静息态BOLD-fMRI在轻度认知障碍和阿尔茨海默病中的应用

发布时间：2018-09-11 17:45

【摘要】：目的：应用静息态BOLD-fMRI成像技术，比较认知功能正常的老年人、aMCI患者和AD患者与后扣带回（PCC）相关的默认网络结构的差异，探讨静息态BOLD-fMRI在MCI患者和AD患者中的应用，为aMCI及AD的早期诊断提供影像依据。方法：收集就诊于山西医科大学第一医院神经内科临床疑诊为aMCI患者10例，男4例，女6例，年龄63～78岁，平均年龄69.3岁；疑诊为AD患者10例，男6例，女4例，年龄65～80岁，平均年龄71.9岁；选取与AD组及aMCI组性别、年龄及受教育程度相匹配的健康志愿者10例，男7例，女3例，年龄60～75岁，平均年龄67.8岁。行头颅常规MRI检查除外脑外伤、脑出血、脑梗塞、脑肿瘤及颅脑手术等神经系统疾病。所有受试者行静息态BOLD-fMRI检查，以PCC为种子区，进行与全脑其他区域基于体素的时间序列相关分析。经获得激活脑区阈值设为经校正的P0.05，激活脑区体素范围10。结果：①正常对照组、aMCI组和AD组在年龄、性别、受教育程度方面差异无统计学意义，MMSE评分在三组之间差异有统计学意义。②正常对照组与PCC有功能连接的脑区包括：前额叶内侧区、双侧海马、丘脑背侧、楔叶及楔前叶、顶下小叶、部分颞叶、双侧小脑半球及小脑蚓部，网络结构的对称性良好，连通性完整。③aMCI组所显示的与PCC有功能连接的脑区和正常对照组相似，但是激活脑区的体素减少，网络结构连通性减弱。④AD组与PCC有功能连接性的脑区包括：双侧前额叶内侧区、楔叶及楔前叶、顶下小叶、部分颞叶等，，激活脑区的部位及范围较正常对照组明显减少，双侧海马未见激活，网络结构存在减弱和断裂。结论：BOLD-fMRI技术作为一种新的MRI成像方法，使磁共振检查不再局限于人脑形态学的研究，已经延伸到脑功能成像的领域，为我们更好的研究脑功能提供了方法。静息态默认网络的提出为我们诊断AD开拓了新思路，AD认为是一种“失连接状态”，MCI患者和AD患者脑内默认网络功能的连通性出现减弱和断裂，为aMCI及AD的早期诊断提供了依据。
[Abstract]:Objective: to compare the difference of the default network structure of (PCC) related to posterior cingulate gyrus (PCC) between elderly patients with normal cognitive function and patients with AD by using resting BOLD-fMRI imaging, and to explore the application of resting BOLD-fMRI in MCI patients and AD patients. To provide imaging evidence for early diagnosis of aMCI and AD. Methods: ten patients with suspected aMCI were collected from Department of Neurology, first Hospital of Shanxi Medical University, including 4 males and 6 females, aged 63 to 78 years, with an average age of 69.3 years, 10 suspected AD patients, 6 males and 4 females. Ten healthy volunteers, 7 males and 3 females, with an average age of 60.75 years, were selected to match the sex, age and education level of AD and aMCI groups, with an average age of 67.8 years. Brain injury, cerebral hemorrhage, cerebral infarction, brain tumor, craniocerebral surgery and other nervous system diseases were excluded by routine cranial MRI. Resting BOLD-fMRI was performed in all subjects, and PCC was used as seed area to analyze the correlation between PCC and voxel based time series in other regions of the brain. The threshold value of activated brain area was set to the corrected P0.05, and the voxel range of activated brain region was 10. 05%. Results the age, sex and sex of the normal control group, MCI group and AD group, There was no significant difference in education level among the three groups. 2 the functional connections between normal control group and PCC included medial prefrontal area, bilateral hippocampus, dorsal thalamus, cuneiform lobe and precuneiform lobe. In the subparietal lobules, part of temporal lobes, bilateral cerebellar hemispheres and cerebellar vermis, the symmetry of the network structure was good, and the brain regions with functional connections with PCC showed similar to those in the normal control group, but the voxins in the activated brain regions were decreased. In the group of weak connectivity of network structure, the functional connectivity between AD and PCC included: bilateral medial prefrontal lobe, cuneiform and precuneiform lobe, inferior parietal lobule, part of temporal lobe, etc. The sites and areas of activation in AD group were significantly less than those in normal control group. No activation was found in the bilateral hippocampus, and the network structure was weakened and broken. Conclusion as a new method of MRI imaging, the study of brain morphology has been extended to the field of brain function imaging, which provides a better method for us to study brain function. The establishment of resting default network opens up a new way for us to diagnose AD. AD is considered to be a kind of "disconnected state". The connectivity of default network in patients with AD and in patients with AD is weakened and broken, which provides a basis for the early diagnosis of aMCI and AD.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R749.16

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