Tai Yuchao, Huang Wei, Zhu Yongyun, Liu Bin, Wang Fang, Liu Zhaochao, Liang Chunyu, Tian Jin, Yang Hongju, Yang Xinglong
Department of Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, P.R. China.
Department of Neurosurgery, The First People's Hospital of Yunnan Province, Kunming, 650032, Yunnan Province, P.R. China.
Brain Imaging Behav. 2025 Sep 18. doi: 10.1007/s11682-025-01057-y.
Gastrointestinal symptoms are one of the most common non-motor symptoms in Parkinson's disease. This study aimed to investigate the neuroimaging mechanisms underlying gastrointestinal symptoms associated with Parkinson's disease using functional connectivity and voxel-based morphometry. The study included 50 healthy controls, 71 Parkinson's disease patients without gastrointestinal symptoms and 84 patients with gastrointestinal symptoms. Differences in gray matter volume among the three groups were assessed. Given a significant decrease in gray matter volume in the right cerebellar hemisphere, it was selected as the seed region for functional connectivity analysis.The Parkinson's disease patients with gastrointestinal symptoms showed significant differences in disease duration, levodopa equivalents daily dose, Hoehn and Yahr stage, unified Parkinson's disease rating scale part Ⅲ, Hamilton anxiety scale, Scales for Outcomes in Parkinson's disease-Autonomic, non-motor symptom scale, Montreal cognitive assessment, and orthostatic hypotension compared to the patients without gastrointestinal symptoms (p<0.05). Lower gray matter volume was observed in the group with gastrointestinal symptoms, particularly in the bilateral cerebellum hemisphere and the left superior temporal gyrus. Compared to the group without gastrointestinal symptoms, functional connectivity between the right cerebellar hemisphere and the right medial and lateral cingulate gyrus and left middle temporal lobe was significantly increased.Parkinson's disease patients with gastrointestinal symptoms present with a prolonged disease course and increased severity of both motor and non-motor symptoms. The gastrointestinal symptoms in Parkinson's disease patients may be associated with structural and functional brain alterations.
胃肠道症状是帕金森病最常见的非运动症状之一。本研究旨在利用功能连接和基于体素的形态测量法，探讨帕金森病相关胃肠道症状的神经影像学机制。该研究纳入了50名健康对照者、71名无胃肠道症状的帕金森病患者和84名有胃肠道症状的患者。评估了三组之间灰质体积的差异。鉴于右侧小脑半球灰质体积显著减少，将其选为功能连接分析的种子区域。与无胃肠道症状的患者相比，有胃肠道症状的帕金森病患者在病程、左旋多巴等效日剂量、Hoehn和Yahr分期、帕金森病统一评分量表第三部分、汉密尔顿焦虑量表、帕金森病自主神经功能结局量表、非运动症状量表、蒙特利尔认知评估量表和直立性低血压方面存在显著差异（p<0.05）。有胃肠道症状的组中观察到灰质体积较低，特别是在双侧小脑半球和左侧颞上回。与无胃肠道症状的组相比，右侧小脑半球与右侧内侧和外侧扣带回以及左侧颞中叶之间的功能连接显著增加。有胃肠道症状的帕金森病患者病程延长，运动和非运动症状的严重程度增加。帕金森病患者的胃肠道症状可能与脑结构和功能改变有关。
