帕金森病伴焦虑患者静息态功能磁共振脑功能连接改变的研究  

A resting-state functional magnetic resonance imaging study on functional connectivity alteration of Parkinson’s disease with anxiety

作　　者：贾永锋 王建伟[1] 刘俊[1] 张克忠[2] 袁永胜[2] 王敏[1] JIA Yongfeng;WANG Jianwei;LIU Jun;ZHANG Kezhong;YUAN Yongsheng;WANG Min(Department of Radiology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China;Department of Neurology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院放射科,江苏南京210029 [2]南京医科大学第一附属医院神经内科,江苏南京210029

出　　处：《南京医科大学学报（自然科学版）》2021年第4期534-539,共6页Journal of Nanjing Medical University(Natural Sciences)

基　　金：国家自然科学基金(81671258)。

摘　　要：目的:观察帕金森病(Parkinson’s disease,PD)伴焦虑患者静息态功能连接改变,并探索PD伴发焦虑的神经病理机制。方法:收集112例PD患者以及54例健康对照者的静息态功能磁共振成像(rs-fMRI)数据,根据汉密尔顿焦虑量表(HAMA)将PD组分为PD伴焦虑(PD-A组)50例和PD不伴焦虑(PD-NA组)62例。通过协方差分析(ANCOVA)和post-hoc t检验进行体素镜像同伦连接(voxel-mirrored homotopic connectivity,VMHC)值的组间统计学比较得到PD-A组与PD-NA组的差异脑区。选取双侧杏仁核为功能连接种子点,计算双侧杏仁核与差异脑区功能连接结果,并分析功能连接值与HAMA评分的相关性。结果:PD-A组、PD-NA组和健康对照组之间的VMHC值有显著性差异,组间post-hoc t检验显示,PD-A与PD-NA相比,双侧额下回(inerior frontal gyrus,IFG)三角部及岛盖部VMHC值减低。种子点功能连接显示左侧杏仁核与左侧额下回的功能连接增强,且功能连接值与HAMA评分呈正相关。结论:PD-A患者存在异常的脑功能活动,双侧额下回的异常VMHC改变以及左侧杏仁核与左侧额下回的功能连接异常,提示额下回-杏仁核相关网络环路可能参与了焦虑的病理发生过程。Objective:To investigate the alterations of functional connectivity among Parkisnon’s disease(PD)patients with anxiety,and to explore its pathological mechanism.Methods:Totally 112 PD patients and 54 healthy controls underwent rs-fMRI scanning.According to the Hamilton anxiety scale(HAMA),112 PD patients were divided into 50 PD with anxiety group(PD-A)and 62 PD without anxiety(PD-NA).ANCOVA and post-hoc t test were performed to assess intergroup difference of voxel-mirrored homotopic connectivity(VMHC)value to obtain the abnormal brain regions.Bilateral amygdala were chosen as seeds to calculate functional connectivity with abnormal brain regions.Estimated a Pearson’s correlation coefficient between functional connectivity calculated above and HAMA scores.Results:VMHC value had significant differences among three groups,post hoc t test showed a decrease of VMHC value in bilateral inferior frontal gyri(IFG)triangular part and opercular part in PD-A group compared to the PD-NA group.Functional connectivity increased between the left amygdala and the left IFG.Furthermore,functional connectivity was positively correlated with HAMA scores.Conclusion:Abnormal brain functional activity exists in PD-A group,suggesting that anxiety in PD is associated with abormalities in IFG-amygdala loop network.

关 键 词：帕金森病 焦虑 静息态功能磁共振成像 体素镜像同伦 功能连接 杏仁核 

分 类 号：R742.5[医药卫生—神经病学与精神病学]