丘脑定量磁化率图预测帕金森病深部脑刺激术后出现幻视。
Pulvinar quantitative susceptibility mapping predicts visual hallucinations post-deep brain stimulation in Parkinson's disease.
机构信息
Department of Neurology, Graduate School of Medicine, Mie University, Mie, Japan.
Department of Neuroimaging and Pathophysiology, Mie University School of Medicine, Mie, Japan.
出版信息
Brain Behav. 2023 Nov;13(11):e3263. doi: 10.1002/brb3.3263. Epub 2023 Sep 24.
PURPOSE
We have reported the relationship between low pulvinar nuclei (PN) intensity in susceptibility-weighted imaging and the appearance of visual hallucinations and cognitive function. The aim of the study was to examine the changes in the quantitative susceptibility mapping (QSM) in patients with Parkinson's disease (PD) who underwent deep brain stimulation (DBS) and verify whether the PN susceptibility value (SV) on QSM can predict visual hallucination and cognitive changes after DBS.
METHODS
This study examined 24 patients with PD who underwent DBS along with QSM imaging on magnetic resonance imaging (MRI). All MRIs were performed within 3 months before surgery. The PN SV was further assessed based on the QSM. Then, associations were examined among cognitive changes, hallucination, and PN SV. The cognitive function of the patient was compared immediately before surgery and at 1 year postoperatively.
RESULTS
Visual hallucinations were observed in seven patients during the follow-up period. The PN SV was ≥0.045 ppm in nine patients with PD, and six of them had visual hallucinations, whereas only one of 15 patients with PD with SV of <0.045 ppm had visual hallucinations (Fisher's exact test, p = .0037).
CONCLUSIONS
The SV of >0.045 ppm at the PN in QSM in patients with PD may provide useful information suggesting visual hallucination and cognitive deterioration after DBS treatment.
目的
我们已经报告了在磁共振成像的磁化率加权成像中，丘脑底核（PN）低信号强度与视觉幻觉和认知功能之间的关系。本研究的目的是研究接受深部脑刺激（DBS）的帕金森病（PD）患者的定量磁化率映射（QSM）变化，并验证 QSM 上的 PN 磁化率值（SV）是否可以预测 DBS 后视觉幻觉和认知变化。
方法
本研究共纳入 24 例接受 DBS 治疗的 PD 患者，同时进行磁共振成像（MRI）的 QSM 成像。所有 MRI 均在手术前 3 个月内进行。进一步根据 QSM 评估 PN SV。然后，检查认知变化、幻觉和 PN SV 之间的关联。比较患者手术前和术后 1 年的认知功能。
结果
在随访期间，7 例患者出现视觉幻觉。9 例 PD 患者的 PN SV 为≥0.045 ppm，其中 6 例出现视觉幻觉，而 15 例 SV <0.045 ppm 的 PD 患者中仅 1 例出现视觉幻觉（Fisher 确切检验，p =.0037）。
结论
PD 患者 QSM 中 PN 的 SV >0.045 ppm 可能提供有用的信息，提示 DBS 治疗后视觉幻觉和认知恶化。
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