终末期肾病患者大脑半球间镜像同伦功能连接的静息态功能磁共振研究  

Interhemispheric functional connectivity in patients with end-stage renal disease: A resting-state functional MRI study

作　　者：郭乔 丁墩 马雪英[1] 李朋 张盼[1] 张燕[4] 张明[1] 麻少辉[1] GUO Qiao;DING Dun;MA Xueying;LI Peng;ZHANG Pan;ZHANG Yan;ZHANG Ming;MA Shaohui(Department of Medical Imaging,The First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061;Department of Medical Imaging,The Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004;Department of Medical Imaging,Shaanxi Nuclear Geology 215 Hospital,Xianyang 712000;Department of Radiology,Baoji Hospital of Traditional Chinese Medicine,Baoji 721000,China)

机构地区：[1]西安交通大学第一附属医院医学影像科,陕西西安710061 [2]西安交通大学第二附属医院医学影像科,陕西西安710004 [3]陕西省核工业二一五医院医学影像科,陕西咸阳712000 [4]宝鸡市中医医院影像科,陕西宝鸡721000

出　　处：《西安交通大学学报（医学版）》2020年第2期177-181,共5页Journal of Xi’an Jiaotong University（Medical Sciences）

基　　金：陕西省自然科学基础研究计划重大基础研究项目(No.S2017-ZRJJ-ZDXM-0058);西安交通大学第一附属医院临床研究课题重点项目(No.XJTU1AF-CRF-2018-006);宝鸡市科技计划项目(No.16SFGG3-5)~~

摘　　要：目的采用静息态功能磁共振(rs-fMRI)体素镜像同伦功能连接(VMHC)方法,研究终末期肾病(ESRD)患者双侧大脑半球间功能连接改变及其与认知功能障碍的关系。方法纳入27例ESRD患者(ESRD组)和26名健康志愿者(对照组),采用蒙特利尔认知评估量表(MoCA)对认知能力进行评分。采集rs-fMRI数据,应用DPABI软件计算ESRD组和对照组双侧大脑半球镜像对称体素间的VMHC值,采用两独立样本t检验比较两组间VMHC值,得到两组间VMHC值有统计学差异的脑区,并对ESRD患者差异脑区的VMHC值与MoCA评分进行相关性分析。结果与对照组相比,ESRD组双侧中央前回、中央沟盖、中央后回、顶下小叶、颞上回、杏仁核、海马旁回、梭状回、岛叶VMHC值降低(高斯随机场校正,体素P<0.001,簇群P<0.05),ESRD组双侧顶下小叶平均VMHC值与MoCA评分呈正相关(r=0.419,P<0.05),其他存在差异脑区的平均VMHC值与MoCA评分均无相关性(P>0.05)。结论ESRD患者在静息态下存在多个双侧大脑半球间功能连接降低的脑区,其中双侧顶下小叶可能在其产生认知功能损害过程中起重要作用。Objective To investigate the alterations of functional connectivity between inter-hemisphere of patients with the end-stage renal disease(ESRD)and its relationships with cognitive impair mentusing oxel-mirrored homotopic connectivity(VMHC)based on resting-state fMRI(rs-fMRI).Methods Totally 27 patients with ESRD(ESRD group)and 26 normal volunteers(control group)were enrolled and underwent rs-fMRI scanning.Montreal Cognitive Assessment(MoCA,Chinese version)was performed on each participant to evaluate the cognitive function.VMHC value between brain hemispheres was calculated with DPABI software based on rs-fMRI data,and the regions with statistically different VMHC value were obtained.The correlation between VMHC in the regions with statistical differences and MoCA scores was evaluated.Results Compared with control group,significantly lower VMHC value was found in precentral gyrus,rolandic operculum,postcentral gyrus,inferior parietal lobule,superior temporal gyrus,amygdala,parahippocampa gyrus,fusiform gyrus and insula in ESRD group(GRF correction;voxel level P<0.001,cluster level,P<0.05).VMHC value of inferior parietal lobule correlated positively with MoCA scores(r=0.419,P<0.05).Conclusion Significant abnormal inter-hemisphere functional connectivity is found in patients with ESRD.Among them,inferior parietal lobule may play an important role in the process of cognitive impairment.

关 键 词：磁共振成像 神经网络 终末期肾病 认知障碍 

分 类 号：R445.2[医药卫生—影像医学与核医学]