应用基于体素的形态测量学方法分析原发性手震颤患者灰质体积变化

摘要

Objective To investigate the abnormalities of brain gray matter volume in patients with clinically-confirmed essential tremor (ET)of the hands only.Methods We analyzed brain gray matter voxel of 1 7 patients (younger than 55 years)with ET of the hands only and 1 7 healthy controls matched in age,gender and education by optimized voxel-based morphometry (VBM).Results VBM showed marked expansion of the bilateral cerebella, occipital fusiform cortices,and precentral lobes (P uncorrected < 0.005 )in ET patients compared with the controls. Atrophy was only detected in left parietal lobe.We also found volume enlargement in the thalamus,midbrain,and melluda of the left side by region of interest (ROI )analysis (P uncorrected <0.005).Conclusion Patients with arm tremor show expansion of gray matter,which might represent the adaptive reorganizational compensation through the increased demand on the visuospatial control of skilled movements in ET patients with early-stage arm tremor. These morphological changes may help to assess early stage and distinguish subtype of ET.%目的：评价单纯手震颤的原发性震颤(essential tremor,ET)患者脑内灰质体积变化。方法选取 l7例临床确诊的,年龄小于55岁的单纯手震颤 ET 患者及17名年龄、性别、教育程度匹配的正常对照者,行全脑三维快速扰相梯度回波(3D fast spoiled gradient echo,3D FSPGR)序列扫描,采用基于体素的形态测量学(voxel-based morphometry, VBM)分析方法,对 ET 患者及正常对照者的脑内灰质体素进行分析。结果与正常对照组相比,ET 患者脑内可见双侧小脑半球前叶、枕叶、颞叶及中央前回体积增大以及左侧顶叶体积缩小(P uncor ected <0.005)；进一步的感兴趣区(region-of-interest,ROI)测定发现左侧丘脑、中脑及延髓体积膨大,桥脑体积缩小(P uncor ected <0.005)。结论应用VBM 方法对于单纯手震颤 ET 患者磁共振图像分析,能够客观揭示其脑内独特的灰质体积改变,有助于进一步探讨ET 的发病机制。