The asymmetry of neural symptoms in Wilson's disease patients detecting by diffusion tensor imaging, resting‐state functional MRI , and susceptibility‐weighted imaging

Objective To investigate the cause of the motor asymmetry in Wilson's disease ( WD ) patients using functional MRI . Methods Fifty patients with WD and 20 age‐matched healthy controls were enrolled. Neurological symptoms were scored using the modified Young Scale. All study subjects underwent diffusion tensor imaging ( DTI ), susceptibility‐weighted imaging ( SWI ), and resting‐state functional MRI (rs‐ fMRI ) of the brain. Six regions of interest ( ROI ) were chosen. Fiber volumes between ROI s on DTI , corrected phase ( CP ) values on SWI , amplitude of low‐frequency fluctuation ( ALFF ), and regional homogeneity ( REHO ) values on rs‐ fMRI were determined. Asymmetry index (right or left value/left or right value) was evaluated. Results Asymmetry of rigidity, tremor, choreic movement, and gait abnormality (asymmetry index = 1.33, 1.39, 1.36, 1.40), fiber tracts between the GP and substantia nigra ( SN ), GP and PU , SN and thalamus ( TH ), SN and cerebellum, head of the caudate nucleus ( CA ) and SN , PU and CA , CA and TH , TH and cerebellum (asymmetry index = 1.233, 1.260, 1.269, 1.437, 1.503, 1.138, 1.145, 1.279), CP values in the TH , SN (asymmetry index = 1.327, 1.166), ALFF values, and REHO values of the TH (asymmetry index = 1.192, 1.233) were found. Positive correlation between asymmetry index of rigidity and fiber volumes between the GP and SN , SN and TH ( r  = .221, .133, p  = .043, .036), and tremor and fiber volumes between the CA and TH ( r  = .045, p  = .040) was found. Conclusions The neurological symptoms of patients with WD were asymmetry. The asymmetry of fiber projections may be the main cause of motor asymmetry in patients with WD .