伴单侧肢体运动症状的早期帕金森病患者双侧大脑半球胶质淋巴系统功能改变

目的 观察伴单侧肢体运动症状的早期帕金森病(PD)患者双侧大脑半球胶质淋巴系统功能改变。方法 前瞻性纳入52例仅单侧肢体出现运动症状的早期PD患者，包括左发型(LPD)21例(LPD组)、右发型(RPD)31例(RPD组);另招募28名健康人作为健康对照组(HC组)。比较3组及两两组间临床表现及沿血管周围间隙的弥散张量成像分析(DTI-ALPS)指数，分析后者与临床量表评分结果的相关性。结果 3组间汉密尔顿抑郁量表(HAMD)评分差异有统计学意义(P<0.05);LPD组和RPD组HAMD评分均高于HC组(P均<0.017)。3组间左侧大脑半球DTI-ALPS(DTIALPS＿L)和右侧大脑半球DTI-ALPS(DTI-ALPS＿R)指数差异均有统计学意义(P均<0.05);LPD组DTI＿ALPS＿R指数、RPD组DTI＿ALPS＿L指数均低于HC组(P<0.017)。PD患者双侧大脑半球DTI-ALPS指数与临床量表评分无明显相关性(P均>0.05)。结论 PD患者胶质淋巴系统功能减退与运动症状同样呈偏侧化，表现为LPD患者DTI-ALPS＿R指数下降...

Glymphatic system functional changes of bilateral cerebral hemispheres in early-stage Parkinson disease patients complicated with unilateral limb motor symptoms

Objective To observe the glymphatic system functional changes of bilateral cerebral hemispheres in early-stage Parkinson disease (PD) patients complicated with unilateral limb motor symptoms. Methods A total of 52 early-stage PD patients complicated with unilateral limb motor symptoms were prospectively enrolled, including 21 cases of left-onset PD (LPD group), 31 cases of right-onset PD (RPD group). Meanwhile, 28 healthy individuals were recruited as healthy controls (HC group). Clinical data and indices of diffusion tensor imaging analysis along the perivascular space (DTI-ALPS) were compared among 3 groups and between each 2 groups. The correlations of DTI-ALPS indices and clinical scales were analyzed. Results Significant difference of Hamilton depression scale (HAMD) score was found among 3 groups (P<0.05). HAMD score of LPD group and RPD group were higher than that of HC group (both P<0.017). There were significant differences of left and right cerebral hemispheres DTI-ALPS (DTI-ALPS_L, DTI-ALPS_R) indices among 3 groups (both P<0.05). DTI_ALPS_R in LPD group was lower than that in HC group (P<0.017), and DTI_ALPS_L in RPD group was lower than that in HC group (P<0.017). No obvious correlation of bilateral cerebral hemisphere DTI-ALPS indices with clinical scales was detected in PD patients (all P>0.05). Conclusion Like that of motor symptoms, glymphatic system dysfunction of PD patients had characteristics of laterality, manifested as DTI_ALPS_R decreased in LPD patients while DTI_ALPS_L decreased in RPD patients.