基于静息态功能MRI对震颤型和姿势不稳/步态障碍型帕金森病功能连接改变的研究  

A Study on Resting-State Functional Connectivity MRI of Tremor-Dominant and Postural Instability Gait Disturbances Subtype Parkinson’s Disease

作　　者：王建伟[1] 贾永锋 张克忠[2] 袁永胜[2] 王敏[1] WANG Jianwei;JIA Yongfeng;ZHANG Kezhong(Department of Radiology,The First Affiliated Hospital of NanJing Medical University,Nanjing 210029,P.R.China)

机构地区：[1]南京医科大学第一附属医院放射科,南京210029 [2]南京医科大学第一附属医院神经内科,南京210029

出　　处：《临床放射学杂志》2020年第8期1487-1492,共6页Journal of Clinical Radiology

基　　金：国家自然科学基金项目资助(编号:81671258)

摘　　要：目的采用静息态功能磁共振成像(rs-fMRI)评估震颤型和姿势不稳/步态障碍型帕金森病(PD)患者的脑功能连接特点。方法搜集震颤型(TD)PD患者16例、姿势不稳/步态障碍型(PIGD)PD患者15例以及健康志愿者17名行rs-fMRI扫描,数据预处理基于Matlab 2012a平台的DPARSF软件,功能连接采用REST软件。选取壳核作为种子点,采用协方差分析和两样本Post-Hoc t检验比较TD组、PIGD组和对照组的脑功能连接差异,以P<0.05认为差异具有统计学意义。结果相较于正常对照组,TD组患者的右侧小脑6区、右侧枕下回、右侧舌回与壳核的脑功能连接增强,双侧额上回、左侧辅助运动区、右侧额中回与壳核的脑功能连接减弱;PIGD组患者的双侧颞极中部、双侧颞下回、左侧颞中回、左侧颞上回、右侧海马旁回、右侧岛叶与壳核的脑功能连接增强,左侧顶下小叶、右侧额中回与壳核的脑功能连接减弱;PIGD组和TD组比较,PIGD组的双侧颞极中部、左侧海马旁回、左侧颞中回、左侧颞上回与壳核的脑功能连接增强,双侧矩状回、双侧楔叶、双侧枕上回、右侧枕中回、右侧舌回与壳核的功能连接减弱。结论TD组与PIGD组的壳核与前额叶、边缘系统、运动感觉皮层、视觉皮层以及小脑之间有着异常的的功能连接,两组在视觉皮层和小脑方面的脑功能连接存在着差异,这可能为揭示两种PD亚型的不同病理生理机制提供新的视角。Objective To evaluate the characteristics of the brain functional connectivity(FC)of the tremor-dominant(TD)subtype and postural instability gait disturbances(PIGD)subtypes of Parkinson’s disease(PD)using resting-state functional magnetic resonance imaging(rs-fMRI).Methods 16 TDs,15 PIGDs and 17 health controls(HC)were chosen to undergo rs-fMRI scanning.The image data were mainly preprocessed with a MATLAB toolbox called DPARSF.REST software was used to process the functional connectivity.Putamen(PUT)was chosen as the seed.Analysis of variance(ANCOVA)and two sample Post-Hoc t-tests were used to compare the FC differences among TD,PIGD and HCs.Results Compared with HCs,patients with TD exhibited statistically significant increased FC with PUT in right cerebellum6,right inferior occipital gyrus and right lingual gyrus,while they showed reduced FC with PUT in bilateral superior frontal gyrus,left supplementary motor area(SMA),right middle frontal gyrus.Patients with PIGD had statistically significant increased FC with PUT in bilateral middle temporal pole,bilateral inferior temporal gyrus,left middle temporal gyrus,left superior temporal gyrus,right parahippocampal gyrus and right insular lobe,while they showed reduced FC with PUT in left inferior parietal lobule and right middle frontal gyrus.On direct comparison between TD and PIGD,patients with PIGD displayed statistically significant increased FC with PUT in bilateral middle temporal pole,left parahippocampal gyrus,left middle temporal gyrus and left superior temporal gyrus,while they showed reduced FC in the bilateral calcarine,bilateral cuneus,bilateral superior occipital gyrus,right middle occipital gyrus and right lingual gyrus.Conclusion There were statistically significant differences in FC between TD and PIGD in visual cortex and cerebellum.This may provide a new perspective to understand the pathophysiologcal mechanisms of the two subtypes of PD.

关 键 词：静息态功能磁共振成像 帕金森病 静止性震颤 姿势不稳/步态障碍 

分 类 号：R742.5[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]