脑梗死患者脑默认网络改变的功能磁共振研究  

Functional MRI for changed brain default mode network in ischemic stroke patients

作　　者：张晨[1] 张敬[1] 孟亮亮[1] 秦文[1] 薛蓉[2] 于春水[1] 

机构地区：[1]天津医科大学总医院放射科,300052 [2]天津医科大学总医院神经内科,300052

出　　处：《中华老年心脑血管病杂志》2015年第3期287-290,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：国家自然科学基金(81271564);天津市自然科学基金(12JCZDJC23800);卫计委公益性行业科研基金(201402019)

摘　　要：目的采用静息态功能MRI功能连接方法观察慢性期基底节区脑梗死患者脑默认网络(DMN)的变化。方法选择慢性期基底节区脑梗死患者17例(脑梗死组),健康体检者22例(对照组),采集静息态功能MRI数据,记录蒙特利尔认知评估量表(MoCA)及简易智能状态检查量表(MMSE)评分。采用腹内侧前额叶皮质、右侧后扣带皮质、左侧后扣带皮质3个感兴趣区提取DMN,取其交集获得DMN掩膜,以该掩膜为种子区,计算其与DMN内各体素功能连接。采用皮尔森相关分析观察差异区功能连接强度与MoCA、MMSE评分以及梗死灶体积的相关性。结果与对照组比较,脑梗死组内侧前额叶皮质及后扣带皮质/楔前叶功能连接明显减低(P<0.05)。脑梗死组内侧前额叶皮质功能连接与MoCA评分呈正相关(r=0.619,P=0.008)。结论脑梗死后DMN损害先于认知功能障碍出现,可能是引起认知功能损害的始动因素。Objective To study the changed brain default mode network in chronic ischemic stroke patients by functional M RI .Methods Seventeen chronic ischemic stroke patients served as an is‐chemic stroke group and 22 sex‐and age‐matched healthy subjects undergoing physical examina‐tion served as a control group in this study .Their functional MRI data and Montreal congnitive assessment （MoCA） and Mini‐Mental State Examination （MMSE） scores were recorded .Default mode network was taken from the ventromedial prefrontal cortex ,right posterior cingulate cortex and left posterior cingulate cortex to generate the default mode network mask .Voxel functional connectivity in the default mode network mask was calculated .Association of functional connec‐tivity strength with MoCA and MMSE scores and infarction size were analyzed by Pearson corre‐lation analysis .Results The functional connectivity of medial prefrontal cortex （MPFC）and pos‐terior cingulate cortex/precuneus was significantly lower in ischemic stroke group than in control group （P〈0.05） .The functional connectivity of MPFC in ischemic stroke group was positively associated with the MoCA score （r= 0 .619 ,P= 0 .008） .Conclusion Default mode network is damaged before cognitive impairment following ischemic stroke ,which is the initial factor for cog‐nitive impairment .

关 键 词：脑梗死 磁共振成像 认知障碍 神经网 海马 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]