老年间质性膀胱炎/膀胱疼痛综合征患者的静息态功能磁共振成像探究  

Differences in Functional Brain Regions in Elderly Patients with Interstitial Cystitis/Painful Bladder Syndrome:A Resting-State Functional Magnetic Resonance Imaging Study

作　　者：闫泽浩 王继鹏 王笑男 孟令峰[2] 张炯 敬吉波 王新昊 张耀光 Yan Zehao;Wang Jipeng;Wang Xiaonan;Meng Lingfeng;Zhang Jiong;Jing Jibo;Wang Xinhao;Zhang Yaoguang(Peking University Fifth School of Clinical Medicine,Beijing 100730,China;Department of Urology,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China;Chinese Academy of Medicine Sciences and Peking Union Medical College,Beijing 100730,China;Department of Radiology,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]北京大学第五临床医学院,北京100730 [2]北京医院泌尿外科、国家老年医学中心中国医学科学院老年医学研究院,北京100730 [3]中国医学科学院北京协和医学院研究生院,北京100730 [4]北京医院放射科、国家老年医学中心、中国医学科学院老年医学研究院,北京100730

出　　处：《中华老年医学杂志》2025年第4期435-441,共7页Chinese Journal of Geriatrics

基　　金：中国医学科学院中央级公益科研院所基本科研业务专项资金(2023-JKCS-21);中央高水平医院临床科研业务费资助(BJ-2023-079);临床试验注册:ChiCTR2400080138。

摘　　要：目的探究老年间质性膀胱炎/膀胱疼痛综合征(interstitial cystitis/bladder pain syndrome,IC/BPS)患者静息状态下大脑功能改变。方法本研究前瞻性纳入自2023年12月至2024年5月就诊于北京医院泌尿外科的7例老年IC/BPS患者作为试验组,同期选取12例老年健康受试者作为对照组。各受试者入组后进行静息态功能磁共振成像(resting-state functional magnetic resonance imaging,rs-fMRI)检查。收集年龄、性别等一般临床资料,以及间质性膀胱炎症状指数(interstitial cystitis symptom index,ICSI)、间质性膀胱炎问题指数(interstitial cystitis problem index,ICPI)、可视疼痛评分(visual analogue scale,VAS)、焦虑自评量表(self-rating anxiety scale,SAS)和抑郁自评量表(self-rating depression scale,SDS)的标准化评估分数。使用Matlab软件对图像进行处理。采用双样本t检验的方法分析对比两组受试者的大脑灰质体积。采用局部一致性(regional homogeneity,ReHo)和低频振幅(amplitude of low-frequency fluctuation,ALFF)算法对受试者的大脑功能性活动进行分析。基于所得的异常脑区作为种子点,进一步采用功能连接算法(functional connectivity,FC)分析其功能脑区之间的连接模式。结果试验组与对照组的年龄(t=-0.68,P=0.536)与性别(χ^(2)=0.019,P=0.891)差异无统计学意义。实验组的SAS、SDS评分均显著高于对照组(P<0.001)。两组受试者的大脑灰质体积无显著差异。与对照组相比,老年IC/BPS患者的左侧顶上回(MNI:x,y,z=-21,-66,60;t=12.5305)的ALFF值升高,左侧楔前叶(MNI:x,y,z=-9,-54,63;t=9.4103)的ReHo值升高。FC分析发现老年IC/BPS患者相较于对照组,其左侧顶上回与中央沟盖(MNI:x,y,z=21,15,3;t=-27.8356)、左侧楔前叶与左后扣带回(MNI:x,y,z=-12,0,42;t=-8.7389)之间FC值显著降低。结论相较于健康老年人群,老年IC/BPS患者存在左侧顶上回与左侧楔前叶的功能异常,并且左侧顶上回与中央沟盖、左侧楔前叶�Objective To investigate alterations in brain function among elderly patients with interstitial cystitis/bladder pain syndrome(IC/BPS)during the resting state.Methods We prospectively recruited seven elderly patients with IC/BPS admitted to the Urology Department of Beijing Hospital from December 2023 to May 2024 as the experimental group,and concurrently selected twelve elderly healthy individuals as the control group.After enrollment,all participants underwent resting-state functional magnetic resonance imaging(rs-fMRI)scans.General clinical data,including age and gender,as well as standardized assessment scores from the Interstitial Cystitis Symptom Index(ICSI),Interstitial Cystitis Problem Index(ICPI),Visual Analogue Scale(VAS),Self-Rating Anxiety Scale(SAS),and Self-Rating Depression Scale(SDS),were collected.The data were processed using Matlab.This study employed a paired sample t-test to analyze the differences in gray matter volume between the two groups.The functional activities of the subjects'brains were analyzed using regional homogeneity(ReHo)and low-frequency amplitude(ALFF)algorithms.Based on the identified abnormal brain regions,further functional connectivity(FC)analysis was conducted to explore the connectivity patterns among the functional brain regions.Results No significant differences were observed in age(t=-0.68,P=0.536)or gender(χ^(2)=0.019,P=0.891)between the experimental group and the control group.The scores of SAS and SDS in the experimental group were significantly higher than those in the control group(P<0.001).No significant difference was observed in cerebral gray matter volume between the two subject groups.In contrast to the control group,the ALFF value of the left superior parietal lobe(MNI:x,y,z=-21,-66,60;t=12.5305)was elevated in elderly patients with IC/BPS,and the ReHo value of the left precuneus(MNI:x,y,z=-9,-54,63;t=9.4103)was also increased.Through FC analysis,it was revealed that elderly IC/BPS patients exhibited significantly lower FC values between the left superior

关 键 词：膀胱炎 间质性 磁共振成像 功能神经成像 低频振幅 功能连接 

分 类 号：R694[医药卫生—泌尿科学]