复发缓解型多发性硬化患者默认网络效应连接的格兰杰因果分析  

Effective connectivity of default mode network in relapsing remitting multiple sclerosis： a resting-state functional MRI Granger causality analysis

作　　者：周福庆[1] 庄莹[2] 龚洪翰[1] 占洁[1] 

机构地区：[1]南昌大学第一附属医院影像科、江西省医学影像研究所,南昌330006 [2]南昌市第二医院肿瘤科,330003

出　　处：《中华神经医学杂志》2014年第12期1193-1197,共5页Chinese Journal of Neuromedicine

基　　金：国家自然科学基金（81060116、81101041、81260217）;江西省青年自然科学基金项目（2013BAB215008）

摘　　要：目的采用基于感兴趣区的二变量系数为基础的格兰杰因果分析方法对复发缓解型多发性硬化（RRMS）患者默认网络（DMN）的效应连接改变进行研究。方法选择自2010年6月至2012年12月期间在南昌大学第一附属医院神经内科就诊的RRMS患者24例为RRMS组，同期24例年龄、性别相匹配的健康志愿者为健康对照组。采集2组成员静息态功能磁共振（rs-fMRI）和T1薄层MRI数据。使用rs-fMRI数据处理助手（DPARSFA）进行数据的预处理，以后扣带回为种子点分别构建2组的DMN，选取其6个主要成份为感兴趣区，使用rs-fMRI数据分析工具包（REST）内置的格兰杰因果分析方法计算DMN主要成份间的效应连接，比较效应连接差异并与临床参数如临床扩展残疾量表（EDSS）、同步听觉连续加法测验评分（PASAT）、修订的疲劳影响量表（MFIS）、脑实质分数fBPF）和T2可见病灶体积进行相关性分析。结果与健康对照组比较，RRMS组双侧顶下叶（IPL）之间的效应连接差异存在统计学意义（t=3．071，P=0．0041，同时效应连接方向发生改变；RRMS组左侧IPL和右侧颞中回（MTG）之间的效应连接差异存在统计学意义（t=2．053，P=0．046），同样存在效应连接方向的改变：RRMS组左侧IPL和右侧IPL间、左侧IPL和右侧MTG间的效应连接系数分别与EDSS呈正相关（r=0．410，P=0．045；r=0．470，P=0．020），与PASAT、MFIS、BPF及T2可见病灶体积之间均无显著相关（P〉0．05）。结论患者左侧IPL的信息流出（向右侧IPL、右侧MTG）增加是一种无效功能代偿。Objective To explore the effective connectivity of default mode network （DMN） in relapsing-remitting multiple sclerosis （RRMS） patients using a resting-state functional MRI （rs-fMRI） Granger causality analysis （GCA）. Methods Twenty four patients with RRMS, admitted to our hospital from June 2010 to December 2012, and 24 age-, and gender-matched healthy controls were examined by rs-fiVIRI and 3D-T1 on Trio 3.0T MRI. The preprocessing and processing rs-fiVIRI data were analyzed using Data Processing Assistant for rs-fMRI Advanced Edition based on Matlab 2012a; the posterior cingulate cortex （PCC） was selected as the seed, and a seed-based correlation analysis was used to construct the spatial patterns of DMN; 6 principal components of DMN were selected as regions of interest; GCA method was used to compare the effective connectivity between the two groups. The specific correlations between effective connectivity changes of DMN and clinical parameters, as scores of clinical expanded disability scale （EDSS）, synchronous auditory continuous additions test （PASAT） andmodified fatigue impact scale （MFIS）, brain parenchymal fraction （BPF） and lesion volume seen under T2, were further analyzed. Results As compared with healthy control group, RRMS group exhibited an altered signed-path coefficient and direction between the left and right inferior parietal lobules （IPLs, t=3.071, P=-0.004）, and the left inferior parietal lobule and the right middle temporal gyrus （MTG, t= 2.053, P=0.046）. Significant positive-relations were observed between EDSS scores and signed-path coefficient between left and right IPLs （t=0.410, P=0.045） and left 1PL and right MTG （t=0.470, 0.020）, respectively. The correlations of altered signed-path coefficient with PASAT scores, BPF, MFIS scores and total white matter lesion loads were not observed （P〉0.05）. Conclusions The abnormal effective connectivity between principal components of DMN in RRMS patients is an invalid compensation. This st

关 键 词：多发性硬化 格兰杰因果分析 功能磁共振成像 静息态 默认网络 效应连接 

分 类 号：R744.51[医药卫生—神经病学与精神病学]