轻度认知障碍患者的嗅觉功能磁共振成像研究  

Olfactory functional magnetic resonance imaging in patients with mild cognitive impairment

作　　者：杭伟[1] 印志娴[1] 冯全志 韩彤[2] 卢醒[1] 张强[1] 周玉颖[3] 刘钢[1] Hang Wei;Yin Zhixian;Feng Quanzhi;Han Tong;Lu Xing;Zhang Qiang;Zhou Yuying;Liu Gang(Department of Otorhinolaryngology Head and Neck Surgery,Tianjin HuanHu hospital,Tianjin 300350,Chin;Department of Radiology,Tianjin HuanHu hospital,Tianjin 300350,Chin;Department of Neurology,Tianjin HuanHu hospital,Tianjin 300350,China)

机构地区：[1]天津市环湖医院耳鼻咽喉头颈外科,300350 [2]天津市环湖医院放射科,300350 [3]天津市环湖医院神经内科,300350

出　　处：《中华耳鼻咽喉头颈外科杂志》2018年第7期500-506,共7页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：天津市卫计委科技基金项目（09KY18、2014KZ040）;天津市卫计委攻关课题（12KG115）

摘　　要：目的应用嗅觉功能磁共振成像（functional magnetic resonance imaging，fMRI）分析轻度认知障碍（mild cognitive impairment，MCI）患者嗅觉相关脑区的激活情况。方法选取就诊于天津市环湖医院痴呆中心的MCI患者（试验组）及无认知障碍的健康受试者（对照组）各26例，应用T＆T嗅觉测试法检查所有受试者的嗅觉功能，应用嗅觉刺激仪采用事件相关设计模式进行嗅觉fMRI扫描，了解受试者全脑及嗅觉相关感兴趣区（region of interest associated with olfactory，ROIawo，包括双侧初级嗅觉皮层、双侧海马、双侧眶额回）的激活情况，分析初级嗅觉皮层激活体素数与嗅觉识别阈、认知障碍严重程度的相关性。应用SPSS 19.0软件进行统计学分析。结果试验组T＆T嗅觉识别阈分数明显高于对照组，差异有统计学意义[（3.57±1.29）分（±s，下同）比（1.02±0.35）分，t＝4.372，P〈0.05]。两种性质气味刺激时，试验组比对照组全脑激活范围明显减小，差异有统计学意义（愉快气味147.36±21.45比323.11±39.76，非愉快气味201.86±24.93比447.73±57.22，t愉快气味＝4.241，t非愉快气味＝5.365，P值均〈0.05）；对照组非愉快气味刺激时全脑激活范围较愉快气味更大，差异有统计学意义（447.73±57.22比323.11±39.76，t＝3.936，P〈0.05）。试验组与对照组相比，ROIawo的激活体素数明显减少，差异有统计学意义[愉快气味51.0[8.0，109.0]（M[P25，P75]，下同）比135.0[21.0，321.5]，非愉快气味65.0[6.0，158.0]比205.0[36.5，491.0]，Z愉快气味＝－2.199，Z非愉快气味＝－2.216，P值均〈0.05]；试验组与对照组相比，初级嗅觉皮层的激活体素数明显减少，差异有统计学意义（愉快气味19.0[4.0，35.5]比46.0[9.0，118.5]，非愉快气味26.0[2.0，51.0]比79.0[17.5，189.0]，Z愉快气味＝－1.898，Z非愉快气味＝－2.167，P值均〈0.05）；试验组初级嗅觉皮层激ObjectiveTo analyze the activation of brain regions associated with olfactory in patients with mild cognitive impairment （MCI） by olfactory functional magnetic resonance imaging （fMRI）. MethodsTwenty six patients with MCI were compared with twenty six controls in the dementia center of Tianjin HuanHu hospital in terms of olfactory function T＆T testing, the differences between the activation of the whole brain and region of interest associated with olfactory （bilateral primary olfactory cortex（POC）, bilateral hippocampus, bilateral orbital frontal gyrus） by olfactory stimulator using event correlation design for olfactory fMRI scanning. To analyze the correlation between the number of activator in POC and the threshold of olfactory discriminate as well as the severity of cognitive impairment.SPSS 19.0 software was used for the statistical analysis. ResultsT＆T olfactory testing revealed that MCI patients had higher scores than controls （3.57±1.29 （±s） vs 1.02±0.35, t=4.372, P〈0.05）. The activation range of whole brain in MCI patients was less than controls （pleasant odor （po） 147.36±21.45 vs 323.11±39.76, unpleasant odor （upo） 201.86±24.93 vs 447.73±57.22, tpo=4.241, tupo=5.365, both P〈0.05）. The activation range of whole brain in inhaling unpleasant odor was more than pleasant odor in controls （447.73±57.22 vs 323.11±39.76, t=3.936, P〈0.05）. The number of activator in ROIawo in MCI patients was less than controls （pleasant odor （po） 51.0[8.0, 109.0]（M[P25, P75]） vs 135.0[21.0, 321.5], unpleasant odor （upo） 65.0[6.0, 158.0]vs 205.0[36.5, 491.0], Zpo=-2.199, Zupo=-2.216, both P〈0.05）. The number of activator in POC in MCI patients was less than controls （pleasant odor （po） 19.0[4.0, 35.5]vs 46.0[9.0, 118.5], unpleasant odor （upo） 26.0[2.0, 51.0]vs 79.0[17.5, 189.0], Zpo=-1.898, Zupo=-2.167, both P〈0.05）. The number of activator in POC was negatively correlated with olfactory discriminate threshold in MCI patients （rpo=-0.415

关 键 词：嗅觉障碍 认知障碍 阿尔茨海默病 磁共振成像 端脑 

分 类 号：R445.2[医药卫生—影像医学与核医学] R749.1[医药卫生—诊断学] R765.63[医药卫生—临床医学]