| 常燕,张熙琬,王媛,刘家金,赵东,付华平,张锦明,单保慈,刘若卓,王瑞民.早发型与晚发型帕金森病多巴胺能神经元和脑葡萄糖代谢变化差异[J].中国医学影像技术,2023,39(10):1445~1449 |
| 早发型与晚发型帕金森病多巴胺能神经元和脑葡萄糖代谢变化差异 |
| Differences of dopamine neurons and brain glucose metabolism between early-onset and late-onset Parkinson's disease |
| 投稿时间：2023-05-31 修订日期：2023-07-21 |
| DOI：10.13929/j.issn.1003-3289.2023.10.002 |
| 中文关键词: 帕金森病 多巴胺 F18氟脱氧葡萄糖 正电子发射断层显像 |
| 英文关键词:Parkinson disease dopamine fluorodeoxyglucose F18 positron-emission tomography |
| 基金项目:国家自然科学基金(11975249)、北京市卫生健康委员会住院医师规范化培训质量提高项目、军队后勤保健专项(23BJZ21)。 |
| 作者 | 单位 | E-mail | | 常燕 | 中国人民解放军医学院研究生院, 北京 100853
中国人民解放军总医院第一医学中心神经内科, 北京 100853 | | | 张熙琬 | 郑州大学物理学院, 河南 郑州 450001
中国科学院高能物理研究所 核技术应用研究中心, 北京 100049 | | | 王媛 | 中国人民解放军总医院第一医学中心核医学科, 北京 100853 | | | 刘家金 | 中国人民解放军总医院第一医学中心核医学科, 北京 100853 | | | 赵东 | 中国人民解放军总医院第一医学中心核医学科, 北京 100853 | | | 付华平 | 中国人民解放军总医院第一医学中心核医学科, 北京 100853 | | | 张锦明 | 中国人民解放军总医院第一医学中心核医学科, 北京 100853 | | | 单保慈 | 中国科学院高能物理研究所 核技术应用研究中心, 北京 100049
北京市射线成像技术与装备工程技术研究中心, 北京 100049 | | | 刘若卓 | 中国人民解放军总医院第一医学中心神经内科, 北京 100853 | | | 王瑞民 | 中国人民解放军总医院第一医学中心核医学科, 北京 100853 | wrm@yeah.net |
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| 中文摘要: |
| 目的 观察早发型帕金森病(EOPD)与晚发型帕金森病(LOPD)多巴胺神经元和脑葡萄糖代谢变化差异。方法 前瞻性纳入45例EOPD患者(EOPD组)、55例LOPD患者(LOPD组)及93名健康对照(HC)者[HC1组(n=47),HC2组(n=46)],行11C-β-CFT 和18F-FDG PET显像;观察EOPD组与HC1组、LOPD组与HC2组脑11C-β-CFT标准摄取值比值(SUVR)和18F-FDG葡萄糖代谢网络模式,以回归分析评估脑区11C-β-CFT SUVR与18F-FDG葡萄糖代谢的关系。结果 EOPD组与HC1组之间,尾状核、壳核和苍白球11C-β-CFT SUVR差异均有统计学意义(P均＜0.05);LOPD组与HC2组之间,伏隔核、尾状核、壳核和苍白球11C-β-CFT SUVR差异均有统计学意义(P均＜0.05)。与HC1组相比,EOPD组双侧尾状核、壳核、苍白球、岛叶、小脑、颞叶、丘脑及额叶葡萄糖代谢明显增高(P均＜0.05);相比HC2组,LOPD组双侧壳核、苍白球、中央旁回、小脑、颞叶及丘脑葡萄糖代谢明显增高(P均<0.05),双侧尾状核和额叶葡萄糖代谢明显减低(P均＜0.05)。尾状核代谢为EOPD组伏隔核11C-β-CFT SUVR减低的影响因素(P＜0.001);尾状核、前额叶、小脑及丘脑代谢均为LOPD组伏隔核11C-β-CFT SUVR减低的影响因素(P均＜0.001)。结论 LOPD患者伏隔核多巴胺神经元受损、尾状核和额叶葡萄糖代谢明显减低,而EOPD患者未见上述表现。 |
| 英文摘要: |
| Objective To observe the differences of dopamine neurons and brain glucose metabolism between early-onset Parkinson's disease (EOPD) and late-onset Parkinson's disease (LOPD). Methods Forty-five EOPD patients (EOPD group), 55 LOPD patients (LOPD group) and 93 healthy controls (HC) (HC1 group [n=47], HC2 group [n=46]) were prospectively enrolled. 11C-β-CFT and 18F-FDG PET imaging were performed. The standard uptake value ratio (SUVR) and 18F-FDG glucose metabolic network pattern of brain were compared between EOPD group and HC1 group, also between LOPD group and HC2 group. Regression analysis was used to evaluate the relationships of 11C-β-CFT SUVR and 18F-FDG glucose metabolism of brain. Results Significant differences of 11C-β-CFT SUVR in caudate nucleus, putamen and globus pallidus were found between EOPD group and HC1 group (all P＜0.05), also among nucleus accumbens, caudate nucleus, putamen and globus pallidus between LOPD group and HC2 group (all P＜0.05). Glucose metabolism in bilateral caudate nucleus, putamen, globus pallidus, insula, cerebellum, temporal lobe, thalamus and frontal lobe in EOPD group were significantly higher than those in HC1 group (all P＜0.05). Glucose metabolism in bilateral putamen, globus pallidus, paracentral gyrus, cerebellum, temporal lobe and thalamus in LOPD group were significantly higher (all P<0.05), while in bilateral caudate nucleus and frontal lobe were significantly lower than those in HC2 group (both P＜0.05). Glucose metabolism in caudate nucleus was the impact factor of decreased 11C-β-CFT SUVR in nucleus accumbens of EOPD group (P＜0.001), while glucose metabolism in caudate nucleus, prefrontal lobe, cerebellum and thalamus were all the impact factors of decreased 11C-β-CFT SUVR in nucleus accumbens of LOPD group (all P＜0.001). Conclusion Dopamine neurons in nucleus accumbens were damaged in LOPD patients with significantly decreased glucose metabolism in caudate nucleus and frontal lobe, which did not occur in EOPD patients. |
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