轻度认知障碍额叶白质1H-MRS与认知功能的相关性  

Correlation between ^(1)H-MRS of frontal lobe white matter and cognitive function in mild cognitive impairment

作　　者：谭智霖 谢琦 廖炎辉 王雅杰 杜磊 陈惠娴 TAN Zhilin;XIE Qi;LIAO Yanhui;WANG Yajie;DU Lei;CHEN Huixian(School of Medicine,South China University of Technology,Guangzhou 510006,China;Department of Imaging,Nansha Hospital,Guangzhou First People's Hospital,Guangzhou Medical University,Guangzhou 510180,China;Department of Imaging,Nansha Hospital,Guangzhou First People's Hospital,the Second Affiliated Hospital of South China University of Technology,Guangzhou 510180,China)

机构地区：[1]华南理工大学医学院,广州510006 [2]广州医科大学附属广州市第一人民医院南沙医院医学影像科,广州510180 [3]华南理工大学附属第二医院南沙医院医学影像科,广州510180

出　　处：《磁共振成像》2021年第8期6-10,共5页Chinese Journal of Magnetic Resonance Imaging

基　　金：广州市科技计划项目对外研发合作专题(编号:201907010020)。

摘　　要：目的探索氢质子磁共振波谱(1H-magnetic resonance spectroscopy,1H-MRS)在轻度认知障碍(mild cognitive impairment,MCI)患者中双侧额叶白质代谢物变化及其应用价值。材料与方法前瞻性收集社区招募并经过筛选的174名志愿者,经过神经心理学量表评估后分为MCI组及正常对照组(normal control,NC)。同时对其双侧额叶白质进行单体素1H-MRS扫描,利用LCModel软件自动计算双侧额叶白质主要代谢物的相对浓度。结合协方差分析、独立样本t检验及非参数曼-惠特尼U检验以比较两组间代谢物相对浓度差异,使用Pearson及Spearman相关分析法探索代谢物相对浓度与量表评分的相关性。结果老年受试者(≥60岁)MCI组左侧额叶白质谷氨酸及谷氨酰胺相对浓度较NC组增加(1.77±0.08、1.48±0.08;Z=2.640,P<0.05)。针对MCI组受试者量表得分进行分析,发现听觉词汇学习测验长延时记忆及再认得分与右侧额叶白质N-乙酰天门冬氨酸+N-乙酰天门冬氨酸谷氨酸(N-acetylaspartate and N-acetylaspartylglutamate,NAA+NAAG)呈负相关(r=-0.241、-0.342,P均<0.05);形状连线测试(shape trails test,STT)-A完成时间与左侧额叶白质NAA+NAAG呈负相关(r=-0.235,P=0.044);STT-A及STT-B完成时间均与右侧额叶白质肌醇呈正相关(r=0.379、0.398,P均<0.05)。结论1H-MRS代谢物改变有望作为临床上早期诊断MCI的参考依据。Objective:To investigate the patterns of metabolic changes in frontal white matter and its diagnostic value for mild cognitive impairment(MCI).Materials and Methods:Neuropsychological tests were prospectively performed to evaluate 174 volunteers recruited from the community,and they were seperated into two groups:MCI and normal control(NC).At the same time,single-voxel 1H-MRS sequence was performed on bilateral frontal white matter.LCModel was conducted for calculating the relative concentration of metabolites automatically.Covariance analysis,independent-samples t test and nonparametric Mann-Whitney U test were used to compare the inter-group differences of relative concentration of metabolites.Pearson and Spearman correlation analysis methods were performed to explore the correlation between the relative concentration of metabolites and neuropsychological test scores.Results:Elderly subjects of MCI group(≥60 years old)had higher relative concentration of glutamate and glutamine in the left frontal white matter than elderly normal controls(1.77±0.08,1.48±0.08;Z=2.640,P<0.05).the performance of auditory verbal learning test(AVLT)delay recalled and recognition was negatively correlated with relative concentration of N-acetylaspartate and N-acetylaspartylglutamate(NAA+NAAG)of right frontal white matter in MCI group(r=-0.241,-0.342,all P<0.05);the completion time of shape trails test(STT)-A was positively correlated with relative concentration of N-acetylaspartate and N-acetylaspartylglutamate(NAA+NAAG)of left frontal white matter(r=-0.235,P=0.044);the completion time of STT-A and STT-B tests were of positive correlation with inositol of right frontal white matter(r=0.379,0.398,all P<0.05).Conclusions:Metabolites changes detected by 1H-MRS may be expected as a clinical reference for early diagnosis of MCI.

关 键 词：磁共振波谱 轻度认知障碍 神经心理学测试 额叶 脑代谢物 

分 类 号：R445.2[医药卫生—影像医学与核医学] R742[医药卫生—诊断学]