帕金森病伴抑郁患者静息态脑功能磁共振成像局部一致性研究

Regional homogeneity in the patients of Parkinson disease with depression:a resting-state functional magnetic resonance imaging study

目的探究帕金森病(Parkinson disease,PD)伴抑郁患者(Parkinson disease patients with depression,DPD)脑区神经元活动同步性特征,寻找DPD特征影像学标志。方法纳入DPD患者22例,PD非抑郁患者(Parkinson disease patients without depression,NDPD)23例,25例年龄、性别及教育年限相匹配的健康受试者作为对照组。所有受试者完成神经功能评估及静息态功能磁共振成像(resting state functional magnetic resonance imaging,rs-fMRI)扫描,采用局部一致性(regional homogeneity,ReHo)方法分析三组各脑区神经元活动同步性,并将DPD各脑区ReHo值与抑郁评分进行相关性分析。结果DPD前额叶左侧额中回、运动皮层中右侧中央前回、左侧辅助运动区和右侧中央旁小叶ReHo值显著增加,右侧前额叶三角部额下回ReHo值显著降低,边缘系统(右侧内侧和旁扣带回、左侧前扣带回和左侧岛叶)、顶叶双侧楔前叶及枕叶与NDPD对比存在ReHo异常。以上大部分脑区ReHo值与抑郁评分显著相关。结论前额叶、边缘系统、运动皮层、顶枕叶脑区功能紊乱与DPD发生、发展相关,以上脑区静息态功能障碍可能可作为DPD诊断及监测疾病进展的影像学标识。

Objective To investigate regional synchrony of neuronal activity and search for the imaging markers of characteristics in the patients of Parkinson disease(PD)with depression(DPD).Methods Twenty-two DPD,twenty-three PD patients without depression(NDPD)and twenty-five age-,gender-and education-matched healthy subjects(HCs)were enrolled as the control group in this research.All participants receiving neurological function evaluation and the resting state functional magnetic resonance imaging(rs-fMRI)scan.Regional homogeneity(ReHo)was used to explore synchrony of neuronal activity of various brain regions in the three groups.At the same time,the correlation between ReHo value and depression score in DPD group was analyzed.Results In patients with DPD,the ReHo of the left median frontal gyrus was significantly increased,while the ReHo of the right triangle inferior frontal gyrus was significantly decreased.Moreover,the ReHo were significantly increased in the motor cortex,including the right precentral gyrus,left supplementary motor area and right paracentral lobule.The limbic system including the right median cingulate and paracingulate gyri,left anterior cingulate gyrus and left insula,bilateral precuneus and occipital lobe all had abnormal spontaneous activity of the neurons.In addition,the severity of depression was significantly correlated with the ReHo values of majority of brain areas with abnormal ReHo.Conclusion The occurrence and development of DPD are correlated with the dysfunction of local brain regions,including the prefrontal lobe,limbic system,motor cortex,the parietal and occipital lobes.The resting-tate brain dysfunction of those brain regions might serve as an imaging marker for DPD diagnosis and monitoring of disease progression.