MRI Study On Cerebral Blood Flow And Brain Structural In Parkinson’s Disease Patients With Depression

Objective:Depression is one of the most common non-movement symptoms of Parkinson’s disease,which seriously affects the prognosis and quality of life,and the pathophysiology of depression in PD(DPD)patients is still unclear.The arterial spin labeling technique and the method of voxel based morphometry were used to investigate the pathophysiological basis of Parkinson’s disease with depression in our study.Methods:We recruited 12 PD patients suffered from major depressive disorder,which was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders,4th edition(DSM-IV)criteria and 17 PD patients without depression(nDPD)and 20 normal control subjects.All subjects were scaned by using 3.0 T MRI with the three-dimensional pseudo continuous arterial spin labeling and three-dimensional Fast spoiled gradient recalled echo sequence to generate the high resolution whole brain perfusion imaging and structural image.Results:①Compared with the nDPD group,DPD group exhibit reduced gray matter CBF in bilateral dorsolateral prefrontal cortex,left middle frontal gyrus,left precentral gyrus,left parahippocampal gyrus,left caudate nucleus,right superior parietal lobule(P<0.01),and reduced gray matter volume in bilateral fusiform gyrus,bilateral parahippocampal gyrus,left inferior temporal gyrus,left middle temporal gyrus,right parahippocampal gyrus,right amygdala(P<0.01).There was a significant negative correlation between the HAMD scores of the patients in DPD group and the gray matter CBF in bilateral dorsolateral prefrontal cortex,left parahippocampal gyrus and the gray matter volume of bilateral parahippocampal gyrus and right amygdala.(P<0.05).②Compared with the NC group,DPD group exhibit reduced gray matter CBF in Left precentral gyrus,middle frontal gyrus,right superior parietal lobule(P<0.01),and reduced gray matter volume in bilateral precuneus,left anterior cingulate gyrus,left parahippocampal gyrus,left posterior cingulate gyrus,right middle temporal lobe,right hippocampus,right insula and right orbitofrontal cortex(P<0.05);③Compared with the NC group,DPD group exhibit reduced gray matter CBF in left precentral gyrus and left middle frontal gyrus(P<0.01),and reduced gray matter volume in bilateral precuneus,left anterior cingulate gyrus,left posterior cingulate gyrus,left superior temporal gyrus,right insula.(P<0.05).Conclusions:Compared to the control group and nDPD group,DPD patients showed multiple gray matter hypoperfusion and atrophy,mainly involving the Prefrontal-Limbic System,and this pathological manifestations may be an important pathophysiological basis for depression symptoms in patients with PD.