基于静息态功能磁共振成像的非神经精神性系统性红斑狼疮低频振幅和功能连接的研究  

Amplitude of Low-Frequency Fluctuations and Functional Connectivity in Non-Neuropsychiatric Systemic Lupus Erythematosus:A Resting-State Functional Magnetic Resonance Imaging Study

作　　者：李晓露 周文苏 张鹏 田为中[2] 夏建国[2] 邹红梅[3] LI Xiaolou;ZHOU Wensu;ZHANG Peng;TIAN Weizhong;XIA Jianguo;ZOU Hongmei(Department of Radiology,Taizhou People's Hospital,Taizhou 225300,China;不详)

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：《中国医学影像学杂志》2021年第12期1170-1176,共7页Chinese Journal of Medical Imaging

基　　金：江苏省卫生健康委科研课题(面上课题)(H2018093)。

摘　　要：目的通过低频振幅(ALFF)及其衍生指标和功能连接(FC)探讨非神经精神性系统性红斑狼疮(non-NPSLE)患者脑功能的变化。资料与方法前瞻性对32例女性non-NPSLE患者和28例健康对照者进行静息状态功能磁共振成像(rs-fMRI)检查。采用ALFF及其衍生指标比率低频振幅(fALFF)评价自发脑活动。将信号差异明显的区域作为感兴趣区,计算感兴趣区和整个大脑之间的FC,以评估网络级别的变化。采用Spearman相关分析non-NPSLE患者差异脑区的影像指标与神经精神量表及病程、实验室检查等临床指标的相关性。结果与健康对照组比较,non-NPSLE组左侧补充运动区标准化低频振幅降低(t=-4.52,P<0.001);右侧颞下回、左侧中央后回fALFF增高(Alphasim校正后P<0.05)。在网络水平上,non-NPSLE患者左侧补充运动区与右侧颞下回/右侧舌回/左侧楔叶,右侧颞下回与左侧枕中回,左侧中央后回与右侧额上回之间的FC降低(FWE校正后P<0.05)。相关性分析显示,左侧中央后回fALFF与简易精神状态量表评分呈正相关(r=0.429,P=0.025),与医院焦虑抑郁量表评分呈负相关(r=-0.386,P=0.047);左侧补充运动区与右侧舌回zFC与IgM呈正相关(r=0.554,P=0.002);左侧补充运动区与左侧楔叶zFC与病程(r=0.544,P=0.003)、IgM(r=0.665,P<0.001)呈正相关;右侧颞下回与左侧枕中回zFC与简易精神状态量表评分呈负相关(r=-0.519,P=0.006),与医院焦虑抑郁量表评分呈正相关(r=0.411,P=0.033)。结论non-NPSLE患者部分脑区的脑功能活动存在异常,且差异脑区的影像指标与临床数据、神经量表之间存在相关性,左侧中央后回ALFF、右侧颞下回与左侧枕中回FC的改变可能是non-NPSLE患者临床前监测认知功能的影像学标志物。Purpose To explore the changes of amplitude of low-frequency fluctuations(ALFF)and functional connectivity(FC)in patient with non-neuropsychiatric systemic lupus erythematosus(non-NPSLE)measured by resting-state functional magnetic resonance imaging(rs-fMRI).Materials and Methods Thirty-two female patients with non-NPSLE and twenty eight female healthy controls underwent rs-fMRI were enrolled.The ALFF and fractional amplitude of low-frequency fluctuations(fALFF)(with and without standardization)were firstly applied to obtain the regions with abnormal activity in patient with non-NPSLE.Then,by taking the significant areas as the seed regions of interest(ROIs),the FC between ROIs and the whole brain were calculated to assess the network-level alterations.Finally,the relationship between significantly altered values of ALFF and FC in non-NPSLE patients,some clinical and neuropsychological data were calculated,respectively.Results Compared with the controls,non-NPSLE patients showed significantly decreased mALFF in left supplementary motor area(t=-4.52,P<0.001),and presented significantly increased fALFF in right inferior temporal gyrus and left postcentral gyrus(Alphasim corrected,P<0.05).At the network level,FC between left supplementary motor area and right inferior temporal gyrus/right lingual gyrus/left cuneus as well as FC between right inferior temporal gyrus and left middle occipital gyrus,and between left postcentral gyrus and right superior frontal gyrus of non-NPSLE patients exhibited significantly lower than those of healthy controls(FWE corrected,P<0.05).The fALFF in left postcentral gyrus was positively correlated with mini-mental state examination(MMSE)(r=0.429,P=0.025)and negatively correlated with hospital anxiety and depression scale(HADS-D)(r=-0.386,P=0.047).The FC value between left supplementary motor area and right lingual gyrus was positively correlated with IgM(r=0.554,P=0.002).The abnormal FC between left supplementary motor area and left cuneus was positively correlated with disease courses

关 键 词：红斑狼疮 系统性 磁共振成像 静息态 认知障碍 低频振幅 功能连接 

分 类 号：R445.2[医药卫生—影像医学与核医学] R593.24[医药卫生—诊断学]