1型发作性睡病患者基于静息态功能磁共振成像的度中心性改变及其预测价值  

Changes and predictive value of degree centrality in patients with narcolepsy type 1 based on resting-state functional magnetic resonance imaging

作　　者：吴兰香 占青青 田胜 郑合情 谢亮[1] 吴伟[1] Wu Lanxiang;Zhan Qingqing;Tian Sheng;Zheng Heqing;Xie Liang;Wu Wei(Department of Neurology,the Second Affiliated Hospital of Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学第二附属医院神经内科,南昌330006

出　　处：《中华神经科杂志》2023年第2期171-177,共7页Chinese Journal of Neurology

基　　金：国家自然科学基金(31860293,82160227);江西省自然科学基金(20192BAB205047);江西省研究生创新专项资金(YC2021-B049)。

摘　　要：目的利用静息态磁共振度中心性技术探讨1型发作性睡病(NT1)患者全脑网络节点中心性的异常改变及其对疾病的预测价值。方法收集2019年9月至2021年11月经广告招募在南昌大学第二附属医院首诊未经治疗的NT1患者18例及年龄、性别相匹配的健康对照18名,进行静息态功能磁共振扫描及Epworth嗜睡量表(ESS)、焦虑自评量表、抑郁自评量表、匹兹堡睡眠质量指数、失眠严重程度量表、多维疲劳量表-20(MFI-20)评分,采用度中心性方法分析NT1患者和健康对照之间度中心性的差异,使用Pearson相关分析探索差异脑区的度中心性与NT1患者临床特征之间的相关性,并采用受试者工作特征(ROC)曲线分析评估差异脑区的度中心性对NT1的预测价值。结果与健康对照相比,NT1患者的右侧颞上回度中心性增高,双侧额中回、右侧楔前叶度中心性减低(均P<0.05,高斯随机场校正)。NT1患者右侧颞上回的度中心性与ESS评分(r=0.82,P<0.001)、MFI-20评分(r=0.48,P=0.040)呈正相关,右侧额中回度中心性与患者的病程呈正相关(r=0.51,P=0.032)。ROC曲线显示右侧颞上回的度中心性预测NT1的曲线下面积(AUC)为0.95。左侧额中回、右侧额中回、右侧楔前叶的度中心性预测非NT1的AUC分别是0.86、0.84和0.87。结论NT1患者存在默认网络、执行网络核心脑区及颞上回的静息态度中心性异常,其中右侧颞上回的度中心性可能是NT1的潜在生物学标志物。Objective To investigate the abnormal changes of the nodal centrality of the whole-brain network in patients with narcolepsy type 1(NT1)through the degree centrality(DC)technique of resting-state magnetic resonance and the predictive value for NT1.Methods From September 2019 to November 2021,18 NT1 patients who were first diagnosed and never accepted managements and 18 age-,sex-matched healthy controls recruited by advertisement in the Second Affiliated Hospital of Nanchang University were required for resting-state functional magnetic resonance imaging scans and clinical scale assessment,including Epworth Sleepiness Scale(ESS),Self-rating Anxiety Scale,Self-rating Depression Scale,Pittsburgh Sleep Quality Index,Insomnia Severity Scale and Multidimensional Fatigue Inventory-20(MFI-20).The differences in DC values between the NT1 patients and healthy controls were analyzed using the DC method.Then,the correlation between DC values in differential brain regions and clinical characteristics of NT1 was explored through Pearson correlation analysis.The receiver operating characteristic(ROC)curve analysis was used to evaluate the predictive value of the DC values in the differential brain regions for NT1 patients.Results Compared with the healthy controls,the DC value of the right superior temporal gyrus was increased,while the DC values of the bilateral middle frontal gyrus and the right precuneus were decreased in the NT1 patients(all P<0.05,Gaussian random-field correction).The DC value of the right superior temporal gyrus in the NT1 patients was positively correlated with the ESS score(r=0.82,P<0.001)and MFI-20 score(r=0.48,P=0.040).The DC value of the right middle frontal gyrus was positively correlated with the disease course(r=0.51,P=0.032).The ROC curve showed that the area under the curve of NT1 predicted by the DC value of the right superior temporal gyrus was 0.95.And the areas under the curve of non-NT1 predicted by the DC values of the left middle frontal gyrus,right middle frontal gyrus,and right precuneu

关 键 词：发作性睡病 磁共振成像 度中心性 默认网络模式 

分 类 号：R445.2[医药卫生—影像医学与核医学] R740[医药卫生—诊断学]