휴식상태 뇌기능자기공명영상을 활용한 파킨슨병 환자의 발성 관련 배쪽시상핵 기능연결성 분석 = Resting-State Functional Connectivity Mediating for Phonation by the Thalamus in Parkinson’s Disease

국문 초록 (Abstract)

배경 및 목적: 본 연구는 파킨슨병(Parkinson’s disease, PD) 환자의 말산출 연결망을 증명하기 위해 휴식상태 기능자기공명영상을 활용하여 발성에 관여하는 주요 핵으로 알려진 배쪽시상핵과 대뇌피질 간의 기능적 연결성(functional connectivity, FC)을 살펴보았다. 방법: 약물이 효과적으로 작용하는 상태인 PD 환자 14명과 정상 성인 10명을 대상으로 3.0 Tesla로 뇌영상을 획득한 뒤 두 집단 간의 FC를 비교하였다. 그리고 집단 간 FC 비교에서 통계적으로 유의한 차이가 확인된 대뇌피질에 대해 집단 내에서 선형적 관련성을 확인하였다. 결과: 통제군에 비해 PD 환자군은 오른쪽 시상과 좌우 대뇌피질 간의 FC가 유의하게 저하되었으며, FC가 감소된 대뇌피질 영역을 구체적으로 살펴보면 좌반구의 상전두이랑, 중전두이랑, 중측두이랑, 쐐기앞부분과 우반구의 내측전두이랑, 중심뒤이랑이었다. 두 집단 간에 차이를 보인 피질영역들 간의 상관관계를 집단 내에서 비교한 결과, 정상 집단은 왼쪽 쐐기앞부분-두정엽 영역(오른쪽 중심뒤이랑)에서 정적 상관관계(r=.857)가 존재한 반면에 PD 환자군은 왼쪽 쐐기앞부분-전두엽 영역(오른쪽 내측전두이랑, 왼쪽 상전두이랑 및 중전두이랑)(r>.60) 간에 정적 상관관계가 확인되었다. 논의 및 결론: 본 연구를 통해 발병 후 PD 환자군의 발성 능력 감소는 오른쪽 배쪽시상핵과 좌우 대뇌피질 간의 기능적 상호작용 감소와 관련되며, 특히 대뇌피질 단계에서 확인된 쐐기앞부분과 전두엽 영역 간의 높은 상관관계는 발성에서 쐐기앞부분이 대뇌피질 영역을 통합하는 주변 핵심으로서 기능할 가능성을 시사하였다.

다국어 초록 (Multilingual Abstract)

Objectives: Phonation impairment is a frequent symptom in patients with Parkinson’s disease (PD). Phonation generally worsens as the disease progresses, causing a progressive loss of communication abilities and increasing isolation from society. Despite our understanding of the sites primarily responsible for phonation in normal subjects (NS), alteration of the functional network in patients with PD still remains unclear. The aim of the present study was to provide evidence of neural systems of phonation, using the resting-state fMRI (rs fMRI) technique, that in comparison to NS, patients with PD exhibited altered functional connectivity associated with the thalamus. Methods: We acquired rs fMRI, and then analyzed the functional interactions from the seed regions of interest (ventral thalamic nuclei). This study included 14 patients with PD and 10 NS. All participants underwent fMRI scanning with a 3.0-Tesla MRI scanner to obtain T2*-weighted single-shot echo planar imaging sequences. Results: The results showed that the patients with PD, in the “ON” medication state, exhibited reductions in the right thalamus and both hemispheres of the cortex in the phonation network compared with controls. Specifically, in the PD group, the right thalamus seeds showed strong contralateral connections with the left cortex. In addition, a positive correlation was found between the left precuneus and the both frontal lobules (r>.60) in the PD group. Conclusion: Using the rs fMRI technique, we provided evidence that the patients with PD exhibited a significantly lower functional connectivity when compared to the NS group in relation to phonation control. Also, our data demonstrated bilateral organization of the rs connectivity in contrast to dominant functional influence of the left hemisphere on correlation organization, and recruitment of the right thalamus within the PD group.

목차 (Table of Contents)

• 연구방법 연구결과 논의 및 결론 REFERENCES

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