脑震荡后综合征患者注意网络与默认网络的功能连接和因果连接的改变  

Altered functional and causal connectivity in attention and default mode network ofpostconeussional syndrome patients

作　　者：江录伟 钱若兵 傅先明 张祎鸣 张栋 夏春生 彭楠 林彬 牛朝诗 汪业汉 Jiang Luwei;Qian Ruobing;Fu Xianming;Zhang Yiming;Zhang Dong;Xia Chunsheng;Peng Nan;Lin Bin;Niu Chaoshi;Wang Yehan(Department of Neurosurgery,Anhui Provincial Hospital Affiliated to Anhui Medical University,First Affiliated Hospital,University of Science and Technology of China,Hefei 230001,China;Department of Neurosurgery,Third Affiliated Hospital of Anhui Medical University,Hefei 230061,China)

机构地区：[1]安徽医科大学附属省立医院、中国科学技术大学附属第一医院神经外科、脑功能与脑疾病安徽省重点实验室,合肥230001 [2]安徽医科大学第三附属医院、合肥市滨湖医院神经外科,合肥230061

出　　处：《中华神经医学杂志》2018年第10期1008-1013,共6页Chinese Journal of Neuromedicine

基　　金：国家自然科学基金（30973084）;安徽省自然科学基金（11040606M167）;安徽省科技攻关计划项目（1301042201）;安徽省重点研究与开发计划（1804h08020244）

摘　　要：目的探讨脑震荡后综合征（PCS）患者注意网络与默认网络的功能连接与因果连接的改变，从脑网络角度评价PCS患者注意功能损伤的机制。方法选择自2015年11月至2016年10月安徽医科大学附属省立医院神经外科门诊收治的轻度颅脑损伤患者23例为试验组，同期招募的年龄、性别、受教育程度与试验组相匹配的正常被试21例为对照组。采集2组被试静息态功能磁共振成像（RS-fMRI）数据，运用独立成分分析（ICA）方法找出2组被试注意网络与默认网络的功能连接改变脑区并进行比较分析。同时运用格兰杰因果分析（GCA）方法分析比较2组被试注意网络与默认网络的因果连接变化。结果ICA方法发现PCS患者功能连接发生减弱的脑区包括：背侧注意网络中左侧额眼区、双侧顶内沟；腹侧注意网络中双侧颞顶联合区、双侧腹侧前额叶；默认网络中双侧内侧前额叶，功能连接发生增强的脑区为默认网络中双侧楔前叶。运用GCA方法对这些差异性脑区进行分析后发现：左侧额眼区至左侧顶内沟和左侧楔前叶的因果连接以及左侧颞顶联合区至左侧楔前叶的因果连接增强，而左侧顶内沟和左侧楔前叶至左侧额眼区的因果连接以及左侧顶内沟至左侧内侧前额叶的因果连接减弱，差异均有统计学意义（P〈0.05）。结论（1）静息态下PCS患者注意网络的功能连接显著降低，可能是引起其注意功能损伤的脑网络基础。（2）注意网络至默认网络的因果流明显增加，这些改变可能与PCS患者通过拮抗作用抑制默认网络的激活以补偿注意功能的损伤相关。ObjectiveTransient brain function inhibition is a common symptom after mild brain injury, but some patients show persistent post-concussional syndrome （PCS）. The aims of this study are to assess functional and causal connectivity of attention and default mode network using resting-state functional MR imaging （fMRI） to investigate the abnormal connectivity and its significance in PCS patients.MethodsResting-state fMRI data were collected from 23 PCS patients with attention disorders, admitted to our hospital from November 2015 to October 2016 and 21 age-, gender, and education-matched healthy controls recruited at the same period. The fMRI data were analyzed by group independent component analysis （ICA） toolbox to attention networks and default mode network （DMN）. The components of the selected networks were compared in PCS and healthy controls to explore the changes of functional connectivity （FC）. Granger causality analysis （GCA） was performed by taking the above significant brain areas as regions of interest （ROIs） to calculate bivariate coefficient of each pair of ROIs. Comparisons were performed to find the significant different causal connectivity of the two groups.ResultsIn attention networks, the FC value of left frontal eye field （FEF）, bilateral intraparietal sulcus （IPS）, bilateral ventral prefrontal cortex （vPFC） and bilateral temporo-parietal junction （TPJ） was decreased. In DMN, the FC value of bilateral medial prefrontal cortex （mPFC） was reduced and bilateral precuneus （PCUN） was enhanced. Correlating GCA value, it was increased significantly from left FEF to left PCUN and IPS, while it was reduced from left PCUN and IPS to left FEF; and it was decreased from left IPS to left vPFC and increased from left TPJ to left PCUN.ConclusionThe attention networks are restrained in resting state, which may influence the attention function in PCS patients; and the causal connection is altered in the above ROIs, and these changes may be related to inhibition o

关 键 词：脑震荡后综合征 独立成分分析 格兰杰因果分析 静息态功能磁共振成像 注意网络 默认网络 

分 类 号：R651.15[医药卫生—外科学]