帕金森病伴冻结步态静息状态脑自发活动改变的磁共振研究  

Study of Brain Spontaneous Activity Changes in Parkinson’s Disease with Freezing of Gait based on Resting-State Functional MRI

作　　者：张秋妹 李子涵 苗新欣 葛绍云 王建伟[2] 张克忠[3] 王敏[2] ZHANG Qiumei;LI Zihan;MIAO Xinxin(Department of Medical Imaging,Nanjing Central Hospital,Nanjing,Jiangsu Province 210018,P.R.China)

机构地区：[1]南京市中心医院医学影像科,210018 [2]南京医科大学第一附属医院放射科,210029 [3]南京医科大学第一附属医院神经内科,210029

出　　处：《临床放射学杂志》2024年第11期1860-1864,共5页Journal of Clinical Radiology

基　　金：国家自然科学基金资助项目(编号:82271273)。

摘　　要：目的分析伴有冻结步态(FOG)的帕金森病(PD)患者静息状态下脑自发活动的改变。方法搜集65例PD患者(31例伴有FOG和34例不伴有FOG)和35名健康对照者(HC)的静息态功能磁共振成像(rs-fMRI)数据,运用低频振幅(ALFF)算法对其脑自发活动模式进行分析,采用协方差分析和事后t检验进行统计学比较。Pearson相关检验分析伴有FOG的PD患者有统计学意义的差异脑区ALFF值与冻结步态问卷(FOGQ)评分之间的相关性。结果与HC相比,伴有FOG的PD患者的左侧丘脑、左侧楔前叶、双侧扣带回后部区域自发活动ALFF减弱,双侧眶额回、左侧顶下小叶、左侧颞中回、左侧中央后回区域自发活动ALFF增强;与不伴有FOG的PD患者相比,伴有FOG的PD患者脑自发活动ALFF增强的脑区包括右侧眶额回、右侧枕上回。Pearson相关分析显示,左侧丘脑ALFF值与FOGQ评分呈负相关(r值为-0.62,P<0.05)。结论伴有FOG的PD患者静息状态下神经元自发活动异常的脑区主要有丘脑、楔前叶、眶额回、顶下小叶等,提示FOG的产生可能与基底神经节、执行控制、默认网络等多个功能网络有关,为进一步了解PD患者FOG的病理生理机制提供一定的帮助。Objective To investigate the alterations of brain spontaneous activity in Parkinson’s disease with freezing of gait,aim to explore the neural mechanisms in the brain causing freezing of gait.Methods A total of 65 PD patients and age-and gender-matched 35 health controls(HC)were undergoing resting state functional MRI(rs-fMRI)scan.Acorrding to the FOGQ,PD patients were divided into two groups,31 PD with freezing of gait[FOG(+)]and 34 PD without freezing of gait[FOG(-)].ALFF of brain activity in different groups was calculated by data processing assistant for resting-state fMRI(DPARSF)and resting-state fMRI data analysis toolkit based on MATLAB.Analysis of covariance and post-hoc t-test were used to compare the differences of brain spontaneous activity among FOG(+),FOG(-)and HCs.Correlation analysis was performed between ALFF value of the regions showing differences and FOGQ scores respectively.Results Compared to healthy controls,PD with freezing of gait patients showed decreased ALFF values in the left thalamus,left precuneus and bilateral post cingulum,while increased ALFF values in bilateral orbital frontal gyrus,left inferior parietal gyrus,left middle temporal gyrus and left precentral gyrus.Compared to PD without freezing of gait patients,PD with freezing of gait patients exhibited increased ALFF values in the right orbital frontal gyrus and right superior occipital gyrus.Additionally,ALFF values in the left thalamus negatively correlated with FOGQ scores(r=-0.62,P<0.05).Conclusion The results demonstrate that FOG in PD is associated with abnormalities in basal ganglia,executive control and default mode network(DMN),it is helpful to understand the pathophysiological mechanism of FOG in Parkinson’s disease.

关 键 词：帕金森病 冻结步态 静息态功能磁共振成像 自发脑活动 低频振幅 

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]