CAJ | 학술논문

目的观察阿尔茨海默病(AD)及轻度认知障碍(MCI)患者情景记忆(EM)编码和提取成绩与静息态脑功能连接网络变化的关系.方法选取2009年1月至2012年7月来自青岛市环秀社区及青岛大学医学院附属医院特需保健科病房及门诊的患者以及健康查体中心的正常人,分为AD组16例、MCI组24例、正常对照组(NC)24名,应用GE3.0T磁共振采集三组静息态fMRI脑血氧水平依赖信号.其后行EM编码、提取测试,并两组间比较行双样本t检验,EM与功能连接行相关分析.结果 AD组、MCI组与NC组比较,与后扣带回(PCC)连接减弱的脑区主要有:双侧颞叶外侧面、前额叶及内侧面,右侧脑岛;升高的脑区主要有:小脑后叶.AD组较MCI组与PCC连接减弱的脑区:前额叶及内侧面,双侧脑岛,右侧颞下回,右侧梭状回;升高的脑区:小脑后叶,右侧枕叶,左侧顶上小叶;MCI组较NC组与PCC连接减弱的脑区:左侧舌回,左侧额叶,右侧颞中回,胼胝体;升高的脑区:小脑后叶.EM编码正确率(％)三组之间(AD组:34 ±20,MCI组:47±17,NC组:69±15)差异均有统计学意义(均P ＜0.05);提取正确率(％)三组之间(AD组:31±18,MCI组:57±22,NC组:81±16),差异均有统计学意义(均P＜0.05).脑功能连接与EM编码显著正相关的脑区:AD组左侧三角部眶部额下回(r =0.642 98),左侧楔叶(r=0.642 98),左侧尾状核(r=0.642 68,均P＜0.005).其余差异均无统计学意义.结论 AD、MCI患者静息脑功能连接网络存在显著差异,AD患者EM编码、提取成绩呈显著性进行性下降;AD患者EM编码成绩下降与其静息脑功能连接网络中部分脑区的连接下降呈正相关.
목적 관찰아이자해묵병(AD)급경도인지장애(MCI)환자정경기억(EM)편마화제취성적여정식태뇌공능련접망락변화적관계.방법 선취2009년1월지2012년7월래자청도시배수사구급청도대학의학원부속의원특수보건과병방급문진적환자이급건강사체중심적정상인,분위AD조16례、MCI조24례、정상대조조(NC)24명,응용GE3.0T자공진채집삼조정식태fMRI뇌혈양수평의뢰신호.기후행EM편마、제취측시,병량조간비교행쌍양본t검험,EM여공능련접행상관분석.결과 AD조、MCI조여NC조비교,여후구대회(PCC)련접감약적뇌구주요유:쌍측섭협외측면、전액협급내측면,우측뇌도;승고적뇌구주요유:소뇌후협.AD조교MCI조여PCC련접감약적뇌구:전액협급내측면,쌍측뇌도,우측섭하회,우측사상회;승고적뇌구:소뇌후협,우측침협,좌측정상소협;MCI조교NC조여PCC련접감약적뇌구:좌측설회,좌측액협,우측섭중회,변지체;승고적뇌구:소뇌후협.EM편마정학솔(％)삼조지간(AD조:34 ±20,MCI조:47±17,NC조:69±15)차이균유통계학의의(균P ＜0.05);제취정학솔(％)삼조지간(AD조:31±18,MCI조:57±22,NC조:81±16),차이균유통계학의의(균P＜0.05).뇌공능련접여EM편마현저정상관적뇌구:AD조좌측삼각부광부액하회(r =0.642 98),좌측설협(r=0.642 98),좌측미상핵(r=0.642 68,균P＜0.005).기여차이균무통계학의의.결론 AD、MCI환자정식뇌공능련접망락존재현저차이,AD환자EM편마、제취성적정현저성진행성하강;AD환자EM편마성적하강여기정식뇌공능련접망락중부분뇌구적련접하강정정상관.
Objective To explore the relationship between the scores of episodic memory (EM)encoding and retrieving and the resting-state changes of brain functional connectivity (FC) network of Alzheimer's disease (AD)and mild cognition impairment (MCI)patients.Methods All subjects were recruited from special care clinic and ward and health physical examination center,Qingdao Huanxiu Community and Affiliated Hospital,Medical College of Qingdao university from January 2009 to July 2012.They were divided into AD group (n =16),MCI group (n =24) and normal control (NC) group (n =24).The resting-state fMRI scans were performed with GE3.0T to acquire the blood oxygenation level dependent signals for EM encoding and retrieving.The two-sample t test was conducted between the groups and linear correlation analysis performed between EM and FC.Results Compared to the NC group,the AD and MCI groups exhibited decreased FC to posterior cingulated cortex (PCC) mainly in bilateral lateral temporal lobe,medial prefrontal cortex and right insula.Increased regions existed in posterior cerebellar lobe.Compared with the MCI group,the AD group showed decreased FC to PCC in medial prefrontal cortex,bilateral insulas,right inferior temporal gyrus and right fusiform gyrus.And increased regions lied in posterior cerebellar lobe,right occipital lobe and left superior parietal lobule.Compared with the NC group,the MCI group exhibited decreased FC to PCC in left lingualis gyms,left frontal lobe,right middle temporal gyms and corpus callosum.And increased regions lied in posterior cerebellar lobe.EM encoding scores (％) (ADgroup 34 ±20,MCI group 47 ± 17,NC group 69 ± 15) were significantly different among three groups (P ＜0.05).And retrieving scores (％)(AD group 31 ± 18,MCI group 57 ± 22,NC group 81 ± 16) were significantly different among three groups (P ＜ 0.05).Altered functional connectivity regions of left triangle orbital-inferior frontal gyrus (r =0.642 98),left cuneus (r =0.642 98) and left caudate nucleus (r =0.642 68) showed positive correlations with the EM encoding scores in AD group (all P ＜ 0.005).Other groups were not statistically significant.Conclusion The resting-state FC networks of AD and MCI groups show significant differences.The MCI and AD patients have progressively decreased scores of episodic memory encoding and retrieving.And the declines of episodic memory encoding and partial regions of restingstate FC network are positively correlated in the AD group.