扩散张量成像对早期帕金森病轻度认知障碍高危患者脑白质微结构改变的纵向分析  

White Matter Microstructural in High-Risk Individuals of Mild Cognitive Impairment in Early-Stage Parkinson’s Disease:A Longitudinal Analysis of Diffusion Tensor Imaging

作　　者：赵晓岩 张维[1] 钟维佳[1] 郭大静[1] 李传明 周治明[1] 周百万 吴小佳[1] ZHAO Xiaoyan;ZHANG Wei;ZHONG Weijia(Department of Radiology,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,P.R.China)

机构地区：[1]重庆医科大学附属第二医院放射科,400010

出　　处：《临床放射学杂志》2021年第6期1045-1049,共5页Journal of Clinical Radiology

基　　金：重庆市卫生计划生育委员会面上项目基金资助项目(编号:2017MSXM030)。

摘　　要：目的探讨早期帕金森病轻度认知障碍(PD-MCI)高危患者脑白质微结构的纵向改变。方法采用扩散张量成像(DTI)及认知量表对来自PPMI数据库的83例认知正常PD(PD-NC)患者进行4年的随访,其中26例进展为PD-MCI(NC-MCI组),57例认知保持正常(NC-stable组)。采用基于纤维束示踪的空间统计分析(TBSS)研究脑白质微结构改变,横向分析两组间各向异性分数(FA)值的差异,并纵向比较NC-MCI组在基线与随访2次测量之间的FA值变化以及与认知评分的相关性。最后,对相关性分析阳性的纤维束FA差值进行向前逐步逻辑回归分析。结果与NC-stable组比较,基线期NC-MCI组右侧前放射冠的FA值减低(P<0.05),随访期NC-MCI组放射冠、胼胝体体部、外囊及丘脑后辐射的FA值减低(P<0.05);NC-MCI组随访期前放射冠、外囊、胼胝体及上纵束的FA值较基线减低(P<0.05);此外,NC-MCI组前放射冠和胼胝FA值的纵向减低与数字字母排序测试(LNS)和符号数字模式测试(SDM)评分的下降呈正相关(P<0.05);逻辑回归分析结果显示,右侧前放射冠FA值降低是NC-MCI向MCI进展的危险因素。结论在PD-MCI诊断前,PD-MCI高危患者的白质微结构发生改变,并可作为早期PD认知功能下降的潜在影像学标志物。Objective To investigate the longitudinal changes of white matter microstructure in high-risk patients with early Parkinson’s disease with mild cognitive impairment(PD-MCI).Methods Diffusion tensor imaging(DTI)and cognitive scale were used to follow up 83 cognitively normal PD(PD-NC)patients from the PPMI database for 4 years,of which 26 cases progressed to PD-MCI(NC-MCI group),the cognition of 57 cases remained normal(NC-stable group).Using fiber bundle tracing-based spatial statistical analysis(TBSS)to study brain white matter microstructure changes,horizontal analysis of the difference in anisotropy score(FA)between the two groups,and longitudinal comparison of NC-MCI group at baseline and follow-up 2 measurements.The change in FA value between and the correlation with cognitive score.Finally,the forward stepwise logistic regression analysis was performed on the FA difference of the fiber bundles with positive correlation analysis.Results Relative to NC-stable group,NC-MCI group showed decreased FA in the right anterior corona radiata(ACR)at baseline(P<0.05),and decreased FA in the ACR,corpus callosum(CC),external capsule(EC)and posterior thalamic radiation at 4-year follow-up(P<0.05).The NC-MCI group demonstrated a longitudinal decreased FA in the ACR,CC,EC and left superior longitudinal fasciculus(P<0.05).Moreover,the decline of Letter–Number Sequencing(LNS)and Symbol-Digit Modalities(SDM)scores were associated with decreased FA of the ACR and CCfibers.Logistic regression analysis showed that decreased FA in the ACR could be a predictor of conversion from a high-risk MCI to PD-MCI.Conclusion For high-risk PD-MCI individuals,the white matter microstructural integrity deterioration may represent potential imaging biomarkers of cognitive decline in early-stage PD patient.

关 键 词：轻度认知障碍 帕金森病 扩散张量成像 基于纤维束示踪的空间统计分析 

分 类 号：R445.2[医药卫生—影像医学与核医学] R742.5[医药卫生—诊断学]