特发性快速眼动睡眠期行为障碍纹状体微结构磁共振成像研究

目的探讨帕金森病(PD)和特发性快速眼动睡眠期行为障碍(iRBD)患者纹状体结构和白质纤维束完整性。方法联合应用基于体素的形态学分析和扩散张量成像对12例特发性快速眼动睡眠期行为障碍患者、12例帕金森病患者及10例性别、年龄和受教育程度相匹配的正常对照者进行头部MRI检查,观察纹状体结构(灰质体积)和白质纤维束完整性[部分各向异性(FA)值]变化。结果与对照组相比,iRBD组左侧尾状核灰质体积缩小(P0.005),以及左侧(P0.005)和右侧(P0.001)尾状核、右侧壳核(P0.05)FA值降低;PD组仅右侧壳核FA值降低(P0.05)。与PD组相比,iRBD组左侧尾状核灰质体积缩小(P0.001),以及左侧(P0.01)和右侧(P0.005)尾状核FA值降低。结论特发性快速眼动睡眠期行为障碍患者存在纹状体灰质体积缩小和白质纤维束完整性损害,其白质纤维束完整性损害与帕金森病具有一致性,为特发性快速眼动睡眠期行为障碍是帕金森病的临床前期提供解剖学依据。

Study on microstructure of corpus striatum in patients with idiopathic rapid eye movement sleep behavior disorder using magnetic resonance imaging

Objective To investigate the structure of corpus striatum and the integrity of white matter fiber in patients with Parkinson's disease (PD) and idiopathic rapid eye movement sleep behavior disorder (iRBD).Methods Twelve patients with iRBD,12 patients with PD and 10 healthy subjects that were well matched in gender,age and education were enrolled in this study.Head MRI examination was performed to all subjects to observe the changes of corpus striatum structure (the gray matter volume) and the integrity of white matter fiber [fractional anisotropy (FA)] by combining voxel-based morphometry (VBM) and diffusion tensor imaging (DTI).Results Compared with healhy subjects,the gray matter volume of left caudate nucleus was significantly decreased (P ＜ 0.005),and FA values of left caudate nucleus (P ＜ 0.005),right caudate nucleus (P ＜ 0.001) and right putamen (P ＜ 0.05) were all significantly reduced in iRBD patients;FA value of right putamen was significantly decreased in PD patients (P ＜ 0.05).Compared with PD patients,the gray matter volume of left caudate nucleus of iRBD patients was significantly reduced (P ＜ 0.001),FA values of left caudate nucleus (P ＜ 0.01) and right caudate nucleus (P ＜ 0.005) of iRBD patients were significantly reduced.Conclusions There is atrophy of gray matter volume and extensive white matter fiber impairment in corpus striatum of patients with iRBD,and the white matter fiber impairment was similar to PD,which provides an anatomical evidence for iRBD being presymptom of PD.