弥散张量成像在早期帕金森病伴发抑郁症状的初步 - 第三军医大学学报.docVIP

早期帕金森病伴抑郁患者边缘系统白质微结构的改变 段晓佳，朱红灿，吴川杰，牛瑞娜，焦淑洁，刘永磊 作者单位：郑州大学第一附属医院神经内科，河南 郑州 450052 摘 要: 目的 探讨早期帕金森病（PD）伴发抑郁症状（PD with depression，PDD）患者边缘系统脑白质微结构的改变，为临床早期诊断PDD提供依据。方法 纳入早期原发性PD患者16例，其中PDD患者7例，不伴发抑郁症状（PD without depression, PDND）9例，选取同期年龄、性别、受教育程度匹配的健康志愿者16例。所有受试者均行汉密顿抑郁量表（Hamilton Depressive Scale,HAMD）、统一帕金森病评定量表运动部分（Unified Parkinsons Disease Rating Scale,UPDRS 3.0版）、HY分期评定及MRI+DTI检查，测量边缘系统各感兴趣区域（region-of-interest，ROI)部分各向异性( fractional anisotropy，FA) 及平均弥散系数(average diffusion coefficient，ADC)，进行统计分析。结果 PD组较健康对照组HAMD评分高（P0.05）；除右丘脑背内侧外，PDD组较健康对照组各ROI区FA值均有下降（P0.05）；PDD组左额叶眶部、双侧前扣带束及左丘脑背内侧FA值较PDND组下降显著（P0.01）；三组间各ROI区ADC值无统计学差异。结论 早期PD伴抑郁患者边缘系统已出现广泛白质微结构的异常改变，其中左额叶眶部、双侧前扣带束及左丘脑背内侧FA值的下降对PDD患者的早期诊断有重要参考价值。 关键词： 帕金森病； 抑郁症状； 边缘系统； 白质； 部分各向异性 中图分类号：R742.5 White-matter changes in limbic system of the patients with depressive symptoms in early-stage Parkinsons disease Duan Xiaojia, Zhu Hongcan, Wu Chuanjie, Niu Ruina, Jiao Shujie, Liu Yonglei.(Department of Neurology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China) Abstract: Objective To investigate white-matter changes in limbic system of the patients with depressive symptoms in early-stage Parkinsons disease, aimed to provide the basis for early diagnosis of PDD. Methods 16 patients with early idiopathic Parkinsons disease (PD) were divided into two groups: those with depression (PDD) and those without (PDND), 16 healthy volunteers were also enrolled in this study. All subjects were assessed by Hamilton depressive scale (HAMD), unified Parkinsons Disease Rating Scale motor part (UPDRS version 3), HY staging and inspected by MRI+DTI. Fractional anisotropy (FA) and average diffusion coefficient (ADC) of each region of interest (ROI) were measured and recorded, underwent statistical analysis. Results The HAMD score in PD group was higher than that in healthy control group (P0.05); except the right medial dorsal thalamus, FA of each ROI in PDD group was lower than that in