早期帕金森病脑白质特征的扩散张量成像基于纤维束追踪空间统计分析
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摘要
目的采用扩散张量成像(DTI)基于纤维束追踪空间统计分析(TBSS)观察早期(Hoehn-Yahr 1~2级)帕金森病(PD)患者脑白质结构的变化,探索DTI多参数变化与PD患者综合评分量表(UPDRS)评分升高具有显著相关的脑区。资料与方法 27例早期PD患者及30例正常对照组行DTI检查,采用TBSS技术分析两组受试者脑白质纤维DTI的各相关参数,包括各向异性分数(FA)、平均扩散系数(MD)、轴向扩散系数(AD)、平行扩散系数(RD),比较两组各DTI参数的差异,分析PD组有差异脑区的FA、MD、RD值与临床UPDRS评分的相关性。结果与对照组相比,PD组多个脑白质区FA值降低,MD、RD值升高(P<0.05),AD值未见明显变化(P>0.05)。PD组较对照组有差异脑区的FA值、MD值、RD值与UPDRS评分均有相关关系(P=0.001);FA值降低和MD、RD值升高并与UPDRS评分具有显著相关的脑区为胼胝体、左侧内囊前肢、双侧前放射冠、双侧上放射冠、左丘脑后辐射(P=0.001)。结论 PD患者存在脑白质结构的改变,可能是髓鞘脱失或纤维完整性受到破坏。
Purpose To observe white matter structure features of patients with early stage(Hoehn-Yahr 1-2 phase) Parkinson's disease(PD) by using diffusion tensor imaging(DTI) based on the fiber bundle analysis tract-based spatial statistics(TBSS); and to explore the brain regions of PD patients in which DTI parameters are significantly correlated with unified Parkinson's disease rating scale(UPDRS) score elevation.Materials and Methods DTI sequence was performed on 27 cases of PD and 30 cases of healthy volunteers.DTI parameters including fractional anisotropy(FA),mean diffusivity(MD),axial diffusivity(AD),and radial diffusivity(RD) were analyzed in all participants by using TBSS technique,and the parameters of two groups were compared.The correlation of clinical UPDRS score with FA value,MD and RD value in the PD group were analyzed.Results Compared with that in the control group,FA values of several brain regions in PD group decreased,while MD and RD value increased(P<0.05).AD showed no obvious change(P>0.05).UPDRS score of PD group was correlated with FA,MD and RD value(P=0.001).The brain regions that showed FA value decreased,MD and RD value increased included corpus callosum,left anterior limb of internal capsule,bilateral anterior radial crown,bilateral superior radial crown and left posterior thalamic radiation(P=0.001).Conclusion There is some changes in white matter structure of the patients with early stage Parkinson's disease,which may due to demyelination or fiber integrity damaged.
Purpose To observe white matter structure features of patients with early stage(Hoehn-Yahr 1-2 phase) Parkinson's disease(PD) by using diffusion tensor imaging(DTI) based on the fiber bundle analysis tract-based spatial statistics(TBSS); and to explore the brain regions of PD patients in which DTI parameters are significantly correlated with unified Parkinson's disease rating scale(UPDRS) score elevation.Materials and Methods DTI sequence was performed on 27 cases of PD and 30 cases of healthy volunteers.DTI parameters including fractional anisotropy(FA),mean diffusivity(MD),axial diffusivity(AD),and radial diffusivity(RD) were analyzed in all participants by using TBSS technique,and the parameters of two groups were compared.The correlation of clinical UPDRS score with FA value,MD and RD value in the PD group were analyzed.Results Compared with that in the control group,FA values of several brain regions in PD group decreased,while MD and RD value increased(P<0.05).AD showed no obvious change(P>0.05).UPDRS score of PD group was correlated with FA,MD and RD value(P=0.001).The brain regions that showed FA value decreased,MD and RD value increased included corpus callosum,left anterior limb of internal capsule,bilateral anterior radial crown,bilateral superior radial crown and left posterior thalamic radiation(P=0.001).Conclusion There is some changes in white matter structure of the patients with early stage Parkinson's disease,which may due to demyelination or fiber integrity damaged.
引文
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[17]席一斌,刘康,折霞,等.采用基于纤维骨架的空间统计方法分析创伤后应激障碍患者急性期全脑白质结构变化情况.中华放射学杂志,2013,47(3):207-210.
