库欣病患者大脑皮层结构相关指标变化研究  

Study on the changes of cortical structure related indicators in patients with Cushing's disease

作　　者：何堃宇 周涛[2] 许军鹏 尚国松 王鹏[2] 余新光[2] 张剑宁 张艳阳[2] HE Kunyu;ZHOU Tao;XU Junpeng;SHANG Guosong;WANG Peng;YU Xinguang;ZHANG Jianning;ZHANG Yanyang(Department of Neurosurgery,Xiong'an Xuanwu Hospital,Xiong'an 070001,China;Department of Neurosurgery,The First Medical Center,Chinese PLA General Hospital,Beijing 100036,China)

机构地区：[1]雄安宣武医院神经外科,河北雄安070001 [2]解放军总医院第一医学中心神经外科医学部,北京100036

出　　处：《空军军医大学学报》2025年第3期324-329,共6页Journal of Air Force Medical University

基　　金：国家自然科学基金(82001798);解放军总医院“3+1”青年科技英才培育项目(20230403)。

摘　　要：目的探索库欣病(CD)患者脑皮层结构相关指标变化,阐明皮层厚度(CT)与表面积(SA)对患者大脑皮层灰质体积丢失的具体贡献。方法纳入解放军总医院第一医学中心30名CD患者为CD组,30名年龄、性别、教育匹配的人员为健康对照组(HC组),在患者术前采集颅脑结构磁共振图像,以进行脑结构分析、寻找脑结构改变的核心指标。结果在基线无差异的条件下,CD组患者灰质总体积显著丢失(P<0.01),总皮层SA(P<0.05)和平均CT均有显著差异(P<0.01),但CT标准化效应大小更高(Cohen's d=1.427)。基于顶点的分析证明,两组受试者在SA无显著差异,仅在团块水平分析发现了少数几个SA减小的区域;相比HC组,CD组患者灰质体积和CT显示出广泛的减少,而且分布较为相似,主要在额内侧回、额上回、颞上回及扣带回等处。结论CD组患者脑灰质体积的变化来自于CT,而非SA;相较HC组,CD组患者的CT显示出广泛的变薄。Objective To investigate the changes of cortical structure related indicators in patients with Cushing's disease(CD),and to elucidate the specific contributions of cortical thickness(CT)and surface area(SA)to gray matter volume loss in patients.Methods Thirty patients with CD were included in the First Medical Center of Chinese PLA General Hospital as the CD group,and 30 age-,sex-,and education-matched healthy controls were included as the healthy control group(HC group).Preoperative cranial magnetic resonance images were collected for brain structural analysis and searching for core indicators of brain structural alterations.Results Under the condition of no difference at baseline,patients in the CD group showed significant loss of total gray matter volume(P<0.01)and significant differences in total cortical SA(P<0.05)and mean CT(P<0.01),but the normalized effect size of CT was higher(Cohen's d=1.427).Vertex-based analysis demonstrated no significant differences between the two groups of subjects in SA,with only a few areas of reduced SA identified by cluster-level analysis,whereas patients in the CD group showed extensive reductions in gray matter volume and CT compared to the HC group,with a more similar distribution,mainly in the medial frontal gyrus,superior frontal gyrus,superior temporal gyrus,and cingulate gyrus.Conclusion Changes in brain gray matter volume in patients in the CD group arise from CT,not SA.CT in patients in the CD group shows extensive thinning compared to that in the HC group.

关 键 词：库欣病 皮质醇 脑灰质 大脑皮层厚度 脑皮层变薄 

分 类 号：R586[医药卫生—内分泌]