帕金森病伴不宁腿综合征的功能磁共振研究  

A Resting-State Functional MRI Study on Parkinson's Disease with Restless Legs Syndrome

作　　者：李宗奇 刘丽沙 周慧 谭华 阮江海 许凤 陈光祥 郭晓燕 Li Zongqi;Liu Lisha;Zhou Hui(Department of Neurology,First People's Hospital of Longquanyi District,Chengdu,Sichuan 610100;Department of Neurology and Radiology,Luzhou,Sichuan 646000,China)

机构地区：[1]龙泉驿区第一人民医院神经内科,四川成都610100 [2]西南医科大学附属医院神经内科,放射科,四川泸州646000

出　　处：《四川医学》2024年第9期988-992,共5页Sichuan Medical Journal

摘　　要：目的探讨帕金森病(PD)伴不宁腿综合征(RLS)患者功能磁共振变化特征。方法选取2019年3月至2020年1月就诊于西南医科大学附属医院PD患者38例,其中PD伴RLS患者23例(PD-RLS组);PD不伴RLS患者15例(PD-nRLS组);同期健康对照者21例(HC组)。所有受试者进行静息态功能磁共振扫描,比较各组间低频振幅(ALFF)和功能连接(FC)的差异,并将PD-RLS组有意义脑区中代表FC强度的Z值与不宁腿综合征评定量表(RLSRS)评分进行相关性分析。结果①与HC组相比,PD-RLS组的左侧小脑、左侧梭状回ALFF增强;与HC组相比,PD-nRLS组的右侧边缘叶、右侧前扣带回、右侧额叶内侧面ALFF减弱;与PD-nRLS组相比,PD-RLS组的右侧顶叶、左侧顶叶、左侧楔前叶ALFF减弱。②与HC组相比,PD-RLS组的右侧小脑后叶、右侧小脑脚与尾状核之间的FC减弱;与HC组相比,PD-nRLS组的右侧颞中回与尾状核之间的FC减弱;与PD-nRLS组相比,PD-RLS组的右侧岛叶、右侧中央后回与尾状核之间的FC增强。③PD-RLS患者的右侧岛叶、右侧中央后回的Z值与RLSRS评分无显著相关性。结论PD-RLS患者双侧顶叶、左侧楔前叶、右侧岛叶、右侧中央后回等脑区神经元活动异常,提示感觉神经网络及边缘系统可能在PD伴RLS的病理生理机制中发挥重要作用。Objective To investigate characteristics of functional MRI in Parkinson's disease(PD)patients with restless legs syndrome(RLS).Methods 38 PD patients admitted in Affiliated Hospital of Southwest Medical University,from March 2019 to January 2020 were recruited.The participants were divided into PD-RLS group(n=23)and PD-nRLS group(n=15)and healthy control group(n=21).Participants were completed resting-state functional MRI.Differences of amplitude of low frequency fluctuation(ALFF)and functional connectivity(FC)were compared among the groups.The correlation between the Z value representing the strength of FC in PD-RLS group and the RLSRS score was analyzed.Results①Compared with HC group,ALFF of the left cerebellum and left fusiform gyrus in PD-RLS group were significantly increased.Compared with HC group,ALFF of right marginal lobe,right anterior cingulate gyrus and right medial frontal lobe in PD-nRLS group were significantly decreased.Compared with PD-nRLS group,ALFF of right parietal lobe,left parietal lobe and left precuneus lobe in PD-RLS group were significantly decreased.②Compared with HC group,FC between right posterior lobe of cerebellum,right cerebellar peduncle and caudate nucleus in PD-RLS group were significantly decreased.Compared with HC group,FC between the right middle temporal gyrus and caudate nucleus in PD-nRLS group was significantly decreased.Compared with PD-nRLS group,FC between right insular lobe,right posterior central gyrus and caudate nucleus in PD-RLS group were significantly increased.③There was no significant correlation between RLSRS score and Z value of right insular lobe and right central posterior gyrus in PD-RLS patients.Conclusion The abnormal activities of neurons in bilateral parietal lobe,left precuneus lobe,right insular lobe and right posterior central gyrus in PD-RLS patients indicate that sensory network and limbic system may play an important role in the pathophysiological mechanism of Parkinson's disease with restless legs syndrome.

关 键 词：帕金森病 不宁腿综合征 功能磁共振 低频振幅 功能连接 

分 类 号：R742.5[医药卫生—神经病学与精神病学]