弥散张量成像在非痴呆帕金森病认知障碍患者中的应用

The value of diffusion tensor imaging in non-dementia Parkinson's disease with mild cognitive impairment

目的探讨帕金森病的轻度认知障碍(PD-MCI)与各脑白质分区微结构改变的关系。方法选择40例帕金森病(PD)患者作为研究对象,其中认知正常组(PD-CogNL)和轻度认知障碍组(PD-MCI组)各20例,另选20例健康志愿者作为对照组,行蒙特利尔认知评估量表(MoCA)评估其认知功能;DTI检查测定脑部50个脑白质分区的微观结构改变。对三组研究对象的MoCA量表得分及其中7个认知阈检查分别进行方差分析,测定50个的分数各向异性(fFA)值,三组之间FA值行方差分析。最后,将PD-MCI组的MoCA量表评分与选定的23个脑区的FA值进行Pearson相关性分析。结果(1)在认知阈检查发现视空间与执行功能、注意力两项差异有统计学意义(P<0.05);(2)在FA值统计中结果为除穹窿、右皮质脊髓束、左皮质脊髓束、左上放射冠差异无统计学意义(P>0.05),其他脑白质分区差异均有统计学意义(P<0.05);(3)将具有统计学意义的脑白质分区,在PD-CogNL组和PD-MCI组间进行统计学分析。结果得出23个脑白质分区具有统计学意义(P<0.05);在PD-MCI组内将上述脑区的FA值和MoCA进行Pearson相关分析,胼胝体体部、胼胝体压部、左扣带(海马)、左穹窿/终纹、右上额枕束、左下额枕束、左钩束和MoCA得分具有相关性且r为正数,P<0.05。结论PD患者轻度认知障碍程度与患者胝体体部、胼胝体压部、左扣带(海马)、左穹窿/终纹、右上额枕束、左下额枕束、左钩束病变严重程度呈正相关,提示这些部位改变可能与PD-MCI患者的认知改变相关,且为进一步研究PD-MCI的病理基础及临床早期诊断提供依据。

Objective To discussion of non-dementia Parkinson's disease with mild cognitive impairment to explore the characteristics and its relations with the microstructure of white matter changes in zoning by diffusion tensor imaging.Method Choose forty cases of Parkinson's patients as the research object,the normal cognitive group(PD-CogNL)and mild cognitive impairment group(PD-MCI group)twenty cases,an alternate twenty cases of healthy volunteers as control group,line the Montreal cognitive assessment scale(MoCA)to assess their cognitive function;Determination of DTI check50brain white matter microstructure change of partition.MoCA scale scores of three groups of research object and its seven cognitive threshold check respectively in the analysis of variance,determine the fractional anisotropy of50(fractional anisotropy,FA)value and FA value line of analysis of variance between three groups.Finally,the PD-MCI group of MoCA rating scale and the FA value in23regions selected Pearson correlation analysis.Results Will be seven cognitive MoCA scale threshold check in the PD-CogNL group and PDvariance analysis between the MCI groups,including visual spatial attention and executive function,two differences statistically significant(P<0.05);To PD-CogNL group,PD-MCI group and the control group FA values of three groups of the statistical analysis,in addition to the vault,right corticospinal tract,left corticospinal tract,upper left radial no statistical significance,other brain white matter partition have statistical significance;Cerebral white matter partition of statistically significant in PD-CogNL group and PD-between the MCI group for statistical analysis.Results it is concluded that23cerebral white matter partition has statistical significance(P<0.05);In PD-MCI group of FA values in the above regions and Pearson correlation analysis to MoCA,corpus callosum,corpus callosum,left cingulate(hippocampus),ZuoQiong longs/end grain,upper right,lower left frontal pillow pillow bouquets,left hook beam and MoCA score is positive correlation and P<0.05.Conclusion PD patients with mild cognitive impairment patients Zhi body body,corpus callosum,left cingulate(hippocampus),ZuoQiong longs/end grain,upper right,lower left frontal pillow pillow bouquets,left hook beam of lesion severity were positively correlated,these areas change may be associated with PD-cognitive changes in patients with MCI,and for further study of PD-provides the reference for the pathological basis and clinical early diagnosis of MCI.