基于fMRI分析技术的额叶肿瘤患者认知功能损伤分析

发布时间：2018-03-20 15:12

本文选题：静息态功能磁共振　切入点：额叶肿瘤　出处：《南京航空航天大学》2017年硕士论文　论文类型：学位论文

【摘要】：额叶肿瘤是颅内常见肿瘤,大多会导致认知损伤,并且神经性功能缺失很早就出现。但在早期,多无明显的临床症状和显著的功能障碍,给早期诊断带来较大的困难。近年来,随着认知神经心理学的发展,对额叶的神经生理功能及额叶病变引起的症状有了进一步的认识,但仍缺乏更深入的全面了解,特别是对于早期额叶患者的认知损伤和局部功能区改变的研究。基于血氧水平依赖的功能磁共振成像(Blood oxygenation level-dependent functional MRI,BOLD-fMRI)技术具有无创、高时空分辨率、可重复性好等特点,已成为脑科学和生命科学研究的重要工具。而静息状态下不需要实验设计和刺激,也不需要被试做出反应,更容易被神经疾病患者接受,已被广泛用于大脑神经性病变的研究中。本文基于静息态功能磁共振技术,分别从大脑功能分化和功能整合两个方面分析额叶肿瘤患者大脑功能的异常改变,并分析额叶占位肿瘤并结合临床认知测试结果,寻找患者认知损伤的可能存在因素,分析患者认知损伤的病理生理机制,揭示对额叶肿瘤患者产生认知功能代偿的脑区。论文主要研究内容如下:1.将低频振荡振幅和功能连接应用到额叶肿瘤患者的认知障碍研究,从神经元的自发活性方面和脑功能连接的角度分析患者脑认知的变化情况,得到患者较正常人认知差异脑区并利用GCA分析差异脑区的信息交互的变化。结果显示:与正常被试相比,额叶肿瘤患者在神经元的自发活性和功能连接均存在显著异常,主要表现在空间注意功能区和听觉言语功能区。分析结果表明,颞叶和岛叶所在的听觉言语功能区受到额叶肿瘤的影响,但在颞叶内部非受损区域有功能重组的现象。2.利用临床上的认知测试评估,将患者分为认知正常组和认知异常组,分别利用ALFF和FCD方法进行分析,从神经元自身活性和大脑功能连接两方面对患者临床认知表现进行分析,讨论临床认知障碍原因。结果显示:两组的差异脑区主要表现在视觉空间功能区和空间注意功能区。分析结果认为,可能是视觉处理或者说是视觉记忆功能区的变化,进而导致认知障碍。本文创新性地结合GCA分析方法,分析额叶肿瘤患者功能分化和功能整合的差异脑区的信息交互的变化,从有向网络方面分析患者的认知损伤机制;并结合临床的认知测试评估,探寻额叶肿瘤患者可能存在的大脑代偿机制。
[Abstract]:Frontal lobe tumors are common intracranial tumors, most of which lead to cognitive impairment, and neurologic dysfunction occurs early. However, in the early stage, there are no obvious clinical symptoms and significant functional disorders, which brings great difficulties in early diagnosis. With the development of cognitive neuropsychology, the neurophysiological function of the frontal lobe and the symptoms caused by the lesion of the frontal lobe have been further understood, but there is still a lack of a more thorough and comprehensive understanding. In particular, the study of cognitive impairment and local functional area changes in early frontal lobe patients. Based on blood oxygen level dependent functional magnetic resonance imaging (fMRI), blood oxygenation level-dependent functional MRII-BOLD-fMRI has the characteristics of noninvasive, high spatial and temporal resolution, and good reproducibility. It has become an important tool in brain science and life sciences. At rest, there is no need for experimental design and stimulation, or for subjects to react, and they are more easily accepted by patients with neurological diseases. It has been widely used in the study of cerebral neuropathy. Based on resting functional magnetic resonance imaging (fMRI), the abnormal changes of brain function in patients with frontal lobe tumors were analyzed from the two aspects of functional differentiation and functional integration. The possible factors of cognitive impairment and the pathophysiological mechanism of cognitive impairment were analyzed. The main contents of this paper are as follows: 1. The low frequency oscillation amplitude and functional connection were applied to the study of cognitive impairment in patients with frontal lobe tumor. From the aspect of neuron spontaneous activity and the angle of brain functional connection, we analyze the changes of patients' brain cognition. The results showed that there were significant abnormalities in the spontaneous activity and functional connection of neurons in patients with frontal lobe tumor compared with normal subjects. The results showed that the auditory and verbal regions of temporal lobe and island lobe were affected by frontal lobe tumor. However, there is a phenomenon of functional recombination in the non-damaged areas within the temporal lobe. (2) the patients were divided into normal cognitive group and abnormal cognitive group by using clinical cognitive test. The results were analyzed by ALFF and FCD methods, respectively. The clinical cognitive performance of the patients was analyzed from the aspects of neuron self activity and brain function connection. This paper discusses the causes of clinical cognitive impairment. The results show that the difference between the two groups is mainly manifested in the visual spatial functional area and the spatial attention functional area. The results of the analysis suggest that it may be the change of visual processing or visual memory functional area. This paper innovatively combined with GCA analysis method to analyze the changes of information interaction between functional differentiation and functional integration of patients with frontal lobe tumor, and analyze the cognitive damage mechanism of patients from the point of view of directed network. Combined with the evaluation of clinical cognitive test, the possible brain compensatory mechanism in frontal lobe tumor patients was explored.
【学位授予单位】：南京航空航天大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R445.2;R739.41

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