额颞叶和小脑及感觉运动区局部的度中心度值异常与帕金森患者冻结步态有关  

Abnormal degree centrality values in the frontotemporal lobe,cerebellum and sensorimotor regions are associated with gait freezing in Parkinson's patients

作　　者：汤伟 徐倩 高婷婷 董辽 杨光[1] 杜小霞 陈伟[2] TANG Wei;XU Qian;GAO Tingting;DONG Liao;YANG Guang;DU Xiaoxia;CHEN Wei(Shanghai Key Laboratory of Magnetic Resonance,Department of Physics,East China Normal University,Shanghai 200062,China;Department of Neurology,Shanghai Ninth People's Hospital Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China;School of Psychology,Shanghai University of Sport,Shanghai 200438,China)

机构地区：[1]华东师范大学物理与电子科学学院,上海市磁共振重点实验室,上海200062 [2]上海交通大学医学院附属第九人民医院神经内科,上海200011 [3]上海体育学院心理学院,上海200438

出　　处：《磁共振成像》2022年第7期84-89,共6页Chinese Journal of Magnetic Resonance Imaging

基　　金：国家自然科学基金(编号:82071282);上海交通大学医学院附属第九人民医院学科特色生物样本库项目(编号:YBKB202120)。

摘　　要：目的本研究运用静息态功能磁共振成像(resting-state functional magnetic resonance imaging,rs-fMRI)探讨伴有冻结步态(freezing of gait,FOG)的帕金森病(Parkinson's disease,PD)患者静息态指标度中心度(degree centrality,DC)的变化特点,并探究FOG产生的病理生理学机制。材料与方法招募17例伴有冻结步态的帕金森病患者(PD with FOG,FOG+),36例无冻结步态的帕金森病患者(PD without FOG,FOG-)和44例健康对照(healthy controls,HC),所有被试均接受rs-fMRI扫描。通过静息态数据计算FOG+、FOG-和HC三组人群的DC值。F检验得到三组间差异具有统计学意义的脑区。双样本t检验比较FOG+、FOG-和HC三组人群两两之间的差异。统计阈值为体素水平P<0.001,团块水平经过整体误差(familywise error rate,FWE)多重比较校正,且团块体素>20。提取组间差异有统计学意义的脑区DC值分别与17项汉密尔顿抑郁量表(17-item Hamilton Rating Scale for Depression,HAMD-17)得分和FOG问卷得分进行相关分析。结果F检验结果表明三组间的主效应在右侧中央前回,右侧中央后回,右侧岛叶,右侧额内侧回,右侧顶上小叶,右侧额叶Sub-Gyral。进一步双样本t检验表明,与HC组相比,FOG+组DC值在右侧额内侧回、左侧中央前回、右侧颞上回显著降低;而在左侧额上回、右侧额上回显著升高。和HC组相比FOG-组DC值在左侧额上回,右侧小脑Ⅸ小叶区的显著升高,在右侧中央后回、左侧中央后回、右侧额上回、左侧中央前回、左侧外核的显著降低。此外,相关性分析显示FOG+组的FOG问卷得分与左侧中央前回、右侧颞上回DC值呈正相关(r=0.574,P=0.020;r=0.506,P=0.046);HAMD-17得分与右侧额内侧回呈正相关(r=0.547,P=0.028)。结论额叶、中央前回、中央后回、颞叶和小脑局部的DC值异常可能与PD患者FOG的发生密切相关。Objective:The purpose of this study is to investigate the changes of degree centrality(DC)in Parkinson's disease(PD)patients with freezing of gait(FOG)by resting-state functional magnetic resonance imaging(rs-fMRI)and to explore the pathological mechanism of FOG.Materials and Methods:A total of 17 patients with PD with FOG(FOG+),36 patients with PD without FOG(FOG-),and 44 healthy controls(HC)were recruited.All subjects underwent rs-fMRI scanning.Calculate the DC values of FOG+,FOGand HC from the resting-state data.The brain regions with statistically significant difference among the three groups were obtained by F test.Two sample t-test was used to compare the differences among FOG+,FOG-and HC.The results were assigned thresholds at P<0.001(voxel level)and Familywise error rate(FWE)corrected to P<0.05 at the cluster level and cluster size>20.The DC values of brain regions with statistically significant differences among groups were extracted and correlated with the scores of 17-item Hamilton Rating Scale for Depression(HAMD-17)and FOG questionnaire.Results:The results showed that the main effects among the three groups were in the right anterior central gyrus,the right posterior central gyrus,the right insula,the right medial frontal gyrus,the right superior parietal lobule,and the right frontal lobe sub-gyral.Further two-sample analysis showed that compared with the HC group,DC value in the FOG+group significantly decreased in the right medial frontal gyrus,left precentral gyrus,and right superior temporal gyrus;However,in the left superior frontal gyrus and the right superior frontal gyrus,there was a significant increase.Compared with the HC group,DC value in the FOG group increased significantly in the left superior frontal gyrus,right cerebellarⅨlobule area,and decreased significantly in the right central posterior gyrus,left central posterior gyrus,right superior frontal gyrus,left central anterior gyrus and left external nucleus.In addition,the correlation analysis showed that the FOG questionnaire scor

关 键 词：帕金森病 冻结步态 度中心度 磁共振成像 

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]