严重嗅觉减退的帕金森病患者内在大脑活动指标的空间和时间一致性改变

Altered spatial and temporal concordance among intrinsic brain activity measures in Parkinson's disease patients with severe hyposmia

目的 探究严重嗅觉减退帕金森病患者(Parkinson’s disease patients with severe hyposmia, PD-SH)大脑空间和时间上的耦合变化,以期了解PD-SH组内在脑活动的动态特征。材料与方法 分析PD-SH组、无/轻度嗅觉减退帕金森病患者(Parkinson’s disease patients with no/mild hyposmia, PD-N/MH)组和健康对照(healthy control, HC)组(各15例)的静息态功能磁共振成像图像。计算4种动态指标的体积一致性和体素一致性,采用单因素方差分析和协方差分析比较组间的体积一致性和体素一致性,并研究一致性值与临床/神经心理评估之间的相关关系。结果 PD-SH组的动态体积一致性均低于PD-N/MH组(P<0.05)和HC组(P<0.05);PD-SH组在左侧颞上回、左侧楔叶、左侧中央后回、右侧楔前叶等区域表现出比PD-N/MH组更高的体素一致性(高斯随机场校正,体素水平P<0.005,团块水平P<0.05)。相比于HC组,PD-SH组在左侧颞下回、颞中回、颞上回、内侧和旁扣带脑回中的体素一致性降低,且在右侧内侧和旁扣带脑回中的体素一致性与气味棒识别测试分数存在正相关关系(r=0.5251, P=0.0444)。结论 本研究揭示了三组被试的大脑内在活动在空间和时间上的一致性差异,为揭示PD患者嗅觉减退的神经生理机制提供结果支持和新的见解。

Objective:This study investigated the spatial and temporal coupling alterations in the brain of Parkinson's patients with severe hyposmia(PD-SH)to understand the dynamic alterations of intrinsic brain activity in the PD-SH group.Materials and Methods:The resting-state functional magnetic resonance imaging data acquired from 15 PD-SH,15 Parkinson's disease patients with no/mild hyposmia(PD-N/MH),and 15 healthy controls(HC)were enrolled in this study.The volume-wise and voxel-wise concordance among four dynamic metrics was calculated.One-way analyses of variance and covariance analysis were used to compare the volume-wise and voxel-wise concordance among the PD-SH,PD-N/MH,and HC groups.The associations between concordance values and clinical/neuropsychological assessments were investigated as well.Results:Compared with the PD-N/MH and HC,the PD-SH had lower dynamic volume concordance in the whole brain(P<0.05).PD-SH showed increased voxel-wise concordance than PD-N/MH in left superior temporal gyrus,left cuneus,left postcentral gyrus and right precuneus(Gaussian random field correction,voxel level P<0.005,cluster level P<0.05).Compared with HC group,we found the decreased voxel-wise concordance in left inferior temporal gyrus,middle temporal gyrus,superior temporal gyrus and middle cingulum of PD-SH.Moreover,the decreased concordance in right middle cingulum was positively associated with the score of Odor Stick Identification Test for the Japanese in PD-SH(r=0.5251,P=0.0444).Conclusions:There were some differences in the spatial and temporal concordance of intrinsic brain activity among the three groups.The analysis of concordance provided results and new insights into the neurophysiological mechanism of hyposmia in PD patients.