行为变异型额颞叶痴呆患者岛叶亚区功能连接及葡萄糖代谢与认知功能的相关性  

Correlations of functional connectivity and glucose metabolism of insular subregions with cognitive function in behavior variant of frontotemporal dementia patients

作　　者：毕晟 陈志庚 何雨洁 薛寒笑 齐志刚[1,2,3] 马杰 杨宏伟[1,2,3] 武力勇 闫少珍[1,2,3] 卢洁 BI Sheng;CHEN Zhigeng;HE Yujie;XUE Hanxiao;QI Zhigang;MA Jie;YANG Hongwei;WU Liyong;YAN Shaozhen;LU Jie(Department of Radiology and Nuclear Medicine,Xuanwu Hospital,Capital Medical University,Beijing 100053,China;Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics,Beijing 100053,China;Key Laboratory of Neurodegenerative Diseases,Ministry of Education,Beijing 100053,China;Department of Neurology,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院放射与核医学科,北京100053 [2]磁共振成像脑信息学北京市重点实验室,北京100053 [3]教育部神经变性病重点实验室,北京100053 [4]首都医科大学宣武医院神经内科,北京100053

出　　处：《中国医学影像技术》2025年第2期196-202,共7页Chinese Journal of Medical Imaging Technology

基　　金：国家重点研发计划(2022YFC2406900);国家自然科学基金(82102010)。

摘　　要：目的观察行为变异型额颞叶痴呆(bvFTD)患者岛叶亚区脑功能连接和葡萄糖代谢及其与认知功能的相关性。方法回顾性纳入38例bvFTD患者(bvFTD组)及44名健康人(对照组),基于功能MRI(fMRI)和18 F-FDG PET数据提取以岛叶亚区为种子点的平均时间序列信号,获得全脑功能连接图;以脑桥为参考,计算标准摄取值比值(SUVR)。比较组间上述参数,分析bvFTD组岛叶亚区SUVR与临床认知功能量表评分的相关性。结果相比对照组,bvFTD组岛叶各亚区与双侧额叶、颞叶、楔前叶、前扣带回及中扣带回功能连接均减弱,部分亚区与双侧顶叶及枕叶功能连接减弱(GRF校正后体素水平P均<0.001、团簇水平P均<0.05);各亚区SUVR均显著降低(GRF校正后体素水平P均<0.001、团簇水平P均<0.05)。bvFTD组右侧腹侧无颗粒岛叶(vIa)、背侧无颗粒岛叶(dIa)、背侧异颗粒岛叶(dId)及左侧背侧无颗粒岛叶(dIa)SUVR与额叶行为量表(FBI)评分呈负相关(r=-0.452~-0.330,P均<0.05)。结论bvFTD患者岛叶亚区存在功能连接及葡萄糖代谢改变,且其右侧vIa、dIa、dId及左侧dIa的SUVR与FBI评分呈负相关。Objective To observe the functional connectivity and glucose metabolism of insular subregions in behavior variant of frontotemporal dementia(bvFTD)patients,also their correlations with cognitive function.Methods Thirty-eight bvFTD patients(bvFTD group)and 44 healthy individuals(control group)were retrospectively enrolled.The average time series signals of insular subregions were extracted as seed points based on functional MRI(fMRI)and 18 F-FDG PET,then whole brain functional connectivity map was obtained.Meanwhile,the pons was selected as the reference brain region,and the standard uptake value ratio(SUVR)of insular subregions were calculated.The above parameters were compared between groups,and the correlations of SUVR of insular subregions with clinical cognitive function scale scores in bvFTD group were analyzed.Results Compared with control group,the functional connections between all insular subregions and bilateral frontal lobe,temporal lobe,anterior cingulate gyrus,anterior cingulate gyrus and middle cingulate gyrus,as well as between some subregions and bilateral parietal and occipital lobes were weakened in bvFTD group(GRF correction,voxel level all P<0.001,cluster level all P<0.05).SUVR of all insular subregions significantly decreased(GRF correction,voxel level all P<0.001,cluster level all P<0.05),which in right ventral agranular insula(vIa),dorsal agranular insula(dIa),dorsal dysgranular insula(dId)and left dorsal agranular insula(dIa)were negatively correlated with frontal behavioral inventory(FBI)score in bvFTD group(r=-0.452--0.330,all P<0.05).Conclusion In bvFTD patients,the functional connectivity and glucose metabolism of insular subregions changed,and SUVR of right vIa,dIa,dId and left dIa were negatively correlated with FBI score.

关 键 词：痴呆 大脑皮层 磁共振成像 F18氟脱氧葡萄糖 正电子发射断层显像 功能连接 

分 类 号：R742[医药卫生—神经病学与精神病学] R817.4[医药卫生—临床医学]