帕金森病脑葡萄糖代谢特点的验证研究

Validation of Cerebral Glucose Metabolic Characteristics Associated with Parkinson's Disease

目的验证帕金森病(PD)脑葡萄糖代谢特点的可重复性。方法回顾性分析复旦大学附属华山医院和中国人民解放军陆军军医大学大坪医院PD患者的静息状态^(18)F-FDG PET显像,采用SPM5分析分别获得PD患者的脑葡萄糖代谢特点,并应用种子点相关分析得到相应的代谢网络,继而在局部脑区和全局网络层面比较两家医院PD患者脑葡萄糖代谢的异同;基于复旦大学附属华山医院已建立的PD相关脑代谢模式(PDRP)计算PDRP表达值,以ROC评估PDRP表达值的诊断效力。结果两家医院PD患者均表现为壳核/苍白球、丘脑、脑桥、感觉运动皮质和小脑葡萄糖代谢增加,顶枕叶相关脑区葡萄糖代谢减低;两家医院队列以外侧壳核和顶叶为种子点的脑代谢网络仅存在微小差异。PD患者的PDRP表达值显著增高:复旦大学附属华山医院PD患者为3. 44±1. 53,对照组为0±0. 98;中国人民解放军陆军军医大学大坪医院PD患者为1. 78±1. 20,对照组为0±0. 68。结论 PD脑葡萄糖代谢特点在不同临床队列研究中具备可重复性,本研究为后续^(18)F-FDG PET显像多中心研究的开展奠定了基础。

Aim To validate the reproducibility and robustness of disease-related cerebral metabolic characteristics associated with Parkinson’s disease( PD) using 18F-FDG PET/CT imaging across independent cohorts. Methods Two independent cohorts which were both composed of PD patients and healthy controls( HC) were recruited,one from Huashan Hospital and the other from Daping Hospital.Each subject undertook a brain 18F-FDG PET/CT imaging in resting state. By analyzing on SPM5,the group characteristics of cerebral metabolic activities were evaluated,and then the related brain metabolic networks from seed-based correlation analysis were acquired. Both of the results were compared with eachother between the two hospitals’ cohorts from regional and overall perspectives. Based on the PD-related pattern( PDRP) got from Huashan Hospital,the expression of PDRP for each person in both hospitals was calculated and the data by receiver operating characteristic( ROC) curve was analyzed. Results The two PD cohorts shared a similar brain glucose metabolic characteristic: increases in the putamen/globus pallidus,thalamus and pons,sensorimotor cortex and cerebellum,and together with decreases in the parieto-occipital areas. The expression of this pattern of PD was higher than that of the control( PD from Huashan: 3. 44 ± 1. 53,HC: 0 ± 0. 98; PD from Daping: 1. 78 ± 1. 20,HC: 0 ± 0. 68). Conclusion This dual-center study showed the high reproducibility and comparability of disease-related cerebral metabolic characteristics across independent cohorts,which set a foundation for the further multi-center study.