老年人脑白质病变相关性跌倒的脑静息态功能磁共振成像  

Resting state fMRI on white matter lesions in the aged with fall risk

作　　者：李正然[1] 常天静 王子璇[2] 张玮艺 詹亚峰 刘勇[4] 王春雪[2] 沈慧聪[1] 

机构地区：[1]首都医科大学附属北京天坛医院神经影像中心,北京100050 [2]首都医科大学附属北京天坛医院神经精神医学与临床心理科,北京100050 [3]南方医科大学生物医学工程学院,广东广州510515 [4]中国科学院自动化研究所脑网络组中心,北京100190

出　　处：《中国医学影像技术》2016年第11期1659-1663,共5页Chinese Journal of Medical Imaging Technology

基　　金：[基金项目]首都临床特色应用研究与成果推广(Z151100004015127)

摘　　要：目的探讨老年人脑白质病变(WMLs)相关性跌倒患者的脑静息态fMRI(rs-fMRI)特征。方法前瞻性选取本院60岁以上的WMLs患者40例,均接受rs-fMRI检查,根据Tinetti平衡和步态量表划分为跌倒风险组(Tinetti<25,n=11)及对照组(Tinetti≥25,n=29)。应用SPM 8软件进行图像处理,识别跌倒风险患者脑网络内及网络间的功能连接异常,并与简易精神状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)评分进行相关性分析。结果跌倒风险组的MMSE(t=4.04,P<0.01)及MoCA(t=3.88,P<0.01)量表评分低于对照组。与对照组比较,跌倒风险组的记忆网络(MeN)脑功能连接减弱(t=2.87,P=0.01);带状盖任务控制网络(CON)和腹侧注意网络(VAN)的功能连接减弱(t=2.59,P=0.01);默认网络(DMN)和额顶任务控制网络(FPN)的功能连接增强(t=-2.13,P=0.04),所有WMLs患者的MeN网络内功能连接与MoCA评分(r=0.39,P=0.01)呈正相关;DMN和FPN功能连接与MMSE(r=-0.40,P=0.01)及MoCA(r=-0.37,P=0.02)呈负相关。结论具有跌倒风险的WMLs患者存在脑网络内及网络间的功能连接异常,并与其认知功能改变存在一定的相关性。Objective To analyze the resting state fMRI（rs-fMRI）characteristics in the aged who had white matter lesions（WMLs）with fall risks.Methods A total of 40patients（age〉60years）with WMLs were enrolled in this prospective study.And all the patients were performed rs-fMRI.According to the Tinetti Balance and Gait Analysis,all patients were divided into experimental group（Tinetti〈25,n=11）and contrast group（Tinetti≥25,n=29）.SPM 8software was used to analyze the data of rs-fMRI,and the abnormal functional connectivity was identified and made correlation analysis with montreal cognitive assessment（MoCA）and mini-mental state examination（MMSE）scores.Results There were statistical differences in the scores of MMSE（t=4.04,P〈0.01）and MoCA（t=3.88,P〈0.01）between two groups.Compared with control group,the intra-functional connectivity of memory retrieval（MeN）decreased in experimental group（t=2.87,P=0.01）.The functional connectivity between cingulo-opercular control network（CON）and ventral attention network（VAN）decreased（t=2.59,P=0.01）and the functional connectivity between default mode network（DMN）and fronto-parietal task control network（FPN）increased（t=-2.13,P=0.04）in experimental group.The intra-functional connectivity of MeN in all the patients showed positive correlation with MoCA scores（r=0.39,P=0.01）.And the functional connectivity of DMN and FPN showed negative correlation with MMSE scores（r=-0.40,P=0.01）and MoCA scores（r=-0.37,P=0.02）.Conclusion In WMLs patients with fall risks,some intra-network and inter-network functional connectivities show significant differences,and these differences are correlated with cognitive performance scores.

关 键 词：白质 意外跌倒 静息态功能磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R742[医药卫生—诊断学]