原发性帕金森病患者脑类淋巴系统功能与抑郁症状的相关性  

Correlation between depression symptoms and function of brain glymphatic system of patients with idiopathic Parkinson′s disease

作　　者：秦驰 王伊霖 程亮星[3] 王玖琦 滕军放[1,2] QIN Chi;WANG Yilin;CHENG Liangxing;WANG Jiuqi;TENG Junfang(Department of Neurology,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052;Key-Disciplines Laboratory for Clinical Medicine of Henan Province,Zhengzhou 450052;Editorial Board of Journal of Basic and Clinical Oncology,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052)

机构地区：[1]郑州大学第一附属医院神经内科,郑州450052 [2]河南省高等学校临床医学重点学科开放实验室,郑州450052 [3]郑州大学第一附属医院《肿瘤基础与临床》编辑部,郑州450052

出　　处：《郑州大学学报（医学版）》2023年第5期618-622,共5页Journal of Zhengzhou University(Medical Sciences)

基　　金：国家自然科学基金面上项目(82171248)。

摘　　要：目的:评估原发性帕金森病(PD)合并抑郁患者脑类淋巴系统形态学及引流功能的改变及其临床意义。方法:35例原发性PD合并抑郁患者(PD+D组)、36例PD不合并抑郁患者(PD组)及32例正常对照纳入研究。行MRI检查,在T2WI的轴向图像上分析额叶皮层和基底节区血管周围间腔(PVS)相对面积,并分析PD+D组PVS相对面积与汉密尔顿抑郁量表(HAMD)评分的相关性;使用3.0T动态增强MRI的T2W1轴向图像分析额叶所有PVS的浓度-时间曲线(CTC)特征性参数,采用K-means聚类算法基于洗入率和峰浓度对CTC进行聚类分析。结果:在额叶和基底节区,PD组PVS相对面积大于正常对照组,PD+D组大于PD组(P<0.05)。PD患者额叶和基底节区PVS相对面积与HAMD评分均呈正相关,r_(P)=0.571(P=0.004)和r_(P)=0.622(P=0.002)。CTC聚类为两型,Ⅰ型CTC斜率较Ⅱ型更陡峭,峰浓度更高。PD+D组Ⅰ型CTC占比(0.30±0.09)高于PD组(0.18±0.04),P<0.05。结论:类淋巴引流功能受损可能在原发性PD患者抑郁症状的发生及进展中发挥重要作用。Aim:To evaluate the morphological change and drainage function of brain glymphatic system in patients with idiopathic Parkinson′s disease(PD)and depression,and explore its clinical significance.Methods:A total of 35 idiopathic PD patients with depression(PD+D group),36 PD patients without depression(PD group)and 32 normal controls were included in the study.Through MRI examination,the relative area of perivascular space(PVS)in the frontal cortex and the basal ganglia was calculated on the axial images of T2WI,respectively.The correlation between the relative area of PVS and Hamilton depression scale(HAMD)score in PD+D group was analyzed.The characteristic parameters of concentration-time curve(CTC)of all PVSs in the frontal cortex were obtained on the axial images of T2WI by 3.0T dynamic contrast-enhanced MRI,and K-means clustering algorithm based on washing rate and peak concentration of CTCs was used for clustering analysis.Results:The relative area of PVSs in the frontal cortex and the basal ganglia in PD+D group was larger than that of PD group,and that in PD group was larger than that in normal control group(P<0.05).The relative area of PVSs in the frontal cortex and the basal ganglia in PD+D group were positively correlated with HAMD score,r_(P) was 0.571 and 0.622(P=0.004,0.002).CTCs was clustered into 2 types,TypeⅠhad steeper slope and higher peak concentration than TypeⅡ.The proportion of TypeⅠCTCs in PD+D group(0.30±0.09)was higher than that(0.18±0.04)in PD group(P<0.05).Conclusion:The brain glymphatic drainage function is impaired,which may play an important role in the onset and progression of depressive symptoms in patients with idiopathic PD.

关 键 词：帕金森病 抑郁症 类淋巴系统 动态增强磁共振 

分 类 号：R742.5[医药卫生—神经病学与精神病学]