帕金森病伴睡眠障碍患者脑结构及功能异常的神经影像学研究

Neuroimaging study of brain structural and functional abnormalities in patients with Parkinson's disease with sleep disorders

在帕金森病(PD)领域,睡眠障碍被公认为是最常出现的非运动症状之一,其与该疾病运动性及非运动性症状的发展进程紧密相关。研究表明PD伴睡眠障碍(如快速眼动睡眠行为障碍)患者较不伴睡眠障碍患者疾病进展更快,且大多数睡眠障碍患者最终都会进展为PD。目前对于睡眠障碍与PD发病机制间的关联尚未充分阐明,因此及早发现PD合并睡眠障碍患者的异常结构及功能变化,对于延缓疾病进展及预防睡眠障碍向PD的转化具有重要价值。近年来,随着影像学技术的不断发展及其广泛应用,诸多神经影像学技术已广泛应用在PD伴非运动症状患者的研究中,如弥散张量成像、静息态功能磁共振成像、神经黑色素敏感成像、SPECT/PET及经颅超声等,它们在帕金森病的研究中扮演着关键角色,其在疾病早期诊断、监测及明确发病机制方面具有重要价值。本文就上述神经影像技术在帕金森病伴睡眠障碍患者的影像学研究进展予以综述,以更全面地理解PD伴睡眠障碍的病理生理机制,并指导临床诊断和治疗。

In the field of Parkinson's disease(PD),sleep disorders are recognized as one of the most common non-motor symptoms,closely related to the development of motor and non-motor symptoms of the disease.Research shows that patients with PD and sleep disorders(such as rapid eye movement sleep behavior disorder)progress faster than those without sleep disorders,and most sleep disorder patients will eventually progress to Parkinson's disease.At present,the relationship between sleep disorders and the pathogenesis of PD has not been fully clarified.Therefore,early detection of abnormal structural and functional changes in patients with PD and sleep disorders is of great value in delaying disease progression and preventing the transformation of sleep disorders into PD.In recent years,with the continuous development of imaging technology and its wide application,many neuroimaging techniques have been widely used in the study of PD patients with non-motor symptoms,such as diffusion tensor imaging,resting-state functional-MRI,neuromelanin sensitive-MRI,SPECT/PET and Transcranial sonography.They play a key role in the study of Parkinson's disease,and they have important value in the early diagnosis,monitoring and clarifying the pathogenesis of the disease.This article reviews the imaging research progress of the above neuroimaging techniques in patients with Parkinson's disease and sleep disorders.To better understand the pathophysiological mechanisms of PD accompanied by sleep disorders,and to guide clinical diagnosis and treatment.