急性脑梗死后应激性血糖升高的脑网络改变及功能连接分析  

The changes in brain network and functional connectivity of stress-induced hyperglycemia after acute cerebral infarction

作　　者：卢鹏超 刘丽莹 崔凯歌 杨冀萍[1] Lu Pengchao;Liu Liying;Cui Kaige;Yang Jiping(Department of Medical Imaging,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第二医院医学影像科,石家庄050000

出　　处：《脑与神经疾病杂志》2024年第5期323-328,共6页Journal of Brain and Nervous Diseases

基　　金：河北省医学科学研究重点课题计划(20240606,20210252);河北省重点研发计划项目(21377784D);政府资助临床优秀医学人才培养项目(ZF2023149)。

摘　　要：目的本研究基于图论及种子点分析,探讨急性脑梗死(ACI)后发生应激性高血糖(SIH)患者的脑网络改变及功能连接分析,发现其脑功能受损的神经机制。方法选取河北医科大学第二医院就诊的ACI后血糖不同程度升高的患者53例,将空腹血糖(FBG)/糖化血红蛋白(HbA1c)比值定义为应激性高血糖比率(SHR),按照第50百分位数将上述被试者基于SHR分为两组,分别命名为低水平P50-组(SHR≤0.92,n=25)和高水平P50+组(SHR>0.92,n=28):所有被试者均进行静息态功能磁共振成像(rs-MRI)并收集数据,计算脑网络相关参数,并基于右侧岛叶种子点进行全脑功能连接分析。结果P50-和P50+两组均具有小世界属性(σ>1),P50+组λ值大于P50-组(P<0.05),而两组间σ、γ值比较差异无统计学意义(P>0.05);与P50-组相比,P50+组右侧岛叶与右侧苍白球、右侧楔前叶、左侧枕叶皮质下区、双侧梭状回、右侧距状裂周围皮质的功能连接减弱。结论ACI后应激性血糖升高时脑网络拓扑结构趋向于规则网络的改变;ACI后发生SIH时右侧岛叶与多个脑区之间的功能连接减弱,相关脑区涉及多个脑网络,这可能是其脑功能受损的神经基础。Objective This study employed graph theory and seed-based correlation analysis to explore the modifications in topological structure and functional connectivity of brain networks in individuals with stressinduced hyperglycemia(SIH) after acute cerebral infarction(ACI),discovering the neural mechanisms of their impaired brain function.Method We collected 53 patients with different degrees of hyperglycemia after ACI from the second hospital of Hebei Medical University.The fasting glucose-to-glycated hemoglobin ratio,referred to as the stress hyperglycemia rate(SHR),was utilized to categorize fifty-three patients into two groups:the SHR(P50-) group(SHR≤0.92,n=25) and the SHR(P50+) group(SHR> 0.92,n=28),based on the 50th percentile of SHR.Functional magnetic resonance data were collected to calculate brain network-related parameters and analyze wholebrain functional connectivity based on right insula seed points.Results Both the P50-and P50+groups exhibited small-world attributes(σ>1) in their respective brain networks.The λ values of brain network attribute parameters in the P50+group were higher than the P50-group(P <0.05),whereas the σ and γ values did not demonstrate significant differences between the two groups(P> 0.05).Compared with the P50-group,the functional connectivity of the right insular lobe to the right pallidum,the right anterior cuneiform lobe,the left inferior occipital cortex,the bilateral fusiform gyrus,and the right talar fissure was weakened in the P50+group.Conclusion The topological structure of the brain network tends to shift towards a regular network following an increase in blood glucose levels after ACI.The functional connections between the right insula and multiple brain regions were weakened during the SIH after ACI,and the related brain regions involved multiple brain networks,which may be the nerve basis of impaired brain function.

关 键 词：急性脑梗死 应激性血糖升高 静息态功能磁共振成像 小世界属性 功能连接 

分 类 号：R743.32[医药卫生—神经病学与精神病学]