颈动脉狭窄和闭塞患者空间工作记忆的功能磁共振成像研究

Functional MRI study of spatial working memory in patients with carotid artery stenosis or occlusion

目的探讨左侧颈内动脉、大脑中动脉狭窄和闭塞患者与正常人空间工作记忆的激活脑区差异。方法选择左侧颈动脉狭窄和闭塞患者10例(病例组),其中左侧颈内动脉狭窄4例,左侧颈内动脉闭塞2例,左侧大脑中动脉狭窄3例,左侧大脑中动脉闭塞1例,另选健康体检者20例(对照组),对病例组和对照组进行空间记忆任务的功能磁共振成像,采用AFNI软件进行分析。结果病例组空间位置记录正确率较对照组明显降低[(79.2±16.5)%vs(88.6±11.8)%,P<0.05]。对照组空间工作记忆的编码期、保持期、提取期脑激活明显强于病例组。结论左侧颈动脉狭窄和闭塞患者空间记忆任务的脑激活区存在损害,功能磁共振成像研究能为早期诊断认知障碍提供影像学依据。

Objective To explore the difference of spatial working memory between the patients with left internal carotid artery（ICA）/middle cerebral artery（MCA） stenosis or occlusion and healthy subjects with functional magnetic resonance imaging. Methods fMRI were acquired in 10 patients with left ICA/MCA stenosis or occlusion （patient group; 4 with ICA stenosis,2 with ICA occlusion,3 with MCA stenosis,1 with MCA occlusion） and 20 healthy subjects（control group） when they received spatial working memory experiment. AFNI software was used to process fMRI data and localize functional areas of brain. Results The accuracy rate of space position re- cord in the patient group was significantly lower than that of the control groupr（79. 2±16. 5）% vs （88. 6±11. 8）%, P 〈 0. 05]. The control group demonstrated more activated brain regions during three phases （encoding, maintaining and retrieval phases） of spatial task compared with the patient group. Conclusions This study revealed the deficits of spatial working memory in patients with left ICA/MCA stenosis or occlusion. These findings can play important roles for the early diagnosis of cognitive impairment.