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帕金森病靜止性震顫腦功能連接的功能磁共振成像研究

發(fā)布時間:2018-07-17 20:46
【摘要】:背景: 隨著我國人口老齡化速度的加快,帕金森病(PD)的發(fā)病率和患病率越來越高。目前PD的發(fā)病機制尚未明確,但它嚴重影響著人們的生活質量。臨床上采用多種方法治療PD,但效果仍不理想,因此實現(xiàn)對PD的診斷是十分重要的。功能磁共振(fMRI)由于具有較高的時間和空間分辨率,且具有無創(chuàng)性,成為目前診斷PD的重要手段之一。 目的: 利用fMRI研究靜息狀態(tài)下PD震顫患者與健康對照者之間的腦部功能連接的差異,初步探討PD震顫患者靜息狀態(tài)下的腦功能活動特點。 方法: 選擇19例PD震顫患者與20例健康對照者進行靜息態(tài)腦功能磁共振成像,采用Siemens Avanto1.5T磁共振,使用標準正交頭顱線圈。 磁共振頭部橫軸位掃描,定位線置于眉弓連線水平,解剖圖像采用T1加權三維快速擾相梯度翻轉恢復(3D-SPGR)序列,參數(shù)為TR/TE=24ms/6ms, FA350,層厚0.9mm, FOV=240mm×240mm,矩陣=256×256;fMRI掃描序列采用T2*-EPI-GRE序列,參數(shù)為TR/TE=2000ms/30ms, FA90°,層厚4mm,間隔1mm,FOV=240mm×240mm,矩陣=64×64;掃描時間為6min。 數(shù)據處理采用統(tǒng)計參數(shù)圖(SPM8)、靜息態(tài)fMRI數(shù)據分析工具包(REST)、靜息態(tài)功能磁共振數(shù)據處理助手(DPARSFA)等軟件對功能數(shù)據進行預處理和統(tǒng)計學分析。分別以雙側蒼白球為種子點,采用功能連接(FC)的方法,分析PD震顫患者和健康者腦部FC的差異。 結果: PD震顫患者中,與右側蒼白球存在功能連接的腦區(qū)包括小腦扁桃體、左側額中葉、右側額中回、中央前回、右側扣帶回。PD震顫患者中,與左側蒼白球存在功能連接的腦區(qū)包括額下回、腹前核、雙側扣帶回、右側輔助運動區(qū)。 健康對照組中,與右側蒼白球存在功能連接的腦區(qū)包括右側顳下回、顳中回、額核、腹外側核、右側緣上回。健康對照組中,與左側蒼白球存在功能連接的腦區(qū)包括邊緣葉、左側顳下回、右側丘腦、額中回、左側中央后回。 與健康對照組相比,PD震顫患者中的左側額中眶回與右側蒼白球存在功能連接增強;與健康對照組相比,PD震顫患者中與右側蒼白球功能連接減弱的腦區(qū)包括右側尾狀核、左側額上回。與健康對照組相比,PD震顫患者中與左側蒼白球功能連接減弱的腦區(qū)包括右側距狀皮層、左側島葉、左側頂下小葉。 結論: 本研究發(fā)現(xiàn)PD震顫患者組腦內神經活動的功能連接與健康對照組之間存在差異;PD震顫患者的默認網絡(DMN)和支配運動的腦區(qū)存在異常。
[Abstract]:Background: with the rapid aging of population in China, the incidence and prevalence of Parkinson's disease (PD) are increasing. At present, the pathogenesis of PD is not clear, but it seriously affects people's quality of life. Many clinical methods are used to treat PD, but the effect is still not satisfactory, so it is very important to realize the diagnosis of PD. Functional magnetic resonance (fMRI) has become one of the most important methods for the diagnosis of PD because of its high spatial and temporal resolution and noninvasive. Objective: to study the difference of brain functional connections between patients with PD tremor and healthy controls with fMRI, and to explore the characteristics of brain function in patients with PD tremor at rest. Methods: 19 patients with PD tremor and 20 healthy controls were selected for resting brain functional magnetic resonance imaging. Siemens Avanto 1.5T magnetic resonance imaging and standard orthogonal head coil were used. Magnetic resonance head axial scan and location line were placed at the level of the line of the eyebrow arch. T1-weighted 3D fast phase gradient inversion recovery (3D-SPGR) sequence was used in the anatomical images. The parameters were TRR / TEN 24ms / 6ms, FA350mm, slice thickness 0.9mm, FOVN 240mm 脳 240mm, matrix 256 脳 256fMRI using T2D- EPI-GRE sequence. The parameters are TRR / T 2000 Ms / 30ms, FA 90 擄, layer thickness 4mm, interval 1mm FOV 240mm 脳 240mm, matrix 64 脳 64, scanning time 6 min. Statistical parameter map (SPM8), rest fMRI data analysis kit (rest) and rest functional magnetic resonance data processing assistant (DPARSFA) were used to preprocess and analyze the data. Using bilateral globus pallidus as seed point, functional junction (FC) was used to analyze the difference of FC in brain between PD tremor patients and healthy subjects. Results: in patients with PD tremor, functional connections with the right globus pallidus included the cerebellar tonsil, left middle frontal lobe, right middle frontal gyrus, precentral gyrus, right cingulate gyrus. The functional connections with the left globus pallidus include subfrontal gyrus, ventral anterior nucleus, bilateral cingulate gyrus, and right auxiliary motor area. In the control group, the functional connections with the right globus pallidus included the right inferior temporal gyrus, middle temporal gyrus, frontal nucleus, ventrolateral nucleus and right superior marginal gyrus. In the healthy control group, functional connections with the left globus pallidus included the marginal lobe, the left subtemporal gyrus, the right thalamus, the middle frontal gyrus, and the left posterior central gyrus. The functional connections between the left middle frontal orbital gyrus and the right globus pallidus were enhanced in PD tremor patients compared with the healthy controls, and the regions of the brain with reduced functional connections with the right globus pallidus included the right caudate nucleus in PD tremors compared with the healthy controls. Left superior frontal gyrus. In PD tremors patients with PD tremors, the areas with reduced functional connections to the left globus pallidus included the right talocortex, the left insular lobe, and the left inferior parietal lobule. Conclusion: this study found that there were differences between the functional connections of neural activity in PD tremor group and the healthy control group. The default network (DMN) of PD tremor patients and the regions of brain innervated motion were abnormal.
【學位授予單位】:廣州中醫(yī)藥大學
【學位級別】:碩士
【學位授予年份】:2014
【分類號】:R742.5;R445.2

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