CAJ | 학술논문

目的：评价单纯手震颤的原发性震颤(essential tremor,ET)患者脑内灰质体积变化。方法选取 l7例临床确诊的,年龄小于55岁的单纯手震颤 ET 患者及17名年龄、性别、教育程度匹配的正常对照者,行全脑三维快速扰相梯度回波(3D fast spoiled gradient echo,3D FSPGR)序列扫描,采用基于体素的形态测量学(voxel-based morphometry, VBM)分析方法,对 ET 患者及正常对照者的脑内灰质体素进行分析。结果与正常对照组相比,ET 患者脑内可见双侧小脑半球前叶、枕叶、颞叶及中央前回体积增大以及左侧顶叶体积缩小(P uncor ected <0.005)；进一步的感兴趣区(region-of-interest,ROI)测定发现左侧丘脑、中脑及延髓体积膨大,桥脑体积缩小(P uncor ected <0.005)。结论应用VBM 方法对于单纯手震颤 ET 患者磁共振图像分析,能够客观揭示其脑内独特的灰质体积改变,有助于进一步探讨ET 的发病机制。
목적：평개단순수진전적원발성진전(essential tremor,ET)환자뇌내회질체적변화。방법선취 l7례림상학진적,년령소우55세적단순수진전 ET 환자급17명년령、성별、교육정도필배적정상대조자,행전뇌삼유쾌속우상제도회파(3D fast spoiled gradient echo,3D FSPGR)서렬소묘,채용기우체소적형태측량학(voxel-based morphometry, VBM)분석방법,대 ET 환자급정상대조자적뇌내회질체소진행분석。결과여정상대조조상비,ET 환자뇌내가견쌍측소뇌반구전협、침협、섭협급중앙전회체적증대이급좌측정협체적축소(P uncor ected <0.005)；진일보적감흥취구(region-of-interest,ROI)측정발현좌측구뇌、중뇌급연수체적팽대,교뇌체적축소(P uncor ected <0.005)。결론응용VBM 방법대우단순수진전 ET 환자자공진도상분석,능구객관게시기뇌내독특적회질체적개변,유조우진일보탐토ET 적발병궤제。
Objective To investigate the abnormalities of brain gray matter volume in patients with clinically-confirmed essential tremor (ET)of the hands only.Methods We analyzed brain gray matter voxel of 1 7 patients (younger than 55 years)with ET of the hands only and 1 7 healthy controls matched in age,gender and education by optimized voxel-based morphometry (VBM).Results VBM showed marked expansion of the bilateral cerebella, occipital fusiform cortices,and precentral lobes (P uncorrected < 0.005 )in ET patients compared with the controls. Atrophy was only detected in left parietal lobe.We also found volume enlargement in the thalamus,midbrain,and melluda of the left side by region of interest (ROI )analysis (P uncorrected <0.005).Conclusion Patients with arm tremor show expansion of gray matter,which might represent the adaptive reorganizational compensation through the increased demand on the visuospatial control of skilled movements in ET patients with early-stage arm tremor. These morphological changes may help to assess early stage and distinguish subtype of ET.