帕金森病伴发睡眠障碍的脑结构形态学分析

Morphological analysis of brain structure in patients with Parkinson's disease complicated with sleep disturbance

目的探讨帕金森病(PD)伴发睡眠障碍的脑结构形态学特征。方法对30例PD患者(PD组)进行睡眠障碍的PD睡眠量表评估和头颅MRI检查。以30名年龄和性别相匹配的健康志愿者为对照组。利用FreeSurfer软件实现了基于体素的图像自动分析。结果 PD组两侧扣带回后部及左侧中央前回皮质厚度较对照组减小,右侧侧脑室较对照组增大,两侧海马体积较对照组减小,两侧额极皮质表面积较对照组减少(均P<0.05)。PD组中睡眠障碍者(PDSD组)左额中回后部、两侧扣带回后部、两侧中央前回及右侧颞叶内侧皮质厚度均较无睡眠障碍者(PDnSD组)减小,两侧海马体积较PDnSD组减小,两侧额及皮质表面积较PDnSD组减少(均P<0.05)。结论 PD睡眠障碍可能与认知及躯体运动相关脑区(左侧额中回后部、中央前回,右侧颞叶内侧区)体积减小有关,PD认知及运动障碍与睡眠障碍有一定解剖联系。

Objective To investigate the morphological features of brain structure associated with sleep disturbance in Parkinson’s disease(PD). Methods Thirty PD patients(PD group) were evaluated for sleep disturbances with PD sleep scale and underwent brain MRI. Control group consisted of 30 healthy volunteers who were matched by age and gender. We used FreeSurfer to achieve automatic image analysis based on voxel. Results Compared with those in the control group, PD patients had smaller posterior cingulate gyrus, smaller cortical matter thickness in the left precentral, larger right lateral ventricle, smaller volumes of hippocampus, as well as smaller volume of frontal pole areas(all P<0.05). Compared with those in without sleep disturbance PD patients(PDnSD group), the patients with sleep disturbance in PD group(PDSD group) had smaller cortical thickness of left middle frontal gyrus, smaller posterior bilateral cingulate gyrus, smaller bilateral anterior central gyrus, smaller right medial temporal lobe, smaller hippocampal, as well as smaller volume frontal and cortical surface area(all P<0.05).Conclusions Sleep disturbances in PD may be associated with decreased brain volume related to cognition and body movement(left posterior middle frontal gyrus, anterior central gyrus, right medial temporal lobe area). PD cognitive and motor disorders are anatomically related to sleep disturbances.