帕金森病与帕金森叠加综合征MRI中脑结构测量学特点及临床相关性研究  

The MRI-based Midbrain Structure Measurements and Clinico-radiological Correlations in Parkinson’s Disease and Parkinson-plus Syndromes

作　　者：彭素丹 陈颖[1] 井秀娜[1] 梁嫣然[1] 卜超 肖颂华[1] 刘军[1] 杨炼红[1] 黄穗乔[3] 陶恩祥[1] PENG Su-dan;CHEN Ying;JING Xiu-na;LIANG Yan-ran;BU Chao;XIAO Song-hua;LIU Jun;YANG Lian-hong;HUANG Sui-qiao;TAO En-xiang(Department of neurology,Sun-Yat-Sen Memorial Hospital,Sun-Yal-Sen University,510120;Department nj radiology,The Seventh Affiliated Hospital,Sun-Yat-Sen University;Department of radiology,Sun-Yat-Sen Memorial Hospital,Sun-Yat-Sen University)

机构地区：[1]中山大学孙逸仙纪念医院神经科,510120 [2]中山大学附属第七医院放射科 [3]中山大学孙逸仙纪念医院放射科

出　　处：《岭南急诊医学杂志》2021年第5期472-474,483,共4页Lingnan Journal of Emergency Medicine

摘　　要：目的:应用MRI成像比较帕金森病(PD)、多系统萎缩(MSA)、进行性核上性麻痹(PSP)患者的中脑结构测量学指标,探讨PD临床症状与MRI中脑结构测量学指标的相关性。方法:序贯性纳入58例PD患者、25例MSA患者、7例PSP患者和49例对照者。行常规头颅MRI检查,测量中脑、黑质致密部等径线。采用MDS-UPDRSⅢ量表评估PD患者运动症状,采用非运动症状评价量表、自主神经症状量表、MMSE、HAMA、HAMD、帕金森病睡眠量表等评估PD患者非运动症状。结果:与对照组相比,PD组、MSA组、PSP组黑质致密部宽度均显著变薄(P<0.05)。MSA组、PSP组中脑前后径较PD组明显变小(P<0.05)。PD组患者运动迟缓、肌强直、中轴体征、自主神经系统症状评分均与黑质致密部宽度呈中等程度负相关(P<0.05)。结论:MRI黑质致密部变窄是PD、MSA和PSP患者共同的脑结构改变。PD患者运动迟缓、肌强直、中轴体征、自主神经系统症状的严重程度与黑质致密部萎缩有关。Objective:To explore the morphological differences of midbrainstructure in patients of Parkinson.s disease(PD),Multiple System Atrophy(MSA),Progressive Supranuclear Palsy(PSP)and control subjects,using conventional MRI;to study the correlations of PD clinical symptoms assessment with midbrain structure measurements.Methods:Fifty-eight PD patients,25 MSA patients,7 PSP patientsand 49 control subjects were successively recruited.All patients underwent conventional brain MRI scan. Linear measurements of substantia nigra pars compacta and midbrainwere measured on the imaging workstation. PD patients completed the clinical rating scales,including MDS Unified Parkinson.s Disease Rating Scale Ⅲ(MDS-UPDRS Ⅲ),Modified Hoehn-Yahr Staging,Non-Motor Symptom Assessment Scale,Scales for Outcomes in Parkinson.s disease-Assessment of Autonomic Dysfunction,MMSE,HAMD,HAMA,and Parkinson. s Disease Sleep Scale. Results:Compared with controls,patients with PD,MSA or PSP had significantly thinner substantia nigra pars compacta(P<0.05). There was significant difference in diameter of midbrainbetween patients with PD and MSA,andbetween patients with PD and PSP(P<0.05). Inthe PD group,the thickness of substantia nigra pars compacta was negatively correlated with scores of bradykinesia,rigidity,axial signs and SCOPA-AUT(P<0.05). Conclusion:Substantia nigra pars compacta became thinner was common change in the brain MRI in patients with PD, MSA and PSP. The severity of bradykinesia, rigidity, axial signs and autonomic symptomswas significantly correlated to atrophy of substantia nigra pars compacta in PD patients.

关 键 词：帕金森病 多系统萎缩 进行性核上性麻痹 黑质致密部 

分 类 号：R742.5[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]