脑梗死运动脑区结构和功能变化的MRI研究  

MRI Study of structure and function within motor cortex in pontine stroke patients

作　　者：汪洋[1] 孟亮亮[1] 秦文[1] 于春水[1] 张敬[1] 

机构地区：[1]天津市医科大学总医院放射科,天津300052

出　　处：《中国医药导报》2017年第7期99-102,F0003,共5页China Medical Herald

基　　金：国家自然科学基金面上项目(81271564);国家卫生计生委公益性行业科研专项项目(201402019);天津市自然科学基金重点项目(12JCZDJC23800)

摘　　要：目的探讨慢性期脑桥脑梗死患者运动相关脑区结构和功能变化。方法选择2006年1月~2010年6月于天津医科大学总医院神经内科就诊的16例慢性期脑桥脑梗死患者,选择25例健康志愿者为对照组。采用3.0T磁共振扫描仪行全脑高分辨率解剖像及静息态fMRI扫描。采用SPM8软件对脑桥脑梗死组与对照组灰质体积行组间比较。将灰质体积存在差异的脑区定义为ROIs,进行基于ROIs的全脑水平rsFC分析。采用SPM8软件对脑桥脑梗死组与对照组功能连接模式进行组间比较。结果与对照组相比,脑桥脑梗死组患者灰质体积缩小区为健侧小脑半球后叶及蚓部(校正后P<0.05,T峰值=-4.438);灰质体积增加区为健侧M1区(校正后P<0.05,T峰值=4.4126)及双侧SMA(校正后P<0.05,T峰值=4.7229)。与对照组相比,脑桥脑梗死组患者健侧小脑半球与健侧PMC(校正后P<0.05,T峰值=4.1639)及双侧SMA(校正后P<0.05,T峰值=4.4663,4.1639)连接增强;健侧M1区与同侧PMC连接增强(校正后P<0.05,T峰值=3.8291),与同侧小脑半球连接减弱(校正后P<0.05,T峰值=-5.0192);双侧SMA与健侧中央后回(校正后P<0.05,T峰值=3.9016)及双侧小脑半球(校正后P<0.05,T峰值=4.1569,4.2991)连接增强。结论脑桥脑梗死可造成远隔运动相关脑区结构改变;脑桥脑梗死既存在结构代偿也存在功能代偿。Objective To investigate the changes of brain structure and function within related motor cortex area in patients with chronic pontine stroke. Methods From January 2006 to June 2010, 16 chronic pontine stroke patients in Department of Neurology of Tianjin Medical University General Hospital were enrolled, 25 healthy participants were enrolled as control group. High-resolution structural MRI and resting state fMRI of the whole brain were acquired by 3T MRI scanner. The gray matter volume between patients and control group were compared by SPM 8 software. The areas which were significantly different in gray matter volume were defined as ROIs. ROIs-h^sed functional connectivi- ty analysis in the global brain level were calculated. The functional connectivity maps of patients group and control group were compared by SPM 8. Results Compared with control group, the patients showed decreased gray matter vol- ume in contralesional cerebellum and vermis （corrected P 〈 0.05, T peak = -4.438） and increased gray matter volume in contralesional M1 （corrected P〈0.05, peak intensity=4. 4128） and bilateral SMA （correc.ted P 〈 0.05, T peak = 4.7229）. Compared with controls, the contralesional cerebellum had increased functional connectivity with contratesional PMC （corrected P 〈 0.05, T peak = 4.1639） as well as bilateral SMA （corrected P 〈 0.05, T peak = 4.4663, 4.1639）; the rsFC of contralesional M1 area with contralesional PMC was increased （corrected P 〈 0.05, T peak = 3.8291）, while decreased with contralesional cerebellum （corrected P 〈 0.05, T peak = -5.0192）; the rsFC of bilateral SMA both with contralesioinal post centralgyrus （corrected P 〈 0.05, T peak = 3.9016） and bilateral cerebellum （corrected P 〈：0.05, Tpeak = 4.1569,4.2991） were increased. Conclusion .The structures in distant cerebral motor areas change in chronic pontine stroke patients. Compensative changes of both structure and function exist in chronic pontine stroke.

关 键 词：脑梗死 灰质体积 静息态功能连接 运动脑区 

分 类 号：R743.3[医药卫生—神经病学与精神病学]