.

[0044] Example 4 This embodiment further describes the magnetic resonance imaging module based on the embodiment 3.

[0045] All MRI scans were performed on a 3.0 T MRI scanner (MAGNETOM Skyra, Siemens Healthineers, Erlangen, Germany) equipped with a 32-channel head coil. T1-weighted images were acquired using a volumetric 3D spoiled gradient-recalled sequence with the following parameters: repetition time TR = 2300 ms, echo time TE = 2.01 ms, inversion angle FA = 8°, field of view FOV = 256 × 256 mm², slice thickness = 1 mm, no slice gap, voxel size = 1.0 × 1.0 × 1.0 mm³, number of slices = 192.

[0046] The repetition time TR = 5100 ms, echo time TE = 72 ms, field of view FOV = 256 × 256 mm², diffusion-sensitive gradient field parameter b-values ​​of 0 and 1000 s / mm², voxel size = 2 × 2 × 2 mm³, diffusion directions = 64, slice thickness = 2 mm, no slice gap, and number of slices = 76 were used.

[0047] Example 5 This embodiment further describes the morphological analysis module based on the embodiment 4.

[0048] This example uses the Unbiased Template Toolbox for Infratentorial Space in Statistical Parametric Mapping software version 12 (SPM12) to perform voxel-based morphometric analysis (VBM) of the cerebellum and brainstem. T1-weighted images were oriented in the LPI orientation prior to analysis, and the image origin was set to the anterior commissure to optimize SUIT algorithm performance. After visual inspection of data artifacts, cerebellar and brainstem structures were isolated from surrounding tissue. The separation results were visually inspected and manually corrected using MRIcron software to ensure that any non-brainstem or non-cerebellar tissue was excluded. Subsequent spatial normalization and slicing generated cerebellar and brainstem gray matter probability maps, modulated by volume changes after normalization using the “preserve” option. These maps were then sliced ​​into Montreal Neurological Institute (MNI) space using a lightly smoothed kernel (3 mm full-width-half-maximum) to preserve spatial accuracy of the infratentorial region.

[0049] Two-sample t-tests were used to compare gray matter volumes between the MSA-P group and healthy controls, with sex and age as covariates. In addition, a voxel-wise linear regression model was used to explore the relationship between gray matter volume and dual-task cost in the MSA-P group after adjusting for sex and age. Statistical significance was set at p < 0.001 at the voxel level.

[0050] Morphological analysis results: This example found that the gray matter volume of the right parietal lobe (lobule IV and lobule V) of the anterior cerebellum of MSA-P patients was significantly reduced. Figure 2However, linear regression analysis did not reveal any association between gray matter volume of the cerebellum / brainstem and dual-task costs.

[0051] Figure 2 Center, A: Gray matter volume is reduced in MSA-P patients compared with healthy controls.

[0052] Example 6 This embodiment further describes the diffusion tensor imaging analysis module based on Embodiment 5.

[0053] The Diffusion Tensor Imaging Analysis module includes: Diffusion tensor imaging (DTI) was used to analyze the dual-task cost of dual-task counting-backward gait (DTG-BC) and its correlation with the infratentorial white matter structures of the cerebellum and brainstem.

[0054] Diffusion tensor imaging (DTI) was used to analyze the dual-task cost of spontaneous animal named dual-task gait (DTG-SAN) and its correlation with the infratentorial white matter structures of the cerebellum and brainstem.

[0055] In this embodiment, the specific method of using the FMRIB diffusion toolbox and the PANDA toolbox to preprocess and analyze the magnetic resonance imaging data to obtain white matter features in diffusion tensor imaging (DTI) is as follows: B1 Preprocessing: The raw data were corrected for head motion and eddy current using the eddy correct command, which applied an anisotropic alignment method to align each diffusion-weighted image with the first b = 0 image. The purpose of this step is to remove artifacts from the DTI data and prepare the data for subsequent feature extraction.

[0056] B2 feature extraction: The diffusion tensor is then calculated using a linear model to generate fractional anisotropy (FA), axial diffusion coefficient (AD), mean diffusion coefficient (MD), and radial diffusion coefficient (RD) maps for the whole brain. The FA value reflects the directional preference of diffusion, and low FA values ​​are often associated with tissue damage. MD indicates the degree of diffusion of water molecules, while AD and RD indicate the degree of axial and radial diffusion, respectively. High MD, AD, and RD values ​​indicate increased diffusivity, which is associated with tissue damage. The purpose of this step is to calculate white matter features in preparation for the subsequent extraction of corresponding white matter features of the infratentorial structure.

