基于静息态功能磁共振的肌萎缩侧索硬化症大脑功能网络研究  

Brain functional network in amyotrophic lateral sclerosis based on resting-state functional magnetic resonance imaging

作　　者：王倩楠[1] 张静娜[1] 乔梁[1] 胡俊 张晔[1] 王莉[1] 桑林琼[1] 李鹏岳[1] 邱明国[1] WANG Qiannan;ZHANG Jingna;QIAO Liang;HU Jun;ZHANG Ye;WANG Li;SANG Linqiong;LI Pengyue;QIU Minguo(Department of Medical Imaging,Faculty of Biomedical Engineering,Army Medical University(Third Military Medical University),Chongqing,400038,China;Department of Neurology,First Affiliated Hospital,Army Medical University(Third Military Medical University),Chongqing,400038,China)

机构地区：[1]陆军军医大学(第三军医大学)生物医学工程与影像医学系医学图像学教研室,重庆400038 [2]陆军军医大学(第三军医大学)第一附属医院神经内科,重庆400038

出　　处：《陆军军医大学学报》2022年第16期1592-1598,共7页Journal of Army Medical University

基　　金：国家自然科学基金青年科学基金项目(81802253);军队卫勤保障能力创新与生成专项应用基础研究项目(21WQ004);重庆市自然科学基金面上项目(cstc2020jcyj-msxmX0311)。

摘　　要：目的探讨肌萎缩侧索硬化症(amyotrophic lateral sclerosis,ALS)脑功能网络异常模式,为ALS早期诊断及预后评估寻找客观影像学标记。方法于2015年5月至2018年3月在陆军军医大学第一附属医院神经内科招募确诊ALS患者25例;同时招募年龄、性别匹配的26例健康志愿者作为对照组,均行3.0T磁共振扫描仪采集静息态(functional magnetic resonance imaging,fMRI)扫描,构建大脑大尺度功能网络。基于图论理论进行网络差异分析,经双样本t检验比较两组脑功能网络的全局和节点属性,并将ALS患者脑功能连接及网络参数与认知及运动功能评分进行Pearson相关分析。结果与健康对照组相比,ALS患者大脑前、后脑区之间功能网络连接显著增强(P<0.05);左侧眶内额上回-缘上回功能连接降低并与修订版ALS功能量表(revised ALS functional rating scale,ALSFRS-R)评分呈正相关(r=0.512,P=0.008)。与健康对照组相比,ALS患者标准化特征路径长度降低,额叶、枕叶等脑区节点效率及节点度增加(P<0.05),扣带回及苍白球等结构的节点效率及节点度降低(P<0.05)。结论应用静息态功能磁共振数据可反映ALS患者脑功能网络连接异常改变,左侧眶内额上回-缘上回功能连接值可作为一种客观影像学标记,用于对ALS的早期诊断及预后评估。Objective To explore the abnormal connection mode of brain functional network in amyotrophic lateral sclerosis(ALS),and to find imaging biomarkers for early diagnosis and prognosis evaluation of ALS.Methods From May 2015 to March 2018,25 patients with ALS were recruited in the Department of Neurology of First affiliated Hospital of Army Medical University,and 26 age-and sex-matched healthy volunteers were enrolled as the healthy control group.Resting-state functional magnetic resonance imaging(fMRI)scans were collected by 3.0 T magnetic resonance scanner,and the whole brain large-scale functional network was constructed.The network differentiation was analyzed on the basis of graph theory.The whole brain and node attributes of the 2 groups of functional brain networks were compared by two sample t test.The functional brain connection,network parameters and cognitive and motor function scores of ALS patients were detected by Pearson correlation analysis.Results Compared with the healthy control group,the functional network connection between the anterior and posterior brain regions of ALS patients was significantly enhanced(P<0.05),and the functional connection between the left orbital superior frontal gyrus and superior marginal gyrus was decreased,which was positively correlated with revised ALS functional rating scale(ALSFRE-R)score(r=0.512,P=0.008).Compared with the healthy control group,the normalized characteristic path length of ALS patients was decreased,while the nodal efficiency and node degree in the frontal and occipital brain regions increased(P<0.05).However,as to the cingulate gyrus and globus pallidus,the nodal efficiency and node degree decreased(P<0.05).Conclusion Rest-fMRI data can reflect the abnormal changes of functional brain network connection in patients with ALS.Superior frontal gyrus superior marginal gyrus functional connection value of the left orbit can be used as an imaging biomarker for the early diagnosis and prognosis of ALS.

关 键 词：肌萎缩侧索硬化症 静息态功能磁共振成像 图论 功能连接 

分 类 号：R319[医药卫生—基础医学] R445.2R746.4