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目的通过磁共振扩散张量成像(DTI)的基于纤维束示踪的空间统计分析(TBSS)技术研究帕金森病(PD)脑白质微结构的损害。方法 PD患者31例和健康对照组34名行磁共振检查,扫描序列包括常规磁共振平扫和DTI,通过TBSS技术比较PD组与对照组白质纤维束的各向异性分数(FA)值,寻找FA值有显著性差异的脑白质纤维束,并分析PD组白质纤维束损伤与MoCA、MMSE、HAMD、ADL和UPDRSIII评分的相关性。结果 PD组有多个纤维束FA值明显低于健康对照组,主要包括胼胝体、上纵束、扣带束、视辐射、额叶及颞叶皮层下弓形纤维、脑干及内囊的白质束。其中胼胝体压部、左上纵束、右上纵束、小脑中脚FA值与MMSE评分呈正相关;右上纵束、左皮质脊髓束、左小脑上脚、右皮质脊髓束和小脑中脚FA值与HAMD评分呈负相关;胼胝体压部、左上纵束、右上纵束FA值与ADL评分呈负相关。结论磁共振DTI的TBSS技术能够发现PD患者白质微结构的损害及其与认知和抑郁之间的关系,有助于研究PD患者认知功能障碍和抑郁的发生机制。
Objective To investigate the damage of white matter microstructure of Parkinson’s disease (PD) by spatial statistical analysis (TBSS) based on fiber bundle tracing using magnetic resonance diffusion tensor imaging (DTI). Methods Totally 31 PD patients and 34 healthy controls were examined by magnetic resonance imaging (MRI). The scanning sequences included conventional magnetic resonance plain scan and DTI. The anisotropic fraction (FA) values of white matter in PD and control groups were compared by TBSS FA values were significantly different in the white matter fiber bundles, and analysis of PD group white matter damage and MoCA, MMSE, HAMD, ADL and UPDRSIII score correlation. Results The FA values of multiple fiber bundles in PD group were significantly lower than those in healthy control group, mainly including corpus callosum, superior longitudinal bundle, cingulate bundle, optic radiation, arcuate fibers in frontal and temporal cortex, white matter bundles in brainstem and internal capsule . The FA value of corpus callosum, left superior longitudinal bundle, right superior longitudinal bundle and cerebellum middle foot was positively correlated with MMSE score; FA value of right superior longitudinal bundle, left corticospinal tract, left superior cerebral cortex, right corticospinal tract and cerebellum midfoot and HAMD Score negatively correlated; FA value of the body pressure of the corpus callosum, the left upper longitudinal and the right vertical longitudinal beam were negatively correlated with the ADL score. Conclusion The magnetic resonance DTI TBSS technique can detect the damage of white matter microstructure and its relationship with cognitive and depression in PD patients and help to study the mechanism of cognitive dysfunction and depression in PD patients.