脑老化的异质性:功能磁共振成像的初步对照研究  

Heterogeneity of aging brain: a preliminary comparative study of functional magnetic resonance imaging in elderly people

作　　者：李春波[1] 申远[1] 吴文源[1] 杨振燕[2] 王培军[2] 翁旭初[3] 张明园[4] 

机构地区：[1]同济大学附属同济医院精神医学科,上海200065 [2]同济大学附属同济医院医学影像科,上海200065 [3]中国科学院心理研究所脑高级功能研究室 [4]上海市精神卫生中心

出　　处：《中华医学杂志》2005年第42期2971-2974,共4页National Medical Journal of China

基　　金：国家自然科学基金资助项目(30170327);上海联合利华研究与发展基金资助项目(145)

摘　　要：目的探索脑功能老化异质性的相关机制。方法10例成功老龄(SA)、10例常态老龄(UA)和9例轻度认知功能损害(MCI)患者进行词汇流畅性作业(VFT)的fMRI检查,比较脑激活表现。结果SA与UA均明显激活顶叶、额叶、扣带前回及枕叶,MCI除右侧额叶外激活普遍低下;SA激活强度大于UA,但差异无统计学意义,二者激活强度均高于MCI,差异有统计学意义(P<0.01)。SA左前额叶(尤其左侧前额叶背外侧皮质)激活显著,UA与MCI激活相对减弱,差异有统计学意义(P=0.01)。SA脑激活呈一致优势侧偏(偏侧化指数LIs=0.46),UA和MCI脑激活总体无偏侧性(LIs分别为-0.12和-0.06);(4)SA与UA均有显著枕叶激活,MCI激活不明显。结论脑老化过程中存在着异质性,涉及了复杂的脑功能机制;左侧前额叶背外侧皮质激活程度和偏侧化指数可作为衡量脑功能老化水平的参考指标。Objective To explore the heterogeneity of aging brain. Methods Blood oxygenation level dependent functional magnetic resonance imaging was performed on 10 subjects meeting the standards of successful aging （SA）, 9 subjects meeting the standards of usual aging （UA）, and 9 subjects meeting the criteria of mild cognitive impairment （MCI）, all age, and sex-matched, under stimulation of verbal fluent test （VFT）. The activation level of different regions of interest （ROI）, laterality index, and the activation level of occipital lobe were analyzed. Results The achievement in VFT of the SA group was greater than that of the UA group, and much greater than that of the MCI group with significant differences between any 2 groups （ all P 〈 0.05） except in the task of “names of vegetables”. The activation volume of the SA group was greater than that of the UA group, and much greater than that of the MCI group. The main activated regions of the SA and UA groups included left precuneus, anterior cingulated gyrus, middle frontal gyrus, superior frontal gyrus and inferior parietal lobule, and bilateral occipital lobes. The main activated regions of the MCI group included the bilateral prefrontal lobe. The intensity of activation was not significantly different between the SA and UA groups, however, was significantly different between the SA and MCI groups and between the UA and MCI groups. The laterality index （LI） was 0.46 in the SA group, significantly higher than those of the UA group （ - 0. 12 ） and MCI group （ - 0.06 ） （ both P 〈 0.01 ）, however, without a significant difference between the UA group and MCI group. The activation of left prefrontal lobe in the SA group was more obvious than that in the UA group, and much more obvious than that in the MCI group with a significant difference between the UA and MCI groups as well （ all P 〈 0.01 ）. The activation volume of the left dorsal lateral prefrontal cortex （DLPFC） in the SA group was 787 voxels, significantly great

关 键 词：老年病 老年人心身评价 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]