CAJ | 학술논문

目的采用静息态功能磁共振(fMRI)技术,探讨轻度阿尔茨海默病(AD)患者的脑默认活动网络(DMN)是否存在异常及其可能的神经机制. 方法以复旦大学附属华山医院和同济大学附属同济医院神经内科门诊自2009年1月至2010年6月收治的24名轻度AD患者和同期上海社区中整群抽样选择的25名正常老年人为研究对象,对其进行简易智能状态(MMSE)、Mattis痴呆评定量表(DRS)检查和静息态脑功能成像.利用低频振幅(ALFF)算法对全脑静息态数据进行对比分析,观察AD患者相对于正常老年人ALFF有显著差异的区域. 结果行为学结果显示:轻度AD患者相对对照组成员记忆功能存在明显损害.静息态fMRI结果显示:与对照组比较,AD患者中与记忆密切相关的后扣带回、前额叶中内侧腹侧、前额叶中内侧背侧等脑区ALFF明显减弱. 结论 AD患者静息态脑DMN中与记忆密切相关的脑区节点活动强度减弱,DMN异常在其早期记忆损害的病理机制中起着非常重要的作用.
목적 채용정식태공능자공진(fMRI)기술,탐토경도아이자해묵병(AD)환자적뇌묵인활동망락(DMN)시부존재이상급기가능적신경궤제. 방법 이복단대학부속화산의원화동제대학부속동제의원신경내과문진자2009년1월지2010년6월수치적24명경도AD환자화동기상해사구중정군추양선택적25명정상노년인위연구대상,대기진행간역지능상태(MMSE)、Mattis치태평정량표(DRS)검사화정식태뇌공능성상.이용저빈진폭(ALFF)산법대전뇌정식태수거진행대비분석,관찰AD환자상대우정상노년인ALFF유현저차이적구역. 결과 행위학결과현시:경도AD환자상대대조조성원기억공능존재명현손해.정식태fMRI결과현시:여대조조비교,AD환자중여기억밀절상관적후구대회、전액협중내측복측、전액협중내측배측등뇌구ALFF명현감약. 결론 AD환자정식태뇌DMN중여기억밀절상관적뇌구절점활동강도감약,DMN이상재기조기기억손해적병리궤제중기착비상중요적작용.
Objective To explore the activity of brain default mode network (DMN) in patients with mild Alzheimer's disease (AD) by resting state functional magnetic resonance imaging (fMRI) and investigate its possible neural mechanism. Methods Twenty-four patients with mild AD,admitted to our hospital from January 2009 to June 2010,and 25 normal controls (NCs) were chosen in this study.All subjects were examined by Mini Mental State Examination (MMSE), Mattis Dementia Rating Scale (DRS) and fMRI.Resting-state whole brain data were analyzed by amplitude of low frequency fluctuation (ALFF) with two-sample t test and the brain regions in mild AD patients having significantly different ALFF comparing to NCs were observed. Results As compared with that in NCs,the memory function in mild AD patients was seriously impaired (P＜0.05).As compared with NCs,mild AD patients showed significantly decreased ALFF in the posterior cingulate cortex,ventral medial prefrontal cortex and dorsal medial prefrontal cortex, which were closely relevant to the memory (P＜0.05). Conclusion AD patients show significantly decreased active intensity of some DMN nodes that relate to memory in resting state; DMN abnormalities play an important role in early memory impairment of AD patients.