心理性ED患者左侧杏仁核白质纤维拓扑属性与勃起功能的相关性

发布时间：2019-03-29 16:37

【摘要】：目的:通过对心理性ED患者脑白质纤维的二值化和加权网络节点度和连接强度拓扑属性值的探讨,分析不同脑区所连接白质纤维髓鞘完整性、数目及其长度在拓扑空间上的改变情况。方法:采集21例心理性ED患者及性别、年龄、受教育程度相匹配的24例对照者的弥散张量成像数据;对所有数据进行预处理,将整个大脑划分为90个区域,追踪全脑白质纤维,构建全脑白质的二值化和加权网络,计算脑区的度和连接强度属性值;对组间属性值进行独立双样本t检验,并对结果进行多重校正,将差异属性值与患者阴茎勃起功能进行皮尔森相关分析。结果:1患者组脑白质二值化网络中左侧三角部额下回(5.95±1.28,7.54±1.44,t=-3.88,P=0.02)、内侧眶部额上回(6.29±3.30,10.08±3.60,t=-3.67,P=0.02)、杏仁核(4.29±1.31,6.50±2.11,t=-4.16,P=0.01)度较对照组(均为校正后P值)显著下降;2患者组基于FA值的脑白质加权网络中左侧三角部额下回(1.72±0.50,2.50±0.68,t=-4.35,P=0.01)、内侧眶部额上回(2.08±1.10,3.17±0.97,t=-3.53,P=0.03)、杏仁核(1.11±0.39,1.80±0.69,t=-4.03,P=0.01)连接强度也均较对照组(均为校正后P值)显著下降;3患者组基于FA值的脑白质加权网络中左侧三角部额下回(1.72±0.50)、内侧眶部额上回(2.08±1.10)、杏仁核(1.11±0.39)连接强度也均较对照组(2.50±0.68,t=-4.35,P=0.01;3.17±0.97,t=-3.53,P=0.03;1.80±0.69,t=-4.03,P=0.01,校正后P值)显著下降;4患者左侧杏仁核度属性值与勃起功能国际问卷总分(r=-0.47,P=0.04)、第2项评分(r=-0.46,P=0.03)以及第3项评分(r=-0.45,P=0.04)均呈负相关。结论:心理性ED患者左侧部分额叶和杏仁核所连接的白质纤维髓鞘完整性受损害,导致患者产生情绪、处理及调控的异常,另外患者左侧杏仁核所连接的白质纤维在大脑信息传递活动中的中心地位和重要性的下降可能与心理性ED相关。
[Abstract]:Objective: to analyze the myelin sheath integrity of white matter fibers connected in different brain regions by discussing the binarization of white matter fibers, the degree of nodes of weighted network and the topological attribute values of connection strength in patients with mental ED. The change of number and its length in topological space. Methods: diffusion Zhang Liang imaging data were collected from 21 patients with mental ED and 24 controls with matched sex, age and education level. All the data were preprocessed, the whole brain was divided into 90 regions, the white matter fibers of the whole brain were tracked, the binarization and weighted network of the white matter of the whole brain were constructed, and the degree of the brain area and the attribute value of the connection intensity were calculated. Independent double-sample t-test was performed among the groups and the results were corrected multiple times. Pearson correlation analysis was carried out between the difference attribute values and the erectile function of the penis of the patients. Results: 1in the patients group, the left inferior frontal gyrus (5.95 卤1.28,7.54 卤1.44, t = 3.88, P < 0.01) and the medial supraorbital gyrus (6.29 卤3.30,10.08 卤3.60, t = 3.67, P < 0.02) were found in the binarization network of the white matter in the left side of the brain, and in the left subfrontal gyrus (5.95 卤1.28,7.54 卤1.44, t = 3.88, P < 0.01). The degree of amygdala (4.29 卤1.31, 6.50 卤2.11, t = 4.16, P < 0.01) was significantly lower than that of the control group (P value after correction). 2in the patients group, the left inferior frontal gyrus (1.72 卤0.50,2.50 卤0.68, t = 4.35, P < 0.01) and the medial supraorbital gyrus (2.08 卤1.10,3.17 卤0.97, t = 3.53, P = 0.03) were based on FA value in the white matter weighted network in the left side of the brain, and the left inferior frontal gyrus (1.72 卤0.50,2.50 卤0.68, t = 4.35, P < 0.01). The connection strength of amygdala (1.11 卤0.39, 1.80 卤0.69, t = 4.03, P < 0.01) was significantly lower than that of the control group (P value after correction). 3The left inferior frontal gyrus (1.72 卤0.50), medial orbital superior frontal gyrus (2.08 卤1.10) and amygdala (1.11 卤0.39) of the white matter weighted network based on FA in the patient group were also significantly stronger than those in the control group (2.50 卤0.68,2.50 卤0.68). T, 4.35, P < 0.01; 3.17 卤0.97, t = 3.53, P = 0.03 卤0.69, t = 4.03, P = 0.01 (P value after correction) decreased significantly; 4There was a negative correlation between the left amygdala degree and the total score of erectile function (r = 0.47, P < 0.04), the second score (r = 0.46, P = 0.03) and the third score (r = 0.45, P = 0.04). Conclusion: the myelin integrity of the white matter fibers connected to the left frontal lobe and amygdala in the patients with psychological ED is impaired, resulting in abnormal mood, management and regulation of the patients. In addition, the decrease in the central position and importance of the white matter fibers connected to the left amygdala in the brain information transmission may be related to psychological ED.
【作者单位】：南京大学医学院附属鼓楼医院男科;南京医科大学附属脑科医院精神四科;东南大学学习科学研究中心;
【基金】：国家自然科学基金(81571430) 中央高校基本科研业务费专项资金资助(021414380134)~~
【分类号】：R698.1

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