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.
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