[0057] B3 Normalization to the infratentorial template: These whole-brain atlases were then registered to each individual's T1-weighted images, followed by separation of the cerebellum and brainstem, spatial normalization, and reslicing to the SUIT template based on the parameters derived from the T1-weighted SUIT analysis. This process generated diffusion value atlases for the cerebellum and brainstem, which were spatially normalized in MNI space, preserving the original intensity (non-modulation). The images were smoothed using a 3 mm full width at half maximum kernel. The purpose of this step was to obtain white matter feature maps of the infratentorial structures for subsequent analysis of the correlation between dual-task costs and the white matter features of the infratentorial structures of the cerebellum and brainstem.

[0058] B4 Correlation between dual-task cost and white matter features of infratentorial structures: A voxel-based linear regression model was constructed, and gender and age were also used as covariates to explore the association between DTI indicators and dual-task cost in the MSA group. The threshold was set at voxel level p < 0.001, and the standard SUIT atlas was used as a mask for cluster-level FWE correction, and the threshold after correction was p < 0.05. We used Duvernoy's human brainstem and cerebellum atlas to determine the location of the significant difference clusters on the SUIT brainstem template. The purpose of this step is to obtain white matter features and structural areas associated with dual-task costs.

[0059] 1. DTI analysis of dual-task costs of DTG-BC like Figure 3 As shown, it is a DTI analysis of the dual task cost of counting backwards and walking simultaneously in MSA-P patients. Figure 3 middle: A: Increased MD in the left MLR and SCP was associated with increased dual-task costs during the right sway period (peak MNI coordinates: -6 -32-18); B, C, D: Increased MD (B), AD (C), and RD (D) in left lobules IV and V were associated with higher dual-task costs during turn duration (peak MNI coordinates: -23 -40 -30; -32 -40 -36; -33 -46 -35); E: MD of right lobule IV, lobule V, lobule VI, right SCP, right ECu, and right MRt were associated with increased dual-task cost of left sway speed (peak MNI coordinates: 7 -41 -53); F: Increased MD in right lobule IV, V, VI, right SCP, right ECu, and right MRt was associated with increased dual-task cost at right sway speed (peak MNI coordinates: 7 -41 -53).

[0060] Explanation of abbreviations: MSA-P: multiple system atrophy with parkinsonism; DTI: diffusion tensor imaging; MNI: Montreal Neurological Institute space; MD: mean diffusivity; RD: radial diffusivity; AD: axial diffusivity; MLR: midbrain motor region; SCP: superior cerebellar peduncle; ECu: lateral cuneate nucleus; MRt: medullary reticular formation.

[0061] The above-mentioned MD (B), AD (C) and RD (D) are all indicators of white matter.

[0062] 2. DTI analysis of dual-task costs of DTG-SAN like Figure 4 As shown, it is a DTI analysis of dual-task cost in the dual-task gait of spontaneously naming animals in MSA-P patients. Figure 4 middle: A: Increased MD in right lobule IV, V, VI, right SCP, right ECu, and right MRt was associated with increased dual-task cost of left sway velocity (peak MNI: 5 -38 -48); B: Increased MD in right lobule IV, V, VI, SCP, Ecu, and MRt was associated with increased dual-task cost of right sway velocity (peak MNI: 5 -39 -53); Abbreviations: MSA-P: multiple system atrophy-parkinsonian type; DTI: diffusion tensor imaging; MNI: Montreal Neurological Institute space; MD: mean diffusivity; RD: radial diffusivity; AD: axial diffusivity; SCP: superior cerebellar peduncle; ECu: lateral cuneate nucleus; MRt: medullary reticular formation.

[0063] In summary, the results of the embodiment are: under STG conditions, there is no difference in gait indicators between MSA-P and HC. In DTG-BC, MSA-P patients showed higher dual-task costs, manifested as longer turning times and shorter swing cycles. Voxel-based morphometric analysis showed that MSA-P patients had reduced gray matter volume in the right IV and V lobules compared with HC. Diffusion tensor imaging analysis showed that in DTG-BC, higher dual-task costs of the right swing cycle were associated with higher mean diffusivity in the left midbrain motor area. In addition, in DTG-BC, higher dual-task costs of turning time were associated with increased mean diffusivity, axial diffusivity, and radial diffusivity in the white matter of the left IV and V lobules.

