中华神经科杂志
中華神經科雜誌
중화신경과잡지
Chinese Journal of Neurology
2013年
9期
586-591
,共6页
周福庆%龚洪翰%庄莹%陈业媛%曾献军%万慧
週福慶%龔洪翰%莊瑩%陳業媛%曾獻軍%萬慧
주복경%공홍한%장형%진업원%증헌군%만혜
多发性硬化,复发缓解型%磁共振成像%神经网%扣带回
多髮性硬化,複髮緩解型%磁共振成像%神經網%釦帶迴
다발성경화,복발완해형%자공진성상%신경망%구대회
Multiple sclerosis,relapsing-remitting%Magnetic resonance imaging%Nerve net%Gyrus cinguli
目的 采用静息态功能磁共振成像(rs-fMRI)基于种子点相关性分析技术对复发缓解型多发性硬化(RRMS)患者默认网络的功能连接改变进行研究.方法 使用3.0T磁共振采集RRMS组和健康对照组(各27例)rs-fMRI数据.数据经预处理后,选择后扣带回(-5,-49,40)为种子点,采用基于种子点相关性分析技术进行功能连接分析,分别在默认网络内和默认网络外脑区比较两组功能连接的差异.分析差异脑区与临床参数如临床扩展残疾量表、同步听觉连续加法测验评分(PASAT)、脑实质分数、T2可见病灶数和病程的相关性.结果 基于种子点相关性分析技术构建的RRMS患者默认网络包含脑区主要有前额叶皮质腹侧、双侧顶下叶、后扣带回及楔前叶等脑区.在默认网络内比较,RRMS患者较健康对照组右侧额上回功能连接下降；右侧小脑后叶、右侧小脑脚、右侧颞中回、右侧额中回、左侧楔前叶及扣带回、右侧角回、右侧扣带回功能连接增高.RRMS患者组默认网络内差异脑区中,右侧颞中回功能连接系数(0.387±0.216)与PASAT呈负相关(r=-0.590,P =0.001);患者右侧额上回功能连接系数(0.039±0.293)与病程之间呈负相关(r=-0.390,P=0.041).在默认网络外比较,RRMS组后扣带回功能连接下降脑区有右侧额上回、左侧枕中回、左侧中央前回；功能连接增高脑区有右侧小脑前叶(含齿状核)、右侧额叶白质区.RRMS组后扣带回与左侧中央前回、右侧小脑前叶功能连接系数(-0.924±0.253和0.217±0.208)分别与病程之间存在正相关(r =0.650,P=0.000;r =0.436,P=0.023).结论 RRMS患者默认网络内和默认网络外均出现后扣带回静息态功能连接的异常改变,表明患者存在功能下降和代偿的复杂过程.RRMS患者存在有限功能重构或重组,以维持默认网络的功能稳定.
目的 採用靜息態功能磁共振成像(rs-fMRI)基于種子點相關性分析技術對複髮緩解型多髮性硬化(RRMS)患者默認網絡的功能連接改變進行研究.方法 使用3.0T磁共振採集RRMS組和健康對照組(各27例)rs-fMRI數據.數據經預處理後,選擇後釦帶迴(-5,-49,40)為種子點,採用基于種子點相關性分析技術進行功能連接分析,分彆在默認網絡內和默認網絡外腦區比較兩組功能連接的差異.分析差異腦區與臨床參數如臨床擴展殘疾量錶、同步聽覺連續加法測驗評分(PASAT)、腦實質分數、T2可見病竈數和病程的相關性.結果 基于種子點相關性分析技術構建的RRMS患者默認網絡包含腦區主要有前額葉皮質腹側、雙側頂下葉、後釦帶迴及楔前葉等腦區.在默認網絡內比較,RRMS患者較健康對照組右側額上迴功能連接下降；右側小腦後葉、右側小腦腳、右側顳中迴、右側額中迴、左側楔前葉及釦帶迴、右側角迴、右側釦帶迴功能連接增高.RRMS患者組默認網絡內差異腦區中,右側顳中迴功能連接繫數(0.387±0.216)與PASAT呈負相關(r=-0.590,P =0.001);患者右側額上迴功能連接繫數(0.039±0.293)與病程之間呈負相關(r=-0.390,P=0.041).在默認網絡外比較,RRMS組後釦帶迴功能連接下降腦區有右側額上迴、左側枕中迴、左側中央前迴；功能連接增高腦區有右側小腦前葉(含齒狀覈)、右側額葉白質區.RRMS組後釦帶迴與左側中央前迴、右側小腦前葉功能連接繫數(-0.924±0.253和0.217±0.208)分彆與病程之間存在正相關(r =0.650,P=0.000;r =0.436,P=0.023).結論 RRMS患者默認網絡內和默認網絡外均齣現後釦帶迴靜息態功能連接的異常改變,錶明患者存在功能下降和代償的複雜過程.RRMS患者存在有限功能重構或重組,以維持默認網絡的功能穩定.
