丘脑卒中后双侧初级感觉皮层结构和功能连接间关系的磁共振成像研究  

The relationship between structural and functional connections in bilateral primary somatosensory cortex and thalamus in thalamic stroke patients:a MRI study

作　　者：陈莉[1,2] 程润田 何淼[1] 吕发金[2] 罗天友[2] CHEN Li;CHENG Runtian;HE Miao;Lü Fajin;LUO Tianyou(Department of Radiology,the Affiliated Hospital of North Sichuan Medical College,Nanchong,Sichuan Province 637000,China;Department of Radiology,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]川北医学院附属医院放射科,四川南充637000 [2]重庆医科大学附属第一医院放射科,重庆400016

出　　处：《实用放射学杂志》2020年第11期1707-1710,共4页Journal of Practical Radiology

基　　金：国家自然科学基金面上项目(81671666);四川省科技厅应用基础研究项目(2019YJ0380);南充市市校科技战略合作项目(NSMC20170433);四川省教育厅重点项目(18ZA0211).

摘　　要：目的明确丘脑卒中后患侧丘脑-初级感觉皮层(S1)、S1-S1的结构和功能连接间的关系.方法35例丘脑卒中患者(卒中组)和健康对照组35例纳入本研究.对所有受试者进行感觉运动功能测试和MRI扫描.首先追踪患侧丘脑-S1、S1-S1纤维束,并提取纤维束的FA;同时计算并提取它们的功能连接值.然后采用一般线性模型比较上述FA和功能连接值的组间差异,P<0.05有统计学意义(Bonferroni校正).最后,进行如下偏相关分析:患侧丘脑-S1的FA与S1-S1的FA、患侧丘脑-S1的FA与功能连接值、患侧丘脑-S1的FA与S1-S1功能连接值、S1-S1的FA与功能连接值.结果(1)卒中组较对照组在患侧丘脑-S1(P<0.001)、S1-S1(P<0.001)的FA显著降低,而患侧丘脑-S1(P=0.010)、S1-S1(P<0.001)的功能连接值明显增高.(2)在卒中组中,患侧丘脑-S1的FA与S1-S1的FA呈正相关(r=0.463,P=0.007);患侧丘脑-S1的FA与S1-S1功能连接值呈负相关(r=-0.417,P=0.016);S1-S1的FA与功能连接值呈负相关(r=-0.509,P=0.002).结论丘脑卒中后可继发性引起患侧丘脑-S1及S1-S1结构连接受损;双侧S1间的功能连接增强可能作为一种功能重组方式来补偿这些结构连接的损伤.Objective To explore the relationship between the structural and functional connections in patients with thalamic stroke between their affected thalamus and primary somatosensory cortex(SI)and S1-S1 bilaterally.Methods Thirty-five patients with thalamic stroke(stroke group)and thirty-five healthy controls(HC group)underwent evaluation for motor and somatosensory function and MRI scanning.We analyzed FA of the fiber tracts between ipsilesional thalamus-S1 and S1-S1 bilaterally.We also analyzed functional connectivity(FC)between these regions.We performed the following correlation analysis between structural and functional connections in the stroke group:between FA of ipsilesional thalamus-S1 and FA of S1-S1,between FA and FC of ipsilesional thalamus-S1,between FA of ipsilesional thalamus-S1 and FC of S1-S1 and between FA and FC of S1-S1.Results(1)Regarding structural connectivity,the stroke group compared to the HC group exhibited markedly reduced FA in the affected ipsilesional thalamus-S1 tracks(P<0.001)and between S1-S1 tracks(P<0.001),while having significantly increased FC in the ipsilesional thalamus-S1(P=0.010)and S1-S1(P<C0.001).(2)The FA of ipsilesional thalamus-S1 was positively correlated with the FA of S1-S1(r=0.463,P=0.007),while FA of ipsilesional thalamus-S1(r=-0.417,P=0.016)and S1-S1(r=-0.509,P=0.002)were respectively negatively correlated with the FC of S1-S1 in the stroke group.Conclusion The thalamic stroke may result in secondary impairment of the thalamus-S1 and S1-S1 fiber tracts.However,the enhancement FC of S1-S1 may serve as a functional compensatory to cope for the damage of these structural connections.

关 键 词：丘脑卒中 结构连接 功能连接 初级感觉皮层 功能重组 

分 类 号：R743[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]