非神经精神性狼疮患者脑网络中心度改变的静息态功能磁共振研究

发布时间：2018-04-29 19:21

本文选题：非神经精神性狼疮 + 静息态功能磁共振　；参考：《南昌大学》2017年硕士论文

【摘要】：目的:采用静息态功能磁共振成像(resting-state functional magnetic resonance imaging,rs-fMRI)基于体素度中心度(voxel-wise degree centrality,DC)分析方法,探讨系统性红斑狼疮(systemic lupus erythematosus,SLE)患者出现神经精神症状之前(非神经精神狼疮)脑功能网络连接属性的改变,以期找到早期诊断神经精神性狼疮(neuropsychiaric systemic lupus erythematosus,NPSLE)的线索以及进一步探明NPSLE的发病机制。方法:首先收集24例临床确诊的无明显神经精神症状的系统性红斑狼疮患者(非NPSLE组)及24例性别、年龄与非NPSLE组相匹配的健康对照者(health controls,HCs组)进行rs-fMRI及T1高清结构像扫描,并记录所有非NPSLE患者的临床资料,计算系统性红斑狼疮疾病活动性指数(systemic lupus erythematosus disease activity index,SLEDAI)评分。然后在Matlab 2012a平台上应用DPABI软件中的功能磁共振处理助手DPARSF进行数据预处理,并采用基于体素的DC方法(矩阵相关系数阈值为0.25)分析rs-fMRI数据。最后分别统计体素水平的DC及人口学、临床参数的组间(非NPSLE组与HCs组)差异,并将非NPSLE组差异脑区的DC值与各临床参数进行相关分析。结果:1、与HCs组比较,非NPSLE组DC值下降的脑区包括右侧额内侧回/额上回/额中回、右侧尾状核,左侧额中回/额下回、左侧前扣带回、左侧小脑后叶,DC值增高的脑区为右侧中央后回/楔前叶/中央旁小叶。2、相关性分析发现,非NPSLE组右侧额内侧回/额上回/额中回DC值与补体C3浓度呈正相关。结论:1、本研究发现,SLE患者在出现神经精神症状之前、头颅cMRI检查阴性时,就已经存在脑功能改变,推测其可能已经处于亚临床NPSLE阶段,因此有必要对SLE患者进行早期评估和干预,以防止脑功能发生进一步损害,最终导致NPSLE的发生。2、本研究还发现,非NPSLE组右侧额内侧回/额上回/额中回的DC值与补体C3浓度呈正相关,提示非NPSLE患者部分脑区的功能损伤可能与补体C3有关,这一发现将有助于我们进一步认识NPSLE的发病机制,并为早期干预的发展提供潜在的方向。
[Abstract]:Aim: to use resting state functional magnetic resonance imagingrs-f MRI-based voxel-wise degree centralityDCanalysis method. To investigate the changes of functional network connections in patients with systemic lupus erythematosus before neuropsychiatric symptoms (non-neuropsychiatric lupus). The aim of this study was to find out the clues of early diagnosis of neuropsychiatric lupus systemic lupus erythematosus (NPSLEs) and to further investigate the pathogenesis of NPSLE. Methods: first of all, 24 patients with systemic lupus erythematosus without obvious neuropsychiatric symptoms (non-NPSLE group), 24 patients with sex and healthy controls matched with non-NPSLE group were examined by rs-fMRI and T1 high-definition structural imaging. The clinical data of all non NPSLE patients were recorded and the systemic lupus erythematosus disease activity index (SLEDAI) score was calculated. Based on Matlab 2012a, the rs-fMRI data are preprocessed by DPARSF, a functional magnetic resonance processing assistant in DPABI software, and the rs-fMRI data are analyzed by voxel based DC method (the threshold of matrix correlation coefficient is 0.25). Finally, the differences of DC and demography of voxel level and clinical parameters (non-NPSLE group and HCs group) were analyzed, and the correlation between DC values and clinical parameters in different brain regions in non-NPSLE group was analyzed. Results compared with HCs group, the decreased DC value in non-NPSLE group included right medial frontal gyrus / superior frontal gyrus / middle frontal gyrus, right caudate nucleus, left middle frontal / inferior frontal gyrus, left anterior cingulate gyrus, and left anterior cingulate gyrus. The area with increased DC value in left posterior lobe was right posterior central gyrus / prewedge / paracentral lobule. Correlation analysis showed that DC value in right medial frontal / superior frontal gyrus / middle frontal gyrus was positively correlated with C3 concentration in non-NPSLE group. Conclusion: 1. In this study, we found that brain function changes had already existed in patients with cMRI before they developed neuropsychiatric symptoms. It was speculated that they might be in the stage of subclinical NPSLE. Therefore, it is necessary to carry out early assessment and intervention in patients with SLE in order to prevent further damage to brain function and ultimately lead to the occurrence of NPSLE. The DC value of right medial frontal gyrus / superior frontal gyrus / middle frontal gyrus was positively correlated with complement C3 concentration in non-NPSLE group, suggesting that the functional damage in some brain regions of non-NPSLE patients might be related to complement C3. This finding will help us to further understand the pathogenesis of NPSLE. It also provides a potential direction for the development of early intervention.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R593.241;R747.9;R445.2

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