【摘要】 目的利用质子磁共振波谱(1 H-MRS)技术,研究帕金森病认知障碍(PD-CIND)患者额叶及扣带回前部的变化,并探讨其病因。方法选取帕金森病(PD)患者33例(MOCA评分≥26分,PD组),PD-CIND患者22例(MOCA评分<26分,PD-CIND组)和健康对照组(HC组)20例,均行1 H-MRS检查,测定脑部扣带回前部、额叶区的N-乙酰天门冬氨酸/肌酸(NAA/Cr)和胆碱复合物/肌酸(Cho/Cr)的比值。结果患肢对侧额叶、扣带回前部的NAA/Cr比值:PD和PD-CIND组均低于HC组(均P<0.05),PD-CIND组低于PD组(P<0.05);患肢同侧额叶NAA/Cr比值3组间差异无统计学意义(P>0.05);患肢同侧扣带回前部的NAA/Cr比值:PD-CIND组低于PD组(P<0.05),PD和HC组比较差异无统计学意义(P>0.05);双侧额叶、扣带回前部的Cho/Cr比值3组间比较差异均无统计学意义(均P>0.05)。结论 1 H-MRS可以检测到PD-CIND患者额叶及扣带回前部的代谢改变,有助于PD-CIND的病因诊断及风险预测。更多还原

【Abstract】 Objective To study the changes in frontal lobe and anterior cingulate cortex in cognitive impairment in Parkinson’s disease(PD-CIND)using proton magnetic resonance spectroscopy(1 H-MRS)technique,and to investigate the etiology.Methods The 1 H-MRS was performed to determine the N-acetylaspartate(NAA)/creatine(Cr)ratio and cholinecompound(Cho)/Cr ratio in frontal lobe and anterior cingulate cortex in 33patients with PD(PD group,MOCA≥26),22patients with PD-CIND(PD-CIND group,MOCA score<26)and 20healthy controls(HC group).Results Compared with PD group,NAA/Cr ratio in contralateral frontal lobe and anterior cingulate cortex increased in HC group but decreased in PD-CIND group(P<0.05).There were no significant differences in NAA/Cr ratio in ipsilateral frontal lobe among the three groups(P>0.05).Furthermore,NAA/Cr ratio in ipsilateral anterior cingulate cortex in PD-CIND group was less than that in PD group(P<0.05).No significant differences in NAA/Cr ratio in ipsilateral anterior cingulate cortex were found between PD group and HC group(P>0.05).In addition,there were no significant differences in Cho/Cr ratio in bilateral frontal lobe and anterior cingulate cortex among the three groups(P>0.05).Conclusion The 1 H-MRS can detect the metabolic changes in frontal lobe and anterior cingulate cortex in patients with PD-CIND.Therefore,1 H-MRS is helpful for etiology diagnosis and risk prediction of PD-CIND.更多还原