Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Changchun Rd. 45, Xicheng district, Beijing 100053, China.
Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Changchun Rd. 45, Xicheng district, Beijing 100053, China.
Cereb Cortex. 2022 Dec 15;33(1):167-175. doi: 10.1093/cercor/bhac059.
Invasive electrophysiological recordings in patients with Parkinson's disease (PD) are extremely difficult for cross-sectional comparisons with healthy controls. Noninvasive approaches for identifying information flow between the motor area and the subthalamic nucleus (STN) are critical for evaluation of treatment strategy. We aimed to investigate the direction of the cortical-STN hyperdirect pathway using simultaneous 18F-FDG-PET/functional magnetic resonance imaging (fMRI). Data were acquired during resting state on 34 PD patients and 25 controls. The ratio of standard uptake value for PET images and the STN functional connectivity (FC) maps for fMRI data were generated. The metabolic connectivity mapping (MCM) approach that combines PET and fMRI data was used to evaluate the direction of the connectivity. Results showed that PD patients exhibited both increased FDG uptake and STN-FC in the sensorimotor area (PFDR < 0.05). MCM analysis showed higher cortical-STN MCM value in the PD group (F = 6.63, P = 0.013) in the left precentral gyrus. There was a high spatial overlap between the increased glucose metabolism and increased STN-FC in the sensorimotor area in PD. The MCM approach further revealed an exaggerated cortical input to the STN in PD, supporting the precentral gyrus as a target for treatment such as the repetitive transcranial magnetic stimulation.
在帕金森病（PD）患者中进行侵入性电生理记录，与健康对照组进行横断面比较极其困难。对于评估治疗策略，识别运动区与丘脑底核（STN）之间信息流动的非侵入性方法至关重要。我们旨在使用同时进行的 18F-FDG-PET/功能磁共振成像（fMRI）来研究皮质-STN 超直接通路的方向。在 34 名 PD 患者和 25 名对照者的静息状态下采集数据。生成 PET 图像的标准摄取值与 fMRI 数据的 STN 功能连接（FC）图的比值。采用将 PET 和 fMRI 数据相结合的代谢连接映射（MCM）方法来评估连接的方向。结果表明，PD 患者在感觉运动区均表现出 FDG 摄取增加和 STN-FC 增加（PFDR<0.05）。MCM 分析显示，左中央前回的 PD 组皮质-STN 的 MCM 值更高（F=6.63，P=0.013）。PD 患者感觉运动区的葡萄糖代谢增加与 STN-FC 增加之间存在高度的空间重叠。MCM 方法进一步显示，PD 中皮质对 STN 的输入过度夸大，支持中央前回作为治疗目标，如重复经颅磁刺激。
