摘要
目的脑深部电刺激(deep brain stimulation,DBS)作为帕金森病的一种外科治疗方法,在临床上得到了广泛的应用,然而,其疗效的潜在机制仍然不详。本研究采用功能磁共振成像(functional magnetic resonance,fMRI)作为工具,试图探索与DBS有关的脑功能连接模式,并通过分析大脑功能连接来阐明DBS治疗的潜在机制。方法41例诊断帕金森病并接受DBS治疗的患者,在手术前和手术后1年收集帕金森病评定量表(UPDRS III)数据。为了检查运动症状改善与大脑功能连接之间的关系,利用fMRI数据对皮层下连接网络进行相关性分析。应用线性回归来预测运动改善结果,并通过留一交叉验证法检验预测模型的准确性。结果帕金森病患者fMRI所得脑功能连接与DBS手术临床结果存在相关性,功能连接分析显示双侧红核与壳核的功能连接与UPDRS-III评分的术后变化之间存在显着关联(左侧:r=-0.44,P=0.0056,右侧r=-0.46,P=0.0029)。结论大脑红核和壳核之间的功能连接可以作为接受DBS手术的帕金森病患者治疗效果的重要预测指标。
Objective The aim of this study was to investigate the differences in clinical response and imaging data before and after surgery in patients with Parkinson’s disease and to attempt to predict clinical response using connectivity differences.Methods Connectivity analysis was performed on resting-state functional magnetic resonance imaging(rs-MRI)of 41 patients with Parkinson’s disease who underwent deep brain stimulation,and the subcortical connectivity network was calculated,evaluated before and one year after surgery on the UPDRSIII scale,correlated with the above-mentioned brain connectivity network,and predicted clinical motor symptoms,and predictive performance was discussed based on actual clinical improvement.Results Functional connectivity(FC)between the subcortical nuclei of interest and the DBS response showed that FC from bilateral red nuclei to the shell nuclei correlated with overall changes in UPDRS-III(left:r=-0.44P=0.0056,right r=-0.46p=0.0029,P<0.05 after FDR correction).In addition,FC predicted the change in UPDRSIII 1 year after DBS(r=0.5P=0.0011 error rate=0.175).Conclusion The functional connectivity between the putamen and the red nucleus can serve as an important predictor of treatment outcomes in PD patients undergoing DBS surgery.
作者
倪陈
陈鹏
熊赤
蒋曼丽
梅加明
牛朝诗
Ni Chen;Chen Peng;Xiong Chi(Department of Neurosurgery,Anhui Provincial Hospital Affiliate to Anhui Medical University.2Department of Neurosurgery,The First Affiliated Hospital of USTC,Anhui Province Key Laboratory of Brain Function and Brain Disease,Hefei,230001,China)
出处
《立体定向和功能性神经外科杂志》
2023年第1期13-16,共4页
Chinese Journal of Stereotactic and Functional Neurosurgery
关键词
帕金森病
脑深部电刺激
功能磁共振
神经网络分析
Parkinson’s disease
Deep brain stimulation
Functional magnetic resonance
Functional connectivity analysis
