~(18)F-FDG PET显像观察特发性快眼动睡眠期行为障碍患者脑葡萄糖代谢特点的研究

目的探讨~(18)F-FDG PET显像观察特发性快眼动睡眠期行为障碍(iRBD)患者脑葡萄糖代谢改变和iRBD脑葡萄糖代谢改变与病程间的相关性。方法纳入多导睡眠监测(PSG)确诊的iRBD患者20例(iRBD组)和年龄、性别匹配的健康对照者19例(对照组)。两组均行~(18)F-FDG PET脑显像。基于自动解剖标记模板将大脑划分为90个左右对称的脑区,计算各脑区葡萄糖代谢半定量值。对iRBD组和对照组各脑区葡萄糖代谢半定量值进行独立样本t检验;并对iRBD组脑葡萄糖代谢改变与病程行Pearson相关分析。结果 (1)与对照组比较,iRBD组的双侧背外侧额上回、双侧眶部额上回、双侧眶部额中回、双侧海马、双侧海马旁回、双侧杏仁核、左侧眶部额下回、左侧岛叶、左侧内侧与旁扣带脑回、左侧中央旁小叶、左侧苍白球的葡萄糖代谢半定量值均增高(P0.05);双侧距状裂周围皮质、双侧楔叶、双侧舌回、双侧枕上回、双侧枕中回、双侧枕下回、双侧角回、双侧颞上回、双侧颞中回、右侧颞横回的葡萄糖代谢半定量值均降低(P0.05)。Pearson相关分析结果,iRBD组双侧杏仁核、双侧颞上回、右侧楔叶、右侧枕上回、右侧颞横回、左侧海马、左侧颞中回的葡萄糖代谢半定量值与病程呈正相关(P0.05);而双侧眶部额上回、双侧眶部额中回、左侧中央旁小叶、左侧眶部额下回、左侧内侧和旁扣带回、右侧背外侧额上回、右侧海马旁回的葡萄糖代谢半定量值与病程呈负相关(P0.05)。结论 iRBD患者脑内存在疾病相关的葡萄糖代谢水平改变,有助于客观评估iRBD病情的变化。

Evaluation of Characteristics of Cerebral Glucose Metabolism in Patients with Idiopathic Rapid Eye Movement Sleep Behavior Disorder Based on 18F-FDG PET Imaging

Aim To explore the cerebral glucose metabolism features in patients with idiopathic rapid eye movement sleep behavior disorder (iRBD) using 18F-FDG PET imaging and evaluate therelationship between regional brain glucose metabolism and duration in iRBD. Methods A total of 20 polysomnographically-confirmed iRBD patients(iRBD group)and age- and gender-matched healthy control were recruited (control group). iRBD patients and controls undertook a brain 18F-FDG PET imaging. The automated anatomic labeling (AAL) template was applied to divide the brain into 90 left-to-right symmetrical regions. Semi-quantitative value of glucose metabolism was calculated. Independent samples t-test was conducted to compare the semi-quantitative value of glucose metabolism between iRBD group and control group. Pearson correlation analysis was performed to detect the relationship between cerebral metabolism alterations and iRBD duration. Results①Relative to healthy controls, iRBD group exhibited significantly increased semi-quantitative value of glucose metabolism in bilateral dorsolateral superior frontal gyrus, bilateral superior frontal gyrus (orbital part), bilateral middle frontal gyrus (orbital part), bilateral hippocampus, bilateral parahippocampal gyrus, bilateral amygdala, left inferior frontal gyrus (orbital part), left insula, left median cingulate and paracingulate gyri, left paracentral lobule and left lenticular nucleus (pallidum) (P<0.05). Furthermore, iRBD patients showed reduced semi-quantitative value of glucose metabolism in bilateral calcarine fissure and surrounding cortex, bilateral cuneus, bilateral lingual gyrus, bilateral superior occipital gyrus, bilateral middle occipital gyrus, bilateral inferior occipital gyrus, bilateral angular gyrus, bilateral superior temporal gyrus, bilateral middle temporal gyrus and right Heschl gyrus (P<0.05). ②iRBD duration correlated positively with semi-quantitative value of glucose metabolism in bilateral amygdala, bilateral superior temporal gyrus, right cuneus, right superior occipital gyrus, right Heschl gyrus, left hippocampus and left middle temporal gyrus (P<0.05), but negatively in bilateral superior frontal gyrus (orbital part), bilateral middle frontal gyrus (orbital part), left paracentral lobule, left inferior frontal gyrus (orbital part), left median cingulate and paracingulate gyri, right dorsolateral superior frontal gyrus and right parahippocampal gyrus (P<0.05). Conclusion Disease-related metabolism abnormalities exist in the brain of iRBD patients, which helps to objectively evaluate the disease evolution.