基于库欣病探究内源性皮质醇暴露对海马逐步功能连接的影响  

The impact of endogenous cortisol exposure on hippocampal stepwise functional connectivity in Cushing's disease

作　　者：尚国松 张艳阳[1,2] 许军鹏 刘斌 冯哲斌[1,2] 何堃宇 余新光 SHANG Guosong;ZHANG Yanyang;XU Junpeng;LIU Bin;FENG Zhebin;HE Kunyu;YU Xinguang(The First Medical Center,Chinese PLA General Hospital,Beijing 100080,China;Chinese PLA Medical School,Beijing 100080,China)

机构地区：[1]解放军总医院第一医学中心,北京100080 [2]解放军医学院,北京100080

出　　处：《空军军医大学学报》2025年第3期337-343,共7页Journal of Air Force Medical University

基　　金：国家自然科学基金(82001798,81871087);解放军总医院“3+1”青年科技英才培育项目(20230403)。

摘　　要：目的基于库欣病(CD)模型探究内源性皮质醇暴露对海马逐步功能连接(SFC)的影响,并分析其与情绪和认知功能的关联。方法2017年5月至2024年5月期间,于解放军总医院第一医学中心共招募86名CD患者和83名健康对照(HC)。收集所有受试者的人口学数据、神经内分泌指标、神经精神量表评分、生活质量评分,以及T1加权MRI和静息态功能MRI数据。以海马为种子点,采用SFC方法分析两组度中心性(DC)值在脑皮质功能连接层级架构上的差异,并评估其与临床指标的相关性。结果在脑区层面,CD组与HC组的初始化差异(第2步)主要涉及双侧额下回、左侧颞叶、右侧海马旁回及岛叶。随着链接步长的增加(第3~5步),这些异常逐渐扩展至默认模式网络(DMN)和视觉网络相关脑区。在脑网络层面,CD患者的海马与边缘系统网络及DMN的DC值在特定步长下(第2~5步)表现出显著异常,并与情绪状态量表评分呈正相关(P<0.05)。结论本研究揭示了在内源性皮质醇暴露条件下,CD患者海马SFC的存在显著异常,并与情绪功能障碍相关。这为研究与皮质醇暴露关联的神经精神疾病提供了新视角,并为制定可能的干预策略提供了依据。Objective To explore the effects of endogenous cortisol exposure on hippocampal stepwise functional connectivity(SFC),and analyze its associations with emotional and cognitive functions based on a model of Cushing's disease(CD).Methods From May 2017 to May 2024,a total of 86 CD patients and 83 healthy controls(HC)were recruited at the First Medical Center of the Chinese PLA General Hospital.Demographic data,neuroendocrine indicators,neuropsychiatric scale scores,quality of life scores,and T1-weighted MRI and resting-state functional MRI data were collected from all subjects.With hippocampus as the seed point,SFC method was used to analyze the differences of degree centrality(DC)values in functional connectivity architectures of cerebral cortex between the two groups and assess their correlations with clinical indicators.Results At the brain region level,the initial differences between the CD group and the HC group(Step 2)primarily involved the bilateral inferior frontal gyrus,left temporal lobe,right parahippocampal gyrus,and insula.As the step length increased(Steps 35),these abnormalities gradually extended to brain regions associated with the default mode network(DMN)and the visual network.At the brain network level,CD patients exhibited significant abnormalities in the DC values of hippocampus and limbic system network as well as DMN at specific step lengths(Steps 25),which showed a positive correlation with scores on emotional state assessment scales(P<0.05).Conclusion This study reveals that abnormalities in hippocampal SFC in CD patients under endogenous cortisol exposure are associated with emotional dysfunction.This provides new insights into neuropsychiatric disorders related to cortisol exposure and offers a basis for potential intervention strategies.

关 键 词：库欣病 海马 逐步功能连接 皮质醇 

分 类 号：R586[医药卫生—内分泌]