CAJ | 학술논문

目的研究静息状态下阿尔茨海默病(Alzheimer's disease,AD)患者丘脑的功能连接模式及其与认知功能的关系.方法对30例AD患者和26名认知功能正常的健康对照者进行静息状态下功能磁共振扫描,比较两组之间丘脑功能连接模式的差异,并分析神经心理评估(MMSE分数、听觉词语学习测试的即刻回忆和延迟回忆等)结果与功能连接强度的关系.结果 AD组的MMSE分数(19.7±4.1),听觉词语学习测试的即刻回忆(2.8±1.7)、延迟回忆(0.7±1.3)成绩(词数)均低于健康对照组(28.8±1.0、5.9±1.2、5.7±2.2),差异有统计学意义(t=11.09、8.09、10.51,均P＜0.05).与健康对照组相比,AD患者左侧丘脑与右侧后/中扣带回、左侧内侧前额叶、右侧额上回/内侧前额叶的功能连接减弱,与左侧颞下回、右侧颞中回、左侧中央后回、左侧小脑后叶、双侧旁中央小叶的功能连接增强；右侧丘脑与右侧额上回/前额叶内侧面、右侧后/中扣带回和右侧海马的功能连接减弱,与左侧额下回、右侧岛叶、左侧中央后回/旁中央小叶、双侧前额叶内侧面以及右侧中央后回的功能连接增强.功能连接强度与神经心理评估成绩存在相关.结论 AD患者丘脑功能连接模式存在异常,增强的功能连接可能是大脑对降低的功能连接的一种代偿反应,这种变化与认知功能相关.
목적 연구정식상태하아이자해묵병(Alzheimer's disease,AD)환자구뇌적공능련접모식급기여인지공능적관계.방법 대30례AD환자화26명인지공능정상적건강대조자진행정식상태하공능자공진소묘,비교량조지간구뇌공능련접모식적차이,병분석신경심리평고(MMSE분수、은각사어학습측시적즉각회억화연지회억등)결과여공능련접강도적관계.결과 AD조적MMSE분수(19.7±4.1),은각사어학습측시적즉각회억(2.8±1.7)、연지회억(0.7±1.3)성적(사수)균저우건강대조조(28.8±1.0、5.9±1.2、5.7±2.2),차이유통계학의의(t=11.09、8.09、10.51,균P＜0.05).여건강대조조상비,AD환자좌측구뇌여우측후/중구대회、좌측내측전액협、우측액상회/내측전액협적공능련접감약,여좌측섭하회、우측섭중회、좌측중앙후회、좌측소뇌후협、쌍측방중앙소협적공능련접증강；우측구뇌여우측액상회/전액협내측면、우측후/중구대회화우측해마적공능련접감약,여좌측액하회、우측도협、좌측중앙후회/방중앙소협、쌍측전액협내측면이급우측중앙후회적공능련접증강.공능련접강도여신경심리평고성적존재상관.결론 AD환자구뇌공능련접모식존재이상,증강적공능련접가능시대뇌대강저적공능련접적일충대상반응,저충변화여인지공능상관.
Objective To study the functional connectivity (FC) pattern of thalamus in patients with Alzheimer' s disease (AD).Methods In the present study,resting state functional magnetic resonance imaging (MRI) data were obtained from 30 patients with AD and 26 subjects with normal cognition (NC).The altered functional connectivity pattern in AD was evaluated by comparing to NC.Then a correlation analysis was performed between the strength of FC of the identified regions and various clinical variables for evaluating the relationships between the strength of FC and the cognitive abilities (MMSE,immediate recall and delayed recall of Auditory Verbal Learning Test) of the AD patients.Results The MMSE(19.7 ± 4.1),immediate recall (2.8 ± 1.7) and delayed recall (0.7 ± 1.3) of Auditory Verbal Learning Test in AD patients were lower than NC group (28.8 ± 1.0,5.9 ± 1.2,5.7 ± 2.2 ; t =11.09,8.09,10.51,all P ＜0.05).Compared to NC,AD patients showed decreased FC between the left thalamus and several regions of brain including right posterior/middle cingulate cortex (PCC/MCC.R),left medial prefrontal cortex (MPFC.L) and right superior frontal gyms/medial prefrontal cortex (SFG/MPFC.R).For the right thalamus,decreased FC was found in SFG/MPFC.R,PCC/MCC.R and right hippocampus.We also found increased FC between the bilateral thalamus and many regions of brain including inferior temporal gyrus,medial temporal gyrus,SFG,postcentral gyrus,paracentral lobule,inferior frontal gyms and insula.Significant correlations between the fitted FC strength and clinical variables were also detected.Conclusions FC pattern of thalamus in AD group is impaired.Increased FC in AD may indicate the presence of a compensatory mechanism.The alteration is related with cognitive function in AD.