fMRI联合WCST对颅脑爆震伤额叶执行功能的评估  

Evaluation of executive function of frontal lobes in patients with blast craniocerebral injury by resting f MRI combined with WCST

作　　者：高玉松[1] 吕宏迪[2] 扈俊华[1] 罗新民[1] 胡承啸[1] 张松坡[1] 柴超[1] 雷亚平 YAN De-qi GAO Yu-song;Lü Hong-di;HU Jun-hua;LUO Xin-min;ZHANG Song-po;CHAI Chao;LEI Ya-ping(Department of Neurosurgery, 159th Hospital, PLA, Zhumadian 463000, China)

机构地区：[1]解放军第159医院神经外科,河南驻马店450000 [2]解放军第159医院,河南驻马店院长450000

出　　处：《中国临床神经外科杂志》2017年第12期821-823,共3页Chinese Journal of Clinical Neurosurgery

基　　金：军队后勤科研计划项目(CJN15J089)

摘　　要：目的利用静息态功能磁共振成像(f MRI)和威斯康辛卡片分类测试(WCST)评估颅脑爆震伤恢复期的额叶执行功能。方法以同一次军事训练中受伤4例成年男性颅脑爆震伤为观察组,以6例健康男性成年人为对照;采集f MRI数据构建脑网络并计算其平均额叶度;同时进行WCST测试。结果受试者头动分析发现,平移不超过2 mm,角度不超过2°,无受试者因头动被剔除。观察组额叶度(4.750±0.646)显著低于对照组(5.550±0.409;P<0.05);两组WCST测试结果均在正常范围内,但观察组WCST值(4.500±0.577)明显低于对照组(6.167±0.753;P<0.05)。观察组额叶平均度和WCST测试得分具有显著相关性(r=0.821,P<0.05),对照组额叶平均度和WCST测试得分也具有显著相关性(r=0.813,P<0.05)。结论颅脑爆震伤恢复期额叶网络可能存在潜在的问题,会引起执行力测试在正常范围内的下降。Objective To evaluate the executive function of frontal lobes in the patients with blast craniocerebral injury by brain function network constructed with resting functional magnetic resonance imaging(fMRI)and Wisconsin Card Sorting Test(WCST).Methods The resting fMRI was performed3months after the injury in4patients with blast craniocerebral injury and6healthy subjects serving as control in order to construct the brain nets and then the average frontal lobes degrees were calculated.WCST was performed at the same time in all the patients and the subjects.The differences in frontal lobe degree and WCST scores were compared between both the groups.The correlativity of the frontal lobes degree with WCST scores were analyzed by pearson correlation.Result The frontal lobes degree and WCST scores were significantly lower in patients with blast craniocerebral injury than those in the healthy subjects(P<0.05),although the WCST scores were in the normal range.Frontal lobes degree was significantly positively associated with the WCST scores in both the groups(P<0.05).Conclusion It is suggested that the frontal lobe networks3months after the injury in the patients with blast craniocerebral injury may have potential disturbance,which may lead to a decrease in executive ability shown by WCST in the normal range.

关 键 词：颅脑爆震伤 功能磁共振 威斯康辛卡片分类测试 额叶执行功能 评估 

分 类 号：R651.15[医药卫生—外科学]