中华物理医学与康复杂志
中華物理醫學與康複雜誌
중화물리의학여강복잡지
CHINESE JOURNAL OF PHYSICAL MEDICINE AND REHABILITATION
2014年
7期
517-522
,共6页
姜财%杨珊莉%陶静%黄佳%叶海程%林志诚%陈立典
薑財%楊珊莉%陶靜%黃佳%葉海程%林誌誠%陳立典
강재%양산리%도정%황가%협해정%림지성%진립전
脑卒中%功能磁共振成像%静息态%认知%海马%功能连接
腦卒中%功能磁共振成像%靜息態%認知%海馬%功能連接
뇌졸중%공능자공진성상%정식태%인지%해마%공능련접
Stroke%Functional magnetic resonance imaging%Resting state%Cognition%Hippocampus%Brain connectivity
目的 采用静息态功能性磁共振成像(fMRI)观察缺血性脑卒中认知功能障碍患者海马,尤其是与默认网络系统的功能连接模式的异常情况及其可能的机制.方法 选取缺血性脑卒中后认知功能障碍患者15例为病例组,健康老年人10例为健康对照组.采用静息态fMRI,选择左、右两侧海马作为感兴趣区,分别与全脑做相关分析,获得健康对照组和病例组的脑功能连接激活图,观察其左右海马与全脑的功能连接模式.结果 与健康对照组比较,病例组与海马功能连接减弱脑区主要包括扣带回、额叶(上、中、下回)、顶下小叶、颞上回等,组间差异有统计学意义(P＜0.05);而功能连接增强的脑区主要包括小脑后叶、枕叶、颞叶内侧、楔前叶、距状沟等,组间差异有统计学意(P＜0.05).结论 脑卒中后认知功能障碍患者海马功能连接模式存在异常,相关脑区之间的功能连接减弱可能是引起脑卒中后认知功能减弱的原因之一,而功能连接增强提示脑卒中认知功能障碍患者可能同时存在相应的代偿机制.
目的 採用靜息態功能性磁共振成像(fMRI)觀察缺血性腦卒中認知功能障礙患者海馬,尤其是與默認網絡繫統的功能連接模式的異常情況及其可能的機製.方法 選取缺血性腦卒中後認知功能障礙患者15例為病例組,健康老年人10例為健康對照組.採用靜息態fMRI,選擇左、右兩側海馬作為感興趣區,分彆與全腦做相關分析,穫得健康對照組和病例組的腦功能連接激活圖,觀察其左右海馬與全腦的功能連接模式.結果 與健康對照組比較,病例組與海馬功能連接減弱腦區主要包括釦帶迴、額葉(上、中、下迴)、頂下小葉、顳上迴等,組間差異有統計學意義(P＜0.05);而功能連接增彊的腦區主要包括小腦後葉、枕葉、顳葉內側、楔前葉、距狀溝等,組間差異有統計學意(P＜0.05).結論 腦卒中後認知功能障礙患者海馬功能連接模式存在異常,相關腦區之間的功能連接減弱可能是引起腦卒中後認知功能減弱的原因之一,而功能連接增彊提示腦卒中認知功能障礙患者可能同時存在相應的代償機製.
목적 채용정식태공능성자공진성상(fMRI)관찰결혈성뇌졸중인지공능장애환자해마,우기시여묵인망락계통적공능련접모식적이상정황급기가능적궤제.방법 선취결혈성뇌졸중후인지공능장애환자15례위병례조,건강노년인10례위건강대조조.채용정식태fMRI,선택좌、우량측해마작위감흥취구,분별여전뇌주상관분석,획득건강대조조화병례조적뇌공능련접격활도,관찰기좌우해마여전뇌적공능련접모식.결과 여건강대조조비교,병례조여해마공능련접감약뇌구주요포괄구대회、액협(상、중、하회)、정하소협、섭상회등,조간차이유통계학의의(P＜0.05);이공능련접증강적뇌구주요포괄소뇌후협、침협、섭협내측、설전협、거상구등,조간차이유통계학의(P＜0.05).결론 뇌졸중후인지공능장애환자해마공능련접모식존재이상,상관뇌구지간적공능련접감약가능시인기뇌졸중후인지공능감약적원인지일,이공능련접증강제시뇌졸중인지공능장애환자가능동시존재상응적대상궤제.
Objective To observe the functional connectivity (FC) pattern linking the hippocampus with the rest of the brain in ischemic stroke patients with cognitive dysfunction,especially the default mode network (DMN).Methods Resting-state functional connectivity magnetic resonance imaging (fMRI) was performed on 15 ischemic stroke patients with cognitive dysfunction (the patient group) and 10 normal elderly controls.The bilateral hippocampus was the region of interest.Correlation analyses yielded a mapping of cerebral functional connectivity activation for both groups.Results Compared with the healthy controls,the patient group showed weakened functional connectivity between the hippocampus and other regions including the cingulate gyrus,the superior,middle and inferior frontal lobes,the inferior parietal lobule and the superior temporal gyrus.But there was enhanced functional connectivity with the cerebellar posterior lobe,the occipital lobe,the medial temporal lobe,the precuneus and the calcarine.The results were significantly different between the two groups.Conclusion The functional connectivity pattern of the hippocampus is impaired in stroke patients with cognitive dysfunction.Reduced functional connectivity between brain regions may be one cause of cognitive dysfunction after stroke,and enhanced functional connectivity may be an appropriate compensatory mechanism.
