2型糖尿病患者海马连接异常的静息态功能磁共振成像研究

发布时间：2018-03-27 07:43

本文选题：认知障碍　切入点：2型糖尿病　出处：《郑州大学》2017年硕士论文

【摘要】：背景与目的:2型糖尿病(type 2 diabetes mellitus,T2DM)不仅是心血管病的危险因素,同时可加速认知功能下降,增加痴呆及阿尔茨海默病的发病的风险。T2DM对认知方面的影响广泛,但是目前为止,相关的发病机制仍然不清楚。本研究采用静息态功能磁共振成像,首次运用格兰杰因果分析方法,对糖尿病人的双侧海马与全脑的其他脑区的有效连接进行分析,探索糖尿病与认知障碍之间的关系。方法:收集无并发症的T2DM患者40名,其中男22名,女18名,平均年龄56.8±10.1岁,并招募健康志愿者40名作为对照组,男18名,女22名,平均年龄54.1±8.7岁。收集两组受试者临床数据,并进行神经心理学量表测试。对糖尿病组和对照组采用3.0T磁共振扫描仪,采集T2WI、FLAIR、T1WI和fMRI图像。应用SPM8和rest分析软件对rs-fMRI的数据进行格兰杰因果分析。应用SPSS 20软件对两组受试者的年龄、受教育水平、BMI、血压、空腹血糖、HbAlc水平及MoCA评分行双样本t检验。采用双样本t检验对fMRI数据分析结果进行统计分析。结果:研究结果指出,以右侧海马为种子点的有效连接外向流中,病人组自左侧颞下回和额下回的连接相对于对照组明显增强,小脑和左侧舌叶明显减弱;而相对于病人组,对照组自左侧距状回、右侧颞中叶和左侧中央后回对右侧海马的有效连接内向流显著增强,小脑和舌叶明显减弱。以左侧海马为种子点的有效连接内向流中,病人组自左侧小脑的连接明显增强,而左侧楔前叶、左侧丘脑、双侧中央后回、额中叶和双侧顶下叶明显减弱。结论:2型糖尿病人的默认网络与海马之间的连接异常,与病人的认知能力下降可能有关。与标准认知量表相比,采用默认网络的异常改变作为筛查2型糖尿病患者认知功能下降会是一种更有效的方法。
[Abstract]:Background and objective: type 2 diabetes mellitus type 2 diabetes mellitusus T2DM is not only a risk factor for cardiovascular disease, but also accelerates cognitive decline and increases the risk of dementia and Alzheimer's disease. T2DM has a wide range of cognitive effects, but so far, The related pathogenesis is still unclear. In this study, resting functional magnetic resonance imaging (fMRI) was used for the first time to analyze the effective connections between the bilateral hippocampus and other brain regions of the whole brain by Granger causality analysis (Granger causality analysis). To explore the relationship between diabetes mellitus and cognitive impairment, 40 T2DM patients without complications were collected, including 22 males and 18 females, with an average age of 56.8 卤10.1 years. 40 healthy volunteers were recruited as control group (18 males and 22 females). The mean age was 54.1 卤8.7 years. The clinical data of the two groups were collected, and the neuropsychological scale was tested. T2WI FLAIRI T1WI and fMRI images were collected. Granger causality analysis of rs-fMRI data was performed by SPM8 and rest software. The age, educational level and blood pressure of the two groups were measured by SPSS 20 software. The level of HbAlc and MoCA score were tested by double sample t test. The results of fMRI data analysis were statistically analyzed by using double sample t test. The connection between the left inferior temporal gyrus and the inferior frontal gyrus in the patient group was significantly increased, and the cerebellum and the left lingual lobe were significantly weakened compared with the control group, while in the patient group, the control group was from the left talar gyrus. The inward flow of the right middle temporal lobe and left posterior central gyrus to the right hippocampus significantly increased, but the cerebellum and tongue lobe decreased significantly. In the left hippocampal seed point, the connection between the left cerebellum and the left cerebellum was significantly enhanced in the patient group. The left anterior cuneate lobe, left thalamus, bilateral posterior central gyrus, middle frontal lobe and bilateral inferior parietal lobe were significantly weakened. Compared with the standard cognitive scale, it is more effective to use the abnormal changes of the default network as a screening method for cognitive impairment in patients with type 2 diabetes mellitus.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R445.2;R587.1

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