基于感兴趣区的帕金森病伴快动眼睡眠障碍静息态功能连接研究

发布时间：2018-05-04 15:10

本文选题：快动眼睡眠期行为障碍 + 帕金森病　；参考：《重庆医科大学》2017年硕士论文

【摘要】：背景:快动眼睡眠行为障碍(Rapid eye movement sleep behavior disorder,RBD)是帕金森病(Parkinson’s disease,PD)中最常见的非运动症状之一,它可以增加PD患者认知受损的风险,是预测PD病情恶化的标志之一。但PD伴RBD患者(patient with PD and RBD,PDR)的发病机制尚不清楚,相关研究提示认知控制机制缺陷可能在PDR中起着一定的作用,前扣带回皮层(Anterior cingulate cortex,ACC)作为认知控制机制中重要的部分,可能参与PDR的病理生理机制。方法:本试验分别纳入15名不伴有RBD的PD患者(patients with PD but no RBD,n PDR),15名伴PDR患者,和17名相匹配的正常对照(healthy controls,HCs)。所有的受试者需要接受静息态功能磁共振(resting-state functional MRI,RS-f MRI)和神经心理评估。我们采用以双侧ACC为感兴趣区的全脑静息态功能连接(resting-state functional connectivity,RS-FC)的方法来研究三组间ACC功能连接模式变化情况。结果:我们发现PD患者双侧ACC均表现出异常的功能连接改变。与正常对照相比,n PDR与PDR患者的ACC功能连接减弱区均主要分布于额叶、顶叶、颞叶、枕叶、扣带回等区域。但PDR功能连接改变涉及团块范围更大,同时还在小脑、脑桥区域也呈现出减弱的ACC功能连接。对比n PDR组,PDR组ACC功能连接减弱主要是在前额叶皮质(prefrontal cortex,PFC)、颞下皮层(inferior temporal cortex,IT cortex)、小脑和脑桥等区域。此外,左侧ACC还与辅助运动区(supplementary motor area,SMA)表现出减弱的功能连接。结论:PDR和n PDR患者均存在异常的ACC功能连接,PDR患者涉及范围更广,提示PDR较n PDR可能存在更严重的认知控制机制缺陷,且异常的认知控制机制可能在PDR的病理生理机制中起着一定作用。
[Abstract]:Background: rapid eye movement sleep behavior disorder (RBD) is one of the most common nonmotor symptoms in Parkinson's disease (PD). It can increase the risk of cognitive impairment in PD patients and is one of the markers to predict the deterioration of PD. However, the pathogenesis of with PD and in PD patients with RBD is still unclear. The related studies suggest that the defect of cognitive control mechanism may play a role in PDR, and the anterior cingulate cortex cingulate cortexACCas an important part of cognitive control mechanism. It may be involved in the pathophysiological mechanism of PDR. Methods: 15 PD patients without RBD were enrolled in this study, 15 patients with PDR and 17 matched normal controls. All subjects were subjected to rest state functional MRI RS-f MRI and neuropsychological assessment. In this paper, we use the method of resting-state functional connectivity (RS-FC) with bilateral ACC as the region of interest to study the changes of ACC functional connection mode among the three groups. Results: we found that bilateral ACC showed abnormal functional junction changes in PD patients. Compared with the normal controls, the ACC functional junctional regions of the patients with PDR and PDR were mainly distributed in the frontal lobe, parietal lobe, temporal lobe, occipital lobe, cingulate gyrus and so on. However, the change of PDR functional junction involved a larger area of mass, but also in the cerebellum, the pons area also showed a weakened ACC functional connection. Compared with n PDR group, the decrease of ACC functional junctions was mainly in prefrontal cortical prefrontal cortex, inferior temporal cortexa IT cortexa, cerebellum and pons. In addition, the left ACC also showed a weakened functional connection with the supplementary motor SMA. Conclusion the presence of abnormal ACC functional junctions in patients with both ACC and n PDR may involve a wider range of patients, suggesting that PDR may have more severe cognitive control mechanism defects than n PDR. Abnormal cognitive control may play a role in the pathophysiological mechanism of PDR.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R742.5

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