不伴认知损伤的2型糖尿病患者静息态脑功能磁共振成像多指标的对比分析  

Comparison of brain functional alterations in type 2 diabetes mellitus based on resting-state functional magnetic resonance imaging indices

作　　者：张戈 张艳伟[2] 刘太元 王涵 魏巍[1] 王梅云[1] ZHANG Ge;ZHANG Yanwei;LIU Taiyuan;WANG Han;WEI Wei;WANG Meiyun(Department of Radiology,Henan Provincial People's Hospital,Zhengzhou 450000,China;Department of Radiology,Bethune International Peace Hospital(980th Hospital of Joint Logistic Support Force),Shijiazhuang 050000,China)

机构地区：[1]河南省人民医院影像科,郑州450000 [2]白求恩国际和平医院(联勤保障部队第980医院)放射诊断科,石家庄050000

出　　处：《磁共振成像》2024年第5期8-12,共5页Chinese Journal of Magnetic Resonance Imaging

基　　金：河南省医学科技攻关计划项目(编号:LHGJ20210028);联勤保障部队第九八〇医院孵育计划项目(编号:FYJHQN202304)。

摘　　要：目的通过多种静息态脑功能磁共振指标探索2型糖尿病(type 2 diabetes mellitus,T2DM)认知功能正常患者的自发神经活动改变。材料与方法前瞻性纳入34名认知功能正常的T2DM患者及年龄、性别、文化程度与T2DM患者相匹配的同等数量的正常对照,两组被试均行3.0 T静息态脑功能磁共振扫描。图像数据经预处理后分别计算低频振荡指数、局部一致性指数、镜像同伦功能连接等指标,采用两样本t检验比较组间差异,并分析不同静息态指标间及与临床指标间的关联关系。结果与正常对照相比,T2DM组患者在左侧前额叶、右侧角回呈现自发神经活动减弱,而在左侧尾状核与辅助运动区呈现神经活动增强(GRF校正,体素水平P<0.001,簇水平P<0.05)。T2DM在前额叶及角回区域低频振幅指数与局部一致性指数显著相关(r=0.592~0.767,校正后P<0.05),但与正常对照相比相关程度降低。结论应用多个静息态脑功能指标可检测T2DM患者存在不同脑区的自发神经活动改变,且不同指标间相关程度降低,可为分析T2DM患者认知损伤发生前的早期脑功能改变提供参考。Objective:To explore the abnormal spontaneous neural activity in type 2 diabetes mellitus(T2DM)without cognitive impairment by combining multiple indices of resting-state functional magnetic resonance imaging(rs-fMRI).Materials and Methods:Thirty-four T2DM patients without cognitive impairment and 34 age,sex and education matched control subjects were included in this study.Both groups received rs-fMRI scans in a 3.0 T MRI scanner.Amplitude of low frequency fluctuation(ALFF),regional homogeneity(ReHo)and voxel-mirrored homotopic connectivity(VMHC)were calculated after image preprocessing.Two sample t-test was performed to explore the abnormal alterations of brain function and the relationship among rs-fMRI indices and clinical characteristics was also investigated.Results:T2DM patients showed decreased spontaneous neural activity in the left prefrontal cortex,right angular gyrus,while increased neural activity in the left caudate nucleus and supplementary motor area(GRF corrected,voxel P<0.001,cluster P<0.05).We also observed a decreased correlation between ALFF and ReHo in the prefrontal cortex and angular gyrus of T2DM(r=0.592-0.767,corrected P<0.05).Conclusions:The application of multiple rs-fMRI indices detected abnormal neural activities in different brain regions of T2DM patients,and the decreased coupling trend between ALFF and could help to understand the early changes before cognitive impairment appeared.

关 键 词：2型糖尿病 静息态功能磁共振成像 磁共振成像 低频振幅 局部一致性 镜像同伦功能连接 

分 类 号：R445.2[医药卫生—影像医学与核医学] R587.1[医药卫生—诊断学]