CAJ | 학술논문

目的采用基于感兴趣区的二变量系数为基础的格兰杰因果分析方法对复发缓解型多发性硬化(RRMS)患者默认网络(DMN)的效应连接改变进行研究. 方法选择自2010年6月至2012年12月期间在南昌大学第一附属医院神经内科就诊的RRMS患者24例为RRMS组,同期24例年龄、性别相匹配的健康志愿者为健康对照组,采集2组成员静息态功能磁共振(rs-flMRI)和T1薄层MRI数据.使用rs-fMRI数据处理助手(DPARSFA)进行数据的预处理,以后扣带回为种子点分别构建2组的DMN,选取其6个主要成份为感兴趣区,使用rs-fMRI数据分析工具包(REST)内置的格兰杰因果分析方法计算DMN主要成份间的效应连接,比较效应连接差异并与临床参数如临床扩展残疾量表(EDSS)、同步听觉连续加法测验评分(PASAT)、修订的疲劳影响量表(MFIS)、脑实质分数(BPF)和T2可见病灶体积进行相关性分析. 结果与健康对照组比较,RRMS组双侧顶下叶(IPL)之间的效应连接差异存在统计学意义(t=3.071,P=0.004),同时效应连接方向发生改变;RRMS组左侧IPL和右侧颞中回(MTG)之间的效应连接差异存在统计学意义(t=2.053,P=0.046),同样存在效应连接方向的改变;RRMS组左侧IPL和右侧IPL间、左侧IPL和右侧MTG间的效应连接系数分别与EDSS呈正相关(r=0.410,P=0.045;r=0.470,P=0.020),与PASAT、MFIS、BPF及T2可见病灶体积之间均无显著相关(p＞0.05). 结论患者左侧IPL的信息流出(向右侧IPL、右侧MTG)增加是一种无效功能代偿.
목적 채용기우감흥취구적이변량계수위기출적격란걸인과분석방법대복발완해형다발성경화(RRMS)환자묵인망락(DMN)적효응련접개변진행연구. 방법 선택자2010년6월지2012년12월기간재남창대학제일부속의원신경내과취진적RRMS환자24례위RRMS조,동기24례년령、성별상필배적건강지원자위건강대조조,채집2조성원정식태공능자공진(rs-flMRI)화T1박층MRI수거.사용rs-fMRI수거처리조수(DPARSFA)진행수거적예처리,이후구대회위충자점분별구건2조적DMN,선취기6개주요성빈위감흥취구,사용rs-fMRI수거분석공구포(REST)내치적격란걸인과분석방법계산DMN주요성빈간적효응련접,비교효응련접차이병여림상삼수여림상확전잔질량표(EDSS)、동보은각련속가법측험평분(PASAT)、수정적피로영향량표(MFIS)、뇌실질분수(BPF)화T2가견병조체적진행상관성분석. 결과 여건강대조조비교,RRMS조쌍측정하협(IPL)지간적효응련접차이존재통계학의의(t=3.071,P=0.004),동시효응련접방향발생개변;RRMS조좌측IPL화우측섭중회(MTG)지간적효응련접차이존재통계학의의(t=2.053,P=0.046),동양존재효응련접방향적개변;RRMS조좌측IPL화우측IPL간、좌측IPL화우측MTG간적효응련접계수분별여EDSS정정상관(r=0.410,P=0.045;r=0.470,P=0.020),여PASAT、MFIS、BPF급T2가견병조체적지간균무현저상관(p＞0.05). 결론 환자좌측IPL적신식류출(향우측IPL、우측MTG)증가시일충무효공능대상.
Objective To explore the effective connectivity of default mode network (DMN) in relapsing-remitting multiple sclerosis (RRMS) patients using a resting-state functional MRI (rs-fMRI) Granger causality analysis (GCA).Methods Twenty four patients with RRMS,admitted to our hospital from June 2010 to December 2012,and 24 age-,and gender-matched healthy controls were examined by rs-fMRI and 3D-T1 on Trio 3.0T MRI.The preprocessing and processing rs-fMRI data were analyzed using Data Processing Assistant for rs-fMRI Advanced Edition based on Matlab 2012a; the posterior cingulate cortex (PCC) was selected as the seed,and a seed-based correlation analysis was used to construct the spatial patterns ofDMN; 6 principal components of DMN were selected as regions of interest; GCA method was used to compare the effective connectivity between the two groups.The specific correlations between effective connectivity changes of DMN and clinical parameters,as scores of clinical expanded disability scale (EDSS),synchronous auditory continuous additions test (PASAT) and modified fatigue impact scale (MFIS),brain parenchymal fraction (BPF) and lesion volume seen under T2,were further analyzed.Results As compared with healthy control group,RRMS group exhibited an altered signed-path coefficient and direction between the left and right inferior parietal lobules (IPLs,t=3.071,P=0.004),and the left inferior parietal lobule and the right middle temporal gyrus (MTG,t=2.053,P=0.046).Significant positive-relations were observed between EDSS scores and signed-path coefficient between left and right IPLs (t=0.410,P=0.045) and left IPL and right MTG (t=0.470,P=0.020),respectively.The correlations of altered signed-path coefficient with PASAT scores,BPF,MFIS scores and total white matter lesion loads were not observed (P＞0.05).Conclusions The abnormal effective connectivity between principal components of DMN in RRMS patients is an invalid compensation.This study adds an important observation for understanding the changed mechanism of pathophysiology in patients with RRMS.