帕金森病患者皮层-小脑代偿机制的磁共振影像学研究

Parkinson’s disease (PD) is a common neurodegenerative disease. With the accelerated aging of Chinese society, the harm of PD becomes more and more serious. Recent domestic and foreign researches, as well as our previous studies showed that PD patients had an increased activation of cortex-cerebellum areas with an increase of local blood flow and volume of grey matter when they were performing movement tasks. This compensatory mechanism may improve the clinical function of PD patients and slow the disease progress in some degree. However, some evidences also showed the increased activity of cortex-cerebellum was associated with worsen clinical symptoms, which may have pathological contributions. Understanding the complex mechanism behind the compensatory-pathology phenomenon deeply, making use of its advantages and limiting its negative effects properly, would play an important role in the diagnosis and treatment of PD patients in future. This program intends to study the dynamic change of cortex-cerebellum and other key brain networks and to analyze the relationship between the increased activation of cortex-cerebellum, change of brain network and improvement or exacerbation of clinical symptoms using functional magnetic resonance imaging techniques and network analysis methods. The above phenomenon would also be observed before and after patients taking medicine and between different disease processes and clinical characteristics of PD patients, which can lay the foundation of understanding the compensatory mechanism of cortex-cerebellum from dynamic and multiple perspectives.

帕金森病（PD）是一种常见的神经退行性疾病，随着社会老龄化的加速，其危害愈来愈严重。近年的国内外研究及本团队前期工作表明，PD患者在执行运动任务时皮层-小脑部分区域的激活比正常人更高，提示皮层-小脑可能针对PD患者的基底节功能缺陷进行了代偿，这种代偿可能改善了PD患者的临床功能，部分延缓了疾病进展。然而也有证据显示，皮层-小脑的活动增加现象与临床症状加重有关，可能具有病理性的贡献。深入理解这一代偿-病理现象背后的复杂机制，对于未来PD患者的诊治具有重要意义。本项目拟采用功能磁共振技术和脑网络分析方法，探讨PD患者执行运动任务时皮层-小脑和其他关键脑区的网络关系动态变化，分析皮层-小脑活动增加、脑网络改变与临床症状改善或加重的关系；并在服药前后、不同疾病进程和临床特征的患者中观察这一机制的变化，为动态多角度的理解PD患者皮层-小脑代偿机制奠定基础。

帕金森病（PD）是一种常见的神经退行性疾病，随着社会老龄化的加速，其危害愈来愈严重。近年的国内外研究及本团队前期工作表明，PD患者在执行运动任务时皮层-小脑部分区域的激活比正常人更高，提示皮层-小脑可能针对PD患者的基底节功能缺陷进行了代偿，这种代偿可能改善了PD患者的临床功能，部分延缓了疾病进展。然而也有证据显示，皮层-小脑的活动增加现象与临床症状加重有关，可能具有病理性的贡献。深入理解这一代偿-病理现象背后的复杂机制，对于未来PD患者的诊治具有重要意义。因此，本项目的研究内容包括：1)探讨PD患者和健康对照在执行简单、复杂运动任务时的皮层-小脑激活模式差异。2) 探讨PD患者服药前后执行简单、复杂运动任务时的皮层-小脑激活改变。3）探讨PD患者临床亚型（不同运动亚型、是否合并认知损伤）、发病年龄、疾病阶段对大脑结构功能的影响，明确皮层-小脑各区域在其中扮演的作用。功能性核磁共振成像的研究结果初步证实了皮质-小脑功能障碍对帕金森病运动障碍的影响；结构研究发现小脑后叶的体积变化与病情严重程度呈显著正相关，说明小脑在其中起了运动代偿的作用，为期两年的纵向的功能研究结果同样支持该观点。且功能研究进一步发现小脑的功能改变对调节震颤为主的帕金森病尤为重要。