Objective To investigate the effect of iron deposition and blood flow in subthalamic nucleus (STN) and globus pallidus internus (GPi) on motor symptoms of early and middle stage of Parkinson disease (PD). Andto analyzethe relation between iron deposition and blood flow of PD. Methods A total of 34 PD patients hospitalized in Neurorehabilitation Center of Beijing Rehabilitation Hospital affiliated to Capital Medical University, who were diagnosed as stage Ⅰ to Ⅲ according to Hoehn-Yahr (H-Y), from July to October 2020 were recruited as PD group, and another 17 healthy people were enrolled as control group in the same period. All subjects underwent whole-brain MR conventional sequence, 3D T1 Bravo, quantitative magnetic resonance imaging (QSM) and 3D arterial spin labeling (3D-ASL) sequence scanning. Based on the map of basal ganglia subregion, QSM and 3D-ASL imaging methods, the QSM and CBF values of STN and GPi were extracted by Matlab software and user-defined code. All patients' motor symptoms were assessed by H-Y Scale, MDS-UPDRS Ⅱ and Ⅲ, 10-meter walking speed and 3D gait analysis (including step frequency, step speed, step time, swing phase, contralateral support phase and step length). Pearson correlation or Spearman correlation were used to analyze the correlation between imaging indexes and motor symptoms in PD patients. Results There were no significant differences in age and gender between the two groups (P> 0.05). The QSM values in STN and GPi, and the CBF value in GPi of PD group were higher than those of the control group [0.008 (0, 0.019) ppm vs -0.003 (-0.015, 0.009) ppm; -0.003 (-0.011, 0.009) ppm vs -0.014 (-0.023, -0.007) ppm; 0.715 (0.657, 0.790) vs 0.617 (0.584, 0.704)], and the differences were statistically significant (P< 0.05). The CBF values in STN and GPi of PD patients were positively correlated with MDS-UPDRS Ⅱ (r=0.352, 0.376; P< 0.05). The QSM value in GPi was positively correlated with step time (r=0.381, P< 0.05). The QSM value in GPi of PD patients were negatively correlated with 10-meter walking speed, step speed, step frequency and step length (r=-0.475, -0.584, -0.462, -0.533; P< 0.05). There was no correlation between the QSM value and the CBF value of STN and GPi in PD patients (P> 0.05). Conclusions The simultaneous assessment of iron deposition and CBF in specific brain regions of PD patients in early and middle stage by QSM and 3D-ASL is of certain value, and may help monitor the progress of PD. However, the exact relationship between the content of iron brain and blood flow in PD remains to be further studied.
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房进平,温齐平,王艺璇,李优伟,刘爱贤,方伯言.早中期帕金森病患者脑铁沉积及血流量改变 对运动症状的影响[J].神经疾病与精神卫生,2022,22(6): DOI :10.3969/j. issn.1009-6574.2022.06.002.