帕金森病患者区域脑活动及动态功能连接的研究

The study on regional brain activity and dynamic functional connectivity in patients with Parkinson′s disease

目的:探讨帕金森病(PD)患者动态局部一致性(dReHo)存在差异的脑区与全脑灰质功能连接(FC)的动态变化及临床意义。方法:纳入32例PD患者及33例健康受试者(NC组)进行静息态磁共振功能成像(rs-fMRI)扫描,采用dReHo方法进行数据分析获得差异脑区,选取dReHo差异脑区为种子点,计算各种子点在多个滑动窗口上与全脑灰质的FC。采用双样本t检验比较PD组与NC组之间功能连接变异系数(FCVC)的差异。通过蒙特利尔认知评估量表(MoCA)和帕金森病统一评分量表(UPDRS)的第Ⅲ部分对患者的运动及认知功能进行评估。最后提取差异脑区与种子点间的FCVC值与临床评分进行相关性分析。结果:与NC组相比,PD组左侧尾状核、右侧壳核以及双侧舌回dReho值减低,另外PD组左侧舌回与右侧舌回、双侧中央后回、右侧中央前回、右侧楔前叶之间FCVC值减低。左侧中央后回与左侧舌回间的FCVC值与UPDRS-Ⅲ评分呈负相关(r=-0.438,P=0.01),右侧中央后回与左侧舌回之间的FCVC值与MoCA评分呈正相关(r=0.415,P=0.02)。结论:帕金森病患者局部脑活动及功能连接的异常变化有助于进一步从脑功能成像角度解释疾病所致运动障碍及其他相关并发症的潜在机制。

Objective:To investigate the dynamic changes and clinical significance of functional connectivity(FC)between altered brain regions found by dynamic regional homogeneity(dReHo)analysis and whole brain gray matter in patients with Parkinson′s disease(PD).Methods:Thirty-two PD patients and 33 healthy controls(NCs)were recruited to undergo resting state functional magnetic resonance imaging(rs-fMRI)scanning.The rs-fMRI data were analysed using dReHo to access altered brain regions.The altered brain regions were selected as seed points to calculate the functional connectivity(FC)with whole brain gray matter.The difference of functional connectivity variable coefficient(FCVC)between the PD patients and the NCs was compared by two-sample t-test.The cognitive function and motor function were evaluated by Montreal Cognitive Assessment(MoCA)and the third part of Unified Parkinson′s disease Rating Scale(UPDRS).Pearson correlation was used to analyze the correlation of FCVC with clinical scores.Results:Compared with NCs,PD patients showed significant decreased dReHo in left caudate,right putamen and bilateral lingual.In additional,a significant decreased FCVC was found in left lingual and right lingual,bilateral postcentral gyrus,right precentral gyrus and right precuneus lobe.In PD patients,the FCVC value between left postcentral and left lingual was negatively correlated with the UPDRS-Ⅲscores(r=-0.438,P=0.01)and the FCVC value between right postcentral and left lingual was positively correlated with the MoCA scores(r=0.415,P=0.02).Conclusion:The abnormalities of local brain activity and functional connectivity in PD patients may help to further explain the potential mechanism of PD-related dyskinesia and other related complications.