基于静息态fMRI的抗N-甲基-D-天冬氨酸受体脑炎患者脑功能局部一致性研究  

Study of Cerebral Functional Regional Homogeneity in Patients with Anti-N-methyl-D-aspartate Receptor Encephalitis by Resting f MRI

作　　者：龙启佳 庞晓敏[1] 郑金瓯[1] 史珂 黎春燕 LONG Qijia;PANG Xiaomin;ZHENG Jinou(Department of Neurology,The First Affiliated Hospital of Guangxi Medical University,Nanning,Guangxi 530021,P.R.China)

机构地区：[1]南宁广西医科大学第一附属医院神经内科,530021

出　　处：《临床放射学杂志》2021年第11期2052-2056,共5页Journal of Clinical Radiology

基　　金：国家自然科学基金地区科学基金项目(编号:81560223);广西自然科学基金项目(编号:2018GXNSFAA050149)。

摘　　要：目的应用静息态功能磁共振成像(rs-fMRI)探讨抗N-甲基-D-天冬氨酸受体(NMDAR)脑炎患者脑功能局部一致性(ReHo)的改变情况。方法纳入18例恢复期抗NMDAR脑炎患者和20名性别、年龄及受教育程度相匹配的健康志愿者。采集两组被试者的rs-fMRI图像,采用双样本t检验比较两组ReHo的差异。以差异脑区的ReHo值与蒙特利尔认知评估基础量表(MoCA-B)、汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD-17)评分行Pearson相关分析。结果与对照组相比,抗NMDAR脑炎患者右侧丘脑ReHo值减低,右侧颞下回及左侧中央后回的ReHo值升高;此外,右侧颞下回ReHo值与执行能力及MoCA-B总分呈负相关。左侧中央后回ReHo值与延迟回忆呈负相关、与MoCA-B总分呈负相关。右侧丘脑的ReHo值与HAMD-17评分呈负相关。结论抗NMDAR脑炎患者存在认知、执行、记忆及情绪功能障碍,其机制可能与右侧丘脑、右侧颞下回及左侧中央后回脑功能活动异常有关。Objective Application of resting state functional magnetic resonance(rs-fMRI) technology to explore the changes of regional homogeneity(ReHo) in patients with anti-N-methyl-D-aspartate receptor(NMDAR) encephalitis. Methods Eighteen patients with anti-NMDAR encephalitis during the recovery period and 20 healthy controls with matching gender, age and education level were enrolled. The rs-fMRI images of the two groups of subjects were collected, and the two-sample T test was used to compare the differences in ReHo between the two groups. Pearson correlation analysis was performed between the ReHo value of different brain regions and the Montreal Cognitive Assessment Basic Scale(MoCA-B), Hamilton Anxiety Scale(HAMA) and Hamilton Depression Scale(HAMD-17) scores. Results Compared with the HC group, in patients with anti-NMDAR encephalitis, the ReHo value of the right thalamus was reduced, and the ReHo value of the right inferior temporal gyrus and the left central posterior gyrus were increased;in addition, the ReHo value, executive ability and MoCA of the right inferior temporal gyrus-B total score is negatively correlated. The ReHo value in the left central posterior gyrus is negatively correlated with delayed recall and the MoCA-B total score is negatively correlated. The ReHo value of the right thalamus is negatively correlated with the HAMD-17 score. Conclusion Patients with anti-NMDAR encephalitis have cognitive, executive, memory, and emotional dysfunctions. The mechanism may be related to the abnormal activities of the right thalamus, right inferior temporal gyrus, and left central posterior gyrus.

关 键 词：抗N-甲基-D-天冬氨酸受体脑炎 认知功能 功能磁共振成像 局部一致性 

分 类 号：R742.9[医药卫生—神经病学与精神病学]