MR引导下聚焦超声治疗特发性震颤术后静息态脑功能局部一致性研究  

Regional homogeneity changes after MR-guided focused ultrasound thalamotomy in essential tremor:A rs-fMRI study

作　　者：邓林林 林家骥 王晓玉 陆皓璇 熊永琴 边祥兵[2] 周珈右 潘隆盛[3] 娄昕 DENG Linlin;LIN Jiaji;WANG Xiaoyu;LU Haoxuan;XIONG Yongqin;BIAN Xingbing;ZHOU Jiayou;PAN Longsheng;LOU Xin(School of Medical Imaging,Guizhou Medical University,Guiyang 550004,China;Department of Radiology,Chinese PLA General Hospital/Chinese PLA Medical School,Beijing 100853,China;Department of Neurosurgery,Chinese PLA General Hospital/Chinese PLAMedical School,Beijing 100853,China)

机构地区：[1]贵州医科大学医学影像学院,贵阳550004 [2]中国人民解放军总医院放射诊断科,北京100853 [3]中国人民解放军总医院神经外科,北京100853

出　　处：《磁共振成像》2022年第9期1-6,12,共7页Chinese Journal of Magnetic Resonance Imaging

基　　金：国家自然科学基金(编号:82151309)。

摘　　要：目的旨在探索MR引导下聚焦超声(MR-guided focus ultrasound,MRgFUS)治疗药物难治性特发性震颤(essential tremor,ET)患者术后局部自发性脑活动的长期纵向变化及与临床震颤评分的相关性。材料与方法前瞻性纳入于2019年1月至2019年5月在中国人民解放军总医院接受MRgFUS丘脑消融术的药物难治性ET患者(ET组)及年龄和性别匹配的健康对照(helathy controls,HC)组各9例,收集ET组基线、MRgFUS术后6个月及MRgFUS术后2年静息态功能磁共振成像(resting state functional magnetic resonance imaging,rs-fMRI)数据和临床震颤评定量表(Clinical Rating Scale for Tremor,CRST)以及HC组rs-fMRI数据。采用基于MATLAB平台的REST plus v1.2工具包中局部一致性(regional homogeneity,ReHo)方法,基于全脑体素配对样本t检验确定ET组基线与MRgFUS术后2年显著差异性脑区,使用DPABI v5.1工具包提取HC组及ET组该显著差异性脑区ReHo值。利用两独立样本t检验比较HC组与ET组该显著差异性脑区自发性和同步性脑活动,采用单因素重复测量方差分析比较ET组基线、MRgFUS术后6个月和MRgFUS术后2年该显著差异性脑区自发性和同步性脑活动。利用Spearman相关性分析对ET组术后临床震颤改善与ET组ReHo值改变之间的变化趋势进行相关性分析;利用Pearson相关性分析对ET组MRgFUS术后2年震颤改善率与ET组基线ReHo值进行相关性分析。结果ET组基线与MRgFUS术后2年显著差异性脑区位于右侧中央后回;与HC组比较,ET组基线右侧中央后回ReHo值显著减低(P<0.01),ET组MRgFUS术后两年右侧中央后回差异无统计学意义(P>0.05);ET组基线、MRgFUS术后6个月、MRgFUS术后2年,右侧中央后回ReHo值升高(F=3.95,P<0.05)。术后临床震颤改善与ReHo值改变之间的变化趋势成正相关;ET组MRgFUS术后2年CRST-A改善率与ET组基线ReHo值呈负相关(r=-0.709,P=0.032)。结论MRgFUS治疗有助于药物难治性ET患者缓解震颤症状,MRgFUS治疗影响Objective:To explore long-term longitudinal changes in local spontaneous brain activity and correlation with clinical tremor scores after MR-guided focused ultrasound(MRgFUS)in essential tremor(ET)patients.Materials and Methods:In this study,we included 9 patients with essential tremor who underwent MRgFUS thalamotomy in the Chinese PLA General Hospital from January 2019 to May 2019 and 9 healthy controls with no statistical difference in age and sex,and 9 healthy volunteers with matched age and sex.We collected resting-state functional MRI(rs-fMRI)data and Clinical Rating Scale for Tremor(CRST)at baseline,6 months and 2 years after MRgFUS thalamotomy in ET patients and rs-fMRI data in healthy volunteers.We used a regional homogeneity(ReHo)approach in the REST plus v1.2 toolkit based on the MATLAB platform,based on whole-brain voxel paired-sample t-tests to identify difference in brain areas in ET patients at baseline and 2 years after MRgFUS thalamotomy,The ReHo values of this significantly different brain region in the HC and ET groups were extracted using the DPABI v5.1 toolkit,a two independent sample t-test was used to compare spontaneous and synchronous brain activity in this significantly different brain region between the HC and ET groups,and one-way repeated measures ANOVA was used to compare spontaneous and synchronous brain activity in this significantly different brain region between the ET group at baseline,6 months after MRgFUS,and 2 years after MRgFUS.We used Spearman correlation analysis to correlate the trend between clinical tremor improvement in the ET group after surgery and the change in ReHo values in the ET group;and Pearson correlation analysis to correlate the rate of tremor improvement in the ET group 2 years after MRgFUS with the baseline ReHo values in the ET group.Results:Findings showed that the significantly different brain regions in the ET group at baseline and 2 years after MRgFUS were located in the right postcentral gyrus.Compared with the HC group,the ReHo value of the right p

关 键 词：磁共振引导下聚焦超声 局部一致性 特发性震颤 静息态功能磁共振成像 临床震颤评定量表 

分 类 号：R445.2[医药卫生—影像医学与核医学] R742[医药卫生—诊断学]