帕金森病静止性震颤脑功能连接的功能磁共振成像研究

发布时间：2018-07-17 20:46

【摘要】：背景：随着我国人口老龄化速度的加快,帕金森病(PD)的发病率和患病率越来越高。目前PD的发病机制尚未明确,但它严重影响着人们的生活质量。临床上采用多种方法治疗PD,但效果仍不理想,因此实现对PD的诊断是十分重要的。功能磁共振(fMRI)由于具有较高的时间和空间分辨率,且具有无创性,成为目前诊断PD的重要手段之一。目的：利用fMRI研究静息状态下PD震颤患者与健康对照者之间的脑部功能连接的差异,初步探讨PD震颤患者静息状态下的脑功能活动特点。方法：选择19例PD震颤患者与20例健康对照者进行静息态脑功能磁共振成像,采用Siemens Avanto1.5T磁共振,使用标准正交头颅线圈。磁共振头部横轴位扫描,定位线置于眉弓连线水平,解剖图像采用T1加权三维快速扰相梯度翻转恢复(3D-SPGR)序列,参数为TR/TE=24ms/6ms, FA350,层厚0.9mm, FOV=240mm×240mm,矩阵=256×256；fMRI扫描序列采用T2*-EPI-GRE序列,参数为TR/TE=2000ms/30ms, FA90°,层厚4mm,间隔1mm,FOV=240mm×240mm,矩阵=64×64；扫描时间为6min。数据处理采用统计参数图(SPM8)、静息态fMRI数据分析工具包(REST)、静息态功能磁共振数据处理助手(DPARSFA)等软件对功能数据进行预处理和统计学分析。分别以双侧苍白球为种子点,采用功能连接(FC)的方法,分析PD震颤患者和健康者脑部FC的差异。结果： PD震颤患者中,与右侧苍白球存在功能连接的脑区包括小脑扁桃体、左侧额中叶、右侧额中回、中央前回、右侧扣带回。PD震颤患者中,与左侧苍白球存在功能连接的脑区包括额下回、腹前核、双侧扣带回、右侧辅助运动区。健康对照组中,与右侧苍白球存在功能连接的脑区包括右侧颞下回、颞中回、额核、腹外侧核、右侧缘上回。健康对照组中,与左侧苍白球存在功能连接的脑区包括边缘叶、左侧颞下回、右侧丘脑、额中回、左侧中央后回。与健康对照组相比,PD震颤患者中的左侧额中眶回与右侧苍白球存在功能连接增强；与健康对照组相比,PD震颤患者中与右侧苍白球功能连接减弱的脑区包括右侧尾状核、左侧额上回。与健康对照组相比,PD震颤患者中与左侧苍白球功能连接减弱的脑区包括右侧距状皮层、左侧岛叶、左侧顶下小叶。结论：本研究发现PD震颤患者组脑内神经活动的功能连接与健康对照组之间存在差异；PD震颤患者的默认网络(DMN)和支配运动的脑区存在异常。
[Abstract]:Background: with the rapid aging of population in China, the incidence and prevalence of Parkinson's disease (PD) are increasing. At present, the pathogenesis of PD is not clear, but it seriously affects people's quality of life. Many clinical methods are used to treat PD, but the effect is still not satisfactory, so it is very important to realize the diagnosis of PD. Functional magnetic resonance (fMRI) has become one of the most important methods for the diagnosis of PD because of its high spatial and temporal resolution and noninvasive. Objective: to study the difference of brain functional connections between patients with PD tremor and healthy controls with fMRI, and to explore the characteristics of brain function in patients with PD tremor at rest. Methods: 19 patients with PD tremor and 20 healthy controls were selected for resting brain functional magnetic resonance imaging. Siemens Avanto 1.5T magnetic resonance imaging and standard orthogonal head coil were used. Magnetic resonance head axial scan and location line were placed at the level of the line of the eyebrow arch. T1-weighted 3D fast phase gradient inversion recovery (3D-SPGR) sequence was used in the anatomical images. The parameters were TRR / TEN 24ms / 6ms, FA350mm, slice thickness 0.9mm, FOVN 240mm 脳 240mm, matrix 256 脳 256fMRI using T2D- EPI-GRE sequence. The parameters are TRR / T 2000 Ms / 30ms, FA 90 掳, layer thickness 4mm, interval 1mm FOV 240mm 脳 240mm, matrix 64 脳 64, scanning time 6 min. Statistical parameter map (SPM8), rest fMRI data analysis kit (rest) and rest functional magnetic resonance data processing assistant (DPARSFA) were used to preprocess and analyze the data. Using bilateral globus pallidus as seed point, functional junction (FC) was used to analyze the difference of FC in brain between PD tremor patients and healthy subjects. Results: in patients with PD tremor, functional connections with the right globus pallidus included the cerebellar tonsil, left middle frontal lobe, right middle frontal gyrus, precentral gyrus, right cingulate gyrus. The functional connections with the left globus pallidus include subfrontal gyrus, ventral anterior nucleus, bilateral cingulate gyrus, and right auxiliary motor area. In the control group, the functional connections with the right globus pallidus included the right inferior temporal gyrus, middle temporal gyrus, frontal nucleus, ventrolateral nucleus and right superior marginal gyrus. In the healthy control group, functional connections with the left globus pallidus included the marginal lobe, the left subtemporal gyrus, the right thalamus, the middle frontal gyrus, and the left posterior central gyrus. The functional connections between the left middle frontal orbital gyrus and the right globus pallidus were enhanced in PD tremor patients compared with the healthy controls, and the regions of the brain with reduced functional connections with the right globus pallidus included the right caudate nucleus in PD tremors compared with the healthy controls. Left superior frontal gyrus. In PD tremors patients with PD tremors, the areas with reduced functional connections to the left globus pallidus included the right talocortex, the left insular lobe, and the left inferior parietal lobule. Conclusion: this study found that there were differences between the functional connections of neural activity in PD tremor group and the healthy control group. The default network (DMN) of PD tremor patients and the regions of brain innervated motion were abnormal.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R742.5;R445.2

【参考文献】