中文摘要：

目的：探求原发性帕金森病（PD）触觉功能脑区异常激活程度是否与病情严重度直接相关;对PD触觉脑功能改变与尾状核功能缺陷间的联系提供可能的影像学依据;对前额叶的激活在PD脑功能机制中所起的作用做出可能的解释。方法：21名早期PD患者,平均年龄（60.43±9.65）岁;22名年龄相匹配的正常志愿者,平均年龄（59.23±11.12）岁。所有患者进行统一PD量表（UPDRS）评分,以评价病情严重程度。首先通过触觉任务的fMR I研究,确定PD患者相较于正常人激活增强和减弱的脑区。接着将上述脑区作为感兴趣区（ROI）,提取出每个PD患者执行触觉任务时各ROI平均BOLD信号强度,并计算信号变化百分比。将各ROI的信号变化与患者病情严重程度作相关分析,同时作ROI之间相关分析。结果：PD患者右侧初级感觉及运动区,右侧辅助运动区,双侧楔前叶,双侧枕叶视觉皮层,左侧颞中回及双侧尾状核的激活较对照组降低;右侧前额叶及右侧尾状核激活较对照组增高。右侧辅助运动区的信号变化与UPDRS评分呈负相关。双侧尾状核与异常激活脑区的信号变化呈现正相关。右侧前额叶与激活降低脑区的信号变化呈现正相关。结论：早期帕金森患者接受触觉刺激时,辅助运动区的信号改变可以提示病情严重程度。尾状核在PD触觉神经功能改变中应该起着重要作用。前额叶激活增加的原因可能并不是代偿作用,而更可能是PD患者神经功能损害的一种体现。

英文摘要：

Objective： To investigate the role of activated brain regions in Parkinson′s disease（PD） during tactile stimulation.Methods： Twenty-one patients with early PD [mean age（60.43±9.65）y] and twenty-two age-matched healthy controls [mean age（59.23±11.12）y] were enrolled in the study.All the patients were tested by the United Parkinson Disease Rating Scale（UPDRS） as the evaluation of the disease severity.A block design was used when the finger tactile stimulation was given to the subjects.The hypoactive and hyperactive regions of PD patients were confirmed first,which were identified as regions of interest（ROI）.ROI analysis was performed to quantify BOLD signal changes when subjects were under tactile stimulation.The correlations of signal changes with disease severity,and correlations of hyperactive with hypoactive regions were analyzed.Results： Right primary sensory and motor cortex,right supplementary motor area（SMA）,bilateral caudates,bilateral precuneus,bilateral occipital visual cortex and left middle temporal gyrus were hypoactivated in PD,while right prefrontal cortex（PFC） and right caudate were hyperactivated.The hypoactivation of right SMA was negatively correlated with disease severity.All the hypoactive and hyperactive regions were positively correlated with activation of caudates.There was a positive correlation between hyperactive PFC and hypoactive regions.Conclusions： The signal change of SMA is directly related to disease severity in early PD,and caudates may play a significant role in PD tactile processing.The hyperactivation of PFC may be not a compensation but a pathophysiological change related to PD neural dysfunction.