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首页|期刊导航|磁共振成像|急性轻度创伤性脑损伤患者静息态功能MRI多模式研究

急性轻度创伤性脑损伤患者静息态功能MRI多模式研究OA北大核心CSTPCD

Multimodal study of resting state functional MRI in patients with acute mild traumatic brain injury

中文摘要英文摘要

目的 采用静息态功能磁共振成像(resting-state functional magnetic resonance imaging,rs-fMRI)测量急性轻度创伤性脑损伤(mild traumatic brain injury,mTBI)患者与健康对照者(health control,HC)基于体素的指标,观察mTBI患者认知功能是否发生改变及其与蒙特利尔认知评估(Montreal Cognitive Assessment,MoCA)量表评分之间是否存在相关性.材料与方法前瞻性纳入31例单侧颅脑损伤11天内的急性mTBI患者,同期招募31例年龄、性别及受教育年限相匹配的HC,对所有受试者进行rs-fMRI扫描,并对mTBI组进行了临床评分.使用SPM 12和DPABI软件对图像进行预处理及基于体素的双样本t检验.使用高斯随机场(Gaussian random-field,GRF)校正.采用卡方检验估计两组性别构成的分布,两组间年龄的影响采用双样本t检验,两组间受教育年限的影响采用U检验.此外,对mTBI组损伤后纳入研究的时间及临床评分采用单样本t检验.采用Spearman相关系数分析mTBI组基于体素的指标与的MoCA量表评分评分的相关性.结果 mTBI组与HC组年龄(t=1.587,P>0.05)、性别(χ2<0.001,P>0.05)和受教育年限(U=448,P>0.05)差异无统计学意义.与HC组相比,急性mTBI患者左侧脑岛、左侧中央后回和左侧中央前回的低频振幅(amplitude of low-frequency fluctuations,ALFF)增加(体素P值<0.005,GRF校正);右侧中央后回和右侧中央前回的分数低频振幅(fractional ALFF,fALFF)增加(体素P值<0.005,GRF校正);右侧楔叶和左侧中央后回的局部一致性(regional homogeneity,ReHo)增加(体素P值<0.005,GRF校正).右侧中央后回与右侧枕中回和右侧楔叶的功能连接(functional connectivity,FC)增强(体素P值<0.005,GRF校正);右侧楔叶与右侧楔前叶的FC增强(体素P值<0.005,GRF校正),右侧楔叶与右侧尾状核的FC减弱(体素P值<0.005,GRF校正).相关性分析显示,MoCA量表评分与基于种子的FC之间存在显著相关性.结论 研究结果表明,在脑损伤后的急性阶段,认知表现与静息状态下自发的大脑活动有关,特别是在默认模式网络(default mode network,DMN)、显著网络(salience network,SAN)和视觉网络中.此外,这项研究证明认知表现与MoCA量表评分之间存在相关性.

Objective:Resting-state functional magnetic resonance imaging(rs-fMRI)was used to measure the difference between patients with acute mTBI and healthy controls(HCs),voxel-based indicators were used to observe whether cognitive function changes in patients with mTBI and the correlation between cognitive function changes and Montreal Cognitive Assessment(MoCA)scale scores.Materials and Methods:Thirty-one patients with acute mTBI within 11 days of unilateral craniocerebral injury were prospectively enrolled.Thirty-one HCs matched for age,gender,and education were recruited at the same time.All subjects underwent rs-fMRI scans,and the mTBI group was clinically scored.SPM 12 and DPABI software were used for image preprocessing and voxel-based two-sample t-test.Gaussian Random-Field(GRF)correction was used chi-square test was used to estimate the distribution of gender composition in the two groups,and the effect of age between the two groups was used two-sample t-test,and the effect of years of education between the two groups was used U test.In addition,the time of enrollment into the study and clinical scores after injury in the mTBI group were analyzed using a one-sample t-test.Spearman correlation coefficient was used to analyze the correlation between the voxel-based indicators and the MoCA scale scores in the mTBI group.Results:There was no significant difference in age(t=1.587,P>0.05),gender(χ2<0.001,P>0.05),and education years(U=448,P>0.05)between the mTBI group and HC group.Compared with HC,the amplitude of low-frequency fluctuations(ALFF)in the left insula,left postcentral gyrus,and left precentral gyrus were increased in patients with acute mTBI(voxel P<0.005,GRF corrected).The fractional amplitude of low-frequency fluctuation(fALFF)was increased in the right postcentral gyrus and right precentral gyrus(voxel P<0.005,GRF corrected).Increased regional homogeneity(ReHo)was observed in the right cuneus and left postcentral gyrus(voxel P-value<0.005,GRF corrected).Enhanced functional connectivity(FC)between the right postcentral gyrus and the right middle occipital gyrus and right cuneus(voxel P<0.005,GRF corrected);FC was enhanced between the right cuneus and the right precuneus(voxel P-value<0.005,GRF corrected),and decreased between the right cuneus and the right caudate nucleus(voxel P-value<0.005,GRF corrected).Correlation analysis showed a significant correlation between MoCA scale scores and seed-based FC.Conclusions:Our findings suggest that cognitive performance is associated with spontaneous brain activity at resting state,especially in the default mode network(DMN),salience network(SAN),and visual network,in the acute phase after brain injury.In addition,this study demonstrated a correlation between cognitive performance and MoCA scale scores.

曾哲;罗琳;陈强;侯斯琦

内蒙古科技大学包头医学院第一附属医院医学影像科,包头 014010内蒙古科技大学包头医学院药学院,包头 014040

临床医学

轻度创伤性脑损伤静息态功能磁共振成像磁共振成像认知表现功能连接

mild traumatic brain injuryresting-state functional magenetic resonance imagingmagenetic resonance imagingcognitive performancefunctional connection

《磁共振成像》 2024 (003)

43-49 / 7

Inner Mongolia Autonomous Region Department of Education Fund Project(No.NJZY23021). 内蒙古自治区教育厅基金项目(编号:NJZY23021)

10.12015/issn.1674-8034.2024.03.008

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