帕金森病患者嗅觉功能障碍与弥散张量成像的相关性

Relationship of Olfactory Dysfunction and Diffusion Tensor Imaging in Patients with Parkinson's Disease

目的探讨帕金森病(Parkinson disease,PD)患者嗅觉功能障碍的发生率及相关特征,研究脑内嗅觉系统微观结构的改变。方法应用T&T嗅觉检测仪分别对PD患者组(n=160)和正常对照组(n=160)进行嗅觉功能测试,分析嗅觉识别阈值与年龄、病程及Hoehn-Yahr(H-Y)分级之间的关系,并对其中PD患者组(n=60)和正常对照组(n=60)进行弥散张量成像(diffusion tensor imaging,DTI)扫描,用基于体素形态测量学(voxe-based morphometry,VBM)评定各项异性分数(fractional anisotropy,FA)。结果 75.63%的PD患者(121/160例)存在嗅觉障碍,明显高于对照组。嗅觉障碍与年龄、病程和H-Y分级之间无明显相关性;VBM双样本分析显示,PD组双侧小脑白质及额叶,左侧直回、眶回及顶叶等区域,FA值显著小于对照组。结论大多数PD患者合并有嗅觉障碍,与病程、年龄及H-Y分级无关,脑内嗅觉系统存在微结构损伤,嗅觉功能检测结合DTI有助于PD的诊断。

Objective To investigate the incidence and related characteristics of olfactory dysfunction in patients with Parkinson＇s disease（PD）and study the changes of the microstructure of olfactory system in the brain.Methods Olfactory function of PD patients（n=160）and matched-control group（n=160）was evaluated by TT olfactometry.The relationship between the threshold of olfactory recognition and age,course of disease and Hoehn-Yahr（H-Y）classification was analysed.A total of 60 PD patients and 60 healthy subjects participated in diffusion tensor imaging（DTI）study.Voxel-wise statistical analysis was employed to analyze the fractional anisotropy（FA）data.Results A total of 75.63% PD patients indicated olfactory dysfunction.The olfactory recognition threshold in PD patients were significantly higher than that in the control group.There was no correlation between the olfactory function and the age,duration or H-Y stage.The damaged white and gray matter showed decreased FA in the bilateral cerebellum and frontal lobe,left rectal gyrus,orbital gyrus and parietal lobe in PD patients.Conclusion Most PD patients had olfactory dysfunction and micro structural damage of olfactory system.There is no correlation between the olfactory function and the age,duration or H-Y stage.Olfactory function test combined with DTI is helpful for the diagnosis of PD.