fMRI基于体素镜像同伦连接方法分析偏侧帕金森病老年患者的病理生理机制

Pathophysiological mechanism of f MRI in the elderly patients with Parkinson's disease by voxel based image homotopy connection

目的采用静息态f MRI基于体素镜像同伦连接(VMHC)方法观察偏侧帕金森病老年患者的脑半球间连接功能改变情况,探讨其可能的病理生理机制。方法收集24例老年原发性偏侧帕金森患者,根据发病侧分为左侧发病组(11例)和右侧发病组(13例)。收集性别、年龄相匹配的15名健康自愿者为对照组。采集静息态f MRI数据,在Matlab7.8平台上进行预处理,计算出三组VMHC改变的脑区,进行相关性分析。结果三组受试者丘脑、舌回、额中及下回、缘上回、额上回、中央前及后回的VMHC值之间差异均有统计学意义(P<0.05)。左侧发病组患者丘脑半球VMHC值明显高于对照组;在视觉皮层、感觉运动皮层、其他脑区(顶下小叶、中央旁小叶、下半月小叶、小脑后叶)的VMHC值明显低于对照组(P<0.05)。右侧发病组患者在前额叶、感觉运动皮层VMHC值明显低于对照组;在丘脑、苍白球、额上回VMHC值明显高于对照组(P<0.05)。左侧发病组患者在视觉皮层、感觉运动皮层VMHC值明显低于对照组;在缘上回VMHC值明显高于对照组(P<0.05)。左侧发病组,枕中回和中央后回的VMHC水平与BDI-Ⅱ评分呈负相关,与MMSE评分呈正相关。右侧发病组,缘上回VMHC水平与病程呈正相关,中后回的VMHC水平与MMSE评分呈正相关。结论老年帕金森患者运动症状偏侧性影响到脑半球间的功能连接模式,可能是偏侧帕金森病的病理生理机制之一。

Objective To observe the side of Parkinson＇s disease in elderly patients with cerebral hemisphere connected function changes by resting state f MRI connected voxel image based on homotopy（ VMHC） method. Methods 24 elderly patients with primary unilateral Parkinson were divided into the left（ n = 11） and the right groups（ n = 13） according to the onset of the disease. Sex and age matched15 healthy volunteers were collected as control group. The resting state f MRI data were collected and processed on the Matlab7.8 platform,and the brain regions of three groups of VMHC were calculated. Results The VMHC values of thalamus,lingual gyrus,middle frontal gyrus,inferior frontal gyrus,superior frontal gyrus,superior frontal gyrus and posterior gyrus of the three groups had significant differences（ P〈0. 05）. The VMHC value of thalamus of left hemisphere onset group was significantly higher than that of control group; the VMHC values of visual cortex,sensorimotor cortex and other brain regions were significantly lower than those of control group（ P〈0. 05）. The VMHC values of prefrontal cortex,sensorimotor cortex of the right side of the patients were significantly lower,the VMHC values of thalamus,globus pallidus,superior frontal gyrus were significantly higher than those of control group（ P〈0. 05）. In left side group,the VMHC levels of middle occipital gyrus and posterior central gyrus was negatively correlated with the BDI-II score,and was positively correlated with the MMSE score.In the right side,the VMHC value of supramarginal gyrus was positively correlated with the duration of the disease,and the VMHC level of middle posterior ring was positively correlated with MMSE score. Conclusions The lateralization of motor symptoms in elderly patients with Parkinson＇s disease might affect the functional connectivity pattern of the cerebral hemispheres,which might be one of the pathophysiological mechanisms of the unilateral disease.