伴发认知障碍帕金森病的弥散张量成像研究

Diffusion tensor imaging studies of Parkinson's disease with cognitive impairment

目的探讨弥散张量成像(DTI)对伴发认知障碍帕金森病的诊断价值。方法对11例帕金森病伴痴呆患者,13例帕金森病伴轻度认知障碍患者,12例单纯帕金森病患者及10例正常对照组志愿者行DTI扫描,采用人工勾画感兴趣区(ROI)的方法在DTI参数图上测量各ROI(双侧扣带束、上纵束、下纵束、钩束、齿状核)的各向异性分数(FA)值,采用单因素方差分析方法进行统计分析。结果所有帕金森病组双侧扣带束、双侧上纵束、左侧钩束及右侧齿状核的FA值均低于对照组(P<0.05);右侧钩束、左侧齿状核FA值改变仅在单纯帕金森病组、对照组间无统计学差异;左侧下纵束FA值仅在帕金森病伴痴呆组、对照组间有统计学差异(P<0.05),而右侧下纵束FA值改变均无统计学差异。在各帕金森病组间比较时双侧扣带束、右侧上纵束、双侧钩束、右侧齿状核FA值改变均具有统计学差异,而左侧上纵束FA值改变仅在单纯帕金森病组、帕金森病伴痴呆组间具有统计学差异(P<0.05),左侧齿状核FA值改变仅在单纯PD、PD-MCI组间无统计学差异。结论伴发认知障碍帕金森病病理改变可能累及脑白质纤维和小脑。

Objective To study the value of diffusion tensor imaging（DTI） in the diagnosis of Parkinson＇s disease with cognitive impairment. Methods DTI was performed in 11 patients with PDD, 13 PD patients with MCI, 12 pure PD patients and 10 control subjects. Regions of interest （ROI） were drawn in bilateral cingulum, upper longitudinal, under longitudinal, uncinate faseiculus and the dentate nucleus on fractional anisotropy （FA） map. Differences in FA between the these groups were studied by one-factor ANOVA. Results FA values of bilateral cingulum, bilateral upper longitudinal, left uncinate fascieulus and right dentate nucleus in all PD groups were lower than control group （P〈0.05）; FA values of right uncinate fasciculus and left dentate nucleus had no significant changes only in pure PD group and control group; FA values of left under longitudinal had significant changes only in PDD and control group; FA values of fight under longitudinal in all groups had no significant changes. FA values of bilateral cingulum, right upper longitudinal, bilateral uncinate fasciculus and right dentate nucleus had significant changes in all PD groups when they were compared between each other; FA values of left upper longitudinal had significant changes only in pure PD and PDD group; FA values of left dentate nucleus had no significant changes only in pure PD and PD-MCI group. Conclusion The pathological changes may damage cerebral white matter fiber and cerebellum in Parkinson＇s disease with cognitive impairment.