基于DKI的步态障碍型帕金森病患者脑结构网络的拓扑属性改变研究

Changes in topological properties of brain structural network in patients with Postural Instability and Gait difficulties based on diffusion kurtos imaging

目的 探讨步态障碍型帕金森患者(PIGD)脑结构网络的拓扑属性特点.方法 对扬州大学附属苏北人民医院自2019年9月-2023年9月收治的32例PIGD患者及30例年龄、性别相匹配的健康志愿者进行DKI扫描,采用图论分析方法计算脑拓扑网络属性参数,使用独立样本t检验对两组脑结构网络的总体参数及节点属性参数进行对比分析.运用Spearman相关分析统计差异脑区的网络特性参数与临床认知评分的相关性.结果 PIGD组较对照组脑网络全局效率明显减小,包括Eglob明显低于对照组(P=0.004,FDR校正).PIGD组Lp值明显高于对照组(P=0.012,FDR校正),而Cp比较,差异无统计学意义(P>0.05,FDR校正).与对照组比较,PIGD组脑结构网络节点效率在右额中回、右中央前回、右颞下回、右顶上回、右枕叶外侧皮层、右杏仁核、左顶下叶、左中央后回明显降低,差异均有统计学意义(P<0.05,FDR校正).PIGD组左侧顶下叶及右侧枕叶外侧皮层节点效率与MMSE评分呈正相关(r=0.504,P=0.003;r=0.374,P=0.035),并且左侧顶下叶节点效率与MOCA评分呈正相关(r=0.437,P=0.012).结论 PIGD患者脑结构网络存在连接异常.

Ob ject ive To analyze the topological characteristics of the brain structural network in Postural Instability and Gait difficulties(PIGD)patients by applying graph theoretical approaches.Methods From September 2019 to September 2023,32 PIGD patients and 30 gender-and age-matched healthy controls(HCs)were recruited to undergo diffusion kurtos isimaging(DKI)scan in Affiliated Northern Jiangsu Province Hospital of Yangzhou University.The global and regional brain structural network properties of the two groups were computed by graph theoretical analysis and compared by two-sample t-test,and used Spearman correlation analysis to statistically analyze the correlation between network characteristic parameters of different brain regions and clinical cognitive scores.Results The global efficiency of the PIGD group's brain network was significantly reduced compared to the control group,including significantly lower Eglob levels(P=0.004,FDR corrected).The Lp value in the PIGD group was significantly higher than that in the control group(P=0.012,FDR correction),while the difference in Cp was not statistically significant(P>0.05,FDR correction).Compared with the control group,the nodal efficiency of the brain structural network of the patient group was significantly decreased in the right middle frontal gyrus,right precentral gyrus,right inferior temporal gyrus,right superior parietal gyrus,right lateral occipital cortex,right amygdala,left inferior parietal lobule,left posterior central gyrus(P<O.05,FDR correction).Node degree in lateral occipital cortex and left inferior parietal lobule showed positively correlated with MMSE score(r=0.374,P=0.035;r=0.504,P=0.003),while node degree in left inferior parietal lobule also showed positively correlated with MOCA socre(r=0.437,P=0.012).Conclusion There is abnormal connection in brain structural network inPIGDpatients.