帕金森病脑多巴胺转运体分布、葡萄糖代谢及临床症状评分的相关性  

Correlations between striatal dopamine transporter distribution, glucose metabolism and clinical symptoms in Parkinson′s disease

作　　者：焦方阳 陶俊 孙金菊 章昊苏 罗一 温建良 赵振凡 许志强 金榕兵 Jiao Fangyang;Tao Jun;Sun Jinju;Zhang Haosu;Luo Yi;Wen Jianliang;Zhao Zhenfan;Xu Zhiqiang;Jin Rongbing(Department of Nuclear Medicine, Daping Hospital, Army Medical University, Chongqing 400042, China;Neurochirurgische Klinik und Poliklinik, Technische Universitat München, Klinikum rechts der Isar, München 2281675, Germany;Department of Neurology, Daping Hospital, Army Medical University, Chongqing 400042, China)

机构地区：[1]陆军军医大学大坪医院核医学科,重庆400042 [2]慕尼黑工业大学附属伊萨河右岸医院神经外科,德国慕尼黑2281675 [3]陆军军医大学大坪医院神经内科,重庆400042

出　　处：《中华核医学与分子影像杂志》2019年第6期349-355,共7页Chinese Journal of Nuclear Medicine and Molecular Imaging

摘　　要：目的探讨帕金森病(PD)患者脑内多巴胺转运体(DAT)分布、葡萄糖代谢及临床症状评分的相关性。方法收集2015年1月至2016年12月间行11C-2β-甲氧甲酰-3β-(4-氟苯基)托烷(CFT)及18F-脱氧葡萄糖(FDG)PET显像且经临床确诊的25例原发性PD患者[男17例、女8例,年龄(59.8±9.2)岁]资料,采用Pearson相关分析分别在整体和体素水平评价PD患者脑内DAT分布、葡萄糖代谢及临床指标之间的相关性。结果PD相关脑代谢网络模式(PDRP)值与统一PD评分量表(UPDRS)运动评分、非运动症状评分量表(NMSS)评分、日常生活能力评分量表(ADL)评分之间呈正相关(r=0.580、0.522、0.557,均P<0.05)。起病侧尾状核、前壳核、后壳核CFT摄取值与UPDRS运动评分呈负相关(r=-0.496、-0.492、-0.457,均P<0.05),与NMSS评分无相关性(r=-0.420、-0.402、-0.355,均P>0.05),起病侧尾状核、前壳核CFT摄取值与ADL评分呈负相关(r=-0.502、-0.522,均P<0.05);起病对侧尾状核、前壳核、后壳核CFT摄取值与PDRP值、UPDRS运动评分、NMSS评分、ADL评分无相关性(r=-0.466^-0.129,均P>0.05)。全脑CFT放射性计数与UPDRS运动评分、ADL评分主要在左侧壳核及尾状核呈负相关(r值:-0.90^-0.47,均P<0.05);全脑相对葡萄糖代谢与各临床症状评分间存在不同的相关性脑区;全脑相对葡萄糖代谢与CFT摄取值主要在双侧尾状核呈正相关(r值:0.47~0.90,均P<0.01),在双侧中央前回、壳核及岛叶呈负相关(r值:-0.90^-0.47,均P<0.01)。结论PD患者脑内多巴胺能功能障碍、葡萄糖代谢变化及临床表现之间存在复杂的相关关系,这可能有助于正确理解PET显像在PD中的作用,并为PD的发病机制研究提供更多证据。Objective To investigate the correlations among striatal dopamine transporter (DAT) distribution, glucose metabolism and Parkinson′s disease (PD) clinical symptoms. Methods Twenty-five clinically confirmed idiopathic PD patients (17 males, 8 females, age:(59.8±9.2) years) who underwent 11C-2-beta-carbomethoxy-3-beta-(4-fluorophenyl)tropane (CFT) and 18F-fluorodeoxyglucose (FDG) PET imaging from January 2015 to December 2016 were reviewed. The detailed clinical scores were systematically collected from all patients. Correlations between DAT distribution, glucose metabolism and clinical symptoms were evaluated at global and voxel levels using Pearson correlation analysis. Results There were significantly positive correlations between the PD-related pattern (PDRP) value and unified PD rating scale (UPDRS) motor scores, non-motor symptoms scale (NMSS) scores, activity of daily living scale (ADL) scores (r values: 0.580, 0.522, 0.557, all P<0.05). The CFT uptake of ipsilateral caudate nucleus, anterior putamen, and posterior putamen were negatively correlated with UPDRS motor scores (r values:-0.496,-0.492,-0.457, all P<0.05), while those had no significant correlations with NMSS scores (r values:-0.420,-0.402,-0.355, all P>0.05). The CFT uptake of ipsilateral caudate nucleus and anterior putamen were negatively correlated with ADL scores (r values:-0.502,-0.522, both P<0.05). There were no significant correlations between CFT uptake in contralateral striatal, anterior putamen, posterior putamen and PDRP values, UPDRS motor scores, NMSS scores and ADL scores(r values: from -0.466 to -0.129, all P>0.05). The presence of the significant correlations between UPDRS motor scores, ADL scores and the CFT radioactive count were confirmed in left caudate nucleus and left putamen (r values: from -0.90 to -0.47, all P<0.05). The metabolic PET imaging disclosed a set of brain regions correlating with the clinical symptoms. The presence of significant correlations between the metabolic PET imaging and CFT uptake were confirmed

关 键 词：帕金森病 多巴胺质膜转运蛋白质类 体征和症状 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]