CAJ | 학술논문

目的采用扩散张量成像(DTI)基于纤维束追踪空间统计分析(TBSS)观察早期(Hoehn-Yahr 1~2级)帕金森病(PD)患者脑白质结构的变化,探索DTI多参数变化与PD患者综合评分量表(UPDRS)评分升高具有显著相关的脑区.资料与方法 27例早期PD患者及30例正常对照组行DTI检查,采用TBSS技术分析两组受试者脑白质纤维DTI的各相关参数,包括各向异性分数(FA)、平均扩散系数(MD)、轴向扩散系数(AD)、平行扩散系数(RD),比较两组各DTI参数的差异,分析PD组有差异脑区的FA、MD、RD值与临床UPDRS评分的相关性.结果与对照组相比,PD组多个脑白质区FA值降低,MD、RD值升高(P<0.05), AD值未见明显变化(P>0.05).PD组较对照组有差异脑区的FA值、MD值、RD值与UPDRS评分均有相关关系(P=0.001);FA值降低和MD、RD值升高并与UPDRS评分具有显著相关的脑区为胼胝体、左侧内囊前肢、双侧前放射冠、双侧上放射冠、左丘脑后辐射(P=0.001).结论 PD患者存在脑白质结构的改变,可能是髓鞘脱失或纤维完整性受到破坏.
목적 채용확산장량성상(DTI)기우섬유속추종공간통계분석(TBSS)관찰조기(Hoehn-Yahr 1~2급)파금삼병(PD)환자뇌백질결구적변화,탐색DTI다삼수변화여PD환자종합평분량표(UPDRS)평분승고구유현저상관적뇌구.자료여방법 27례조기PD환자급30례정상대조조행DTI검사,채용TBSS기술분석량조수시자뇌백질섬유DTI적각상관삼수,포괄각향이성분수(FA)、평균확산계수(MD)、축향확산계수(AD)、평행확산계수(RD),비교량조각DTI삼수적차이,분석PD조유차이뇌구적FA、MD、RD치여림상UPDRS평분적상관성.결과 여대조조상비,PD조다개뇌백질구FA치강저,MD、RD치승고(P<0.05), AD치미견명현변화(P>0.05).PD조교대조조유차이뇌구적FA치、MD치、RD치여UPDRS평분균유상관관계(P=0.001);FA치강저화MD、RD치승고병여UPDRS평분구유현저상관적뇌구위변지체、좌측내낭전지、쌍측전방사관、쌍측상방사관、좌구뇌후복사(P=0.001).결론 PD환자존재뇌백질결구적개변,가능시수초탈실혹섬유완정성수도파배.
Purpose To observe white matter structure features of patients with early stage (Hoehn-Yahr 1-2 phase) Parkinson''s disease (PD) by using diffusion tensor imaging (DTI) based on the fiber bundle analysis tract-based spatial statistics (TBSS); and to explore the brain regions of PD patients in which DTI parameters are significantly correlated with unified Parkinson''s disease rating scale (UPDRS) score elevation. Materials and Methods DTI sequence was performed on 27 cases of PD and 30 cases of healthy volunteers. DTI parameters including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were analyzed in all participants by using TBSS technique, and the parameters of two groups were compared. The correlation of clinical UPDRS score with FA value, MD and RD value in the PD group were analyzed.Results Compared with that in the control group, FA values of several brain regions in PD group decreased, while MD and RD value increased (P<0.05). AD showed no obvious change (P>0.05). UPDRS score of PD group was correlated with FA, MD and RD value (P=0.001). The brain regions that showed FA value decreased, MD and RD value increased included corpus callosum, left anterior limb of internal capsule, bilateral anterior radial crown, bilateral superior radial crown and left posterior thalamic radiation (P=0.001).Conclusion There is some changes in white matter structure of the patients with early stage Parkinson''s disease, which may due to demyelination or fiber integrity damaged.