中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2019, Vol. 14 ›› Issue (5): 868-875.doi: 10.4103/1673-5374.249235

• 原著:脑损伤修复保护与再生 • 上一篇    下一篇

特发性快速眼动睡眠行为障碍患者的脑灰质体积评估

  

  • 出版日期:2019-05-15 发布日期:2019-05-15
  • 基金资助:

    中美生物医学合作研究计划; 国家自然科学基金; 上海市青年科技英才扬帆计划

Assessing gray matter volume in patients with idiopathic rapid eye movement sleep behavior disorder

Xian-Hua Han 1 , Xiu-Ming Li 1 , Wei-Jun Tang 2 , Huan Yu 3 , Ping Wu 1 , Jing-Jie Ge 1 , Jian Wang 3 , Chuan-Tao Zuo 1 , Kuang-Yu Shi 4   

  1. 1 PET Center, Huashan Hospital, Fudan University, Shanghai, China
    2 Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
    3 Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
    4 Department of Nuclear Medicine, Technical University Munich, Munich, Germany
  • Online:2019-05-15 Published:2019-05-15
  • Contact: Chuan-Tao Zuo, MD, zuoct_cn2000@126.com.
  • Supported by:

    This study was supported by the China-US Biomedical Collaborative Research Program, No. 81361120393 (to CTZ); the National Natural Science Foundation of China, No. 81401135 (to PW), 81671239 (to CTZ); and the Shanghai Sailing Program, No. 18YF1403100 (to JJG).

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摘要：

特发性快速眼动睡眠行为障碍（iRBD）患者患神经退行性疾病的风险很高，但基于体素的形态学方法评估iRBD患者脑结构异常的研究则相对较少。研究着手通过一种基于体素对脑结构磁共振成像(MRI)自动、全面、客观的分析技术--基于体素形态学分析方法分析iRBD患者脑结构改变，并确定该改变与iRBD患者临床表现的相关性。对19例经多导睡眠监测确诊的iRBD患者（男女比例16：3;平均年龄66.6±7岁）和20名年龄匹配的健康对照（男性/女性5:15;平均年龄63.7±5.9岁）进行脑结构T1加权MRI扫描。使用基于体素的形态学方法和基于统计参数图8的两样本t检验和多元回归分析来分析灰质体积（GMV）数据。与对照组相比，iRBD患者在颞中回和小脑后叶GMV增大，但罗兰迪克岛盖、中央后回、岛叶、扣带回、楔前叶、直回，额上回的GMV减少。iRBD持续时间与楔前叶、楔回、顶上回、中央后回、后扣带回、海马、舌回、枕中回、颞中回和小脑后叶GMV呈正相关。此外，阶段性下颌肌电活动与海马，楔前叶，梭形回，中央前回，额上回，楔骨，下顶叶，角回，顶上回，旁中央小叶和小脑后叶GMV呈正相关。iRBD患者脑GMV与疾病持续时间和肌电活动之间无明显相关性。这些发现扩宽了我们对iRBD患者灰质改变认识，为以前此类患者脑功能障碍和临床表现的相关性提供了解剖影像学证据。

orcid: 0000-0002-8856-7217 (Chuan-Tao Zuo)

关键词: 特发性快速眼动睡眠行为障碍, 突触核蛋白病, 磁共振成像, 灰质体积, 统计参数图, 基于体素的形态学, 结构, 帕金森病, 神经退行性疾病

Abstract:

Idiopathic rapid eye movement sleep behavior disorder (iRBD) is often a precursor to neurodegenerative disease. However, voxel-based morphological studies evaluating structural abnormalities in the brains of iRBD patients are relatively rare. This study aimed to explore cerebral structural alterations using magnetic resonance imaging and to determine their association with clinical parameters in iRBD patients. Brain structural T1-weighted MRI scans were acquired from 19 polysomnogram-con?rmed iRBD patients (male:female 16:3; mean age 66.6 ± 7.0 years) and 20 age-matched healthy controls (male:female 5:15; mean age 63.7 ± 5.9 years). Gray matter volume (GMV) data were analyzed based on Statistical Parametric Mapping 8, using a voxel-based morphometry method and two-sample t-test and multiple regression analysis. Compared with controls, iRBD patients had increased GMV in the middle temporal gyrus and cerebellar posterior lobe, but decreased GMV in the Rolandic operculum, postcentral gyrus, insular lobe, cingulate gyrus, precuneus, rectus gyrus, and superior frontal gyrus. iRBD duration was positively correlated with GMV in the precuneus, cuneus, superior parietal gyrus, postcentral gyrus, posterior cingulate gyrus, hippocampus, lingual gyrus, middle occipital gyrus, middle temporal gyrus, and cerebellum posterior lobe. Furthermore, phasic chin electromyographic activity was positively correlated with GMV in the hippocampus, precuneus, fusiform gyrus, precentral gyrus, superior frontal gyrus, cuneus, inferior parietal lobule, angular gyrus, superior parietal gyrus, paracentral lobule, and cerebellar posterior lobe. There were no significant negative correlations of brain GMV with disease duration or electromyographic activity in iRBD patients. These findings expand the spectrum of known gray matter modifications in iRBD patients and provide evidence of a correlation between brain dysfunction and clinical manifestations in such patients. The protocol was approved by the Ethics Committee of Huashan Hospital (approval No. KY2013-336) on January 6, 2014. This trial was registered in the ISRCTN registry (ISRCTN18238599).

Key words: nerve regeneration, idiopathic rapid eye movement sleep behavior disorder, synucleinopathies, magnetic resonance imaging, gray matter volume, statistic parametric mapping, voxel-based morphometry, structure, Parkinson’s disease, neurodegenerative diseases, neural regeneration