摘要
目的观察伴单侧肢体运动症状的早期帕金森病(PD)患者双侧大脑半球胶质淋巴系统功能改变。方法前瞻性纳入52例仅单侧肢体出现运动症状的早期PD患者,包括左发型(LPD)21例(LPD组)、右发型(RPD)31例(RPD组);另招募28名健康人作为健康对照组(HC组)。比较3组及两两组间临床表现及沿血管周围间隙的弥散张量成像分析(DTI-ALPS)指数,分析后者与临床量表评分结果的相关性。结果3组间汉密尔顿抑郁量表(HAMD)评分差异有统计学意义(P<0.05);LPD组和RPD组HAMD评分均高于HC组(P均<0.017)。3组间左侧大脑半球DTI-ALPS(DTI-ALPS_L)和右侧大脑半球DTI-ALPS(DTI-ALPS_R)指数差异均有统计学意义(P均<0.05);LPD组DTI_ALPS_R指数、RPD组DTI_ALPS_L指数均低于HC组(P<0.017)。PD患者双侧大脑半球DTI-ALPS指数与临床量表评分无明显相关性(P均>0.05)。结论PD患者胶质淋巴系统功能减退与运动症状同样呈偏侧化,表现为LPD患者DTI-ALPS_R指数下降、RPD患者DTI-ALPS_L指数下降。
Objective To observe the glymphatic system functional changes of bilateral cerebral hemispheres in early-stage Parkinson disease(PD)patients complicated with unilateral limb motor symptoms.Methods A total of 52 early-stage PD patients complicated with unilateral limb motor symptoms were prospectively enrolled,including 21 cases of left-onset PD(LPD group),31 cases of right-onset PD(RPD group).Meanwhile,28 healthy individuals were recruited as healthy controls(HC group).Clinical data and indices of diffusion tensor imaging analysis along the perivascular space(DTI-ALPS)were compared among 3 groups and between each 2 groups.The correlations of DTI-ALPS indices and clinical scales were analyzed.Results Significant difference of Hamilton depression scale(HAMD)score was found among 3 groups(P<0.05).HAMD score of LPD group and RPD group were higher than that of HC group(both P<0.017).There were significant differences of left and right cerebral hemispheres DTI-ALPS(DTI-ALPS_L,DTI-ALPS_R)indices among 3 groups(both P<0.05).DTI_ALPS_R in LPD group was lower than that in HC group(P<0.017),and DTI_ALPS_L in RPD group was lower than that in HC group(P<0.017).No obvious correlation of bilateral cerebral hemisphere DTI-ALPS indices with clinical scales was detected in PD patients(all P>0.05).Conclusion Like that of motor symptoms,glymphatic system dysfunction of PD patients had characteristics of laterality,manifested as DTI_ALPS_R decreased in LPD patients while DTI_ALPS_L decreased in RPD patients.
作者
刘玉靖
袁佳莹
廖海燕
谭长连
蔡赛男
LIU Yujing;YUAN Jiaying;LIAO Haiyan;TAN Changlian;CAI Sainan(Department of Radiology,the Second Xiangya Hospital of Central South University,Changsha 410011,China)
出处
《中国医学影像技术》
CSCD
北大核心
2023年第12期1787-1791,共5页
Chinese Journal of Medical Imaging Technology
基金
国家重点研发计划(2022YFC2009900)
湖南省自然科学基金(2022JJ30818)
长沙市自然科学基金(kq2202416)
湖南省临床医疗技术创新引导项目(2021SK53502)。
关键词
帕金森病
脑
胶质淋巴系统
弥散张量成像
Parkinson disease
brain
glymphatic system
diffusion tensor imaging
