伴视空间工作记忆障碍的早期帕金森病18F-FDG PET显像脑葡萄糖代谢特点  

Characteristics of brain glucose metabolism on 18F-FDG PET imaging in patients with early Parkinson's disease accompanied by visuospatial working memory impairment

作　　者：李修明 刘丰韬 张宇燕 谭海波 Li Xiuming;Liu Fengtao;Zhang Yuyan;Tan Haibo(PET Center,Huashan Hospital,Fudan University,Shanghai 200235,China;Department of Neurology, Huashan Hospital,Fudan University,Shanghai 200040,China;Department of Ophthalmology,Huashan Hospital,Fudan University,Shanghai 200040,China)

机构地区：[1]复旦大学附属华山医院PET中心,上海200235 [2]复旦大学附属华山医院神经内科,上海200040 [3]复旦大学附属华山医院眼科,上海200040

出　　处：《中华核医学与分子影像杂志》2019年第1期10-14,共5页Chinese Journal of Nuclear Medicine and Molecular Imaging

基　　金：上海市自然科学基金(15ZR1405400);上海市卫生与计划生育委员会科研课题(201440596).

摘　　要：目的用18F-脱氧葡萄糖(FDG)PET显像研究伴有视空间工作记忆障碍的早期帕金森病(PD)患者脑葡萄糖代谢特点。方法研究对象为2015年1月至2017年3月的早期PD患者[伴视空间工作记忆障碍组,男14例,女6例,年龄(55.7±6.7)岁;无视空间工作记忆障碍组,男13例,女7例,年龄(55.7±8.5)岁]及健康对照[男14名,女6名,年龄(54.6±6.4)岁]。受试者均行18F-FDGPET显像,获得脑葡萄糖代谢图像。应用统计参数图(SPM)进行数据分析,比较各组脑葡萄糖代谢变化的差异和特点。结果与健康对照组比较,早期PD患者在壳核、苍白球、丘脑、脑桥、小脑和初级运动皮质区均表现为葡萄糖代谢明显增强,而枕叶及颞叶部分脑区代谢减低(Zmax:3.19~6.86,t:2.11~9.96,均P<0.001)。有视空间工作记忆障碍早期PD患者与无视空间工作记忆障碍患者相比,出现了双侧背外侧额前回、双侧后顶叶等视觉处理中枢葡萄糖代谢减低区。结论伴视空间工作记忆障碍的早期PD患者脑内视觉通道葡萄糖代谢异常可能是其视空间工作记忆障碍的原因之一。Objective To assess the characteristics of brain glucose metabolism in patients with early Parkinson's disease(PD)accompanied by visuospatial working memory impairment using 18F-fluorodeoxyglucose(FDG)PET imaging.Methods Between January 2015 and March 2017,early PD patients with visuospatial working memory impairment(14 males,6 females,age:(55.7±6.7)years),early PD patients without visuospatial working memory impairment(13 males,7 females,age:(55.7±8.5)years)and healthy controls(14 males,6 females,age:(54.6±6.4)years)were included.Resting-state 18F-FDG PET was performed to obtain the brain glucose metabolism.Subsequently,statistical parametric mapping(SPM)was used to compare the brain glucose metabolic changes among different groups.Results Compared with the control group,hypermetabolism was observed in putamen,globus pallidus,thalamus,pons,cerebellum and primary motor cortex and hypometabolism was found in part of the occipital and temporal lobe in the groups of early PD(Zmax values:3.19-6.86,t values:2.11-9.96,all P<0.001).The PD group with visuospatial working memory impairment had hypometabolism regions in bilateral lateral prefrontal cortex and posterior parietal cortex compared with the group without visuospatial working memory impairment.Conclusion Abnormal metabolism of glucose in visual processing channels of brain in early PD patients may be one of the causes of visuospatial working memory impairment.

关 键 词：帕金森病 视觉障碍 记忆障碍 记忆 短时 正电子发射断层显像术 脱氧葡萄糖 

分 类 号：R742.5[医药卫生—神经病学与精神病学] R817.4[医药卫生—临床医学]