基于VBM-DARTEL方法研究男性重度阻塞性睡眠呼吸暂停患者大脑灰质体积变化与认知功能的关系  

Correlation Between Gray Matter Volume Change and Cognitive Function in Male Severe Obstructive Sleep Apnea:A Voxel-Based Morphology-DARTEL Study

作　　者：李海军[1] 辛会珍 余宏辉 张娟 魏志鹏 彭德昌[1] LI Haijun;XIN Huizhen;YU Honghui;ZHANG Juan;WEI Zhipeng;PENG Dechang(Department of Radiology,the First Affiliated Hospital of Nanchang University/Jiangxi Province Medical Imaging Research Institute,Nanchang 330006,China)

机构地区：[1]南昌大学第一附属医院影像科,江西省医学影像研究所,江西南昌330006

出　　处：《中国医学影像学杂志》2020年第12期918-922,共5页Chinese Journal of Medical Imaging

基　　金：国家自然科学基金地区项目(81860307,81560285);江西省自然科学基金项目(20181ACB20023,20202BABL216036);江西省教育厅重点项目(700544006);江西省教育厅青年项目(GJJ190133)。

摘　　要：目的探讨成年男性重度阻塞性睡眠呼吸暂停(OSA)患者大脑灰质体积的变化及其与认知功能的关系。资料与方法采集经多导睡眠监测确诊的36例OSA患者及40例健康对照者(对照组)的3D-T1薄层全脑容积结构图像。基于VBM-DARTEL方法对图像进行后处理分析。比较两组全脑体素水平灰质体积的差异,并分析其与总睡眠时间、动脉血氧饱和度、蒙特利尔认知量表(MoCA)评分的相关性。结果与对照组比较,OSA组左侧丘脑、左侧角回、左侧中扣带回、右侧海马旁回、双侧小脑后叶及双侧梭状回等灰质体积明显减低,右侧小脑后叶灰质体积增加(P<0.05)。偏相关分析发现,OSA患者左侧丘脑减低的灰质体积与总睡眠时间及MoCA评分呈正相关(r=0.482、0.477,P=0.05);减低的右侧海马旁回体积、右侧梭状回体积与N2%呈正相关(r=0.479,P=0.05),右侧小脑后叶减低的灰质体积与最低动脉血氧饱和度呈正相关(r=0.351,P=0.045)。结论男性OSA患者存在多个脑区灰质体积萎缩,部分脑区灰质萎缩与认知、多导睡眠监测有关。Purpose To analyze the brain gray matter volume(GMV)changes in adult male patients with severe obstructive sleep apnea(OSA)using voxel-based morphometry(VBM)methods,and to explore its relationship with cognitive function.Materials and Methods Thirty-six patients with OSA confirmed by polysomnograph and 40 healthy controls(control group)who underwent the 3D-T1WI MRI scans were enrolled in this study.VBM-DARTEL method was used to postprocessing analysis.The difference in voxel level GMV of the whole brain between OSA group and control group was compared,and the correlations between GMV difference and total sleep time,arterial blood oxygen saturation as well as Montreal cognitive scale(MoCA)score were analyzed.Results Compared with the control group,the GMV of OSA group was significantly decreased in left middle cingulate cortex,left thalamus,left angular gyrus,right parahippocampal gyrus,bilateral fusiform gyrus and bilateral cerbellar posterior lobe,the GMV of OSA group was significantly increased in right cerbellar posterior lobe(P<0.05).Partial correlation analysis showed that the GMV in the left thalamus was positively correlated with total sleep time and MoCA score(r=0.482 and 0.477,P=0.05),the right parahippocampal gyrus and right fusiform gyrus volume was positively correlated with N2%(r=0.479,P=0.05),right cerbellar posterior lobe volume was positively correlated with SaO2 in OSA group(r=0.351,P=0.045).Conclusion Male OSA patients have GMV atrophy in multiple brain areas.Gray matter atrophy in some brain areas is related to cognition and polysomnography data.

关 键 词：睡眠呼吸暂停 阻塞性 磁共振成像 脑 灰质 认知障碍 基于体素的形态学测量 

分 类 号：R768[医药卫生—耳鼻咽喉科] R445.2[医药卫生—临床医学]