帕金森病患者脑灰质变化的VBM-MRI研究

摘要

Objective To delineate the gray matter changes of Parkinson's disease(PD) patients applied by voxel-based morphometry method (VBM) of magnetic resonance imaging (MRI). Methods of the regional gray matter volume was studied using voxel-based morphometry in 28 PD patients including 14 early stage PD (EPD) and 14 late stage PD (LPD) and 32 age- and education-matched controls. Results Compared with normal controls, PD patients had significant reductions of the gray matter volume in the frontal lobe (bilateral superior frontal gyrus, left inferior frontal gyrus), bilateral temporal lobes (superior temporal gyrus, middle temporal gyrus), right cingulated gyrus, right thalamus, bilateral caudate nucleus, and left inferior parietal lobe . Compared with EPD, LPD had significant reductions of gray matter volume in the frontal lobe(bilateral superior frontal gyrus, right inferior frontal gyrus, right orbitofrontal cortex and bilateral medial anterior frontal lobe), temporal lobe (right superior temporal gyrus, left middle temporal gyms),right parahippocampal gyrus, right caudate nucleus and right hypothalamus. Conclusions PD patients have significant reductions of the gray matter volume mainly in the frontal lobe, temporal lobe, right cingulate gyrus and subcor-tical gray matter. With the progression of PD, the reductions of gray matter volume increase in these regions and expend to the limbic system.%目的 应用核磁共振的基于体素形态学(voxel-based morphometry method of magnetic resonance imaging.VBM-MRI)技术,研究帕金森病(Parkinson disease,PD)患者大脑灰质变化的状况.方法 28例PD组与年龄、受教育年限相匹配32例健康对照组的VBM-MRI图像数据进行比较,PD组中,早期PD组(early Parkinson disease.EPD,n=14)与晚期PD组((late Parkinson disease.LPD,n=14)的VBM-MRI图像数据进行比较.结果 与健康对照组比较.VBM-MRI显示PD组患者存在下列脑区灰质体积减少:额叶(双侧额上回、左额下回)、双侧颞叶(颞上回、颞中回)、右侧扣带回、右侧丘脑、双侧尾状核及左顶下小叶.与EPD比较.VBM-MRI显示LPD在下列脑区存在灰质体积减少:额叶(双侧额上回、右侧额下回、右侧额叶眶部、双侧内侧前额叶),颞叶(右侧颞上回、左侧颞中回),右侧海马旁回、右侧尾状核、右侧下丘脑,差异均有显著统计学意义.结论 本组PD患者的脑灰质改变,主要集中在额叶、颞叶、右侧扣带回及皮质下的灰质.随着PD病程进展,这些部位的灰质减少加剧,并在边缘叶有进展的趋势.