[0064] Conclusions: MSA-P patients had higher dual-task burden compared with HC, and abnormal dual-task cost in MSA-P may indicate infratentorial microstructural lesions, such as lesions in gray and white matter.

[0065] In the follow-up, the correlation between dual-task cost and the infratentorial gray and white matter of the brain can be used to establish a dual-task cost prediction model, and the dual-task cost prediction model can be used to predict the lesions of the infratentorial microstructural gray and white matter in patients with MSA-P.

[0066] The above is a specific description of the implementation mode of the present invention, but the present invention is not limited to the described embodiments. Those skilled in the art may make various equivalent modifications or substitutions without violating the spirit of the present invention, and these equivalents or substitutions are all included in the scope defined by the claims of the present invention.

Claims

1. Analyze the dual-task cost and brain micro-lesion system in patients with Parkinson's disease, characterized by: include: A gait collection module is used to collect the single-task and dual-task gait data of the participant and process the gait data to obtain the gait feature data of the participant; a gait analysis module, connected to the gait acquisition module, for analyzing the differences between the single-task and dual-task gaits of the participants and calculating the dual-task cost based on the gait feature data; an MRI module for collecting MRI data of participants; A morphological analysis module, connected to the magnetic resonance imaging module and the gait analysis module, for performing voxel-based morphological analysis on the magnetic resonance imaging data to analyze the correlation between the participants' dual-task costs and the subtentorial gray matter of the brain; The diffusion tensor imaging analysis module is connected to the magnetic resonance imaging module and the gait analysis module, and is used to perform diffusion tensor imaging analysis on the magnetic resonance imaging data to analyze the correlation between the dual-task cost of the participants and the subtentorial white matter of the brain.

2. The system for analyzing dual-task costs and brain micro-lesions in patients with Parkinson's disease and multiple system atrophy as claimed in claim 1, characterized in that: The gait acquisition module includes a video gait measurement system, which includes a camera and a processing terminal. The camera collects image data of the participant in single-task gait, dual-task gait with reverse counting, and dual-task gait with spontaneous animal naming, and sends the collected image data to the processing terminal. The processing terminal processes the image data to obtain gait feature data, and evaluates the disease severity and overall cognitive function of the participant based on the gait feature data.

3. The system for analyzing dual-task costs and brain micro-lesions in patients with Parkinson's disease and multiple system atrophy as described in claim 2, characterized in that: In the gait acquisition module, the single-task gait includes: the participant walks back and forth three times on a 3-meter walkway at a fixed distance from the camera; The reverse counting dual-task gait includes: participants perform an additional task of counting backwards from 100 while walking in front of a camera; The spontaneous animal naming dual-task gait includes an additional task in which participants spontaneously name non-repeated animals while walking in front of a camera.

4. The system for analyzing dual-task costs and brain micro-lesions in patients with Parkinson's disease and multiple system atrophy as claimed in claim 2, characterized in that: In the gait acquisition module, the gait characteristic data include: swing period, double support period, stride, step height, step frequency, step speed, stride speed, swing speed and turn duration; In the gait analysis module, for the turning duration and double support period, the dual-task cost is: the dual-task gait index minus the single-task gait index; For swing period, stride length, step height, step frequency, step speed, stride velocity, and swing velocity, the dual-task cost is: the single-task gait index minus the dual-task gait index.

5. The system for analyzing dual-task costs and brain micro-lesions in patients with Parkinson's disease and multiple system atrophy as claimed in claim 2, characterized in that: In the gait collection module, the unified multiple system atrophy assessment method was used to assess the severity of the participants' disease, and the Montreal cognitive assessment method was used to assess the participants' overall cognitive function.

