摘要
不宁腿综合征(RLS)的神经影像学研究为我们深入了解此病的发病机制提供了很多有用信息。基于体素形态学分析和弥散张量成像发现RLS患者存在脑微结构异常,在脑白质层面异常脑区比较一致,主要分属感觉运动系统和边缘系统。功能磁共振成像同样发现感觉运动网络和边缘网络的神经活动和(或)功能连接发生改变。单光子发射计算机断层显像和正电子发射计算机断层显像证实RLS存在多巴胺通路异常,不仅涉及黑质纹状体通路,还涉及中脑边缘通路。铁敏感磁共振成像明确RLS脑内铁含量减少,以黑质和丘脑的铁含量减少为著。总结上述神经影像学研究,我们推测RLS的发病基础可能是脑内铁含量减少,以致黑质纹状体和中脑边缘多巴胺能通路异常,进一步引起感觉运动网络和边缘网络功能障碍,从而发生RLS。
The neuroimaging provides a lot of useful information about the neuromechanism of restless legs syndrome(RLS).The voxel-based morphometry and diffusion tensor imaging findings reported brain microstructural abnormalities,which were more consistent concerning levels of white matter and belonged to the sensorimotor and limbic system.Functional magnetic resonance imaging(MRI)studies also demonstrated the neural activity and/or functional connectivity changes in the sensorimotor and limbic network.Positron emission tomography and single photon emission computed tomography studies supported the dysfunction of the dopaminergic pathways involving not only the nigrostriatal but also mesolimbic pathways.Iron-sensitive MRI verified low brain iron content mainly in substantia nigra and thalamus.The primary change might be the reduction of brain iron content,which leads to the dysfunction of the nigrostriatal and mesolimbic dopaminergic pathways and in turn to a dysregulation of sensorimotor and limbic network resulting in the symptoms of RLS.
作者
李哲
周苗苗
蔡巧娣
陈俊
雒晓东
徐评议
Li Zhe;Zhou Miaomiao;Cai Qiaodi;Chen Jun;Luo Xiaodong;Xu Pingyi(Department of Neurology,the First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510120,China;Department of Encephalopathy,the Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510120,China;Department of Radiology,the Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510120,China)
出处
《中华神经科杂志》
CAS
CSCD
北大核心
2019年第3期231-237,共7页
Chinese Journal of Neurology
基金
国家重点研发计划(2016YFC1306601)
国家自然科学基金资助项目(81430021,81870992,81603681)
广东省自然科学基金资助项目(2018A030310521).
关键词
不宁腿综合征
磁共振成像
体层摄影术
发射型计算机
单光子
Restless legs syndrome
Magnetic resonance imaging
Tomography,emission-computed,single-photon
