成人双侧重度感音神经性聋静息态功能性磁共振成像特点的研究
发布时间：2018-12-16 20:08
【摘要】：目的和意义听觉皮层是听觉的高级中枢,位于颞上回及颞横回内,主要功能是用于处理听觉传入信息,当听觉产生时,部分其他脑区也参与听觉相关活动。耳聋发生后,听觉皮层将发生功能重组,并参与处理其他非听觉信息,而语前聋和语后聋的重组模式不同。我们利用静息态功能性磁共振(fMRI)功能连接方法观察成人不同类型重度感音神经性聋的听觉相关皮层重塑模式,了解语前聋和语后聋的听觉中枢重塑特点,为其进一步干预治疗提供依据。研究方法选取2016年3月至2016年11月在我院就诊的双侧重度以上感音神经性聋成人患者共20例,其中语前聋10例,语后聋10例,另选取听力正常者20例作对照组。使用3.0T超导磁共振机进行常规T1WI、T2WI、T2-FLAIR序列扫描后进行静息态fMRI扫描及结构像扫描。将数据进行预处理,选取双侧初级听觉皮层为种子点,运用静息态fMRI功能连接方法分析3组受试者的脑功能成像表现。对3组受试者的数据分别做单样本t检验,两组间对比采用独立样本t检验,Alphasim校正,阈值分别为P0.01和P0.05,最小有意义激活数分别为K18 和 K85。结果分别以左侧和右侧BA41区为种子点时,正常组的正激活脑区主要包括双侧的颞上回、脑岛、前扣带回、辅助运动区等。语前聋组的正激活脑区主要包括双侧的颞上回、脑岛、前扣带回、中央后回、中央前回、枕下回等。语后聋组的正激活脑区主要包括双侧颞上回、中央前回,中央后回等。正常组较语前聋组增加激活的区域有右侧脑岛、颞极等,减少激活的有双侧中央后回、中央前回、枕下回等。正常组较语后聋组增加激活的区域有左侧颞中回、颞下回等,减少激活的有额上回、中央前回等。语前聋组较语后聋组增加激活的区域有右侧额下回、脑岛等,减少激活的区域有侧额中回、右侧颞上回、缘上回等。结论1.静息态fMRI成像方法可以有效地观察正常人大脑的功能连接情况和耳聋患者听觉皮层的功能重组变化,并且具有空间时间分辨率好、操作简便、无侵袭性等优点,适合运用于临床研究。2.与正常听力者对比,语后聋患者双侧听觉皮层之间连接减少,听觉皮层与躯体感觉运动皮层、语言相关皮层的连接增强。3.与正常听力者对比,语前聋患者双侧听觉皮层之间连接减少,听觉皮层与躯体感觉运动皮层、视觉皮层的连接增强。4.与语后聋对比,语前聋听觉皮层与躯体感觉运动皮层的连接增强更显著。
[Abstract]:Objective and significance auditory cortex is an advanced center of hearing located in superior temporal gyrus and transverse temporal gyrus. The main function of auditory cortex is to process auditory afferent information. After the onset of deafness, the auditory cortex will undergo functional reorganization and participate in the processing of other non-auditory information, but the recombination pattern of prelingual deafness and postlingual deafness is different. We observed the auditory cortical remodeling patterns of different types of severe sensorineural hearing loss in adults with resting functional magnetic resonance (fMRI) functional junctions, and understood the characteristics of auditory central remodeling in prelingual and postlingual deafness. To provide the basis for its further intervention and treatment. Methods from March 2016 to November 2016, 20 adult patients with bilateral severe sensorineural deafness were selected, including 10 prelingual deafness, 10 postverbal deafness and 20 normal hearing. A 3.0T superconducting magnetic resonance machine was used to scan the conventional T1WIN T2WIT2-flair sequence and then the rest fMRI scan and the structural image scanning were performed. The data were preprocessed and the bilateral primary auditory cortex was selected as the seed point. The brain functional imaging performance of the three groups was analyzed by resting fMRI functional connection method. The data of the three groups were tested by single sample t test. The independent sample t test and Alphasim correction were used in the comparison between the two groups. The threshold values were P0.01 and P0.05, and the minimum significant activation numbers were K18 and K85respectively. Results when the left and right BA41 regions were used as seed points respectively, the positive activated brain regions in the normal group mainly included bilateral superior temporal gyrus, cerebral island, anterior cingulate gyrus, auxiliary motor area and so on. In the prelingual deafness group, the active brain regions mainly included bilateral superior temporal gyrus, cerebral island, anterior cingulate gyrus, posterior central gyrus, precentral gyrus and inferior occipital gyrus. The positive activated brain regions in postlingual deafness group included bilateral supratemporal gyrus, precentral gyrus and postcentral gyrus. In the normal group, the activation was increased in the right cerebral island, temporal pole, bilateral posterior central gyrus, precentral gyrus and inferior occipital gyrus. In the normal group, the areas of increased activation were left middle temporal gyrus, inferior temporal gyrus, suprafrontal gyrus, precentral gyrus and so on. The increased activation in prelingual deafness group compared with postverbal deafness group included right inferior frontal gyrus, cerebral island and so on. The reduced activation areas included lateral middle frontal gyrus, right superior temporal gyrus, superior marginal gyrus, and so on. Conclusion 1. Resting fMRI imaging can effectively observe the functional connections of the normal brain and the functional recombination of the auditory cortex in deafness patients, and has the advantages of good spatial and temporal resolution, simple operation, no invasion, and so on. Suitable for clinical research. 2. Compared with normal hearing, the connection between bilateral auditory cortex and somatosensory motor cortex and language-related cortex in postlingual deafness patients was decreased, and the connection between auditory cortex and somatosensory motor cortex was enhanced. Compared with normal hearing, the connection between bilateral auditory cortex and somatosensory motor cortex and visual cortex was decreased in prelingual deafness patients. Compared with postlingual deafness, the connection between auditory cortex and somatosensory motor cortex was significantly enhanced.
