帕金森病患者静息态脑功能局部一致性研究

Study of regional homogeneity of rest-state brain function in patients with Parkinson's disease

目的探讨帕金森病(PD)患者静息态脑功能局部一致性(ReHo)的变化。方法采集22例原发性PD患者(PD组)和22名健康对照者(正常对照组)的静息态功能磁共振(fMRI)数据,并进行比较。分析PD患者"开"期和"关"期局部一致性(ReHo)值差异有统计学意义的脑区的Re Ho值与PD患者左手对指改善率的相关性。结果与正常对照组比较,PD组"关"期ReHo值的减少主要集中在左侧壳核、双侧小脑半球,而增加的脑区集中在右侧丘脑、左侧额中回、左侧运动前区、右侧顶下小叶、右侧中央后回、双侧辅助运动区、楔前叶。PD组患者"开"期双侧小脑、颞下回、右侧壳核、右侧楔前叶、右侧丘脑、双侧辅助运动区ReHo值较"关"期显著增加;而右侧小脑后叶、右侧颞中回、右侧颞上回、左侧额中回、左侧额上回、右侧后扣带回较"关"期显著。PD患者左手对指改善率为1.59%~126.67%,平均(54.15±38.02)%。Pearson相关性分析结果显示,PD患者右侧丘脑ReHo值与左手对指改善率呈正相关(r=0.637,P<0.01)。结论 PD患者静息态脑功能存在广泛异常,左旋多巴对于PD患者的大脑功能环路具有修饰作用。丘脑作为运动环路的一个重要节点,在PD患者中其神经元代谢、功能等也发生了改变。

Objective To explore the changes of regional homogeneity（ Re Ho） of rest-state brain function in patients with Parkinson＇s disease（ PD）. Methods Rest-state functional magnetic resonance imaging（ f MRI） were checked in 22 PD patients（ PD group） and 22 normal controls（ normal control group）,the results were analyzed.Correlation analysis of Re Ho between PD in the on state and off state versus the left finger opposition task improvement ratio of the PD was performed. Results Compared with normal control group,brain region of Re Ho values decreased in＂off＂time of PD group was left putamen and bilateral cerebellum,and brain region increased in right thalamus,left middle frontal gyrus,left premotor area,inferior parietal lobule,right postcentral gyrus,bilateral supplementary area and bilateral praecuneus. Re Ho values of bilateral cerebellum,right inferior temporal gyrus,right putamen,right praecuneus, right thalamus and bilateral supplementary area in PD group at ＂on＂ time were significantly increased than those at ＂off＂time; and right cerebellum posterior lobe,right middle temporal gyrus,right superior temporal gyrus,left middle frontal gyrus,lift superior frontal gyrus and right posterior cingulate gyrus in PD group at ＂on＂time were significantly decreased than those at＂off＂time. The improvement rate of the left finger opposition task in PD patient was 1. 59%-126. 67%,average（ 54. 15 ± 38. 02） %. Pearson correlation analysis showed that the right thalamus Re Ho of PD was positive correlated with their improvement rate of the left finger opposition task（ r = 0. 637,P 0. 01）. Conclusions The resting state brain function of PD patients is extensively abnormal. L-dopa may normalize aberrant functional circuits in PD. As an important node of the motor circuits,the function and metabolize of the neurons in thalamus has been changed in PD patients.