血管性轻度认知障碍脑默认网络功能连接及不同频段下比率低频振幅的研究

发布时间：2018-04-14 05:06

本文选题：血管性轻度认知障碍 + 静息态功能磁共振　；参考：《山西医科大学》2017年硕士论文

【摘要】：目的:利用静息态功能磁共振成像(Rs-f MRI)技术,探讨血管性轻度认知障碍(Va MCI)患者静息态脑默认网络(DMN)的后扣带回功能连接(FC)和不同频段下比率低频振幅(f ALFF)的变化特点及其与认知功能的相关性。方法:选取2016年07月至2017年02月在山西医科大学附属第二医院神经内科门诊、住院部患者及体检中心健康体检者,22例Va MCI患者作为试验组,21名性别、年龄和受教育程度相匹配的认知功能正常者作为对照组。以上两组均行基于血氧水平依赖(BOLD)的Rs-f MRI扫描,比较两组受试者感兴趣区后扣带回(PCC)与其他脑区的FC差异及在经典频段(0.01-0.08Hz)、slow-5亚频段(0.01-0.027Hz)和slow-4亚频段(0.027-0.073Hz)下的f ALFF差异,明确Va MCI患者的DMN变化特点,并分析Va MCI组的蒙特利尔认知评估(Mo CA)量表的评分分值与FC值、f ALFF值的关系。结果:1.Va MCI组的MMSE总分(25.55±1.92)、Mo CA总分(18.59±3.63)以及Mo CA亚项中的视空间与执行功能(2.59±1.09)、注意力与计算力(2.77±0.92)、语言(1.5±1.06)、抽象力(0.23±0.43)及延迟回忆(3.23±1.15)亚项的得分都明显低于认知正常对照组(28.29±0.96、27.71±1.06、4.05±0.59、5.86±0.36、2.81±0.41、1.81±0.41、4.24±0.94),差异有统计学意义(P0.05);Mo CA亚项中的命名(2.63±0.58)及定向力(5.18±1.22)亚项与对照组相比(2.71±0.56、5.86±0.36),差异无统计学意义(P0.05)。2.两组组内分析表明Va MCI组和对照组都存在广泛FC及f ALFF值升高的脑区,包括后扣带回(PCC)、楔前叶(PCu)、顶下小叶(IPL)等脑区。其PCC、PCu在两组中的FC及f ALFF值最高。3.Va MCI组与对照组相比较,颅内存在广泛的DMN变化:(1)Va MCI组后扣带回与全脑FC强度低于对照组的脑区包括前扣带回(ACC)、右/左侧眶部额中回、左侧颞下回,未发现FC明显升高的脑区。(2)经典频段(0.01-0.08Hz)的f ALFF变化:右侧楔前叶及右侧颞上回的f ALFF值下降;左侧眶部额下回及左侧颞下回的f ALFF值增高。(3)亚频段的f ALFF:在slow-5亚频段右侧颞下回、双侧小脑及左侧角回的f ALFF值下降;在右侧舌回及左侧颞上回的f ALFF值升高;在slow-4亚频段左侧顶上小叶、左侧背外侧额上回及左侧颞下回的f ALFF值下降;在右侧颞上回及右侧岛叶的f ALFF值增高。4.Va MCI组异常DMN与Mo CA评分的相关性:在slow-5亚频段,左侧角回f ALFF值与Mo CA评分呈正相关,其他DMN异常脑区的FC值及f ALFF值与Mo CA评分未发现明显的相关性。结论:1.Va MCI患者在静息态下表现出异常的后扣带回功能连接模式。2.Va MCI患者脑默认网络存在异常的自发活动改变,且Va MCI患者异常活动的脑区在不同频段下有不同的异常自发活动的空间分布特征;3.在slow-5亚频段左侧角回异常的自发活动变化与Mo CA评分呈正相关,这一发现可为Va MCI的临床诊断提供功能影像学的依据。
[Abstract]:Objective: to use resting functional magnetic resonance imaging (Rs-f MRI) technique.To investigate the changes of posterior cingulate functional junction (FCC) of resting brain default network (DMN) in patients with mild vascular cognitive impairment (Va MCI) and its correlation with cognitive function in patients with Va MCI.Methods: from July 2016 to February 2017, 22 patients with Va MCI in the Department of Neurology, the second affiliated Hospital of Shanxi Medical University were selected as the experimental group.Those with normal cognitive function matched with age and education level served as control group.Both groups underwent Rs-f MRI scanning based on blood oxygen level dependent (Bod). The difference of FC in the posterior cingulate gyrus of the region of interest between the two groups and the difference of f ALFF in the classical frequency range 0.01-0.08Hzslow-5 subband and slow-4 subband 0.027-0.073Hz) were compared between the two groups.To determine the characteristics of DMN changes in patients with Va MCI, and to analyze the relationship between the score of the Montreal Cognitive Assessment scale (MCA) and the value of FC / F ALFF in the Va MCI group.Results in the Va MCI group, the total score of MMSE was 25.55 卤1.92mCA (18.59 卤3.63), the visual space and executive function in the subitem of Mo CA was 2.59 卤1.09g, the attention and computational power was 2.77 卤0.92g, the language was 1.5 卤1.06C, the abstract ability was 0.23 卤0.43) and the subitems of delayed recall were significantly lower than those in the normal