帕金森病认知功能障碍患者低频振幅算法功能性磁共振研究  

Application of amplitude of low frequency fluctuation to cognitive impaired patients with Parkinson＇s disease：a resting state fMRI study

作　　者：吴学敏[1] 候亚男[1] 刘江涛[2] 张开元[2] 李坤成[2] 陈彪[1] 吴涛[1] 

机构地区：[1]首都医科大学宣武医院神经生物室,北京100053 [2]首都医科大学宣武医院核磁共振室,北京100053

出　　处：《中华行为医学与脑科学杂志》2013年第3期218-220,共3页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：国家自然科学基金资助项目（81271429）

摘　　要：目的探讨帕金森病认知功能障碍患者脑活动的改变及其意义。方法观察帕金森病认知功能障碍患者的脑血氧水平依赖信号（BOLD）的低频振幅（ALFF）改变。采集29例帕金森病患者（PD），其中16例认知功能正常组（PDCN）；13例认知功能障碍组（PDCI）以及16例健康志愿者（HC）的BOLD数据，运用ALFF算法分析，获得每个被试者的统计图，用两独立样本t检验，以P〈0．05，t〉2．05为阎值，显示PDCI相对于HC及PDCN的ALFF增高和减弱的区域，且对PD组不同脑区的ALFF与认知测试得分进行相关分析。结果与PDCN组相比，PDCI组ALFF减弱的脑区分布在在尾状核（-3，9，12）、枕叶（0，-78，-15）和内侧颞叶（42，9，-27）；而活动增强的脑区主要分布在额上叶（9，63，24）。和HC组相比，PDCI在楔前叶（12，-57，36）、顶下小叶（-42，-54，45）的活动增强；而在后侧皮质（6，-8，-18）以及尾状核（-3，9，12）的活动减弱。PD组ALFF改变的区域与蒙特利尔认知评估北京版（MoCA）以及神经心理学测试得分（包括记忆力、注意力、视空问功能以及执行功能）有显著相关性。结论PDCI静息状态下表现出异常的脑功能活动方式，这些异常活动可能与帕金森病痴呆（PDD）的产生相关。Objective To investigate the changes of amplitude of low frequency fluctuation （ALFF） of the resting state fMRI in cognitively impaired Parkinson＇ s disease patients and discuss its underling neurophysio-logical mechanism. Methods Blood oxygen level-dependent low-frequency amplitude （ALFF） in resting-state functional magnetic resonance imaging were calculated in 16 healthy controls （HC） and 29 idiopathic Parkinson＇s disease patients （ 16 of which were patients with cognitive normal, PDCN and 13 with cognitive impairment, PDCI）. The brain regions showing increased and decreased ALFF in patients were demonstrated by comparing normal subjects with 2-sample t -test with threshold of P 〈 0.05 and the analysis of the relationship between the different regions of the brain activity and cognitive function tests scores were also analyzed. Results Compared with PDCN, the PDCI patients showed decreased activity in the caudate nucleus （ - 3,9,12 ） , occipital lobe （ 0, - 78, - 15 ） and medial temporal lobe （ 42,9, - 27 ） and increased activity in the superior frontal gyrus （ 9,63,24 ）. PDCI patients showed increased activity mainly in the preeuneus and inferior parietal lobules compared with controis. Additionally, the regions with ALFF changes had significant correlations with the cognitive performance of patients as measured by Montreal cognitive test（ Beijing Version） and neuropsychological tests （including memory, attention,visuospatial functions and executive function）. Conclusion The results demonstrate that there is a specific pattern of intrinsic activity in PDCI providing insights into neurophysiological mechanisms of the Parkinson＇ s disease dementia.

关 键 词：帕金森病 认知功能障碍 静息态 低频振荡幅度 

分 类 号：R44[医药卫生—诊断学] R742[医药卫生—临床医学]