帕金森病伴疲劳患者的大脑功能与结构磁共振成像研究  

Functional and Structural Magnetic Resonance Imaging Study in Parkinson's Disease Patients with Fatigue

作　　者：鲍奕清 王二磊[1] 邹楠 王孟璞 亚洋 伋立荣 彭佳雯 毛成洁[2] 范国华[1] BAO Yiqing;WANG Erlei;ZOU Nan(Department of Radiology,The Second Affiliated Hospital of Soochow University,Suzhou,Jiangsu Province 215004,P.R.China)

机构地区：[1]苏州大学附属第二医院影像科,215004 [2]苏州大学附属第二医院神经内科,215004 [3]浙江省精神疾病临床医学研究中心,温州医科大学附属康宁医院,温州325000

出　　处：《临床放射学杂志》2024年第8期1265-1270,共6页Journal of Clinical Radiology

基　　金：江苏省老年健康科研项目(编号:LKZ2022009);苏州市科技发展计划项目(编号:SKY2022011);苏州市医学会“影像医星”科技立项项目(编号:2022YXM03)。

摘　　要：目的探究帕金森病(PD)伴疲劳(PDF)患者功能与结构异常。方法纳入PDF患者32例,PD不伴疲劳组(nPDF)32例,健康对照组(NCs)36名。采用低频振幅(ALFF)方法分析三组脑区神经元活动,并结合基于体素的形态学测量方法来观察三组间的灰质体积(GMV)。将各影像指标与疲劳评分进行相关性分析。结果较于nPDF组和NCs组,PDF组在两侧楔前叶,右侧丘脑/尾状核(THA/CAU),左侧丘脑/海马(THA/HIP)和右侧罗兰迪克岛盖/壳核/脑岛(ROL/PUT/INS)的ALFF值降低;在右侧海马/杏仁核/壳核(HIP/AMYG/PUT)和左侧颞极(颞上回)/杏仁核/壳核(TPOsup/AMYG/PUT)的GMV降低。此外,PDF组疲劳严重程度量表(FSS)评分与左侧THA/HIP和右侧THA/CAU的ALFF值,右侧HIP/AMYG/PUT和左侧TPOsup/AMYG/PUT的GMV值呈负相关。结论PDF患者边缘区域、丘脑、基底节区和顶颞叶的功能以及结构异常可能与PDF的发生发展有关。Objective This study aims to investigate the functional and structural abnormalities in Parkinson's disease patients with fatigue(PDF).Methods A total of 32 PDF patients,32 Parkinson's disease patients without fatigue(nPDF),and 36 normal controls(NCs)were included.The amplitude of low⁃frequency fluctuation(ALFF)method was utilized to analyze neuronal activity,while the voxel⁃based morphometry method was employed to observe gray matter volume(GMV)in the three groups.Finally,the correlation between imaging indicators and FSS scores was examined.Results Compared to nPDF and NCs group,significantly decreased ALFF values in the PDF group were observed in the bilateral precuneus,the right thalamus/caudate nucleus(THA/CAU),the left thalamus/hippocampus(THA/HIP)and the right rolandic operculum/putamen/insula;Gray matter atrophy was found in the right hippocampus/amygdala/putamen(HIP/AMYG/PUT)and the left temporal pole(superior temporal gyrus)/amygdala/putamen(TPOsup/AMYG/PUT).In addition,FSS scores in the PDF group were negatively correlated with the ALFF values in the left THA/HIP and right THA/CAU,as well as the GMV values in the right HIP/AMYG/PUT and left TPOsup/AMYG/PUT.Conclusion The abnormal function and structure in the limbic lobe,thalamus,basal ganglia and parietotemporal lobe may be implicated in the occurrence and progression of PDF.

关 键 词：帕金森病 疲劳 功能磁共振成像 低频振幅 基于体素的形态学分析 

分 类 号：R742.5[医药卫生—神经病学与精神病学]