Page 64 - 南京医科大学学报自然科学版

南京医科大学学报（自然科学版） 第41卷第4期
·534 · Journal of Nanjing Medical University（Natural Sciences） 2021年4月

·临床医学·

帕金森病伴焦虑患者静息态功能磁共振脑功能连接改变的研究

贾永锋 ，王建伟 ，刘 俊 ，张克忠 ，袁永胜 ，王 敏 1*
1
1
1
2
2
南京医科大学第一附属医院放射科，神经内科，江苏 南京 210029
1 2
［摘 要］ 目的：观察帕金森病（Parkinson’s disease，PD）伴焦虑患者静息态功能连接改变，并探索PD伴发焦虑的神经病理机
制。方法：收集112例PD患者以及54例健康对照者的静息态功能磁共振成像（rs⁃fMRI）数据，根据汉密尔顿焦虑量表（HAMA）
将PD组分为PD伴焦虑（PD⁃A组）50例和PD不伴焦虑（PD⁃NA组）62例。通过协方差分析（ANCOVA）和post⁃hoc t检验进行体
素镜像同伦连接（voxel⁃mirrored homotopic connectivity，VMHC）值的组间统计学比较得到PD⁃A组与PD⁃NA组的差异脑区。选
取双侧杏仁核为功能连接种子点，计算双侧杏仁核与差异脑区功能连接结果，并分析功能连接值与HAMA评分的相关性。结
果：PD⁃A组、PD⁃NA组和健康对照组之间的VMHC值有显著性差异，组间post⁃hoc t检验显示，PD⁃A与PD⁃NA相比，双侧额下回
（inerior frontal gyrus，IFG）三角部及岛盖部VMHC值减低。种子点功能连接显示左侧杏仁核与左侧额下回的功能连接增强，且
功能连接值与HAMA评分呈正相关。结论：PD⁃A患者存在异常的脑功能活动，双侧额下回的异常VMHC改变以及左侧杏仁核
与左侧额下回的功能连接异常，提示额下回⁃杏仁核相关网络环路可能参与了焦虑的病理发生过程。
［关键词］ 帕金森病；焦虑；静息态功能磁共振成像；体素镜像同伦；功能连接；杏仁核
［中图分类号］ R742.5 ［文献标志码］ A ［文章编号］ 1007⁃4368（2021）04⁃534⁃06
doi：10.7655/NYDXBNS20210410

A resting ⁃ state functional magnetic resonance imaging study on functional connectivity

alteration of Parkinson’s disease with anxiety
2
2
1
1
1
JIA Yongfeng ，WANG Jianwei ，LIU Jun ，ZHANG Kezhong ，YUAN Yongsheng ，WANG Min 1*
1 Department of Radiology，Department of Neurology，the First Affiliated Hospital of Nanjing Medical University，
2
Nanjing 210029，China
［Abstract］ Objective： To investigate the alterations of functional connectivity among Parkisnon’s disease（PD）patients with anxiety，
and to explore its pathological mechanism. Methods：Totally 112 PD patients and 54 healthy controls underwent rs⁃fMRI scanning.
According to the Hamilton anxiety scale（HAMA），112 PD patients were divided into 50 PD with anxiety group（PD⁃A）and 62 PD
without anxiety（PD⁃NA）. ANCOVA and post⁃hoc t test were performed to assess intergroup difference of voxel⁃mirrored homotopic
connectivity（VMHC）value to obtain the abnormal brain regions. Bilateral amygdala were chosen as seeds to calculate functional
connectivity with abnormal brain regions. Estimated a Pearson’s correlation coefficient between functional connectivity calculated
above and HAMA scores. Results：VMHC value had significant differences among three groups，post hoc t test showed a decrease of
VMHC value in bilateral inferior frontal gyri（IFG）triangular part and opercular part in PD⁃A group compared to the PD⁃NA group.
Functional connectivity increased between the left amygdala and the left IFG. Furthermore，functional connectivity was positively
correlated with HAMA scores. Conclusion：Abnormal brain functional activity exists in PD⁃A group，suggesting that anxiety in PD is
associated with abormalities in IFG⁃amygdala loop network.
［Key words］ Parkinson’s disease；anxiety；resting⁃state functional magnetic resonance imaging；voxel⁃mirrored homotopic connecti⁃
vity；functional connectivity；amygdala
［J Nanjing Med Univ，2021，41（04）：534⁃539］

［基金项目］ 国家自然科学基金(81671258)
∗
通信作者（Corresponding author），E⁃mail：jsphwangmin@njmu.edu.cn