non-NPSLE患者基于静息态fMRI的局部一致性研究  

The changes of brain regional homogeneity in non-NPSLE patients:a resting-state functional magnetic resonance imaging study

作　　者：李晓露 夏建国[2] 邹红梅[3] 周文苏 张鹏 LI Xiao-lou;XIA Jian-guo;ZOU Hong-mei(Graduate School of Dalian Medical University,Dalian 116044,China)

机构地区：[1]大连医科大学研究生院,辽宁大连116044 [2]江苏省泰州市人民医院影像科,江苏泰州225300 [3]江苏省泰州市人民医院风湿免疫科,江苏泰州225300

出　　处：《放射学实践》2021年第12期1467-1473,共7页Radiologic Practice

摘　　要：目的:基于静息态功能MRI分析脑组织的局部一致性(ReHo),探讨非神经精神系统性红斑狼疮(non-NPSLE)患者脑功能活动的变化特征及其意义。方法:采用局部一致性(ReHo)来评价32例女性non-NPSLE患者和28例健康志愿者者(对照组)脑局部功能活动的变化特征。在non-NPSLE患者中,采用多元回归分析,在全脑水平找到标准化局部一致性(mReHo)值与临床指标、神经精神量表评分之间具有相关性的脑区;把具有相关性脑区的mReHo值提取出来,与临床指标和神经精神量表评分进行Spearman相关性分析,计算具体的相关系数。结果:与对照组相比,non-NPSLE患者组中左侧颞下回和左侧尾状核的mReHo降低(团块水平AlphaSim校正,P<0.05)。多元回归及Spearman相关性分析结果显示:简易精神状态量表(MMSE)评分与右侧眶内额上回和左侧额中回的mReHo呈正相关(r=0.607,P<0.001;r=0.645,P<0.001);医院焦虑抑郁量表-抑郁(HADS-D)评分与左侧和右侧顶上回的mReHo呈负相关(r=-0.751,P<0.001;r=-0.730,P<0.001);医院焦虑抑郁量表(HADS-A)评分与左侧楔前叶mReHo呈负相关(r=-0.802,P<0.001);病程与右侧杏仁核的mReHo呈负相关(r=-0.702,P<0.001);血清补体C4浓度与右侧中央后回的mReHo呈正相关(r=0.645,P<0.001)。结论:non-NPSLE患者左侧颞下回、左侧尾状核的ReHo存在异常,且在全脑水平上某些脑区的ReHo与临床指标及神经精神量表评分之间存在相关性,提示脑活动异常可能发生在NPSLE之前,特定脑区的ReHo改变可能与non-NPSLE发病机制有关。Objective:To explore the changes of regional homogeneity in non-neuropsychiatric systemic lupus erythematosus(non-NPSLE)patients using resting-state functional magnetic resonance imaging(rs-fMRI).Methods:32 female patients with non-NPSLE and 28 healthy controls were examined by rs-fMRI.The difference of brain functional activities between two groups were compared using index of regional homogeneity(ReHo).Multivariable logistic analysis was used to find the possible associations of mReHo based on the whole brain with clinical and neuropsychological data in non-NPSLE patients.Then the mReHo values of the brain regions with significant correlation were extracted for Spearman analysis to obtain the r values.Results:mReHo values was decreased in the left inferior temporal gyrus and left caudate nucleus in non-NPSLE patients.There was significant positively correlation between MMSE and mReHo in the right superior orbital frontal gyrus and left middle frontal gyrus(r=0.607,P<0.001;r=0.645,P<0.001).HADS-D score was negatively correlated with mReHo in left and right superior parietal gyrus(r=-0.751,P<0.001;r=-0.730,P<0.001).HADS-A score was negatively correlated with mReHo in the left precuneus(r=-0.802,P<0.001).Course of disease was negatively correlated with mReHo in the right Amygdala(r=-0.702,P<0.001).C4-level in serum was positively correlated with mReHo in the right postcentral gyrus(r=0.645,P<0.001).Conclusion:Abnormal ReHo in multiple brain regions were found in patients with non-NPSLE and several brain areas showed correlations with clinical and neuropsychological data,suggesting that abnormal brain activity might occur before NPSLE,and the changes of ReHo in specific brain regions may be one cause of cognitive dysfunction in SLE patients.

关 键 词：系统性红斑狼疮 静息态功能磁共振成像 局部一致性 神经精神量表 

分 类 号：R445.5[医药卫生—影像医学与核医学] R593.24[医药卫生—诊断学]