脑白质疏松症患者静息态功能磁共振功能连接的研究  

A resting-state functional magnetic resonance imaging study of functional connectivity in patients with leukoaraiosis

作　　者：金少华 俞俊杰 陆敏艳 葛绍云 李子涵 贾永锋 王敏 Jin Shaohua;Yu Junjie;Lu Minyan;Ge Shaoyun;Li Zihan;Jia Yongfeng;Wang Min(School of Medical Imaging,Nanjing Medical University,Nanjing 210029,China;Department of Radiology,Jiangsu Shengze Hospital Affiliated to Nanjing Medical University,Suzhou 215200,China;Department of Neurology,Jiangsu Shengze Hospital Affiliated to Nanjing Medical University,Suzhou 215200,China;Department of Radiology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学医学影像学院,南京210029 [2]南京医科大学附属江苏盛泽医院放射科,苏州215200 [3]南京医科大学附属江苏盛泽医院神经内科,苏州215200 [4]南京医科大学第一附属医院放射科,南京210029

出　　处：《中华行为医学与脑科学杂志》2023年第12期1071-1077,共7页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：国家自然科学基金(81671258)。

摘　　要：目的观察脑白质疏松症(leukoaraiosis,LA)患者的静息态脑功能连接的变化特点,探讨LA患者认知功能损害的神经病理机制。方法收集2022年8月至2023年2月在南京医科大学附属江苏盛泽医院就诊的28例LA患者(LA组)以及性别、年龄、教育程度相匹配的30例健康志愿者(normal control,NC组)的静息态脑功能数据。采用简易智能精神状态检查量表、连线测试,Stroop色词测验等量表评估被试的认知功能。采用基于MATLAB R2022a的DPABI V6.1软件计算和统计两组间体素镜像同伦连接(voxel-mirrored homotopic connectivity,VMHC)差异,组间比较采用两样本t检验,将所得差异脑区作为种子点与全脑进行功能连接,使用Pearson相关分析计算功能连接值与神经量表评分的相关性。结果组间比较显示,LA组距状裂周围皮质(x=±18,y=-63,z=15)、中央后回(x=±39,y=-27,z=48)、舌回(x=±12,y=-51,z=-6)、枕中回(x=±27,y=-75,z=24)、岛叶(x=±36,y=6,z=3)的VMHC值较NC组减低(P<0.05)。种子点功能连接结果显示,LA组右侧距状裂周围皮质与两侧楔前叶、右侧背外侧前额叶皮质、右侧颞中回功能连接减弱(P<0.05),右侧中央后回与左侧距状裂周围皮质、左侧颞中回、右侧舌回功能连接减弱(P<0.05)。Pearson相关分析结果显示,LA组中,右侧距状裂周围皮质-右侧背外侧前额叶皮质的功能连接值与Stroop色词测验C评分呈负相关(r=-0.39,P<0.05);所有受试者右侧距状裂周围皮质-右侧背外侧前额叶皮质的功能连接值与Stroop色词测验C评分呈负相关(r=-0.48,P<0.001),与连线测试B评分呈负相关(r=-0.40,P<0.01),右侧距状裂周围皮质-左侧楔前叶的功能连接值与连线测试B评分呈负相关(r=-0.45,P<0.001)。结论LA患者大脑半球间功能连接的失同伦以及皮质间联合环路功能连接的减弱可能与认知功能损害的神经病理过程有关。ObjectiveTo investigate the alterations of brain resting-state functional connectivity in patients with leukoaraiosis(LA),and to explore its neuropathological mechanism of cognitive dysfunction.MethodsFrom August 2022 to February 2023,28 patients with LA(LA group)and 30 gender,age and education level matched normal controls(NC group)in Jiangsu Shengze Hospital affiliated to Nanjing Medical University were prospectively recruited.Mini mental state examination,trail-making test,and Stroop color-word test were used to evaluate the cognitive function of participants,rs-fMRI images were processed by DPABI V6.1 based on MATLAB R2022a.Voxel-mirrored homotopic connectivity(VMHC)values were calculated and two-sample t test were performed to compare the differences in local brain activity between the two groups.The brain regions with significant differences were selected as the seeds to calculate the functional connectivity(FC)values of the whole brain,and Pearson correlation analyses were performed to evaluate the correlation between the FC values and neuropsychological scores.ResultsThe VMHC values of the calcarine fissure and surrounding cortex(CAL)(x=±18,y=-63,z=15),postcentral gyrus(PoCG)(x=±39,y=-27,z=48),lingual gyrus(LING)(x=±12,y=-51,z=-6),middle occipital gyrus(x=±27,y=-75,z=24)and insula(x=±36,y=6,z=3)in the LA group were lower than those in the NC group(P<0.05).The seed points FC results showed,FC values between right CAL(CAL.R)and bilateral precuneus(PCUN),right dorsolateral prefrontal cortex(DLPFC.R)and right temporal_mid were reduced in the LA group(P<0.05);FC values between PoCG.R and left CAL,left temporal_mid and right LING were reduced too(P<0.05).Additionally,the FC value in the LA group between CAL.R and DLPFC.R was negatively correlated with the Stroop C score(r=-0.39,P<0.05).The FC value in LA group and NC group between CAL.R and DLPFC.R was negatively correlated with the Stroop C score(r=-0.48,P<0.001)and also negatively correlated with the trail making test B(TMT-B)score(r=-0.40,P<0.01),and th

关 键 词：脑白质疏松症 静息态功能磁共振 功能连接 认知功能 

分 类 号：R743[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]