목적 채용정식태공능자공진성상(rs-fMRI)기우충자점상관성분석기술대복발완해형다발성경화(RRMS)환자묵인망락적공능련접개변진행연구.방법 사용3.0T자공진채집RRMS조화건강대조조(각27례)rs-fMRI수거.수거경예처리후,선택후구대회(-5,-49,40)위충자점,채용기우충자점상관성분석기술진행공능련접분석,분별재묵인망락내화묵인망락외뇌구비교량조공능련접적차이.분석차이뇌구여림상삼수여림상확전잔질량표、동보은각련속가법측험평분(PASAT)、뇌실질분수、T2가견병조수화병정적상관성.결과 기우충자점상관성분석기술구건적RRMS환자묵인망락포함뇌구주요유전액협피질복측、쌍측정하협、후구대회급설전협등뇌구.재묵인망락내비교,RRMS환자교건강대조조우측액상회공능련접하강；우측소뇌후협、우측소뇌각、우측섭중회、우측액중회、좌측설전협급구대회、우측각회、우측구대회공능련접증고.RRMS환자조묵인망락내차이뇌구중,우측섭중회공능련접계수(0.387±0.216)여PASAT정부상관(r=-0.590,P =0.001);환자우측액상회공능련접계수(0.039±0.293)여병정지간정부상관(r=-0.390,P=0.041).재묵인망락외비교,RRMS조후구대회공능련접하강뇌구유우측액상회、좌측침중회、좌측중앙전회；공능련접증고뇌구유우측소뇌전협(함치상핵)、우측액협백질구.RRMS조후구대회여좌측중앙전회、우측소뇌전협공능련접계수(-0.924±0.253화0.217±0.208)분별여병정지간존재정상관(r =0.650,P=0.000;r =0.436,P=0.023).결론 RRMS환자묵인망락내화묵인망락외균출현후구대회정식태공능련접적이상개변,표명환자존재공능하강화대상적복잡과정.RRMS환자존재유한공능중구혹중조,이유지묵인망락적공능은정.
Objective To examine brain regions with a functional connection to posterior cingulate cortex (PCC) in a relapsing-remitting multiple sclerosis (RRMS) group compared with matched control subjects,and to employ resting-state functional MRI (rs-fMRI) to PCC connectivity gathered by investigating synchronic low frequency fMRI signal fluctuations of default mode network with seed-based correlation analysis (SCA).Methods Twenty-seven patients with RRMS (RRMS group) and 27 age-,and sexmatched healthy controls (HC group) were examined by resting-state fMRI,DTI and 3D-T1 on Siemens Trio Tim 3.0T.The fMRI data preprocessing and processing was performed using Data Processing Assistant for Resting-State fMRI Advanced Edition (DPARSFA) based on Matlab 2012a,and PCC (-5,-49,40)was selected as seed.An SCA approach was used to analyze the rs-fMRI data.We examined the differences in SCA-derived connectivity metrics in patients with RRMS and healthy controls,and analyzed correlations between connectivity correlation coefficient of the differences regions and MRI-derived metrics (brain parenchymal fraction,T2 lesion load),as well as clinical metrics (expanded disability status scale,paced auditory serial addition test,and disease duration) of the disease.Results The SCA via functional connectivity of PCC showed that the temporal correlation between the blood-oxygen-level-dependent signals of the default mode network was reliable spatial patterns of activation in patients with RRMS.The lower connectivity in right superior frontal gyrus within default mode network,and higher connectivity in right posterior lobe of cerebellum,right crus of cerebellum,right medial frontal gyrus,right medial occipital gyrus,left precuneus/cingulate gyrus,right angular gyrus and right cingulate gyrus were found in our study.Significant negative-related was observed between the paced auditory serial addition test and functional connectivity in right middle temporal gyrus (0.387 ± 0.216) of RRMS patients (r =-0.59,P =0.001).Significant negative correlation also was observed between the course of disease and functional connectivity in right superior frontal gyrus (0.039 ± 0.293) in patients (r =-0.39,P =0.041).There was no significant correlations between other regions with different functional connectivity and expanded disability status scale,disease duration,or brain atrophy.The connectivity in right superior frontal gyrus,left medial occipital gyrus,left precentral gyrus was decreased; and connectivity in right cerebellum anterior lobe (dentate),right frontal lobe white matter was significantly increased.Significant positive correlation was observed between the course of disease and functional connectivity in left precentral gyrus (-0.924 ± 0.253),right cerebellum anterior lobe (dentate ;0.217 ± 0.208) of RRMS patients (r =0.650,P =0.000;r =0.436,P =0.023),respectively.Conclusion These findings reveal the compensatory mechanism of the brain in response to structural damage,by means of increased activation or synchronization of default mode network,which seems to be finite.
