OSAHS患者的脑功能异常改变:基于VMHC的静息态fMRI研究  

Abnormal changes of brain function in patients with OSAHS:VMHC-based rs-fMRI study

作　　者：伋立荣 王二磊[1] 陈锐[2] 王婧[2] 亚洋 苏桐 程超虹 范国华[1] JI Lirong;WANG Erlei;CHEN Rui;WANG Jing;YA Yang;SU Tong;CHENG Chaohong;FAN Guohua(Department of Radiology,the Second Affiliated Hospital of Soochow University,Suzhou 215000,China;Department of Respiratory,the Second Affiliated Hospital of Soochow University,Suzhou 215000,China)

机构地区：[1]苏州大学附属第二医院放射科,苏州215000 [2]苏州大学附属第二医院呼吸科,苏州215000

出　　处：《磁共振成像》2023年第9期13-18,共6页Chinese Journal of Magnetic Resonance Imaging

基　　金：国家自然科学基金(编号:82070095);苏州市科技发展计划(编号:SKY2022011);江苏省老年健康科研项目(编号:LKZ2022009);苏州大学附属第二医院青年职工预研基金项目(编号:SDFEYLC2245);苏州市医学会“影像医星”科技立项项目(编号:2022YX-M03)。

摘　　要：目的探讨阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)患者脑镜像同伦连接(voxel-mirrored homotopic connectivity,VMHC)的改变及其与临床指标的相关性。材料与方法本研究以呼吸暂停低通气指数(apnea hypopnea index,AHI)15次/h为界值,分为中度或重度组(OSAHS组,n=68)、正常或轻度组(对照组,n=47)。所有被试者均为男性,均行多导睡眠(polysomnography,PSG)监测、剑桥神经心理自动化成套测试、结构及静息态fMRI扫描。比较组间VMHC指标差异,并提取异常脑区VMHC值与PSG指标和剑桥认知指标进行偏相关分析。结果与对照组相比,OSAHS组在双侧后扣带回、岛叶和颞上回的VMHC值显著增加(GRF校正,体素水平P<0.001,团块水平P<0.05,双尾);OSAHS组双侧后扣带回和岛叶的VMHC值均与空间再认记忆(spatial recognition memory,SRM)选择时间呈正相关(r=0.318,P=0.010;r=0.437,P<0.001)。结论OSAHS患者表现为特定脑区的VMHC值增高,提示脑功能代偿机制,并且这种异常脑改变与认知功能损害存在一定的相关性。Objective:To explore the alterations of voxel-mirrored homotopic connectivity(VMHC)in obstructive sleep apnea-hypopnea syndrome(OSAHS)patients and the correlations with clinical indicators.Materials and Methods:In this study,apnea hypopnea index(AHI)15 was taken as the cut-off value,and the subjects were divided into moderate or severe group(OSAHS group,n=68),normal or mild group(control group,n=47).All subjects were male,and underwent polysomnography(PSG)monitoring,cambridge neuropsychological test automated battery assessment,structural and resting-state functional MRI scans.Compared the differences in VMHC between the two groups,and the VMHC values of the abnormal brain regions were extracted to perform the partial correlation analysis with PSG and Cambridge cognitive indicators.Results:Compared with the control group,the OSAHS group showed significantly increased VMHC in bilateral posterior cingulate gyrus,insula and superior temporal gyrus(GRF corrected,voxel level P<0.001,cluster level P<0.05,two tailed).The VMHC value of bilateral posterior cingulate gyrus and insula were positively correlated with the selection time of spatial recognition memory(SRM)(r=0.318,P=0.010;r=0.437,P<0.001).Conclusions:Patients with OSAHS presente increased VMHC in specific brain regions,suggesting the compensatory mechanism of brain function,and there are certain correlations between the abnormal brain changes and cognitive impairment.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 静息态功能磁共振成像 镜像同伦连接 认知功能损害 脑功能损害 

分 类 号：R445.2[医药卫生—影像医学与核医学] R563.8[医药卫生—诊断学]