静息态功能MRI观察帕金森病伴疲劳患者局部一致性及功能连接

目的 观察帕金森病（PD）伴疲劳（PD-F）患者局部一致性（ReHo）及功能连接（FC），探索其局部脑区分离功能和连接功能。方法 纳入29例PD-F患者（PD-F组）和29例PD不伴疲劳（PD-NF）患者（PD-NF组），以35名健康对照者为对照（HC组）；采集静息态功能MRI（fMRI），完成临床量表评估；计算ReHo，并分析其与疲劳严重程度量表（FSS）评分的相关性；将2组患者ReHo值存在差异且与FSS相关脑区设为ROI，观察全脑体素水平FC。结果 PD-F组右侧罗兰迪克岛盖ReHo值显著降低（体素P=0.001，总体错误率校正P<0.05）；PD组右侧罗兰迪克岛盖ReHo值与FSS评分呈负相关（r=-0.539，P<0.001）。PD-F组右侧罗兰迪克岛盖与双侧中扣带回的FC减弱（体素P=0.001，FWE校正P<0.05）。结论 PD-F患者右侧罗兰迪克岛盖脑区分离功能且与双侧中扣带回FC异常，并均参与PD-F病理生理机制。

Resting state functional MRI observation on regional homogeneity and functional connectivity in Parkinson disease patients with fatigue

Objective To observe regional homogeneity (ReHo) and functional connectivity (FC) in patients of Parkinson disease (PD) with fatigue (PD-F), and to explore the separation function and connectivity function of PD-F local brain regions. Methods Totally 29 PD-F patients (PD-F group), 29 PD without fatigue (PD-NF) patients (PD-NF group) and 35 age and gender matched healthy controls (HC group) were enrolled. All subjects underwent clinical scale evaluation and resting-state functional MRI (fMRI). ReHo was calculated and correlated with the fatigue severity scale (FSS). The brain regions with ReHo differences between PD-F and PD-NF groups and correlated to FSS were set as ROI for FC of the whole brain voxel level. Results ReHo of right Rolandic operculum in PD-F group significantly decreased (voxel P=0.001, family wise error rate correction, P<0.05). ReHo values of right Rolandic operculum in all PD patients were negatively correlated with FSS (r=-0.539, P<0.001). In PD-F group, FC between right Rolandic operculum and bilateral middle cingulate gyrus decreased (voxel P=0.001, FWE correction, P<0.05). Conclusion The dysfunction of right Rolandic operculum local brain region and relative abnormal FC with bilateral middle cingulate gyrus were involved in the pathophysiological mechanism of PD-F.