6 research outputs found
νμ° ν μ μμμ μ΄μ©ν νν¨μ¨λ³κ³Ό μ°κ΄λ μΆ©λμ‘°μ μ₯μ μ λ―ΈμΈκ΅¬μ‘°μ νΉμ± λΆμ
νμλ
Όλ¬Έ (μμ¬)-- μμΈλνκ΅ λνμ : λμΈμ§κ³Όνκ³Ό, 2012. 2. μ΄μ¬μ±.Impulse control disorder (ICD) has been focused one of the major malicious side-effects in Parkinsons disease (PD) patients medicated with dopaminergic agonists. However, structural changes in ICD have not been measured in comparison to normal PD. This study deals with the differences in ICD to elucidate structural causes or effects of the characteristic pathological conditions.
Three age-matched groups (the normal aged controls, PD patients ICD negative, PD patients ICD positive) were selected, and images of total 28 subjects were count in the statistical analyses. The acquisition of diffusion tensor images was done on a 3T system (Trio, Siemens, Germany) with 30 non-collinear diffusion gradients and one of zero gradients, using spin-echo EPI sequence. The evaluation of white matter differences was done with voxel-based measures of fractional anisotropy (FA) and mean diffusivity (MD). Preprocessing and postprocessing of the diffusion images were done using FSL Brain Analysis Toolbox (FMRIB Software Library, FMRIB, Oxford Univ. UK). For group comparisons, statistical analyses were performed in voxel-base using skeleton image of mean FA as the mask of images. General linear model was designed by GLM package included in FSL and nuisance factors of age, gender, Hoehn-Yahr stage, MMSE score, and PD duration were disregarded. Corrected t-stats were found by permutation tests of 5000 permutation trials using Randomise package of FSL.
Statistic results from diffusion images revealed no distinctive changes in comparisons between ICD negative or positive PD groups and CON group. However, it is discovered that ICD patients have substantially higher FA values (corrected, p < 0.05) in various regions. These include right hemispheric striatal radiation which comprises globus pallidus, subthalamic nucleus and substantia nigra. Tracts of orbitofrontal cortex linked to subgenual anterior cingulate cortex in left hemisphere also had significantly higher FA value compared to PDC.
It is expected that some of the main structural changes in ICD patients potentially indicate dopaminergic reward processing system functions are relatively preserved in ICD patients compared to PDC. This difference is elucidated in particular tracts linking basal ganglia and substantia nigra. Therefore it is concluded that ICD may be caused more easily among PD patients with intact dopaminergic reward system, supporting previous studies of dopaminergic overstimulation inferences. Characteristic behaviors under pathological conditions of ICD are potentially provoked by excessive supply of dopaminergic signals while not required.μΆ©λ μ‘°μ μ₯μ (Impulse control disorder, ICD)λ λνλ―Ό μ£Όλμ½λ¬Όμ 볡μ©νλ νν¨μ¨λ³ νμλ€μκ² λνλλ μ£Όμ λΆμμ©μ νλλ‘ μ£Όλͺ©λμ΄ μλ€. κ·Έλ¬λ μΆ©λ μ‘°μ μ₯μ λ₯Ό μλ νμλ€μ μ κ²½ κ΅¬μ‘°κ° μΌλ°μ μΈ νν¨μ¨λ³ νμμ μ΄λ»κ² λ€λ₯Έμ§μ κ΄ν μ°κ΅¬λ λΆμ‘±νμλ€. μ΄ μ°κ΅¬μμλ μΆ©λ μ‘°μ μ₯μ νμμκ²μ νΉμ§μ μΌλ‘ λνλλ ꡬ쑰μμ λ³νλ₯Ό λ°νμΌλ‘μ¨ μ΄ μ§νμ μμΈμ΄λ κ²°κ³Όμ λν μ΄ν΄λ₯Ό λκ³ μ νλ€.
