早期偏侧帕金森病患者的脑半球间功能连接改变的初步研究  

Interhemispheric functional connectivity changes in early Parkinson disease with the symptom asymmetry

作　　者：贺娜英[1] 凌华威[1] 陈克敏[1] 张泳 丁蓓[1] 黄娟[1] 严福华[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院放射科,200025 [2]通用电气医疗集团磁共振研发部

出　　处：《中华放射学杂志》2014年第8期621-626,共6页Chinese Journal of Radiology

摘　　要：目的 采用静息态fMRI（rs-fMRI）基于体素镜像同伦连接（VMHC）方法观察偏侧帕金森病（PD）患者的脑半球间功能连接的改变情况.方法 共收集早期右侧发病PD（RPD） 16例,左侧发病PD（LPD） 15例,及年龄、性别和教育水平匹配的正常对照（HC） 19名,采集静息态fMRI数据.然后对数据进行预处理,采用协方差分析（ANCOVA）及两样本t检验比较并计算出LPD组与RPD组VMHC值改变的脑区[P＜0.05,多重比较（AlphaSim）联合簇≥16个体素校正],并对2组患者间VMHC差异脑区的脑半球间功能连接强度与临床特征进行Pearson相关分析.结果 与对照组相比,LPD组患者在视觉皮层、感觉运动皮层、小脑皮层等部位的脑半球间功能连接强度减弱（体素大小为17 ～ 77,t值为-5.06-3.42,P值均＜0.05）,而RPD组则在前额叶和感觉运动皮层的脑半球间功能连接强度降低（体素大小为26、30,t值为-4.96、-3.75,P值均＜0.05）,此外,LPD组与RPD组患者在基底节区的VMHC均升高.相对于RPD组患者,LPD组患者的VMHC在视觉皮层、感觉运动皮层减低（体素大小为16、18,t值为-3.68、-3.87,P值均＜0.05）,而在缘上回升高（体素大小为44,￡值为4.72,P＜0.05）.基于ROI的相关分析发现,在LPD组,枕下回及中央后回的VMHC与贝克抑郁自评量表（BDI-Ⅱ）呈负相关（r值分别为-0.58、-0.59,P值均＜0.05）,而与简易精神量表测试（MMSE）值呈正相关（r值分别为0.56、0.52,P值均＜0.05）.在RPD组,缘上回的VMHC与病程呈正相关（r=0.56,P＜0.05）,中央后回的VMHC与MMSE呈正相关（r=0.53,P＜0.05）.结论 PD患者的运动症状偏侧性影响到脑半球间功能连接的模式,可能对理解偏侧PD的病理生理机制提供了一个新的视角.Objective To investigate changes of the interhemispheric coordination integrity in patients with hemi-parkinsonism using resting-state functional magnetic resonance imaging（rs-fMRI） homotopy technique called voxel-mirrored homotopic connectivity（VMHC）.Methods Sixteen Parkinson disease（PD） patients with right body side motor symptom onset（RPD）,15 patients with left side onset（LPD）,and 19 age-,gender-,and education-matched healthy controls（HC） were included in this study.rs-fMRI scanning and pre-processed the raw data were performed.Then by using analysis of variance（ANOVA） and two sample t tset,we performed VMHC analyses on rs-fMRI data of these participants（P＜0.05,corrected with AlphaSim,clusters≥16 voxels）.Exploratory linear correlations analyses were performed between the VMHC of regions showing significant group differences and the clinical features of LPD or RPD patients.Results Compared with HCs,patients with LPD had significantly reduced VMHC in visual regions,sensorimotor regions,and the cerebellar cortex（voxels size of 17-77,t=-5.06--3.42,P＜0.05）.Patients with RPD exhibited decreased VMHC in the prefrontal cortex and sensorimotor regions.Both LPD and RPD groups had increased VMHC in subcortical regions.When compared with the RPD group,the LPD group displayed decreased VMHC in the visual regions,sensorimotor regions（voxels=16 and 18; t=-3.68and-3.87,respectively,both P＜0.05） and increased VMHC in the supramarginal gyrus（voxels=4,t=4.72,P＜0.05）;ROI-based correlation analyses indicated that the VMHC in the inferior occipital gyrus and the postcentral gyrus was negatively correlated with the BDI-Ⅱ scores in the LPD group（r=-0.58 and-0.59,respectively; both P＜0.05）,and positively correlated with the MMSE scores（r=0.56 and 0.52,respectively;both P＜0.05）.In the RPD group,a positive correlation was found for the VMHC in the supramarginal gyrus and the illness duration（r=0.56,P＜0.05） and for the VMHC in the postcentral gyrus and the（mini-m

关 键 词：帕金森病 磁共振成像 神经网络(计算机) 

分 类 号：R742.5[医药卫生—神经病学与精神病学]