前庭神经鞘瘤患者静息态脑功能网络变化的研究  

Functional reorganization of resting state in patients with vestibular schwannoma

作　　者：王兴朝[1] 王博[1] 范阳[1] 杨智君[1] 赵赋[1] 王振民[1] 马淑杰[1] 张晶[1] 熊志霞 邹启红[1] 刘丕楠[1] 

机构地区：[1]首都医科大学附属北京天坛医院神经外科,100050

出　　处：《中华神经外科杂志》2014年第4期368-372,共5页Chinese Journal of Neurosurgery

基　　金：“十二五”科技支撑计划课题（2012BAI12B03）;北京市自然科学基金（7112049）;北京市卫生系统高层次卫生技术人才队伍建设专项经费资助（2011-03-027）

摘　　要：目的利用静息态功能磁共振成像技术，结合局部一致性（ReHo）分析方法，研究前庭神经鞘瘤患者的大脑功能活动变化情况，着重探讨前庭神经鞘瘤患者听力损伤所引起的中枢皮层重塑。方法对42例单侧前庭神经鞘瘤患者（左侧21例，右侧21例）和24例健康对照组进行静息态功能磁共振检查，对数据分别进行局部一致性分析，运用单因素方差分析比较三组人群在全脑水平上大脑各区域活动的变化。结果三组人群在涉及听觉处理、多感官信息整合及大脑默认网络功能等的脑区上出现了局部活动的显著异常（P〈0．05），主要包括双侧岛叶皮质、左侧颞上回皮质、双侧中央前回，双侧枕叶等区域。结论前庭神经鞘瘤患者出现了听觉皮层及相关感知觉处理脑区的功能活动改变，在出现听力损伤的过程中引起了大脑皮层的功能重塑。Objective To investigate the underlying mechanisms of cortical reorganization in vestibular schwannoma （ VS ） patients compared with normal controls by using resting - state functional magnetic resonance imaging combined with regional homogeneity （ReHo） analysis. Methods Using resting - state functional magnetic resonance imaging, we investigated the underlying mechanisms of cortical reorganization with 42 unilateral hearing loss participants （21 of each side） resulted from VS compared with 24 matched normal controls. ReHo results were further analyzed by single - factor analysis of variance comparing （ ANOVA ） among three groups in the whole brain levels. Results The three groups had shown a significant difference in several brain regions served to auditory processing, default model network and multi - sensory information integration （ P 〈 O. 05 ） , including bilateral insular cortex, the left superior temporal gyrus cortex, bilateral precentral gyrus and occipital areas. Regionally, we found that ReHo value, of the left superior temporal sulcus （STS） was decreased, and of bilateral insnla cortex （IC） was increased, emphasizing cortical reorganization of VS patients. Conclusions VS patients had functional plasticity in auditory cortex and brain areas involving in perceptual processing, and the process of hearing damage caused the function remodeling in cerebral cortex. Further, our findings had important implications for a variety of other sensory impairments, and it gave rise to new considerations regarding functional networks that involve the IC. Finally, our findings supported the theory that changes in sensory experience could drive plasticity within and beyond the auditory networks in unilateral hearing processing of VS patients.

关 键 词：神经鞘瘤 前庭 听力损害 皮层重塑 静息态功能磁共振成像 

分 类 号：R739.4[医药卫生—肿瘤]