νκ· λμ΄λ₯Ό κ°κ² μ‘°μ ν μΈ κ°μ νΌνμκ΅°(λμ΄ λ§μ μ μμΈ, μΆ©λ μ‘°μ μ₯μ κ° μλ νν¨μ¨λ³ νμ, μΆ©λ μ‘°μ μ₯μ κ° μλ νν¨μ¨λ³ νμ)μ΄ μ νλμμΌλ©°, μ΄ 28λͺ
μ νΌνμ λ°μ΄ν°λ₯Ό λμμΌλ‘ ν΅κ³λΆμμ μννμλ€. νμ° ν
μ μμ(Diffusion tensor image)μ νλμ 3T μ기곡λͺ
μμ μμ€ν
μμ μ€νμμ½ EPI μνμ€λ₯Ό μ΄μ©νμ¬ μ΄λ£¨μ΄μ‘κ³ , κ°μΈλΉ 30λ°©ν₯μ νμ°κΈ°μΈκΈ°μ νμ°κΈ°μΈκΈ° 0μ΄ μ μ©λ 31κ°μ μ΄λ―Έμ§λ₯Ό μ»μλ€. λ°±μ§(White matter) λ³νμ νκ°λ voxel λ¨μλ‘ Fractional anisotropy (FA) κ° λ° Mean diffusivity (MD) κ°μ λΉκ΅νμ¬ μ΄λ£¨μ΄μ‘λ€. νμ° μμμ μ μ²λ¦¬μ νμ²λ¦¬λ FSL νλ‘κ·Έλ¨(FMRIB Software Library, FMRIB, Oxford Univ. UK)μ ν΅ν΄ μννμλ€. νΌνμκ΅° κ°μ ν΅κ³μ μΈ κ΅¬λΆμ μν΄μ FA κ°μ voxel λ¨μλ‘ μΆμΆνμ¬ λ§λ μ΄λ―Έμ§λ₯Ό νκ· νμμΌλ©°, λͺ¨λ κ°λ³ μ΄λ―Έμ§μλ κ³ μ μμΉκ°μ μ μ©νμ¬ μΌμ κ° μ΄μλ§ νκ· κ³Ό λΉκ΅ν μ μλλ‘ νμλ€. νΌνμκ΅°μ μΌλ°μ νλͺ¨λΈ(General linear model)μ FSLμ ν¬ν¨λ GLM λκ΅¬λ‘ κ΅¬μ±νμμΌλ©°, μΌλ°μ νλͺ¨λΈμμ λμ΄, μ±λ³, Hoehn-Yahr μ μμμ€, MMSE μ μμμ€, PD λ°λ³κΈ°κ°μ μ°¨μ΄λ 무μνλλ‘ νμλ€.
μ€μ κ°μ λΉκ΅λ FSLμ Randomise λꡬλ₯Ό μ΄μ©ν 5000μμ΄μ λΉλͺ¨μν΅κ³λ‘ μ΄λ£¨μ΄μ‘μΌλ©°, λ€μ€λΉκ΅λ‘ μΈν μλ¬λ₯Ό κ΅μ ν TμμΉλ₯Ό μ»μλ€. ν΅κ³μ κ²°κ³Όμ μνλ©΄, μΆ©λ μ‘°μ μ₯μ κ° μκ±°λ μλ νν¨μ¨λ³ νμμ μ μκ΅° κ°μ λλ ·ν μ°¨μ΄λ μμλ€. κ·Έλ¬λ μΆ©λ μ‘°μ μ₯μ κ° μλ νν¨μ¨λ³ νμλ μλ νμμ λΉν΄ μ¬λ¬ κ³³μμ μ μνκ² λ λμ FA κ°μ κ°μ‘λ€(λ€μ€λΉκ΅ μλ¬ κ΅μ λ¨, p < 0.05). μ°¨μ΄κ° λλ μμλ€ κ°μ΄λ° μ°λ°κ΅¬μμλ ν체(Substantia nigra), μμνν΅(Subthalamic nucleus)κ³Ό λ΄μ°½κ΅¬(Globus pallidus)λ₯Ό μλ μ 쑰체(Striatum) μμμ λ°±μ§μ΄ λνμ μ΄μλ€. μ’λ°κ΅¬μμλ μμμ λνΌμ§(Orbitofrontal cortex)κ³Ό μ¬νμ λλμνΌμ§(Subgenual anterior cingulate cortex)μ μλ λ°±μ§μ FAκ°μ΄ μΆ©λμ‘°μ μ₯μ νμλ€μμ λ λμλ€.
μ κ²°κ³Όλ₯Ό ν λλ‘, μΆ©λμ‘°μ μ₯μ νμλ€μμ 보μ΄λ μ°¨μ΄κ° λνλ―Όμ κ΄μ¬νλ 보μ νλ‘ κΈ°λ₯μ μλμ μΈ λ³΄μ‘΄μ μλ―Ένλ€κ³ μμΈ‘ν μ μμλ€. ν΅κ³μ μ°¨μ΄λ νΉν κΈ°μ ν΅(Basal Ganglia)κ³Ό ν체(Substantia nigra)λ₯Ό μλ μ κ²½λΆμμ λνλ¬λ€. κ·Έλ¬λ―λ‘ μ°λ¦¬λ λνλ―Όμ΄ κ΄μ¬ν 보μ νλ‘κ° λΉκ΅μ 보쑴λ νν¨μ¨λ³ νμμμ μΆ©λ μ‘°μ μ₯μ κ° λ μ½κ² μΌμ΄λ κ°λ₯μ±μ΄ μλ€κ³ κ²°λ‘ μ§μμΌλ©°, μ΄λ λνλ―Ό μ νΈμ μ§λμΉ κ°νμ μν΄ μΆ©λ μ‘°μ μ₯μ κ° λ°μν μ μλ€λ κΈ°μ‘΄ μ°κ΅¬μμμ μΆλ‘ μ λ·λ°μΉ¨νλ€. μ΄λ‘λΆν° μΆ©λ μ‘°μ μ₯μ μμμ νλ μ΄μμ κ³Όμμ λνλ―Ό μ νΈλ‘ μΈν΄ μ΄λ°λ μ μμμ μΆμΈ‘ κ°λ₯νλ€.Maste