中华神经科杂志
中華神經科雜誌
중화신경과잡지
Chinese Journal of Neurology
2014年
4期
219-224
,共6页
邓丽霞%阮杏林%黄华品%林海龙%邓艳青%林婉挥
鄧麗霞%阮杏林%黃華品%林海龍%鄧豔青%林婉揮
산려하%원행림%황화품%림해룡%산염청%림완휘
认知障碍%扣带回%磁共振成像%脑血管障碍
認知障礙%釦帶迴%磁共振成像%腦血管障礙
인지장애%구대회%자공진성상%뇌혈관장애
Cognition disorders%Gyrus cinguli%Magnetic resonance imaging%Cerebrovascular disorders
目的 研究静息状态下皮质下缺血性脑血管病后的非痴呆型血管性认知障碍(VCIND)患者前扣带回功能连接的模式特征及其与认知功能的相关关系.方法 对14例VCIND患者和16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,比较两组之间前扣带回功能连接模式的差异,并分析VCIND组的蒙特利尔认知评估(MoCA)量表评分分值与功能连接强度的关系.结果 (1) VCIND组的视空间或执行功能(3.14 ±0.29)、注意力或计算力(3.79 ±0.37)、语言(1.14±0.21)、定向力(4.14±0.53)亚项及MoCA总分(17.29 ±1.53)均低于健康对照组(4.93±0.07、5.93±0.07、2.93 ±0.26、5.93 ±0.07、27.57 ±0.33),差异有统计学意义(t=31.62、32.50、28.51、12.00、39.71,均P＜0.05)；抽象能力或记忆力(4.36±0.74)、命名(2.79±0.11)亚项与对照组(4.79 ±0.80、2.93 ±0.07)差异无统计学意义(t=1.76、1.00,均P＞0.05).(2)VCIND组前扣带回与全脑功能连接低于健康对照组的脑区:左侧颞中回/颞上回、额上回/额中回/额下回、后扣带皮质/楔前叶、顶下小叶/角回,右侧颞中回/颞上回、眶额回/额下回、顶下小叶/角回、额上回/额中回；高于健康对照组的脑区:右小脑后叶、距状裂、左额中回、左中央前回.(3) VCIND组前扣带回的功能连接强度与MoCA分值呈正相关的脑区:左顶下小叶、右侧颞中回、右额上回、左侧颞上回；呈负相关的脑区:右内囊后肢、左楔前叶、左颞中回、右内囊前肢.结论 VCIND患者在静息状态下表现出异常的前扣带回功能连接模式,这种异常改变可能是VCIND的病理基础,对VCIND具有一定的预测价值.
目的 研究靜息狀態下皮質下缺血性腦血管病後的非癡呆型血管性認知障礙(VCIND)患者前釦帶迴功能連接的模式特徵及其與認知功能的相關關繫.方法 對14例VCIND患者和16名認知功能正常的健康對照者進行靜息狀態下功能磁共振掃描,比較兩組之間前釦帶迴功能連接模式的差異,併分析VCIND組的矇特利爾認知評估(MoCA)量錶評分分值與功能連接彊度的關繫.結果 (1) VCIND組的視空間或執行功能(3.14 ±0.29)、註意力或計算力(3.79 ±0.37)、語言(1.14±0.21)、定嚮力(4.14±0.53)亞項及MoCA總分(17.29 ±1.53)均低于健康對照組(4.93±0.07、5.93±0.07、2.93 ±0.26、5.93 ±0.07、27.57 ±0.33),差異有統計學意義(t=31.62、32.50、28.51、12.00、39.71,均P＜0.05)；抽象能力或記憶力(4.36±0.74)、命名(2.79±0.11)亞項與對照組(4.79 ±0.80、2.93 ±0.07)差異無統計學意義(t=1.76、1.00,均P＞0.05).(2)VCIND組前釦帶迴與全腦功能連接低于健康對照組的腦區:左側顳中迴/顳上迴、額上迴/額中迴/額下迴、後釦帶皮質/楔前葉、頂下小葉/角迴,右側顳中迴/顳上迴、眶額迴/額下迴、頂下小葉/角迴、額上迴/額中迴；高于健康對照組的腦區:右小腦後葉、距狀裂、左額中迴、左中央前迴.(3) VCIND組前釦帶迴的功能連接彊度與MoCA分值呈正相關的腦區:左頂下小葉、右側顳中迴、右額上迴、左側顳上迴；呈負相關的腦區:右內囊後肢、左楔前葉、左顳中迴、右內囊前肢.結論 VCIND患者在靜息狀態下錶現齣異常的前釦帶迴功能連接模式,這種異常改變可能是VCIND的病理基礎,對VCIND具有一定的預測價值.
