皮层下缺血性血管性认知功能障碍患者的脑默认网络及局域一致性功能磁共振研究

发布时间：2018-01-04 03:44

本文关键词：皮层下缺血性血管性认知功能障碍患者的脑默认网络及局域一致性功能磁共振研究　出处：《南京大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的运用静息态功能磁共振成像(rs-fMRI)研究皮层下缺血性血管性认知功能障碍(SIVCI)患者在静息状态下的默认脑网络,并探索其默认脑网络(DMN)与认知功能间的相关性。方法收集缺血性脑小血管疾病患者68例,经临床痴呆量表评分后分为轻度血管性痴呆组(SIVaD组)12例,非痴呆型血管性认知功能障碍组(SIVCIND组)21例,认知功能正常者35例为对照组,分别采集高分辨率结构像和静息态功能磁共振数据,通过独立成分分析方法(ICA)计算分别对SIVCIND组与正常对照组、SIVaD组与SIVCIND组、SIVaD组与正常对照组DMN的功能连接进行组间比较,观察静息状态下脑默认网络的改变情况,并分析SIVaD患者默认网络与认知功能间的相关性。结果与正常对照组相比,SIVCIND组患者默认网络脑区的功能连接既有增高也有降低,增高的脑区包括双侧顶叶及后扣带回,降低的脑区包括眶额叶、内侧前额叶、前扣带回及双侧枕叶；SIVaD组患者后扣带回及双侧顶叶的功能连接增强,而内侧前额叶、双侧枕叶及双侧颞叶的功能连接减低；与SIVCIND组比较,SIVaD组患者双侧顶叶功能连接明显升高,前扣带回、后扣带回及部分枕叶功能连接显著减低。SIVaD患者DMN统计脑图与数字连线试验、注意力及延迟记忆能力等多个临床量表评分存在显著相关性,差异有统计学意义(p0.05)。结论在静息状态下,血管性认知功能障碍患者的大脑默认模式网络存在异常,并存在以执行功能障碍为主的多个领域的认知功能损害,其认知功能障碍可能与额叶—皮质下环路受损有关。独立成分分析在评价血管性认知功能障碍及其早期诊断中有重要价值。目的运用局部一致性(ReHo)方法探讨皮层下缺血性血管性认知功能障碍(SIVCI)患者在静息状态下的脑功能变化特点。方法采集68例缺血性脑小血管疾病患者,经临床痴呆量表评分后分为血管性痴呆组(SIVaD组)12例,非痴呆型血管性认知功能障碍组(SIVCIND组)21例,认知功能正常者35例为对照组,分别采集高分辨率结构像和静息态功能磁共振数据,通过局部一致性方法对比3组患者静息态下脑功能活动的改变,并分析SIVCI患者ReHo改变脑区与认知功能间的相关性。结果与正常对照组相比,SIVaD组患者ReHo值增高的脑区包括右侧额中回、前扣带回及双侧顶叶,降低的脑区包括内侧前额叶,后扣带回、双侧颞叶及双侧小脑之间；SIVCIND组患者内侧前额叶、双侧颞叶、左侧额下回部分脑区ReHo显著降低,而右侧额叶、双侧顶叶及双侧枕叶的部分脑区ReHo增高；与SIVCIND组比较,SIVaD组患者后扣带回ReHo值显著减低,右侧额叶、双侧顶叶及胼胝体显示ReHo显著增高。SIVCI患者ReHo统计脑图与MOCA、数字连线实验等量表评分存在显著相关性,差异有统计学意义(p0.05)。结论在静息状态下,皮层下血管性认知功能障碍患者BOLD信号一致性较高的脑区之间存在大量的纤维联系,用ReHo方法检测出的异常脑结构区对于血管性认知功能障碍患者的诊断具有一定意义的价值。
[Abstract]:Objective using resting state functional magnetic resonance imaging (rs-fMRI) study of subcortical ischemic vascular cognitive impairment (SIVCI) patients with the default brain network in the resting state, and to explore the brain default network (DMN) and the correlation between cognitive function. Methods patients with ischemic cerebral small vessel disease in 68 cases, the clinical dementia scale the score is divided into mild vascular dementia group (SIVaD group) 12 cases, vascular cognitive impairment no dementia group (SIVCIND group) 21 cases, normal cognitive function in 35 cases as control group, high resolution imaging and resting state fMRI data were collected through independent component analysis (ICA) calculation the SIVCIND group and normal control group, SIVaD group and SIVCIND group, SIVaD group and normal control group with DMN function were compared between groups, observation of resting state brain default network change situation, and analysis of SIVaD in patients with silent The correlation between cognitive function and the recognition network. Results compared with the control group, SIVCIND group of patients with cerebral area of functional connectivity in the default network both increased also decreased, increased brain regions including bilateral parietal and posterior cingulate regions of the brain, including reduced orbitofrontal cortex, medial prefrontal cortex, anterior cingulate and bilateral occipital lobe; SIVaD group of patients with posterior cingulate and parietal cortex functional connectivity, and the medial prefrontal cortex, bilateral occipital lobe and bilateral temporal lobe decreased functional connectivity; compared with SIVCIND group, SIVaD group of patients with bilateral parietal cortex functional connectivity increased, anterior cingulate cortex, posterior cingulate and.SIVaD were significantly lower in patients with DMN connected brain map and statistics digital connection test of occipital lobe function, attention and delayed memory ability of multiple clinical scores showed significant correlation, the difference was statistically significant (P0.05). Conclusion in the resting state, vascular cognitive impairment Because of abnormal brain default mode network, cognitive impairment and the presence of multiple fields to perform dysfunction, cognitive dysfunction may be related to the frontal cortex - loop dysfunction. Independent component analysis in the evaluation of vascular cognitive dysfunction and its early diagnosis has important value. To use the local consistency (ReHo) method to investigate the subcortical ischemic vascular cognitive impairment (SIVCI) patients with changes in the resting state brain function. Methods the data of 68 cases of ischemic cerebral small vessel disease patients, the clinical dementia rating scale scores were divided into vascular dementia group (SIVaD group) 12 cases, vascular cognitive impairment no dementia group (SIVCIND group) in 21 cases, normal cognitive function in 35 cases as control group, high resolution imaging and resting state fMRI data were collected by comparing local consistency methods 3 Brain activity of patients during resting state changes, and analysis of SIVCI ReHo in patients with cognitive brain function area and change the correlation between results. Compared with the normal control group, SIVaD group, ReHo value of patients with brain areas including increased right middle frontal gyrus, anterior cingulate and parietal cortex, brain regions decreased including medial prefrontal cortex, posterior between the cingulate gyrus, bilateral temporal lobe and bilateral cerebellum; group SIVCIND patients with medial prefrontal cortex, bilateral temporal lobe, left inferior frontal brain regions of ReHo decreased significantly, while the right frontal lobe, bilateral parietal lobe and bilateral occipital lobe of the brain regions of ReHo increased; compared with SIVCIND group, SIVaD group of patients with posterior cingulate ReHo values were significantly lower. Right frontal lobe, bilateral parietal cortex and corpus callosum showed that ReHo was significantly increased in.SIVCI patients and MOCA ReHo statistical map, digital connection experiment scale score showed significant correlation, the difference was statistically significant (P0.05). Conclusion in the resting state, There is a large number of fiber connections between the regions with high BOLD signal consistency in subcortical vascular cognitive impairment. The abnormal brain structure detected by ReHo method has a certain value for the diagnosis of patients with vascular cognitive impairment.

【学位授予单位】：南京大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R749.13;R445.2

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