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1、早期帕金森病伴抑郁患者边缘系统白质微结构的改变段晓佳，朱红灿，吴川杰，牛瑞娜，焦淑洁，刘永磊作者单位：郑州大学第一附属医院神经内科，河南郑州450052摘要:目的探讨早期帕金森病（PD）伴发抑郁症状（PDwithdepression，PDD）患者边缘系统脑白质微结构的改变，为临床早期诊断PDD提供依据。方法纳入早期原发性PD患者16例，其中PDD患者7例，不伴发抑郁症状（PDwithoutdepression,PDND）9例，选取同期年龄、性别、受教育程度匹配的健康志愿者16例。所有受试者均行汉密顿
2、抑郁量表（HamiltonDepressiveScale,HAMD）、统一帕金森病评定量表运动部分（UnifiedParkinson'sDiseaseRatingScale,UPDRS3.0版）、H&Y分期评定及MRI+DTI检查，测量边缘系统各感兴趣区域（region-of-interest，ROI)部分各向异性(fractionalanisotropy，FA)及平均弥散系数(averagediffusioncoefficient，ADC)，进行统计分析。结果PD组较健康对照组HAMD评分高（P<
3、0.05）；除右丘脑背内侧外，PDD组较健康对照组各ROI区FA值均有下降（P<0.05）；PDD组左额叶眶部、双侧前扣带束及左丘脑背内侧FA值较PDND组下降显著（P<0.01）；三组间各ROI区ADC值无统计学差异。结论早期PD伴抑郁患者边缘系统已出现广泛白质微结构的异常改变，其中左额叶眶部、双侧前扣带束及左丘脑背内侧FA值的下降对PDD患者的早期诊断有重要参考价值。关键词：帕金森病；抑郁症状；边缘系统；白质；部分各向异性中图分类号：R742.5White-matterchangesinlimb
4、icsystemofthepatientswithdepressivesymptomsinearly-stageParkinson'sdiseaseDuanXiaojia,ZhuHongcan,WuChuanjie,NiuRuina,JiaoShujie,LiuYonglei.(DepartmentofNeurology,theFirstAffiliatedHospitalofZhengzhouUniversity,Zhengzhou450052,China)Abstract:ObjectiveTo
5、investigatewhite-matterchangesinlimbicsystemofthepatientswithdepressivesymptomsinearly-stageParkinson'sdisease,aimedtoprovidethebasisforearlydiagnosisofPDD.Methods16patientswithearlyidiopathicParkinson'sdisease(PD)weredividedintotwogroups:thosewithdepr
6、ession(PDD)andthosewithout(PDND),16healthyvolunteerswerealsoenrolledinthisstudy.AllsubjectswereassessedbyHamiltondepressivescale(HAMD),unifiedParkinson's通信作者：朱红灿，电话：13903836557，E-mail：zhc660407@hotmail.comDiseaseRatingScalemotorpart(UPDRSversion3),H&Ys
7、tagingandinspectedbyMRI+DTI.Fractionalanisotropy(FA)andaveragediffusioncoefficient(ADC)ofeachregionofinterest(ROI)weremeasuredandrecorded,underwentstatisticalanalysis.ResultsTheHAMDscoreinPDgroupwashigherthanthatinhealthycontrolgroup(P<0.05);exceptther
8、ightmedialdorsalthalamus,FAofeachROIinPDDgroupwaslowerthanthatinhealthycontrolgroup(P<0.05);FAofleftfrontalorbital,bilateralanteriorcingulatefasciculusandleftmedialdorsalthalamusinPDDgroupdecreasedsignificantlycomparedwithPDNDgroup(P<0.