【学位授予单位】：南方医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R764.43;R445.2
[Abstract]:Objective and significance auditory cortex is an advanced center of hearing located in superior temporal gyrus and transverse temporal gyrus. The main function of auditory cortex is to process auditory afferent information. After the onset of deafness, the auditory cortex will undergo functional reorganization and participate in the processing of other non-auditory information, but the recombination pattern of prelingual deafness and postlingual deafness is different. We observed the auditory cortical remodeling patterns of different types of severe sensorineural hearing loss in adults with resting functional magnetic resonance (fMRI) functional junctions, and understood the characteristics of auditory central remodeling in prelingual and postlingual deafness. To provide the basis for its further intervention and treatment. Methods from March 2016 to November 2016, 20 adult patients with bilateral severe sensorineural deafness were selected, including 10 prelingual deafness, 10 postverbal deafness and 20 normal hearing. A 3.0T superconducting magnetic resonance machine was used to scan the conventional T1WIN T2WIT2-flair sequence and then the rest fMRI scan and the structural image scanning were performed. The data were preprocessed and the bilateral primary auditory cortex was selected as the seed point. The brain functional imaging performance of the three groups was analyzed by resting fMRI functional connection method. The data of the three groups were tested by single sample t test. The independent sample t test and Alphasim correction were used in the comparison between the two groups. The threshold values were P0.01 and P0.05, and the minimum significant activation numbers were K18 and K85respectively. Results when the left and right BA41 regions were used as seed points respectively, the positive activated brain regions in the normal group mainly included bilateral superior temporal gyrus, cerebral island, anterior cingulate gyrus, auxiliary motor area and so on. In the prelingual deafness group, the active brain regions mainly included bilateral superior temporal gyrus, cerebral island, anterior cingulate gyrus, posterior central gyrus, precentral gyrus and inferior occipital gyrus. The positive activated brain regions in postlingual deafness group included bilateral supratemporal gyrus, precentral gyrus and postcentral gyrus. In the normal group, the activation was increased in the right cerebral island, temporal pole, bilateral posterior central gyrus, precentral gyrus and inferior occipital gyrus. In the normal group, the areas of increased activation were left middle temporal gyrus, inferior temporal gyrus, suprafrontal gyrus, precentral gyrus and so on. The increased activation in prelingual deafness group compared with postverbal deafness group included right inferior frontal gyrus, cerebral island and so on. The reduced activation areas included lateral middle frontal gyrus, right superior temporal gyrus, superior marginal gyrus, and so on. Conclusion 1. Resting fMRI imaging can effectively observe the functional connections of the normal brain and the functional recombination of the auditory cortex in deafness patients, and has the advantages of good spatial and temporal resolution, simple operation, no invasion, and so on. Suitable for clinical research. 2. Compared with normal hearing, the connection between bilateral auditory cortex and somatosensory motor cortex and language-related cortex in postlingual deafness patients was decreased, and the connection between auditory cortex and somatosensory motor cortex was enhanced. Compared with normal hearing, the connection between bilateral auditory cortex and somatosensory motor cortex and visual cortex was decreased in prelingual deafness patients. Compared with postlingual deafness, the connection between auditory cortex and somatosensory motor cortex was significantly enhanced.
【学位授予单位】：南方医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R764.43;R445.2
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