自由水成像探究早期帕金森病多巴胺系统关键核团的改变  

Analysis of Changes in Key Nuclei of Dopamine System in Early Parkinson's Disease via Free Water Imaging

作　　者：郑谨翌 申雨 丁凯玥 魏巍 白岩 王梅云 ZHENG Jinyi;SHEN Yu;DING Kaiyue;WEI Wei;BAI Yan;WANG Meiyun(不详;Department of Radiology,Henan Provincial People's Hospital&People's Hospital of Zhengzhou University,Zhengzhou 450003,China;Biomedical Research Institute,Henan Academy of Sciences,Zhengzhou 450003,China)

机构地区：[1]新乡医学院河南省人民医院医学影像科,河南郑州450003 [2]河南省人民医学影像科,河南郑州450003 [3]河南省科学院生物医学研究所,河南郑州450003

出　　处：《中国医学影像学杂志》2025年第2期121-126,共6页Chinese Journal of Medical Imaging

基　　金：国家重点研发计划重点专项项目(2023YFC2414200);国家自然科学基金面上项目(82371934);河南省医学科技攻关计划省部共建青年项目(SBGJ202303007)。

摘　　要：目的通过自由水成像探讨早期帕金森病(PD)脑部多巴胺系统的关键基底核团中自由水(FW)的变化,揭示其与早期PD的潜在联系。资料与方法2023年2—12月在帕金森病进展标志物计划数据库中纳入早期PD患者62例及健康对照27例,同时自行招募河南省人民医院年龄、性别匹配的健康对照组25例。所有受试者均进行临床量表评估及MRI数据采集。通过自由水成像计算多巴胺系统关键核团的FW,并分析PD组与健康对照组FW的差异及PD组FW与临床量表评分的相关性。结果PD组的双侧黑质致密部(SNc)及腹侧被盖区(VTA)中FW均显著高于健康对照组(Z=2.458~3.914,P<0.05);PD组双侧SNc的FW与运动障碍学会统一帕金森病评估量表Ⅲ评分及特质焦虑量表评分(r^(2)=0.223,P<0.001;r^(2)=0.125,P=0.018;r^(2)=0.151,P=0.003;r^(2)=0.128,P=0.017)呈显著相关,左侧VTA的FW与运动障碍学会统一帕金森病评估量表Ⅲ评分(r^(2)=0.143,P=0.004)及右侧VTA的FW与特质焦虑量表评分(r^(2)=0.125,P=0.019)均呈显著相关。结论PD患者SNc及VTA的FW在早期显著升高,并与PD患者运动和非运动症状相关。FW可能反映了大脑退行性病变,这种改变可能与患者运动功能和非运动功能减退相关。Purpose To investigate the changes of free water(FW)values in the key basal ganglia of dopamine system in the brain of early Parkinson's disease(PD)by free water imaging,and to reveal the potential relationship between the changes and early PD.Materials and Methods From February to December 2023,62 patients with early PD and 27 healthy controls were enrolled in the Parkinson's Disease Progression Markers Project database,and 25 age-and sex-matched healthy controls were self-recruited from Henan Provincial People's Hospital.All subjects underwent clinical scale assessment and MRI data collection.Free water imaging was used to calculate the FW values of key nuclei in dopamine system,and the difference of FW values between PD group and healthy controls group,the correlation between FW values of PD group and clinical scale scores were analyzed.Results The FW values of compact part of substantia nigra(SNc)and ventral tegmental area(VTA)in PD group were significantly higher than those in healthy controls group(Z=2.458-3.914,all P<0.05).Regression analysis showed that FW values of SNc were correlated with the movement disorder society-sponsored revision unified Parkinson′s disease rating scale(MDS-UPDRS)Ⅲscores and state-trait anxiety inventory(STAI)scores on both sides(r^(2)=0.223,P<0.001;r^(2)=0.125,P=0.018;r^(2)=0.151,P=0.003;r^(2)=0.128,P=0.017),the FW value of VTA on the left was significantly correlated with MDSUPDRSⅢscore(r^(2)=0.143,P=0.004)and the FW value of the right VTA was significantly correlated with the STAI score(r^(2)=0.125,P=0.019).Conclusion The FW values of SNc and VTA in PD patients are significantly increased in the early stage,and are correlated with motor and non-motor symptoms in PD patients.FW values may reflect brain degeneration,and this change may be related to the decline of motor and non-motor function in patients.

关 键 词：帕金森病 弥散张量成像 自由水成像 黑质 腹侧被盖区 

分 类 号：R742.5[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]