急性轻度创伤性脑损伤患者三重网络模型的静息态功能磁共振功能连接改变  

Changes in functional connectivity in patients with acute mild traumatic brain injury based on a triple-network model:a resting state functional MRI study

作　　者：李逢芳[1] 任军[1] 路丽彦 陈宇辰[1] 殷信道[1] Li Fengfang;Ren Jun;Lu Liyan;Chen Yuchen;Yin Xindao(Department of Radiology,Nanjing First Hospital,Nanjing Medical University,Nanjing 210006,China)

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)医学影像科,南京210006

出　　处：《中华行为医学与脑科学杂志》2023年第3期231-237,共7页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：国家自然科学基金 (82102012,82102006)。

摘　　要：目的:探讨急性期轻度创伤性脑损伤(mild traumatic brain injury,mTBI)患者静息状态下突显网络(salient network,SN)、执行控制网络(executive control network,ECN)和默认模式网络(default mode network,DMN)组成的"三重网络模型"的功能连接改变。方法:2020年8月至2021年12月纳入45名急性期mTBI患者(mTBI组)和40名性别、年龄、教育程度相匹配的健康对照者(healthy control,HC组)。所有受试者采用蒙特利尔认知评估(Montreal cognitive assessment,MoCA)量表进行神经认知状态评分。基于功能磁共振独立成分分析(independent component analysis,ICA)构建静息态功能网络,提取SN、ECN和DMN,并进行功能网络连接(functional network connectivity,FNC)分析。随后,分析功能连接异常与认知障碍表现之间的相关性。采用SPSS 19.0进行统计分析,双样本t检验进行组间比较。结果:与HC组相比,急性mTBI组在SN(左侧岛叶)(MNI:x,y,z=-36,15,0,t=3.693)和ECN(左侧顶上回)(MNI:x,y,z=-33,-69,54,t=3.333)功能连接增强(FDR校正,P<0.05),在DMN(左侧额上回)(MNI:x,y,z=-30,30,42,t=-4.063)和DMN(左侧角回)(MNI:x,y,z=-21,-66,33,t=-4.101)功能连接降低(FDR校正,P<0.05)。对于FNC分析,急性mTBI组在SN(IC26)-DMN(IC8)之间的功能网络连接增强,在SN(IC26)-DMN(IC12)和ECN(IC3)-DMN(IC12)之间的功能网络连接降低。左侧顶上回功能连接改变与MoCA评分(r=-0.627,P<0.01),SN(IC26)-DMN(IC12)功能连接与MoCA评分(r=0.411,P=0.005)存在相关性。结论:急性mTBI患者SN、ECN和DMN组成"三重网络模型"的网络内及网络间静息态功能连接发生改变,且与认知功能下降存在相关性,这有助于更好地理解急性mTBI及创伤后认知功能障碍的神经病理学机制,并可能成为识别和预测mTBI后认知障碍的有效影像学标志物。Objective To investigate the resting state functional connectivity changes of the"triple network model"composed of salient network(SN),executive control network(ECN)and default mode network(DMN)in patients with acute mild traumatic brain injury(mTBI).Methods From August 2020 to December 2021,forty-five acute mTBI patients(mTBI group)and 40 healthy controls(HC group)with matched sex,age,and education were included.The Montreal cognitive assessment(MoCA)scale was used to evaluate the cognitive status of all subjects.The resting state network(RNS)was established based on independent component analysis(ICA),and the SN,ECN and DMN were extracted,then functional network connectivity(FNC)was analyzed.Subsequently,the correlation between functional connectivity abnormalities and the performance of cognitive impairment was analyzed.SPSS 19.0 was used for statistical analysis and double sample t test was used for comparison between the tow groups.Results Compared with HC group,mTBI group had enhanced functional connectivity between SN(L-insula)(MNI:x,y,z=-36,15,0,t=3.693)and ECN(left superior parietal gyrus,L-SPG)(MNI:x,y,z=-33,-69,54,t=3.333)(FDR adjust,P<0.05),and decreased functional connectivity between DMN(left superior frontal gyrus,L-SFG)(MNI:x,y,z=-30,30,42,t=-4.063)and DMN(L-angular gyrus)(MNI:x,y,z=-21,-66,33,t=-4.101)(FDR adjust,P<0.05).For FNC analysis,functional network connectivity in SN(IC26)-DMN(IC8)was enhanced in the acute mTBI group and decreased between SN(IC26)-DMN(IC12)and ECN(IC3)-DMN(IC12).The changes of left superior parietal gyrus functional connection were negatively correlated with MoCA score(r=-0.627,P<0.01),and SN(IC26)-DMN(IC12)connection was positively correlated with MoCA score(r=0.411,P=0.005).Conclusions In patients with acute mTBI,the resting functional connectivity changes within and between the networks of the"triple network model"composed of SN,ECN and DMN,and is related to the decline of cognitive function.This will help to better understand the neuropathological mechanism of acute m

关 键 词：轻度创伤性脑损伤 磁共振成像 突显网络 执行控制网络 默认模式网络 

分 类 号：R651.15[医药卫生—外科学] R445.2[医药卫生—临床医学]