[18]Kendi A,Lehericy S,Luciana M,et al.Altered diffusion in the frontal lobe in Parkinson disease.Am J Neuroradiol,2008,29(3):501-505.
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[20]Haller S,Badoud S,Nguyen D,et al.Individual detection of patients with Parkinson disease using support vector machine analysis of diffusion tensor imaging data:initial results.Am J Neuroradiol,2012,33(11):2123-2128.
[2]王玉红,沈钧康,刘春风,等.帕金森病患者脑灰质核团T2弛豫时间的初步研究.医学影像学杂志,2010,20(1):9-13.
[3]吴青霞,丁蓓,凌华威,等.磁共振扩散张量成像在评估帕金森病脑内白质改变中的应用.实用放射学杂志,2010,26(7):923-925,966.
[4]伊慧明,江山.基于纤维束示踪的空间统计方法研究进展及其应用.国际医学放射学杂志,2011,34(2):162-165.
[5]Gattellaro G,Minati L,Grisoli M,et a1.White matter involve merit in idiopathic parkinson disease:a diffusion tensor imaging study.Am J Neuroradiol,2009,30(6):1222-1226.
[6]Zhang K,Yu C,Zhang Y,et al.Voxel-based analysis of diffusion tensor indices in the brain in patients with Parkinson's disease.Eur J Radiol,2011,77(2):269-273.
[7]Ibarretxe-Bilbao N,Junque C,Marti MJ,et al.Olfactory impairment in Parkinson's disease and whitematter abnormalities in central olfactory areas:a voxel-based diffusion tensor imaging study.Mov Disord,2010,25(12):1888-1894.
[8]刘兆会,李猛,鲜军舫,等.采用基于纤维束示踪的空间统计分析方法观察先天性耳聋患者的脑白质改变.中国医学影像技术,2010,26(7):1226-1229.
[9]Gelb DJ,Oliver E,Gilman S.Diagnostic criteria for Parkinson disease.Arch Neurol,1999,56(1):33-39.
[10]Vieira Karuta SC,Raskin S,De Carvalho Neto A,et al.Diffusion tensor imaging and tract-based spatial statistics analysis in Friedreich's ataxia patients.Parkinsonism Relat Disord,2015,21(5):504-508.
[11]Miao W,Li J,Tang M,et al.Altered white matter integrity in adolescents with prelingual deafness:a high-resolution tractbased spatial statistics imaging study.Am J Neuroradiol,2013,34(6):1264-1270.
[12]Smith SM,Nichols TE.Threshold-free cluster enhancement:addressing problems of smoothing,threshold dependence and localisation in cluster inference.Neuroimage,2009,44(1):83-98.
[13]Yilmaz N,Karaali K,Ozdem S,et al.Elevated S100B and neuron specific enolase levels in patients with migraine-without aura:evidence for neurodegeneration?Cell Mol Neurobiol,2011,31(4):579-585.
[14]Kunimatsu N,Aoki S,Kunimatsu A,et al.Tract-specific analysis of white matter integrity disruption in schizophrenia.Psychiatry Res,2012,201(2):136-143.
[15]Du GW,Lewis MM,Styner M,et al.Combined R2*and diffusion tensor imaging changes in the substantia nigra in Parkinson's disease.Mov Disord,2011,26(9):1627-1632.
[16]Schwarz ST,Abaei M,Gontu V,et al.Diffusion tensor imaging of nigral degeneration in Parkinson's disease:a region-ofinterest and voxel-based study at 3 T and systematic review with meta-analysis.Neuroimage Clin,2013,3:481-488.
[17]席一斌,刘康,折霞,等.采用基于纤维骨架的空间统计方法分析创伤后应激障碍患者急性期全脑白质结构变化情况.中华放射学杂志,2013,47(3):207-210.
[18]Kendi A,Lehericy S,Luciana M,et al.Altered diffusion in the frontal lobe in Parkinson disease.Am J Neuroradiol,2008,29(3):501-505.
[19]Kim HJ,Kim SJ,Kim HS,et al.Alterations of mean diffusivity in brain white matter and deep gray matter in Parkinson's disease.Neurosci Lett,2013,550(550):64-68.
[20]Haller S,Badoud S,Nguyen D,et al.Individual detection of patients with Parkinson disease using support vector machine analysis of diffusion tensor imaging data:initial results.Am J Neuroradiol,2012,33(11):2123-2128.