摘要
目的特发性快眼动睡眠行为障碍(idopathic rapid eye movement sleep behavior disorder,iRBD)又称帕金森病临床前期,为寻找其早期损害的证据,利用功能核磁共振探查其早期大脑自发活动性的改变,以提供其脑损害的影像证据。方法选取符合诊断标准的iRBD 21例,性别、年龄匹配的健康对照组22例,进行认知量表及统一帕金森病等级评分-运动部分(Unified Parkinson’s Disease Rating Scale motor section,UPDRSⅢ)测评,并进行功能磁振扫描,利用局部一致性(region homogeneity,ReHo)方法进行数据分析;结果与正常对照组相比,iRBD组Rey-Osterrieth复杂图形测验(ROCFT)、听词语学习测验(AVLT)N1、N2、N3、符号数字模式测验(SDMT)、数字排序测验-注意力部分(DOT-A)得分均下降(U=133.5、t=-2.416、t=-2.873、U=134.5、U=81.0、U=144.5,P<0.05),连线测验B(TMT-B)及UPDRSⅢ得分明显增加(U=138.0、U=121.0,P<0.05);与对照组比较,iRBD组基底节区右尾状核、左壳核、右壳核及右苍白球局部一致性明显下降(t=-4.611、t=-4.360、t=-4.298、t=-3.422,P<0.05)。结论iRBD患者存在视空间、记忆、执行、注意及运动方面损害,其基底节区神经团块内部自发活动一致性明显下降,提示基底节区功能活动异常,可能是iRBD早期基底节损害的标记。
Objective To explore early damaged evidence,we checked spontaneous brain activity by resting-state functional magnetic resonance imagine(rs-fMRI)in iRBD recalled preclincal to Parkinsion in order to provide reliable imaging information.Methods Recruited 21 iRBD patients according with international diagnostic criteria,and 22 gender,age matched health controls.All subjects were examined by cognitive tests,UPDRSⅢ and rs-fMRI,and rs-fMRI data were analyzed using region homogeneity(ReHo)means.Result The scores of Rey-Osterrieth Complex Figure Test-copy,N1,N2,and N3 of Auditory Verbal Learning Test(AVLT),symblo digit modalities test(SDMT),Digit order test-attention(DOT-A)respectively in the iRBD group,which were significantly lower than that in the health control(HC)group respectively(U=133.5,t=-2.416,t=-2.873,U=134.5,U=81.0,U=144.5,P<0.05).The scores of Trail Making Test B(TMT-B)and Unified Parkinson’s Disease Rating Scale motor section(UPDRSⅢ-motor)were significantly lower than that in the HC group respectively(U=138.0,U=121.0,P<0.05).Compare with the HC groups,decreased ReHo were in right caudate,bilateral putamen and right pillidum in iRBD group respectively(t=-4.611,t=-4.360,t=-4.298,t=-3.422,P<0.05).Conclusion There were impairments in visual space,memory,executive function,attention and movement in iRBD patients,as well as abnormal brain spontaneous activity in striatum,which may be a early marker of striatum damage.
作者
王曼
王升辉
李中林
白莹莹
周瑶
张红菊
WANG Man;WANG Shenghui;LI Zhonglin(Department of Medical Imaging Centre,Department of Neurology,Henan Province People’Hospital,Zhengzhou 450003,China)
出处
《中风与神经疾病杂志》
CAS
2021年第5期399-403,共5页
Journal of Apoplexy and Nervous Diseases
基金
河南省医学科技攻关计划项目(201601022)。
