无认知功能障碍帕金森病患者脑皮层体积变化与运动功能的相关性

Correlation of cortex volume change and motor function in Parkinson′s disease without cognitive impairment

目的:探讨帕金森病(PD)患者大脑皮层体积与健康对照之间的差异,结合帕金森运动评分探讨存在体积差异的皮质信号与临床症状的相关性。方法:32例无认知功能障碍的PD患者(PD-wCI)及31例健康志愿者(对照组),首先采用统一帕金森病评定量表(UPDRS-Ⅲ)对每例被试者的运动功能进行评分,采用Siemens Skyra 3.0T磁共振扫描仪对纳入两组受试者行三维磁化准备快速梯度回波(MPRAGE)序列T 1WI扫描,采用DPABI软件中基于体素的形态学方法(VBM)对图像进行后处理,比较两组间皮层体积的差异(GRF检验,voxel P<0.001,cluster P<0.05),将有显著差异脑区的体积与UPDRS-Ⅲ评分进行相关性分析。结果:PD组患者右侧中央前回及中央后回的皮层体积较对照组明显减小(P<0.001),而且这两个脑区的体积与UPDRS-Ⅲ评分之间均存在显著负相关(右侧中央前回:r=-0.472,P=0.006;右侧中央后回:r=-0.510,P=0.003)。结论:PD患者大脑皮层部分区域的体积较小且减小程度与运动功能评分之间呈负相关,提示脑功能成像可在一定程度上揭示帕金森病所致感觉运动功能障碍的发生机制。

Objective:To investigate the difference of cerebral cortex volume between patients with Parkinson′s disease(PD)patients and health control(HC)subjects,and to explore the correlation between cortical signals with volume difference and clinical symptoms combined with Parkinson′s motor score.Methods:32 cases of PD without cognitive impairment(PD-wCI)and 31 cases of HC subjects were included in this study.Motor function score of each PD patient was evaluated using the Unified Parkinson Disease Rating Scale(UPDRS)-Ⅲ.All subjects of the two groups underwent MRI scan with magnetization prepared rapid acquisition gradient echo(MPRAGE)sequence T 1WI at a Siemens Skyra 3.0 tesla MRI scanner.Voxel-based morphometry(VBM)analysis method in DPABI software was used for image post-processing.The areas of cortical volume difference between the two groups were statistically analyzed(GRF inspection,voxel:P<0.001,cluster:P<0.05).The correlation was analyzed between the cortex with volume difference in PD patients and UPDRS-Ⅲscore.Results:The volume of the right anterior central gyrus and posterior central gyrus in PD group was significantly decreased compared with that in HC group(P=0.000).There was significant negative correlation between the signal of the volume-reduced cortex in PD patients and UPDRS-Ⅲscore(right precentral gyrus:r=-0.472,P=0.006;right post-central gyrus:r=-0.510,P=0.003).Conclusion:The difference of cortex volume change between PD and HC and the significant negative correlation between cortical volume-reduced region and UPDRS-Ⅲscore might be able to explain the mechanism of sensori motor dysfunction caused by PD using functional brain imaging.