磁共振成像影像学参数与老年帕金森病患者认知功能障碍的相关性研究

doi:10.3969/j.issn.1003-9198.2026.09.012

摘要/Abstract

摘要： 目的探讨MRI影像学参数对老年PD患者认知功能障碍(CI)的预测价值。方法采用回顾性、巢式病例对照研究,选取2023年4月至2025年6月新疆医科大学第二附属医院收治的65例PD合并CI患者为PD-CI组,同期选取65例未发生CI的PD患者为PD组。2组患者均行MRI检查采集表观弥散系数(ADC)、各向异性分数(FA)。收集2组一般临床资料,采用多因素logistic回归分析探讨老年PD患者发生CI的影响因素,采用ROC曲线分析MRI影像学参数预测PD患者发生CI的价值。结果与PD组比较,PD-CI组受教育年限少、病程长、Hoehn-Yahr(H-Y)分级Ⅲ～Ⅳ级者比例增加(P＜0.05)。与PD组比较,PD-CI组黑质区ADC水平升高,FA降低,差异有统计学意义(P＜0.05)。Logistic回归分析结果显示,病程长、H-Y分级为Ⅲ～Ⅳ级、高ADC水平是老年PD患者发生CI的危险因素,高FA是其保护因素。ROC曲线分析结果显示:ADC、FA联合预测老年PD患者发生CI的AUC(95%CI)为0.894(0.828～0.941),高于ADC、FA单独预测的0.790(0.709～0.856)、0.787(0.706～0.853)(Z=2.008、1.990,P<0.05)。结论黑质ADC、FA是老年PD患者发生CI的影响因素,ADC、FA联合检测对于老年PD患者发生CI具有良好的预测价值。

关键词: 帕金森病, 老年人, 磁共振成像, 弥散张量成像, 认知功能障碍

Abstract: Objective To explore the predictive value of magnetic resonance imaging (MRI) parameters for cognitive impairment (CI) in elderly patients with Parkinson’s disease (PD). Methods A retrospective, nested case-control study was conducted. A total of 65 patients with PD complicated with CI, admitted to the Second Affiliated Hospital of Xinjiang Medical University from April 2023 to June 2025, were enrolled as the PD-CI group. Concurrently, 65 PD patients without CI were selected as the PD group. Both groups underwent MRI scans, and apparent diffusion coefficient (ADC) and fractional anisotropy (FA) were recorded. Clinical data of both groups were collected. Multivariate logistic regression analysis was used to identify the influencing factors of CI in elderly PD patients, and receiver operating characteristic (ROC) curve analysis was employed to evaluate the value of MRI imaging parameters in predicting the occurrence of CI in PD patients. Results Compared with the PD group, the PD-CI group had fewer years of education, longer disease duration, and a higher proportion of Hoehn-Yahr (H-Y) stage Ⅲ-Ⅳ (P<0.05). Compared with the PD group, the PD-CI group showed increased ADC levels and decreased FA values in the substantia nigra (P<0.05). Logistic regression analysis showed that long disease duration, H-Y stage Ⅲ-Ⅳ, and high ADC levels were risk factors for CI in elderly PD patients, while high FA was a protective factor. ROC curve analysis results showed that the AUC(95%CI) for predicting CI in elderly PD when combining ADC and FA was 0.894 (0.828-0.941), which was higher than that of ADC and FA alone [0.790(0.709-0.856) and 0.787(0.706-0.853), Z=2.008, 1.990, P<0.05, respectively]. Conclusions ADC and FA of the substantia nigra are influencing factors for the occurrence of CI in elderly PD patients, and the combination of ADC and FA has a good predictive value for the occurrence of CI in elderly patients with PD.

Key words: Parkinson’s disease, aged, magnetic resonance imaging, diffusion tensor imaging, cognitive dysfunction

中图分类号:

R 742.5

姜磊, 刘莹, 曾辉. 磁共振成像影像学参数与老年帕金森病患者认知功能障碍的相关性研究[J]. 实用老年医学, 2026, 40(9): 924-928.

JIANG Lei, LIU Ying, ZENG Hui. Correlation between MRI imaging parameters and cognitive dysfunction in elderly patients with Parkinson’s disease[J]. Practical Geriatrics, 2026, 40(9): 924-928.

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