CAJ | 학술논문

目的探讨低级别胶质瘤患者(LGG)认知功能及手术前、后脑结构功能网络的改变情况.方法对8例拟诊为额叶LGG患者于手术前、后分别进行静息态脑功能(resting-state fMRI)数据采集.术前及术后运用中文版蒙特利尔认知评估量表(MoCA)进行评估,并与8名正常志愿者对照研究.结果病例组术前、术后认知评分平均值分别为(22.5±1.5)分和(21.8±2)分,对照组(27.9±2.1)分,患者组评分低于对照组,差异有统计学意义(P＜0.05).以0.05≤Kcost≤0.35为网络阈值,术前、术后患者脑网络均符合小世界特性,局域效应Elocal对照组大于术前、术后LGG组,全局效应Eglobal术前、术后LGG组都高于对照组,当术后小世界属性(σ=2.49)低于术前(σ=2.68),术前信息传输最大的脑功能区分别为后扣带回,缘上回,岛叶；术后则分别为楔前叶、距状沟和额上回.术前脑功能网络最大簇系数分别为嗅皮质、颞横回和距状沟；术后分别为豆状核、颞横回和枕上回.术前信息传输的平均路径小于术后,且小世界属性参数与中文版蒙特利尔认知评估呈正相关.结论 LGG伴有认知功能改变,手术前、后均符合具有小世界网络属性.
목적 탐토저급별효질류환자(LGG)인지공능급수술전、후뇌결구공능망락적개변정황.방법 대8례의진위액협LGG환자우수술전、후분별진행정식태뇌공능(resting-state fMRI)수거채집.술전급술후운용중문판몽특리이인지평고량표(MoCA)진행평고,병여8명정상지원자대조연구.결과 병례조술전、술후인지평분평균치분별위(22.5±1.5)분화(21.8±2)분,대조조(27.9±2.1)분,환자조평분저우대조조,차이유통계학의의(P＜0.05).이0.05≤Kcost≤0.35위망락역치,술전、술후환자뇌망락균부합소세계특성,국역효응Elocal대조조대우술전、술후LGG조,전국효응Eglobal술전、술후LGG조도고우대조조,당술후소세계속성(σ=2.49)저우술전(σ=2.68),술전신식전수최대적뇌공능구분별위후구대회,연상회,도협；술후칙분별위설전협、거상구화액상회.술전뇌공능망락최대족계수분별위후피질、섭횡회화거상구；술후분별위두상핵、섭횡회화침상회.술전신식전수적평균로경소우술후,차소세계속성삼수여중문판몽특리이인지평고정정상관.결론 LGG반유인지공능개변,수술전、후균부합구유소세계망락속성.
Objective To explore the property of brain functional networks and cognitive function changes in patients with frontal lobe low-grade gliomas (LGG).Methods 8 cases of suspected frontal lobe LGG patients were undergone with resting-fMRI scanning to analyze the small-world property of the LGG,meanwhile the LGG groups had Montreal (MoCA) cognitive score exam compared with the control group.Results The value of MoCA was 22.5 ± 1.5,21.8 ± 2.0,and 27.9 ± 2.1 respectively with statistical significance (P ＜ 0.05) in the LGG groups and the control groups.The LGG group cognitive score was significantly lower than that in the control group with statistical significance (P＜ 0.05).As to threshold,the two groups were consistent with the small world property.The LGG local efficiency was smaller than that of the controls,the postoperative small world properties (σ=2.49) were lower than that the pre-operative (σ =2.68),the largest brain function areas of preoperative information transmission were respectively the supramarginal gyrus,posterior cingulate,insula,and the postoperative being the precuneus,calcarine sulcus and superior frontal gyrus.The maximum cluster coefficient of the preoperative functional network were respectively the entorhinal cortex,transverse temporal gyrus and the calcarine sulcus,and postoperative were Wilson,transverse temporal gyri and occipital gyrus.Preoperative information transmission path was less than the postoperative,and the small world properties were positively correlated with MoCA.Conclusion LGG accompany by the changes of cognitive function,and with the small world network property preand post-operation.