Zhang Ruirui, Li Zhonglin, Bai Yingying, Xu Pengfei, Zhang Jiewen, Zhang Hongju
Department of Neurology, People's Hospital of Henan University, Zhengzhou 450003, China.
Department of Imaging, People's Hospital of Henan University, Zhengzhou 450003, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2020 Jan 30;40(1):125-130. doi: 10.12122/j.issn.1673-4254.2020.01.20.
To investigate the changes in behaviors and brain structural network in patients with idiopathic rapid eye movement sleep behavior disorder (iRBD).
Twenty patients with iRBD (iRBD group) and 22 healthy control subjects were evaluated using the Unified Parkinson's Disease Rating Scale (UPDRS) and Hoehn-Yahr staging. Diffusion tensor imaging and graph- theoretical analysis were performed for analyzing the topological characteristics of brain structural networks of the patients, and the correlation between the behavioral changes and the changes in the topological characteristics of the brain networks was analyzed.
The UPDRS score was significantly higher in iRBD group than in the healthy control group ( < 0.05). No significant difference was found in small-world attributes between the patients with iRBD and the control subjects (>0.05). The patients with iRBD exhibited significantly shortened characteristic shortest path length Lp ( < 0.05) and significantly increased global efficiency, local efficiency and assortativity ( < 0.05). Examination of regional topological properties of the brain network revealed abnormal node properties in the frontal, temporal, parietal, occipital, and striatal and limbic lobes in patients with iRBD. The patients also had significantly increased degree centrality of the left pallidum and enhanced nodal efficiency in the left thalamus, superior temporal gyrus, temporal pole and bilateral superior occipital gyrus, bilateral putamens as well as the right gyrus rectus, amygdala, supramarginal gyrus, and middle temporal gyrus. The nodal local efficiency was significantly increased in the left superior frontal gyrus, middle cingulate gyrus, superior parietal gyrus, bilateral fusiform gyrus, right superior motor area, postcentral gyrus and angular gyrus of the patients with iRBD. The nodal shortest path was significantly shortened in the left superior motor area, pallidum, thalamus, superior temporal gyrus, temporal pole, bilateral putamens, bilateral superior occipital gyrus, right rectus gyrus, amygdala, supramarginal gyrus and middle temporal gyrus, and the nodal clustering coefficient was significantly lowered in the left superior occipital gyrus of the patients. In patients with iRBD, the UPDRS I score was positively correlated with the nodal efficiency in the right supramarginal gyrus (=0.50, < 0.05) and local nodal efficiency in the right fusiform gyrus (=0.53, < 0.05), and negatively correlated with the nodal clustering coefficient in the left superior occipital gyrus (=-0.552, < 0.05).
Patients with iRBD present with abnormal changes in mental condition, behaviors, emotions, activities of daily living and motor functions. The brain structural network of patient with iRBD still has a small-world property with abnormal global topological property and abnormal distribution of local topological property in the cortex, striatum and limbic system.
探讨特发性快速眼动睡眠行为障碍（iRBD）患者的行为及脑结构网络变化。
采用统一帕金森病评定量表（UPDRS）和Hoehn-Yahr分期对20例iRBD患者（iRBD组）和22名健康对照者进行评估。进行扩散张量成像和图论分析以分析患者脑结构网络的拓扑特征，并分析行为变化与脑网络拓扑特征变化之间的相关性。
iRBD组UPDRS评分显著高于健康对照组（P<0.05）。iRBD患者与对照者之间的小世界属性无显著差异（P>0.05）。iRBD患者表现出特征最短路径长度Lp显著缩短（P<0.05），全局效率、局部效率和聚类系数显著增加（P<0.05）。对脑网络区域拓扑属性的检查显示，iRBD患者额叶、颞叶、顶叶、枕叶、纹状体和边缘叶的节点属性异常。患者左侧苍白球的度中心性也显著增加，左侧丘脑、颞上回、颞极以及双侧枕上回、双侧壳核以及右侧直回、杏仁核、缘上回和颞中回的节点效率增强。iRBD患者左侧额上回、中央扣带回、顶上回、双侧梭状回、右侧中央前回、中央后回和角回的节点局部效率显著增加。左侧中央前回、苍白球、丘脑、颞上回、颞极、双侧壳核、双侧枕上回、右侧直回、杏仁核、缘上回和颞中回的节点最短路径显著缩短，患者左侧枕上回的节点聚类系数显著降低。在iRBD患者中，UPDRS I评分与右侧缘上回的节点效率（r=0.50，P<0.05）和右侧梭状回的节点局部效率（r=0.53，P<0.05）呈正相关，与左侧枕上回的节点聚类系数（r=-0.552，P<0.05）呈负相关。
iRBD患者在精神状态、行为、情绪、日常生活活动和运动功能方面存在异常变化。iRBD患者的脑结构网络仍具有小世界属性，但其全局拓扑属性异常，皮质、纹状体和边缘系统的局部拓扑属性分布异常。