6. The system for analyzing dual-task costs and brain micro-lesions in patients with Parkinson's disease and multiple system atrophy as claimed in claim 1, characterized in that: The nuclear magnetic resonance imaging module is a nuclear magnetic resonance imaging scanner, which is equipped with a 32-channel head coil, and uses a volumetric three-dimensional spoiled gradient recall sequence to acquire a t1-weighted image, and the parameters are: repetition time TR = 2300 ms, echo time TE = 2.01 ms, inversion angle FA = 8°, field of view FOV = 256 × 256 mm², layer thickness = 1 mm, no layer gap, voxel size = 1.0 × 1.0 × 1.0 mm³, number of layers = 192; The MRI data were acquired using an echo planar imaging sequence with the following parameters: repetition time TR = 5100 ms, echo time TE = 72 ms, field of view FOV = 256 × 256 mm², diffusion-sensitive gradient field parameter b values ​​of 0 and 1000 s / mm², voxel size = 2 × 2 × 2 mm³, diffusion direction = 64, slice thickness = 2 mm, no slice gap, and number of slices = 76.

7. The system for analyzing dual-task costs and brain micro-lesions in patients with Parkinson's disease and multiple system atrophy as claimed in claim 1, characterized in that: The morphological analysis of the morphological analysis module comprises the following steps: A1, orient the T1-weighted image in the MRI data in the LPI direction, and set the image origin to the anterior commissure; A2, visual inspection of MRI data for artifacts, followed by separation of cerebellum and brainstem structures from surrounding tissue; A3. Visual inspection and calibration of the separated cerebellum and brainstem structures; A4. Perform spatial normalization and slicing on the corrected cerebellum and brainstem structures to obtain map slices and generate cerebellum and brainstem gray matter probability maps, by modulating the normalized volume changes using the retention option during generation; A5. Set the map slices to the Montreal Neurological Institute space and use a slight smoothing kernel to maintain the spatial accuracy of the infratentorial area to obtain the registered gray matter probability map.

8. The system for analyzing dual-task costs and brain micro-lesions in patients with Parkinson's disease and multiple system atrophy as claimed in claim 7, characterized in that: The morphological analysis of the morphological analysis module includes: The gray matter volumes of the patients with multiple system atrophy with parkinsonism and the healthy control group were compared using the registered gray matter probability maps with gender and age as covariates using two-sample t-tests; Voxel-wise linear regression model I was used to analyze the relationship between cerebellar and brainstem infratentorial gray matter volumes and dual-task cost in patients with multiple system atrophy with parkinsonism after adjusting for gender and age.

9. The system for analyzing dual-task costs and brain micro-lesions in patients with Parkinson's disease and multiple system atrophy as claimed in claim 1, characterized in that: The Diffusion Tensor Imaging Analysis module includes: The dual-task cost of counter-counting dual-task gait was analyzed using diffusion tensor imaging and correlated with infratentorial white matter structures in the cerebellum and brainstem; Dual-task costs of spontaneous animal-named dual-task gaits were correlated with infratentorial white matter structures in the cerebellum and brainstem using diffusion tensor imaging.

10. The system for analyzing dual-task costs and brain micro-lesions in patients with Parkinson's disease and multiple system atrophy according to claim 1, characterized in that: The diffusion tensor imaging analysis of the diffusion tensor imaging analysis module includes the following steps: B1. Preprocessing: The MRI data were corrected for head motion and eddy current using the eddy correct command, and each diffusion-weighted image was aligned with the first b=0 image using the anisotropic alignment method; B2. Feature extraction: A linear model is used to calculate the diffusion tensor of the preprocessed MRI data to generate the whole-brain fractional anisotropy, axial diffusion coefficient, mean diffusion coefficient, and radial diffusion coefficient white matter feature maps; B3, Normalization to the infratentorial template: The whole brain atlas is registered to the T1-weighted image of each individual, and the cerebellum and brainstem are separated, spatially normalized, and re-sliced ​​to the SUIT template to obtain the white matter feature map of the infratentorial structure of the cerebellum and brainstem; B4. Correlation between dual-task cost and white matter features of infratentorial structures: A voxel-based linear regression model II was constructed, and the white matter feature maps of the infratentorial structures of the cerebellum and brainstem and the dual-task cost were input into the linear regression model II to calculate the association between the infratentorial white matter of the cerebellum and brainstem and the dual-task cost; In linear regression model II, the threshold was set at voxel level p1 < 0.001, and the standard SUIT atlas was used as a mask for cluster-level FWE correction, with a threshold of p2 < 0.05 after correction; Duvernoy's human brainstem and cerebellum atlas was used to determine the location of the significantly different clusters on the SUIT brainstem template.

Images