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目的利用PETCT研究帕金森病(PD)认知功能障碍患者的脑18F-FDG葡萄糖代谢特点,分析PD患者认知功能进行性下降与脑葡萄糖代谢显像的相关性。方法将2017年2月-2018年11月PD患者42例(男性27例,女性15例)按蒙特利尔认知评估量表(MOCA)分为无认知功能障碍(PD-NCI)组、轻度认知功能障碍(PD-MCI)组和痴呆(PDD)组,同时选取健康对照组33例(男性19例,女性14例),进行前瞻性研究。受检者按体质量静脉注射5.55 MBq/kg的18F-FDG后行PETCT显像,采用飞利浦Syntegra软件进行图像分析,比较各组间脑代谢及认知功能的差异和相关性。结果 (1) MOCA认知功能评分方面,PDD组、PD-MCI、PD-NCI组的MOCA评分逐渐升高(F=7.38,P<0.05)。ADL日常生活能力方面,PDD组、PD-MCI、PD-NCI组及NC组的ADL评分逐渐降低(F=9.15,P<0.05)。(2)与健康对照组相比,PDD组额叶、顶叶、颞叶、枕叶的广泛大脑皮质18F-FDG代谢减低(t=-9.53～-6.06,P均<0.05);而PD-MCI组主要在额叶、颞叶等前皮质区为主的脑皮质代谢减低(t=-6.63、-4.85,P均<0.05)。(3)PDD患者顶叶、枕叶后皮质区的18F-FDG代谢与MOCA中的视空间的认知领域评分呈正相关性(r=0.642、0.580,P<0.05),而PD-MCI、PD-NCI组PD患者脑代谢与MOCA、ADL评分无相关性(P>0.05)。结论 PETCT脑18F-FDG葡萄糖代谢显像能客观反映PD患者认知功能障碍损害的进展过程,且其测得的顶叶、枕叶后皮质脑代谢改变同MOCA量表的评估结果具有良好的相关性。
Abstract：Objective To study the 18F-FDG glucose metabolism in Parkinson′s Disease(PD) patients with cognitive impairment by means of positron emission tomography coupled with computer tomography(PET-CT). Analysed was the relationship between progressive decline of cognitive function and brain glucose metabolism imaging in PD patients. Methods According to the Montreal Cognitive Assessment Scale(MOCA), 42 patients(27 males and 15 females) diagnosed with PD from August 2018 to August 2019 were divided into three groups: PD-NCI group without cognitive impairment, PD-MCI group with mild cognitive impairment and PDD group with dementia. 33 healthy controls(19 males and 14 females) were selected setting as healthy control. After intravenous injection of 5.55 MBq/kg 18F-FDG, the subjects underwent PETCT imaging. Philips Syntegra software was used for image analysis. The difference and correlation of brain metabolism and cognitive function in each group were compared. Results(1) In terms of the score of MOCA cognitive function, the score of MOCA in PDD group, PD-MCI group and PD-NCI group were increased gradually(F=7.38, P<0.05). In contrast, The ADL scores of PDD group, PD-MCI group, PD-NCI group and NC group were dropped gradually(F=9.15, P<0.05).(2) Compared with the control group, the metabolism of 18F-FDG in frontal lobe, parietal lobe, temporal lobe and occipital lobe were decreased in PDD group(t=-9.53～-6.06, all P<0.05). In PD-MCI group, the metabolism of cerebral cortex significantly decreased mainly in prefrontal cortex and temporal cortex(t=-6.63,-4.85, all P<0.05).(3) There was a positive correlation observed between 18F-FDG metabolism in parietal and occipital cortex and visual spatial cognitive domain score in MOCA(r=0.642, 0.580, P<0.05). There was no correlation between brain metabolism and MOCA, ADL scores inPD-MCI and PD-NCI groups(P>0.05). Conclusion The brain 18F-FDG glucose metabolism imaging of PETCT was shown to be able to objectively reflect the progression of CI damage in PD patients, and the changes of brain metabolism in parietal and occipital cortex measured by PET-CT were found to have a good correlation with the evaluation results of MOCA scale.
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基本信息:
中图分类号:R742.5
引用信息:
[1]夏欢,罗琴,杨新玲.帕金森病认知功能损害的脑葡萄糖代谢研究[J].新疆医科大学学报,2019,42(12):1513-1517.
基金信息:
国家自然科学基金地区科学基金(81960243)
2019-12-15
2019-12-15