목적 연구정식상태하피질하결혈성뇌혈관병후적비치태형혈관성인지장애(VCIND)환자전구대회공능련접적모식특정급기여인지공능적상관관계.방법 대14례VCIND환자화16명인지공능정상적건강대조자진행정식상태하공능자공진소묘,비교량조지간전구대회공능련접모식적차이,병분석VCIND조적몽특리이인지평고(MoCA)량표평분분치여공능련접강도적관계.결과 (1) VCIND조적시공간혹집행공능(3.14 ±0.29)、주의력혹계산력(3.79 ±0.37)、어언(1.14±0.21)、정향력(4.14±0.53)아항급MoCA총분(17.29 ±1.53)균저우건강대조조(4.93±0.07、5.93±0.07、2.93 ±0.26、5.93 ±0.07、27.57 ±0.33),차이유통계학의의(t=31.62、32.50、28.51、12.00、39.71,균P＜0.05)；추상능력혹기억력(4.36±0.74)、명명(2.79±0.11)아항여대조조(4.79 ±0.80、2.93 ±0.07)차이무통계학의의(t=1.76、1.00,균P＞0.05).(2)VCIND조전구대회여전뇌공능련접저우건강대조조적뇌구:좌측섭중회/섭상회、액상회/액중회/액하회、후구대피질/설전협、정하소협/각회,우측섭중회/섭상회、광액회/액하회、정하소협/각회、액상회/액중회；고우건강대조조적뇌구:우소뇌후협、거상렬、좌액중회、좌중앙전회.(3) VCIND조전구대회적공능련접강도여MoCA분치정정상관적뇌구:좌정하소협、우측섭중회、우액상회、좌측섭상회；정부상관적뇌구:우내낭후지、좌설전협、좌섭중회、우내낭전지.결론 VCIND환자재정식상태하표현출이상적전구대회공능련접모식,저충이상개변가능시VCIND적병리기출,대VCIND구유일정적예측개치.
Objective To study the functional connectivity (FC) pattern of anterior cingulated cortex in patients with vascular cognitive impairment with no dementia (VCIND) after subcortical ischemic vascular disease,and to analyze the relationship between FC and cognitive function.Methods Resting state functional magnetic resonance imaging (MRI) data were acquired from 14 patients with VCIND and 16 healthy volunteers with normal cognition.The altered functional connectivity pattern in VCIND was valuated by comparing to normal control.Then a correlation analysis was performed between the strength of FC and the Montreal Cognitive Assessment (MoCA) scores in patients with VCICD.Results (1) The visual space or executive function (3.14 ± 0.29),attention or computing power (3.79 ± 0.37),language (1.14 ± 0.21),directional power (4.14 ± 0.53) items,and the total points of MoCA (17.29 ± 1.53) in VCIND were significantly lower than that in the normal control group (4.93 ± 0.07,5.93 ± 0.07,2.93 ± 0.26,5.93 ± 0.07,27.57 ± 0.33 ; t =31.62,32.50,28.51,12.00,39.71,all P ＜ 0.05).While the abstract ability or memory (4.36 ± 0.74),the naming (2.79 ± 0.11) items in VCIND were not significantly different with that in the control group (4.79 ± 0.80,2.93 ± 0.07 ; t =1.76,1.00,both P ＞ 0.05).(2) Compared with the control group,the patients showed FC decrease between the anterior cingulated cortex and several brain regions,including the left middle temporal gyrus/left superior temporal gyrus,the left superior frontal gyrus/left middle frontal gyrus/left inferior frontal gyrus,the left posterior cingulated cortex/left precuneus,the left inferior parietal lobule/left angular gyrus,the right middle temporal gyrus/right superior temporal gyrus,the right orbit frontal cortex/right inferior frontal gyrus,the right inferior parietal lobule/right angular gyrums,and the right superior frontal gyrus/right middle frontal gyrus.There were also some regions that showed increased FC,which included the right posterior lobe of the cerebellum,the calcarine fissure,the left middle frontal gyrus,and the left precentral gyrus.(3) In the VCIND patients,the brain regions which positively correlated with the MoCA scores were the left inferior parietal lobule,the right middle temporal gyrus,the right superior frontal gyrus,and the left superior temporal gyrus.The negativerelated brain regions were the right posterior limb of internal capsule,the left middle temporal gyrus,the left precuneus,and the right anterior limb of internal capsule.Conclusions VCIND patients show abnormal FC pattern of anterior cingulated cortex,which could be the pathological basis of VCIND,and have certain predictive value for VCIND.
