神经精神性狼疮患者静息态脑功能网络改变  

Changes of resting-state brain functional network in patients with neuropsychiatric systemic lupus erythematosus

作　　者：李一凡 孙中茹 王宁[2] 夏建国[2] 高俊逸 张继[2] 田为中[2] LI Yifan;SUN Zhongru;WANG Ning;XIA Jianguo;GAO Junyi;ZHANG Ji;TIAN Weizhong(Nantong University Medical School,Nantong 226001,China;Department of Imaging,Taizhou People's Hospital,Taizhou 225300,China)

机构地区：[1]南通大学医学院,江苏南通226001 [2]泰州市人民医院影像科,江苏泰州225300

出　　处：《中国医学影像技术》2023年第9期1306-1310,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的通过度中心性(DC)和功能连接(FC)观察神经精神性狼疮(NPSLE)患者静息态脑功能网络改变。方法前瞻性纳入23例NPSLE患者(NPSLE组)及28名健康志愿者(对照组),行静息态功能MRI(rs-fMRI),并对NPSLE患者完善简易精神状态量表(MMSE)、蒙特利尔认知评估量表(MoCA)、运动和认知功能疲劳量表(FSMC)(包括FSMC-M及FSMC-C)、医院焦虑抑郁量表(HADS)(包括HADS-A及HADS-D)评估及实验室检查(C3、C4、IgA、IgM、IgG);比较组间各脑区Fisher-Z变换DC(zDC)差异,以组间zDC存在差异脑区为种子点,分析全脑Fisher-Z变换FC(zFC),评估NPSLE组上述脑区zDC及zFC与神经心理学量表及实验室指标的相关性。结果相比对照组,NPSLE组左侧距状裂周围皮层、右侧眶内额上回zDC均降低(P_(FWE校正)均<0.05),左侧距状裂周围皮层-右侧眶内额上回zFC降低,右侧眶内额上回与右侧内侧额上回、左侧楔前叶、右侧颞下回、左侧顶下缘角回及右侧角回zFC均降低(P_(FWE校正)均<0.05)。NPSLE患者左侧距状裂周围皮层-右侧眶内额上回zFC与FSMC-M、FSMC-C均呈负相关(r=-0.493、-0.471,P均<0.05),右侧眶内额上回-左侧楔前叶zFC与FSMC-M、FSMC-C均呈负相关(r=-0.485、-0.553,P均<0.05),右侧眶内额上回-左侧顶下缘角回zFC及右侧眶内额上回-右侧角回zFC与IgA均呈负相关(r=-0.460、-0.483,P均<0.05)。结论NPSLE患者左侧距状裂周围皮层及右侧眶内额上回DC及多个脑区FC降低。Objective To observe the changes of resting-state brain functional network in patients with neuropsychiatric systemic lupus erythematosus(NPSLE)based on degree centrality(DC)and functional connectivity(FC).Methods Totally 23 NPSLE patients(NPSLE group)and 28 healthy volunteers(control group)were prospectively enrolled,and resting-state functional MRI(rs-fMRI)were acquired.Patients in NPSLE group also underwent mini-mental state examination(MMSE),Montreal cognitive assessment(MoCA),fatigue scale for motor and cognitive functions(FSMC)(including FSMC-M and FSMC-C),hospital anxiety and depression scale(HADS)including HADS-A and HADS-D,as well as laboratory tests(C3,C4,IgA,IgM,IgG).Fisher Z transform DC(zDC)of various brain regions were compared between groups.Brain regions with significantly different zDC were taken as seed points to analyze the whole brain Fisher Z transform FC(zFC),and correlations of zDC and zFC of the above brain regions with neuropsychological scale and laboratory indicators in NPSLE patients were analyzed.Results Compared with control group,zDC of the left calcarine fissure surrounding cortex and right medial orbital superior frontal gyrus decreased,so did zFC of the left calcarine fissure surrounding cortex-right medial orbital superior frontal gyrus,and zFC of the right medial orbital superior frontal gyrus and right medial superior frontal gyrus,left precuneus,right inferior temporal gyrus,left inferior parietal gyrus and right angular gyrus decreased in NPSLE group(all P _(FWE correction)<0.05).In NPSLE patients,zFC of the left calcarine fissure surrounding cortex-right medial orbital superior frontal gyrus of were negatively correlated with FSMC-M and FSMC-C(r=-0.493,-0.471,both P<0.05),zFC of the right medial superior frontal gyrus-left precuneus were negatively correlated with FSMC-M and FSMC-C(r=-0.485,-0.553,both P<0.05),while zFC of the right medial orbital superior frontal gyrus-left inferior parietal gyrus and zFC of the right medial orbital superior frontal gyrus-right angular gyr

关 键 词：红斑狼疮 系统性 磁共振成像 狼疮血管炎 中枢神经系统 度中心性 功能连接 

分 类 号：R593.24[医药卫生—内科学] R445.2[医药卫生—临床医学]