帕金森病睡眠障碍患者扩散张量成像  

Diffusion tensor imaging in Parkinson disease with sleep disorders

作　　者：李二凤[1] 杜忠德[1] 刘佳佳 刘卫国[3] 

机构地区：[1]中国人民解放军第89医院神经内科,山东潍坊261021 [2]南京市浦口医院神经内科,江苏南京210031 [3]南京医科大学附属脑科医院神经内科,江苏南京210029

出　　处：《中国医学影像技术》2015年第7期997-1001,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的采用扩散张量成像(DTI)技术观察帕金森病睡眠障碍患者大脑微结构变化。方法对40例PDSD患者(SD组)和20例PDNSD患者(NSD组)采用帕金森病相关量表评估运动症状(MS)和非运动症状(NMS),分析DTI的FA与SD的关系。结果 SD组汉密尔顿抑郁量表(HAMD)、帕金森病非运动症状(PD-NMS)筛查问卷(NMSQ)总分较NSD组高,帕金森病睡眠量表(PDSS)总分较NSD组低,差异均有统计学意义(P均<0.05);PD患者PDSS评分与HAMD、汉密尔顿焦虑量表(HAMA)、NMSQ总分呈负相关(r=-0.64、-0.63、-0.46,P均<0.01);SD组FA值较NSD组降低的脑区有右侧丘脑前辐射、左侧颞中回、左侧颞下回、右侧边缘叶、右侧下丘脑及右侧杏仁核、右扣带回纤维、右内侧丘系;SD组睡眠障碍程度与右侧丘脑前辐射FA值呈负相关(r=-0.38,P=0.04)。结论 PDSD患者参与睡眠调节的大脑微结构病变明显,病变与PDSD疾病严重程度相关。可利用DTI对病情进行评估,并可能会成为早期诊断睡眠障碍PD患者的影像学标记。Objective To explore the brain microstructure differences between Parkinson disease with and without sleep disorders（PDNSD）using diffusion tensor imaging.Methods A total of 40 consecutive PDSD outpatients（SD group）and 20 PDNSD outpatients（NSD group）were enrolled.The motor symptoms（MS）and non-motor symptoms（NMS）of the 60 patients were assessed with Parkinson disease rating scales.The relationship between FA and sleep disorder were analyzed.Results Compared with NSD group,the Hamilton rating scale for depression（HAMD）,the Parkinson disease non-motor symptoms（PD-NMS）questionnaire（NMSQ）total scores of SD group were significantly higher and Parkinson＇s disease sleep scale（PDSS）scores were lower（all P〈0.05）.The PDSS scores and HAMD,the Hamilton Anxiety Rating Scale（HAMA）and NMSQ total scores were negatively correlated（r=-0.64,-0.63,-0.46,all P〈0.01）.Compared with NSD group,brain areas of FA values were significantly lower in the right anterior thalamic radiation,the left middle temporal gyrus,the left inferior temporal gyrus,the right limbic lobe,the right hypothalamus,the right amygdaloid nucleus and the right cingulum fiber,the right medial lemniscus.The SD severity of SD group was negatively correlated with FA values of right anterior thalamic radiation（r=-0.38,P=0.04）.Conclusion Brain changes are identified in regions involved in sleep regulation,the abnormalities is associated with the SD severity.Therefore,the DTI may assess the disease progression and serve as a noninvasive early biomarker for diagnosis of sleep disorders in PD.

关 键 词：帕金森病 睡眠障碍 扩散磁共振成像 

分 类 号：R741[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]