【摘 要】
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Objective We used resting-state fMRI to investigate short-term ReHo changes after unilateral thalamotomy in tremor-dominant PD,and to speculate about its possible mechanism on tremor suppression.Metho
【机 构】
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Department of Radiology,Zhongnan Hospital of Wuhan University
【出 处】
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中华放射学学术大会2016、中华医学会第23次全国放射学学术大会暨中华医学会第24次全国影像技术学术大会
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Objective We used resting-state fMRI to investigate short-term ReHo changes after unilateral thalamotomy in tremor-dominant PD,and to speculate about its possible mechanism on tremor suppression.Methods 26 patients and 31 healthy subjects(HS)were recruited.Patients were divided into two groups according to right-(rPD)and left-side(lPD)thalamotomy.Tremor was assessed using the 7-item scale from the Unified Parkinsons disease rating scale motor score(mUPDRS).Patients were scanned using resting state fMRI after 12h withdrawal of medication,both preoperatively(PDpre)and 7-day postoperatively(PDpost),whereas healthy subjects were scanned once.The regions associated with tremor and altered ReHo due to thalamic ablation were examined.Results The impact of unilateral VIM thalamotomy was characterized in the frontal,parietal,temporal regions,basal ganglia,thalamus,and cerebellum.Compared with PDpre,significantly reduced ReHo was found in the left cerebellum in patients with rPDpost,and slightly decreased ReHo in the cerebellum vermis in patients with lPDpost,which was significantly higher than HS.We demonstrated a positive correlation between the ReHo values in the cerebellum(in rPD,peak coordinate [-12,-54,-21],R = 0.64,P = 0.0025,and peak coordinate [-9,-54,-18],R = 0.71,P = 0.0025; in lPD,peak coordinate [3,-45,-15],R = 0.71,P = 0.004)in the pre-surgical condition,changes of ReHo induced by thalamotomy(in rPD,R =0.63,P = 0.021,R = 0.6,P = 0.009; in lPD,R = 0.58,P = 0.028)and tremor scores contralateralto the surgical side,respectively.Conclusion The specific area that may be associated with PD tremor and altered ReHo due to thalamic ablation is the cerebellum.The neural basis underlying thalamotomy is complex; cerebellum involvement is far beyond cerebello-thalamic tract breakage.
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