cognitive control group (28.29 卤0.96n 27.71 卤1.064.05 卤0.595.86 卤0.362.81 卤0.362.81 卤0.41.81 卤0.41n 4.24 卤0.944).The difference was statistically significant (P 0.05 卤0.58) and orientation (5.18 卤1.22) between the two subitems (2.71 卤0.56N 5.86 卤0.36g), no significant difference was found between the two subitems (P 0.05 卤0.58) and P 0.05 卤1.22 (P 0.05 卤0.36), and there was no significant difference between the two subitems (P 0.05 卤0.58) and orientation (5.18 卤1.22).In both groups, both Va MCI group and control group showed extensive areas of increased FC and f ALFF, including posterior cingulate gyrus, anterior cuneate MCI, inferior parietal lobules, and so on.The FC and f ALFF values of the two groups were the highest. 3. Compared with the control group, there were extensive DMN changes in the intracranial area of the posterior cingulate gyrus and the whole brain FC intensity of the posterior cingulate gyrus and the whole brain of the Va MCI group, including the anterior cingulate gyrus, the middle frontal gyrus of the right / left orbital part, and the middle frontal gyrus of the right / left orbital part.In the left infratemporal gyrus, no significant increase in FC was found in the brain region. The changes of f ALFF in the classical frequency range of 0.01-0.08 Hz): the value of f ALFF in the right anterior cuneate lobe and the right superior temporal gyrus decreased;The f ALFF value of the left inferior frontal gyrus and left infratemporal gyrus was increased in the subband of slow-5. The f ALFF value of the bilateral cerebellum and the left angular gyrus decreased in the right inferior temporal gyrus of the slow-5 subband, and the f ALFF value in the right lingual gyrus and the left superior temporal gyrus was higher than that in the left superior temporal gyrus.The f ALFF value of left superior parietal lobe, left dorsolateral superior frontal gyrus and left infratemporal gyrus decreased in the subband of slow-4, and increased in the right superior temporal gyrus and right insular lobe. 4. The correlation between abnormal DMN and Mo CA score in the Va MCI group: in the slow-5 subband, there was no significant difference between f ALFF in the left superior dorsolateral frontal gyrus and the left inferior temporal gyrus.There was a positive correlation between left angle gyrus f ALFF value and Mo CA score, but no significant correlation between FC value and f ALFF value and Mo CA score in other abnormal brain regions of DMN.Conclusion: 1. The patients with Va MCI showed abnormal posterior cingulate functional connection pattern at rest. 2. There were abnormal spontaneous changes of brain network in patients with Va MCI.The spatial distribution of abnormal spontaneous activity in the brain region of patients with Va MCI was different at different frequencies.The spontaneous activity of abnormal left angular gyrus in the subband of slow-5 was positively correlated with the Mo CA score, which may provide functional imaging evidence for the clinical diagnosis of Va MCI.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R749.13

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