长期肝气郁结遗忘型轻度认知功能障碍的静息态功能磁共振研究  

Resting-state Functional Magnetic Resonance Study of Amnesic Mild Cognitive Impairment Patients with Long-term Gan-qi Stagnation

作　　者：詹向红[1] 刘紫阳[1] 王同明[2] 侯俊林[1] 刘永[1] ZHAN Xiang-hong;LIU Zi-yang;WANG Tong-ming;HOU Jun-lin;LIU Yong(Basic Medical College,Henan University of Chinese Medicine,Zhengzhou,450046;Radiology Department,Henan Provincial Hospital of Traditional Chinese Medicine,Zhengzhou,450000)

机构地区：[1]河南中医药大学基础医学院,郑州450046 [2]河南省中医院放射科,郑州450000

出　　处：《中国中西医结合杂志》2021年第8期928-934,共7页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金资助项目(No.81173148,No.81473556);河南省科技攻关项目(No.182102310269);河南中医药大学优秀博士科研启动项目(No.RSBSJJ2019-18)。

摘　　要：目的寻找肝气郁结型遗忘型轻度认知功能障碍(肝郁aMCI)患者认知功能损伤的神经影像学特征,探讨长期负性情绪积累肝郁aMCI患者认知功能下降的神经影像学机制。方法筛选6个月及以上符合肝气郁结标准的aMCI患者39例,另选取健康体检人员19名为对照组。通过病例对照研究,采用蒙特利尔认知评估量表(MoCA)评估两组被试的认知功能;运用静息态功能磁共振技术,选取左、右海马、扣带回、内侧前额叶为种子区做基于全脑体素功能连接(FC)分析,评价大脑差异功能连接;对认知行学数据与神经影像学差异结果进行相关性及多因素分析,阐释肝郁a MCI发生的神经机制。结果行为学方面,与正常组比较,除命名认知域差异无统计学意义外,肝郁aMCI患者总体认知功能、视空间/执行功能、注意、抽象、延迟回忆能力明显下降(P<0.05),语言与定向认知域下降呈现边缘显著(0.05<P<0.1);功能磁共振检测方面,左侧海马与右舌回、右距状裂周围皮层之间的FC降低(P<0.05,FWE团块校正),且功能连接下降与肝郁症状积分之间呈负相关(r=-0.318,P<0.05),与定向认知存在正相关(r=0.268,P<0.05)。结论长期负性情绪肝气郁结aMCI可能通过影响大脑海马与舌回、距状裂周围皮层等部位负责的抑制干扰信息及注意动机启动,从而导致认知功能下降。Objective To observe the neuroimaging features of amnesic mild cognitive impairment(a MCI)patients with long-term Gan-qi stagnation(GQS),and to explore the neuroimaging mechanism of cognitive decline of aMCI with long-term GQS.Methods A total of 39 aMCI volunteers in line with the criteria for GQS for 6 months or more were screened out.Besides,19 healthy persons were chosen as the control group.According to case-control study,Montreal Cognitive Assessment Scale(MoCA)was used to evaluate the cognitive function of the two groups.Left and right hippocampus,cingulate gyrus,and medial prefrontal lobe were selected as seeds area to do a whole brain-based voxel function connection analysis to evaluate brain differences in functional connectivity(FC).Then relevant analysis and multiple-factor analysis of imaging data and cognitive behavior data were taken to elucidate the neural mechanism of aMCI with GQS.Results In terms of behavior,as compared with the normal group,except for the naming cognitive domains,the overall cognitive function,visual space/executive function,attention,abstraction,and delayed recall ability of aMCI of GQS significantly decreased(P<0.05).Decline of language and orientation cognition domains were obviously seen at edge(0.05<P<0.1).In terms of r-fMRI,FC between left hippocampus and right lingual as well as right calcarine was reduced(P<0.05,FWE clusters correction),and decreased FC was negatively correlated with the score of GQS(r=-0.318,P<0.05),while it was positively correlated with directional cognition(r=0.268,P<0.05).Conclusion aMCI with long-term negative emotion GQS caused decreased cognitive function possibly by affecting the ability of suppressing interference information and initiating motivation of attention charged by hippocampus,tongue gyrus,and calcarine.

关 键 词：肝气郁结 长期负性情绪 遗忘型轻度认知功能障碍 静息态功能磁共振 功能连接 

分 类 号：R445.2[医药卫生—影像医学与核医学] R749.1[医药卫生—诊断学]