中风与神经疾病杂志2017，Vol.34Issue(1)：21-26,6.
MRS 联合 DTI 评估帕金森病认知障碍的初步研究
Evaluation the Parkinson’s disease patients with congnitive impairment using 1H magnetic resonance spectroscopy and diffusion tensor imaging
摘要
Abstract
Objective To investigate the cerebral lesions in Parkinson ’ s disease patients with cognitive impairment by using 1H magnetic resonance spectroscopy(1H -MRS)and diffusion tensor imaging (DTI),and to assess the value of these advanced MRI techniques in early diagnosis and severity assessment of PD-CI.Methods Fourteen patients with PD and fourteen normal controls were recruited .Disease severity of the PD patients was measured with Hoehn and Yahr scale . Cognitive damage of all the subjects was measured with Montreal Cognitive Assessment ( MoCA) scale.The resonance sig-nals concentration of N-acetylaspartate (NAA),Choline (Cho),and Creatine (Cr) in the bilateral frontal lobes,temporal lobes,substantia nigra and corpus striatum were measured .Fractional anisotropy (FA) values in the same ROI regions were examined by using DTI .The relationships were analyzed among the MoCA sores ,MRS ratios,and the DTI values .Results The MoCA sore showed an apparent decrease in the PD patients (20.29 ±2.867)compared with controls (26.36 ±1. 393)(P<0.05).The NAA/Cr ratio showed a gradual decrease in the frontal lobe ,temporal lobe,and corpus striatum of PD patients compared with controls (P<0.05).But the NAA/Cr ratio discrepancy in substantia nigra was negative .There was no significant difference in Cho/Cr ratio between PD patients and controls .Compared with controls , PD patients re-vealed decreased FA value in the frontal lobe and substantia nigra (P<0.05).There was no significant difference of the FA value in temporal lobe and corpus striatum between PD patients and controls (P>0.05).MoCA scale was positively associated with NAA/Cr ratio in frontal lobe(r=0.833,P<0.05),temporal lobe(r=0.785,P<0.05) and with FA value in the frontal lobe (r=0.871,P<0.05).Furthermore,in the frontal lobe of PD patients,the NAA/Cr ratio was positively associated with the FA value (r=0.866,P<0.05).Conclusion Combination of 1H-MRS with DTI can appropriately demonstrate the potential impairment in PD patients with cognitive impairment , and provide structural and metabolic evi-dence for early diagnosis of PD-CI.The decreased NAA/Cr and FA values in the frontal lobe may be correlated with cogni-tive impairment .关键词
帕金森病/认知障碍/磁共振波谱成像/弥散张量成像Key words
Parkinson ’ s disease/Cognitive impairment/Magneticresonance spectroscopy/Diffusion tensor imaging分类
医药卫生引用本文复制引用
魏欢,王晋,战丽萍,李青芸,翟娜,李建辉,安明顺,张丽娟..MRS 联合 DTI 评估帕金森病认知障碍的初步研究[J].中风与神经疾病杂志,2017,34(1):21-26,6.基金项目
云南省科技厅-昆医联合专项 （）
