阻塞性睡眠呼吸暂停低通气综合征患者脑网络度中心度改变的静息态功能磁共振研究

发布时间：2018-04-04 13:22

  本文选题：阻塞性睡眠呼吸暂停低通气综合征　切入点：基于体素水平度中心度　出处：《南昌大学》2017年硕士论文

【摘要】：目的:阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)患者已经发现某些特定大脑结构及脑局部功能的变化。然而,全脑功能网络的拓扑组织属性仍然不清楚。本研究采用基于体素水平的度中心度(voxel-wise degree centrality,DC)方法去探索OSAHS患者全脑功能网络拓扑属性及内在功能枢纽(hubs)区域的改变。方法:首先纳入40例经多导睡眠监测(PSG)新确诊的OSAHS患者及睡眠好的正常对照组(good sleepers,GS)40例参与本项研究。所有的被试者进行了静息状态功能磁共振成像(functional magnetic resonance imaging,fMRI)扫描和临床及认知功能评估。其次,基于Matlab 2012a平台,采用DPABI及REST软件包对静息态功能磁共振数据进行预处理,然后计算每一个被试全脑基于体素水平的DC值,采用单样本及两样本t检验分别比较组内及组间参数,提取OSAHS患者组间异常脑区的DC值,并与临床评估量表进行相关分析。最后,以OSAHS患者DC值减低的脑区作为感兴趣区进行全脑种子点功能连接(functional connectivity,FC)分析,进一步去探索功能连接异常的脑区。结果:(1)OSAHS患者组及GS组存在高度相似的较高DC值分布(功能hubs)区域。然而,与GS组比较,OSAHS患者组左侧枕中回、后扣带皮层、左侧额上回和双侧顶叶小叶的DC值显著减低;而右侧眶额叶皮质、双侧小脑后叶和双侧豆状核,延伸到壳核、海马体及颞下回的DC值显著增高,这些异常区域均位于功能hubs脑区内。(2)种子点FC分析发现,与GS组比较,OSAHS患者组减低的DC脑区与枕叶、额叶、颞叶、小脑等广泛脑区功能连接减低。(3)线性相关分析发现OSAHS患者组呼吸紊乱指数与左侧枕中回(r=-0.535,P=0.001)、左侧顶下小叶(r=-0.415,P=0.012)、右侧顶下小叶(r=-0.351,P=0.036)减低的DC值呈负相关;觉醒指数与左侧枕中回(r=-0.449,P=0.006)、左侧顶下小叶(r=-0.360,P=0.031)、右侧顶下小叶(r=-0.396,P=0.017)减低的DC值呈负相关;蒙特利尔认识功能评分与后扣带回(r=0.406,P=0.014)、左侧额上回(r=0.570,P0.001)减低的DC呈正相关。结论:(1)OSAHS患者存在特定内在的异常的功能网络拓扑属性的改变,包括左侧枕中回、后扣带皮层、左侧额上回和双侧顶叶小叶的DC值减低,右侧眶额叶皮质、双侧小脑后叶和双侧豆状核等的DC值增加;提示OSAHS患者功能网络集成和分离异常及功能hubs节点存在损害及代偿性改变。(2)部分异常脑区的DC值与认知功能评分、疾病严重程度存在显著的相关,这可能是OSAHS患者认知功能损害的可能神经机制,将为我们理解OSAHS患者认知功能损害的神经病理机制提供了新的见解。
[Abstract]:Objective: obstructive sleep apnea hypopnea syndrome (OSAHS) patients with obstructive sleep apnea hypopnea syndrome (OSAHS) have found some changes in specific brain structure and brain function.However, the topological properties of the whole brain functional network are still unclear.In this study, we used a voxel-wise degree centrality DCA method based on voxel level to explore the topological properties of global functional network and the changes of internal functional hubs in patients with OSAHS.Methods: forty patients with OSAHS diagnosed by polysomnography and 40 healthy controls were included in this study.All subjects underwent resting state functional magnetic resonance imaging of MRI scans and evaluated their clinical and cognitive functions.Secondly, based on Matlab 2012a platform, DPABI and REST software package were used to preprocess the resting functional magnetic resonance data, and then the DC values of the whole brain based on voxel level were calculated.Single sample and two samples t test were used to compare the parameters in group and group respectively. DC values of abnormal brain regions in patients with OSAHS were extracted and correlated with clinical assessment scale.Finally, the functional connectivity of the whole brain was analyzed by using the brain region with decreased DC value in OSAHS patients as the region of interest, so as to further explore the abnormal functional connectivity areas.Results there was a highly similar distribution of high DC values (functional hubs) between the OSAHS and GS groups.However, the DC values of left occipital middle gyrus, posterior cingulate cortex, left superior frontal gyrus and bilateral parietal lobule in OSAHS group were significantly lower than those in GS group, while the right orbital frontal cortex, bilateral posterior cerebellar lobe and bilateral lenticular nucleus extended to putamen nucleus.The DC values of hippocampus and infratemporal gyrus were significantly increased. These abnormal areas were located in the functional hubs brain area. FC analysis showed that compared with the GS group, the DC decreased in the occipital, frontal and temporal lobes.灏忚剳绛夊箍娉涜剳鍖哄姛鑳借繛鎺ュ噺浣，

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