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目的 探讨帕金森病(PD)患者静息态功能性磁共振成像(fMRI)的影像学改变. 方法 选择福建医科大学附属第一医院神经外科自2013年9月至2014年3月收治的PD患者12例,以同期健康体检者12例做为正常对照组,采用基于血氧水平依赖(BOLD)的fMRI技术进行静息态磁共振扫描,统计分析PD组与正常对照组受试者低频振幅(ALFF)图和局部一致性(ReHo)图的差异以及PD组患者脑区ALFF值、ReHo值与帕金森综合评分量表(UPDRSⅢ)评分、Hoehn-Yahr分级的相关性. 结果 与正常对照组比较,PD组患者ALFF值减低的脑区为左侧丘脑,ALFF值增加的脑区为边缘叶、右侧海马旁回、右颞中极.PD组患者小脑后叶、小脑扁桃体区ALFF值与UPDRSⅢ评分呈正相关,左额上回ALFF值与Hoehn-Yahr分级呈负相关.与正常对照组比较,PD组患者ReHo值减低的脑区为左罗兰氏岛盖部、左颞上回、岛叶;ReHo值增加的脑区为左侧额上回、右额上回、左额中回、BA9、额内侧回.PD组患者右颞上回、右岛叶,ReHo值与UPDRSⅢ评分呈负相关,额内侧回、边缘叶、前扣带回、额内侧眶部、额上回中部、BA32、BA10脑区ReHo值与Hoehn-Yahr分级呈正相关. 结论 PD患者脑功能存在异常,ReHo、ALFF改变与非运动症状及脑连接环路的异常有关,脑功能增强可能是一种代偿性反应.

Objective To explore the changes of rest-state functional MRI (fMRI) features in patients with Parkinson's disease.Methods Twelve patients with Parkinson's disease,collected in our hospital from September 2013 to March 2014,and 12 volunteers (controls) were recruited.The fMRI based on blood oxygen level dependent (BOLD) was performed at resting state; the differences of amplitude of low frequency fluctuation (ALFF) and regional homogeneity (ReHo) were statistically analyzed; and the correlations of values of ALFF and ReHo with uniformed Parkinsonism rating scale (UPDRS) scores and Hoehn-Yahr (H-Y) grading were analyzed.Results PD patients exhibited increased ALFF values in the limbic lobe,the right parahippocampal gyrus and the right middle temporal pole,and reduced ALFF values in the left thalamus as compared with the controls.PD patients exhibited increased ReHo values in the superior medial frontal gyrus,the left middle frontal gyrus,brodmann area (BA) 9 and medial frontal gyrus,and reduced ReHo values in the left rolandic,the left superior temporal gyrus and insula lobe as compared with the controls.ALFF values were positively correlated with the UPDRS Ⅲ scores in the right posterior cerebellum lobe and cerebellar tonsil.ALFF values and H-Y grading were negatively correlated on the left superior frontal gyrus.Negative correlation was noted between the ReHo values and UPDRS Ⅲ scores in the right superior temporal gyrus and insular lobe.Positive correlation was noted between the ReHo values and H-Y grading in medial frontal gyrus,limbic lobe,anterior cingulate,medial orbitofrontal area,middle superior frontal gyrus,BA32,left superior frontal gyrus and BA10.Conclusion By resting-state fMRI,abnormal brain function in Parkinson's disease was noted; ReHo and ALFF showed abnormal changes in the connection of neuronal networks,and the compensatory response may lead to the increased brain function.