脑损伤患者额叶前皮质微结构MRI变化与认知功能损伤的相关性分析  

Correlation between MRI Changes of Prefrontal Cortex Microstructure and Cognitive Impairment in Patients with Brain Injury

作　　者：鲍景蕾 尹继君[1] 郭倩 BAO Jinglei;YIN Jijun;GUO Qian(Department of Neurology,the Second People's Hospital of Liaocheng City,Liaocheng,Shandong 252600,China)

机构地区：[1]聊城市第二人民医院神经内科,山东聊城252600

出　　处：《临床误诊误治》2024年第3期33-38,共6页Clinical Misdiagnosis & Mistherapy

基　　金：山东省医药卫生科技发展计划项目(202114010801)。

摘　　要：目的 探讨脑损伤患者额叶前皮质微结构MRI变化与认知功能损伤的相关性。方法 选取2020年3月—2022年3月收治的脑损伤120例,根据有无认知功能损伤分为损伤组与无损伤组,每组60例;另选取60例体检健康者作为对照组。比较3组蒙特利尔认知评估量表(MoCA)各维度评分及总分,并比较有无认知功能损伤、不同认知功能损伤程度患者额叶前皮质微结构MRI变化[扩散各向异性分数(FA)、平均扩散率(MD)、轴向扩散峰度(AK)、平均扩散峰度(MK)、径向扩散峰度(RK)],分析额叶前皮质微结构MRI变化与认知功能损伤程度的相关性。结果 损伤组视空间与执行、注意力与计算力、语言功能、抽象能力、延迟记忆领域评分及MoCA总分低于无损伤组、对照组(P<0.01);损伤组前、旁扣带脑回右侧FA、AK及MK低于无损伤组(P<0.01);轻度认知功能损伤患者前、旁扣带脑回右侧FA、AK及MK高于中重度认知功能损伤患者(P<0.01);右侧FA、AK及MK与认知功能损伤程度呈负相关(P<0.01)。结论 脑损伤患者额叶前皮质微结构MRI变化可用于早期评估认知功能损伤,为临床评估脑损伤患者认知功能受损程度提供依据,利于针对性展开后续治疗,改善预后。Objective To investigate the correlation between MRI changes of prefrontal cortex microstructure and cognitive function impairment in patients with brain injury.Methods A total of 120 patients with brain injury treated from March 2020 to March 2022 were selected and divided into injury group(n=60) and non-injury group(n=60) according to cognitive function impairment.Another 60 healthy subjects undergoing physical examination were selected as control group.The scores of all dimensions and total scores of the Montreal Cognitive Assessment Scale(MoCA) were compared among the three groups,and the changes of prefrontal cortex microstructure [diffusion anisotropy score(FA),mean diffusion rate(MD),axial diffusion kurtosis(AK),mean diffusion kurtosis(MK),radial diffusion kurtosis(RK)] in patients with or without cognitive function impairment and different injury degrees were compared.The correlation between MRI change of prefrontal cortex microstructure and the degree of cognitive function impairment was analyzed.Results Visual space and executive function,attention and computing power,language function,abstract ability,delayed memory domain scores and total MoCA scores of the injury group were lower than those of the non-injury group and the control group(P<0.01).The FA,AK and MK on the right side of anterior and paracingulate gyrus in injury group were lower than those in non-injury group(P<0.01).The FA,AK and MK on the right side of anterior and paracingulate gyrus in patients with mild cognitive impairment were higher than those in patients with moderate and severe cognitive impairment(P<0.01).The FA,AK and MK on the right side were negatively correlated with the degree of cognitive function impairment(P<0.01).Conclusion MRI changes of the prefrontal cortex microstructure in patients with brain injury can be used for early assessment of cognitive function impairment,providing evidence for clinical assessment of cognitive function impairment in patients with brain injury,which is conductive to carrying out targeted fo

关 键 词：脑损伤 额叶前皮质微结构 扩散各向异性分数 平均扩散率 轴向扩散峰度 认知功能损伤 蒙特利尔认知评估量表 相关性分析 

分 类 号：R651.15[医药卫生—外科学]