【摘要】 目的 以静息态功能磁共振的研究方法探索进展期帕金森病(Advanced Parkinson’s disease,aPD)患者丘脑各个亚区与其他脑区之间功能连接的差异，并探讨异常功能连接与神经心理学评分之间的关系。方法 对2018年12月-2021年11月就诊于广东省人民医院的进展期帕金森病患者(aPD组)26例和38名健康对照者(Healthy control,HC)组的临床资料收集、神经心理学评估以及静息态功能磁共振扫描，以5个丘脑亚区作为种子点进行功能连接分析，并采用多元线性回归分析方法分析aPD患者认知功能与丘脑亚区异常功能连接的相关性。结果 aPD组左侧双侧腹前部(Ventral anterior,VA)与左侧中央后回、左侧扣带回中部之间的功能连接显著增强；右侧VA与左侧中央后回、左侧扣带回中部之间的功能连接显著增强。多元回归分析发现，左侧VA与左侧中央后回的功能连接(Functional connectivity,FC)值与色词干扰测试干扰效应(Stroop interfere effects,SIE)呈负相关(β=-0.773,P=0.027),右侧VA与左侧扣带回中部的FC值与Stroop SIE呈正相关(β=0.937,P=0.007);左侧VA与左侧中央后回的FC值与数字符号转换测试得分呈正相关(β=0.862,P=0.022);右侧VA与左侧中央后回的FC值与木块图案测试得分呈负相关(β=-0.891,P=0.025)。结论 aPD患者丘脑VA与左侧中央后回、左侧扣带回中部存在功能连接增强；双侧腹前丘脑功能改变可能与帕金森病运动症状相关；aPD患者右侧腹前丘脑与扣带回皮质功能变化可能引起PD患者认知功能障碍，特别是注意力和执行功能的障碍。更多还原

【Abstract】 Objective To explore the differences in functional connectivity(FC)between thalamus subregions and other brain regions, and the association between abnormal FC and cognitive function. Methods 26 patients with advanced PD(aPD) who were reffered to neurology outpatient clinics of Guangdong General Hospital from December 2018 to November 2021, and 38 healthy controls(HC) were enrolled. Demographic and clinical data including motor, cognitive and emotional function were collected. Functional magnetic resonance(fMRI) scanning was performed in aPD and control groups, and 5 thalamus subregions were selected as seeds for FC analysis. Using multiple linear regression analysis, the association between cognitive function and abnormal FC values in thalamic nuclei of aPD patients was analyzed. Results The functional connection between the left Ventral Anterior(VA) nuclei of thalamus and the left posterior central gyrus, as well as the connection between the left VA and the left middle cingulate gyrus were significantly increased in aPD group. The functional connection between the right VA and the left posterior central gyrus, as well as the left middle cingulate gyrus were significantly increased. Multiple regression analysis showed that values of FC between the left VA and the left posterior central gyrus were negatively correlated with Stroop interfere effects(SIE)(β=-0.773, P=0.027), while values of FC between the right VA and the left middle cingulate gyrus were positively correlated with SIE(β=0.937, P=0.007). The values of FC between the left VA and the left posterior central gyrus were positively correlated with the symbol digit modalities test score(β=0.862, P=0.022). The values of FC between the right VA and the left posterior central gyrus were negatively correlated with block design test scores(β=-0.891, P=0.025).Conclusion Patients with aPD have higher values of FC between VA and the left posterior central gyrus, as well as the left middle cingulate gyrus. Functional changes in bilateral VA thalamus domains may be related to motor symptoms of Parkinson’s disease. Patients with aPD may experience changes in the functional connection between the right anterior ventral thalamus and cingulate cortex, which may cause cognitive dysfunction in PD patients, especially in attention and executive function.更多还原