帕金森病认知障碍额叶及扣带回前部的磁共振波谱改变  

Changes in Magnetic Resonance Spectroscopy of Frontal lobe and Anterior Cingulate Cortex in Cognitive Lmpairment in Parkinson's Disease

作　　者：潘晓波[1] 卓文燕[1] 杜中立[1] 杨建豪[1] 陈超[1] 

机构地区：[1]珠海市人民医院神经内科,广东珠海519000

出　　处：《南昌大学学报（医学版）》2014年第5期50-53,共4页Journal of Nanchang University：Medical Sciences

摘　　要：目的利用质子磁共振波谱(1 H-MRS)技术,研究帕金森病认知障碍(PD-CIND)患者额叶及扣带回前部的变化,并探讨其病因。方法选取帕金森病(PD)患者33例(MOCA评分≥26分,PD组),PD-CIND患者22例(MOCA评分<26分,PD-CIND组)和健康对照组(HC组)20例,均行1 H-MRS检查,测定脑部扣带回前部、额叶区的N-乙酰天门冬氨酸/肌酸(NAA/Cr)和胆碱复合物/肌酸(Cho/Cr)的比值。结果患肢对侧额叶、扣带回前部的NAA/Cr比值:PD和PD-CIND组均低于HC组(均P<0.05),PD-CIND组低于PD组(P<0.05);患肢同侧额叶NAA/Cr比值3组间差异无统计学意义(P>0.05);患肢同侧扣带回前部的NAA/Cr比值:PD-CIND组低于PD组(P<0.05),PD和HC组比较差异无统计学意义(P>0.05);双侧额叶、扣带回前部的Cho/Cr比值3组间比较差异均无统计学意义(均P>0.05)。结论 1 H-MRS可以检测到PD-CIND患者额叶及扣带回前部的代谢改变,有助于PD-CIND的病因诊断及风险预测。Objective To study the changes in frontal lobe and anterior cingulate cortex in cog-nitive impairment in Parkinson’s disease（PD-CIND）using proton magnetic resonance spectrosco-py（1 H-MRS）technique,and to investigate the etiology.Methods The 1 H-MRS was performed to determine the N-acetylaspartate（NAA）/creatine（Cr）ratio and cholinecompound （Cho）/Cr ratio in frontal lobe and anterior cingulate cortex in 33 patients with PD（PD group,MOCA≥26）,22 patients with PD-CIND（PD-CIND group,MOCA score〈26）and 20 healthy controls（HC group）. Results Compared with PD group,NAA/Cr ratio in contralateral frontal lobe and anterior cingu-late cortex increased in HC group but decreased in PD-CIND group（P〈0.05）.There were no sig-nificant differences in NAA/Cr ratio in ipsilateral frontal lobe among the three groups（P〉0.05）. Furthermore,NAA/Cr ratio in ipsilateral anterior cingulate cortex in PD-CIND group was less than that in PD group（P〈0.05）.No significant differences in NAA/Cr ratio in ipsilateral anteri-or cingulate cortex were found between PD group and HC group（P〉0.05）.In addition,there were no significant differences in Cho/Cr ratio in bilateral frontal lobe and anterior cingulate cor-tex among the three groups（P〉0.05）.Conclusion The 1 H-MRS can detect the metabolic chan-ges in frontal lobe and anterior cingulate cortex in patients with PD-CIND.Therefore,1 H-MRS is helpful for etiology diagnosis and risk prediction of PD-CIND.

关 键 词：帕金森病 认知障碍 质子磁共振波谱 额叶 扣带回前部 

分 类 号：R749.1[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]