帕金森病伴焦虑患者静息态功能磁共振脑功能连接改变的研究

A resting-state functional magnetic resonance imaging study on functional connectivity alteration of Parkinson’s disease with anxiety

目的:观察帕金森病(Parkinson’s disease,PD)伴焦虑患者静息态功能连接改变,并探索PD伴发焦虑的神经病理机制。方法:收集112例PD患者以及54例健康对照者的静息态功能磁共振成像(rs-fMRI)数据,根据汉密尔顿焦虑量表(HAMA)将PD组分为PD伴焦虑(PD-A组)50例和PD不伴焦虑(PD-NA组)62例。通过协方差分析(ANCOVA)和post-hoc t检验进行体素镜像同伦连接(voxel-mirrored homotopic connectivity,VMHC)值的组间统计学比较得到PD-A组与PD-NA组的差异脑区。选取双侧杏仁核为功能连接种子点,计算双侧杏仁核与差异脑区功能连接结果,并分析功能连接值与HAMA评分的相关性。结果:PD-A组、PD-NA组和健康对照组之间的VMHC值有显著性差异,组间post-hoc t检验显示,PD-A与PD-NA相比,双侧额下回(inerior frontal gyrus,IFG)三角部及岛盖部VMHC值减低。种子点功能连接显示左侧杏仁核与左侧额下回的功能连接增强,且功能连接值与HAMA评分呈正相关。结论:PD-A患者存在异常的脑功能活动,双侧额下回的异常VMHC改变以及左侧杏仁核与左侧额下回的功能连接异常,提示额下回-杏仁核相关网络环路可能参与了焦虑的病理发生过程。

Objective:To investigate the alterations of functional connectivity among Parkisnon’s disease(PD)patients with anxiety,and to explore its pathological mechanism.Methods:Totally 112 PD patients and 54 healthy controls underwent rs-fMRI scanning.According to the Hamilton anxiety scale(HAMA),112 PD patients were divided into 50 PD with anxiety group(PD-A)and 62 PD without anxiety(PD-NA).ANCOVA and post-hoc t test were performed to assess intergroup difference of voxel-mirrored homotopic connectivity(VMHC)value to obtain the abnormal brain regions.Bilateral amygdala were chosen as seeds to calculate functional connectivity with abnormal brain regions.Estimated a Pearson’s correlation coefficient between functional connectivity calculated above and HAMA scores.Results:VMHC value had significant differences among three groups,post hoc t test showed a decrease of VMHC value in bilateral inferior frontal gyri(IFG)triangular part and opercular part in PD-A group compared to the PD-NA group.Functional connectivity increased between the left amygdala and the left IFG.Furthermore,functional connectivity was positively correlated with HAMA scores.Conclusion:Abnormal brain functional activity exists in PD-A group,suggesting that anxiety in PD is associated with abormalities in IFG-amygdala loop network.