伴随可能快速眼动睡眠行为障碍帕金森病患者的性别特异性脑形态及网络差异研究  

Sex-specific brain morphology and network differences in Parkinson's disease patients with probable rapid eye movement sleep behavior disorder

作　　者：刘阳 张鹏飞 李昊 周亮 姜婧琪 姜艳丽[1,2,3] 杨文霞 张静 LIU Yang;ZHANG Pengfei;LI Hao;ZHOU Liang;JIANG Jingqi;JIANG Yanli;YANG Wenxia;ZHANG Jing(Second Clinical School,Lanzhou University,Lanzhou 730030,China;Department of Magnetic Resonance,Lanzhou University Second Hospital,Lanzhou 730030,China;Gansu Province Clinical Research Center for Functional and Molecular Imaging,Lanzhou 730030,China;Gansu Medical MRI Equipment Application Industry Technology Center,Lanzhou 730030,China)

机构地区：[1]兰州大学第二临床医学院,兰州730030 [2]兰州大学第二医院核磁共振科,兰州730030 [3]甘肃省功能及分子影像临床医学研究中心,兰州730030 [4]甘肃省医用核磁共振装备应用行业技术中心,兰州730030

出　　处：《磁共振成像》2025年第3期1-9,17,共10页Chinese Journal of Magnetic Resonance Imaging

基　　金：国家自然科学基金项目(编号:81960309);甘肃省科技计划项目(编号:21JR7RA438)。

摘　　要：目的探讨帕金森病(Parkinson's disease,PD)患者在不同亚组中形态学改变模式的性别差异。材料与方法从帕金森病进展标记计划数据库共获取278名参与者的高分辨率T1加权磁共振成像和临床量表数据。以快速眼动睡眠行为障碍(rapid eye movement sleep behavior disorder,RBD)筛查问卷的5分为截止点,分为PD-pRBD(≥5分)和PDnonRBD(<5分),最后被试包括93名PD-pRBD患者和114名PDnonRBD患者以及71名健康对照(healthycontrol,HC)。计算解剖学工具箱12(Computational Anatomy Toolbox 12,CAT12)用于获取灰质体积和皮层形态学指标数据,随后基于皮层形态学指标构建个体水平的形态学相似性网络。最后用图论分析的方法计算网络拓扑属性。结果PD-pRBD组中,男性额叶和颞叶的灰质体积(gray matter volume,GMV)低于女性(P=0.008、0.002),而女性额叶的回旋指数(gyrification index,GI)低于男性(P=0.024)。PDnonRBD组中,男性额叶的GI比女性低(P=0.009)。基于图论的网络分析显示,男性PD-pRBD患者较女性患者表现更低的网络信息整合能力,特别是在分形维度(fractal dimension,FD)网络的全局属性方面。此外,PD-pRBD组男性患者在霍普金斯语言学习测试-修订版(Hopkins Verbal Learning Test-Revised,HVLT-R)的延迟记忆评分和蒙特利尔认知评估(Montreal Cognitive Assessment,MoCA)与形态学网络指标密切相关(均P<0.05)。结论伴随和不伴随RBD的PD患者在单纯形态学和网络层面都具有显著性别特异性模式,同时PD-pRBD组中男女之间的性别差异较nonRBD组更加广泛,并且进一步与认知相关,这一发现强调了在PD-pRBD患者诊治中考虑性别差异的重要性。Objective:To explore gender differences in morphological change patterns among different subgroups of Parkinson's disease(PD) patients.Materials and Methods:High-resolution T1-weighted magnetic resonance imaging and clinical scale data were collected from a total of 278 participants in the Parkinson's disease Progression Marker Initiative database.Using a cutoff score of 5 on the rapid eye movement sleep behavior disorder(RBD) screening questionnaire,patients were classified into PD-pRBD(≥ 5 points) and PD-nonRBD(< 5 points) groups.The final sample included 93 PD-pRBD patients,114 PDnonRBD patients,and 71 healthy controls(HC).The Computational Anatomy Toolbox 12(CAT12) tool was utilized to gather data on gray matter volume(GMV) and cortical morphological metrics.Subsequently,individual-level morphological similarity networks were constructed based on these cortical metrics.Finally,the topological properties of the network were analyzed using graph theoretic methods.Results:In the PD-pRBD group,GMV in the frontal and temporal lobes of males was lower than that of females,while the gyrification index(GI) in the frontal lobes was lower in females than in males(P = 0.024).However,the GI of the frontal lobe in males was lower than that in females within the PDnonRBD group(P = 0.009).Network analyses based on graph theory revealed that male PD-pRBD patients displayed lower network information integration compared to female patients,particularly in terms of the global properties of fractal dimension(FD) networks.Moreover,in the PD-pRBD group,male patients showed a strong correlation between morphological network metrics and cognitive performance as measured by the delayed memory score of Hopkins Verbal Learning Test-Revised(HVLT-R) memory scores and the Montreal Cognitive Assessment(MoCA)(all P < 0.05).Conclusions:PD patients with and without RBD exhibit significant sex-specific patterns at both the morphological and network levels.Moreover,the sex differences between males and females in the PD-RBD group are more ext

关 键 词：帕金森病 快速眼动睡眠行为障碍 磁共振成像 性别差异 个体形态学网络 皮层形态学 

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]