探讨基于定量磁化率成像在帕金森病伴焦虑患者脑深部核团中的铁沉积特征  

Exploration of iron deposition characteristics in deep brain nuclei of Parkinson’s disease patients with anxiety based on quantitative magnetic susceptibility imaging

作　　者：周亭利 李昕阳 尚丹丹 苏闻[3] 李淑华[3] 马欣昕[3] 陈敏[1] 李春媚[1] Zhou Tingli;Li Xinyang;Shang Dandan;Su Wen;Li Shuhua;Ma Xinxin;Chen Min;Li Chunmei(Department of Radiology,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Department of Radiology,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China;Department of Neurology,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]北京医院放射科,国家老年医学中心,中国医学科学院老年医学研究院,北京协和医学院,中国医学科学院,北京100730 [2]北京医院放射科,国家老年医学中心,中国医学科学院老年医学研究院,北京100730 [3]北京医院神经内科,国家老年医学中心,中国医学科学院老年医学研究院,北京100730

出　　处：《中国医刊》2025年第1期89-93,共5页Chinese Journal of Medicine

基　　金：国家自然科学基金(82071891)。

摘　　要：目的基于定量磁化率成像(QSM)技术探讨帕金森病(PD)伴焦虑的患者脑深部灰质核团中铁沉积的变化,并评估焦虑状态与脑深部灰质核团中铁沉积程度的相关性。方法前瞻性纳入2022年2月至2024年2月于北京医院神经内科就诊的PD患者,使用汉密尔顿焦虑量表(HAMA)评估PD患者的焦虑状态,根据是否伴有焦虑将研究对象分为PD不伴焦虑(PD-n)组(25例)与PD伴焦虑(PD-a)组(20例)。所有患者均通过QSM扫描获得基底节水平及中脑水平核团及小脑齿状核的磁化率值。采用Spearman相关性分析探讨所有PD患者各核团磁化率值与HAMA评分的相关性。结果PD-n组与PD-a组年龄、性别、蒙特利尔认知评估量表评分及Hoehn-Yahr分期比较差异无统计学意义(P>0.05),PD-a组HAMA评分高于PD-n组,差异有统计学意义(P<0.05)。PD-a组患者右侧红核、左侧黑质和右侧黑质的磁化率值均高于PD-n组,差异有统计学意义(P<0.05)。Spearman相关性分析结果显示,左侧红核、右侧红核、左侧黑质及右侧黑质的磁化率值与HAMA评分之间呈正相关(P<0.05)。结论PD患者焦虑的发生及焦虑程度与部分QSM所反映的脑深部灰质核团铁沉积具有相关性,QSM为解释PD患者焦虑发生的潜在机制提供潜在可能。Objective The purpose of this study is to explore the changes in iron deposition in gray matter nuclei of PD patients with anxiety compared to those without anxiety,based on quantitative susceptibility mapping(QSM)technology,and evaluate the correlation between anxiety status and iron deposition in gray matter nuclei of PD patients.Method PD patients admitted to the Department of Neurology of Beijing Hospital from February 2022 to February 2024 were prospectively included,and the anxiety status of PD patients was assessed using the Hamilton anxiety scale(HAMA).The subjects were divided into 25 cases of PD without anxiety(PD-n)group and 20 cases of PD with anxiety(PD-a)group according to whether they were accompanied by anxiety.All subjects underwent QSM scanning to obtain magnetic susceptibility values of basal ganglia,midbrain nuclei,and cerebellar dentate nucleus.Spearman correlation coefficient analysis was used to test the correlation between the magnetic susceptibility values of each nucleus and HAMA score.Result There were no statistically significant differences in age,gender,Montreal cognitive assessment scores and Hoehn-Yahr staging between the PD-n group and the PD-a group(P>0.05),while the HAMA score of the PD-a group was higher than that of the PD-n group(P<0.05).The magnetic susceptibility values of the right red nucleus,left substantia nigra and right substantia nigra in PD-a group were higher than those in PD-n group,and the difference was statistically significant(P<0.05).Spearman correlation analysis showed that the magnetic susceptibility values of left red nucleus,right red nucleus,left substantia nigra and right substantia nigra were positively correlated with HAMA scores(P<0.05).Conclusion The occurrence and severity of anxiety in PD patients are correlated with iron deposition in some deep gray matter nuclei,and QSM provides a potential explanation for the underlying mechanisms of anxiety in PD patients.

关 键 词：定量磁化率成像 帕金森病 焦虑 黑质 恐惧回路 

分 类 号：R445[医药卫生—影像医学与核医学]