帕金森病伴痴呆患者的脑灰质结构研究

Study of Brain Gray Matter Structures in Parkinson's Disease Patients Associated with Dementia

目的采用体素的形态学分析方法,分析帕金森病伴痴呆(PDD)患者全脑灰质异常区域及分布特征,探寻与PDD有关的脑结构变化。方法应用3D T1WI脑容积扫描序列(3D-FSPGR)对12例PDD组和12例无痴呆的帕金森病组进行扫描,通过统计参数图软件(SPM5)对两组的灰质数据进行计算并作独立样本的t检验分析,两组数据的灰质体积差异采用国际通用的统计参数图表示。结果与PD组相比,PDD组脑灰质体积异常减少的脑区包括:两侧颞叶(右颞上回、左颞上回)、边缘系统(两侧后扣带回、左侧扣带回、右侧海马旁回、海马)、右侧顶枕叶(右侧楔前叶、楔叶)及左侧额下回、左侧岛叶。未见明显灰质体积增加脑区。结论边缘系统及大脑新皮层的体积缺失与PD患者的痴呆关系密切。

Objective To investigate the abnormal region of gray matter and its distribution in patients with Parkinson＇s disease complicated by dementia（PDD） by using voxel-based morphometry（VBM） method,and to analyze PDD-related brain structural changes.Methods A total of 12 patients with clinically-defined PDD（PDD group） and 12 Parkinson＇s disease patients without dementia（PD group） were enrolled in this study.Using three-dimensional fast spoiled gradient echo sequence（3D FSPGR） the brain volumetric scanning was performed in all patients.Gray matter data were analyzed using a voxel-based morphometry method and independent sample t-test based on statistical parametric mapping 5 software.The international statistical parametric mapping was used to express the differences in gray matter volume.Results Unlike the results observed in PD group,in PDD group the reduction in gray matter volume was observed in bilateral superior temporal gyrus,bilateral posterior cingutate and left cingulated gyrus,right parahippocampa gyrus and hippocampus,right precuneus and right cuneus,left inferior frontal gyrus and left insular lobe, while no obvious increase in brain gray matter volume was detected.Conclusion Gray matter atrophy in limbic system and cerebral new cortex is closely related to the presence of dementia.