静息态功能磁共振成像观察复发-缓解型多发性硬化壳核功能连接改变

Resting state fMRI observation on functional connectivity of putamen in relapsing remitting multiple sclerosis

目的运用fMRI评价复发-缓解型多发性硬化(RRMS)患者静息状态下双侧壳核与全脑功能连接的改变。方法以20例RRMS患者(RRMS组)及20名健康志愿者(正常对照组)的双侧壳核为ROI进行全脑功能连接分析,并观察其与临床评估参数之间的相关性。结果与正常对照组相比,RRMS组左侧壳核功能连接增强区域包括左侧额中回、右侧额下回、左侧顶下小叶,减弱区域包括双侧边缘叶、左侧海马旁回、左侧颞中回;右侧壳核功能连接减弱区域包括左侧额上回、左侧颞下回、左侧边缘叶;双侧壳核异常功能连接区域与病程及扩展残疾量表评分、进步式听觉累加测试评分之间均未见明显相关性(P均>0.05)。结论 RRMS患者壳核与全脑功能连接存在异常,其功能连接改变可能是临床常见运动及认知功能障碍的原因之一。

Objective To analyze functional connectivity （FC） of bilateral putamens using resting-state functional MRI （rs-fMRI） in patients with relapsing-remitting multiple sclerosis （RRMS）. Methods Totally 20 patients with RRMS （RRMS group） and 20 healthy controls （HCs group） underwent rs-fMRI scan. Bilaterally putamens were chosen as ROIs, and FC analysis was executed between the putamen and the whole brain region. The correlation between the brain regions with abnormal FC and the clinical parameters in patients with RRMS was investigated. Results Compared with HCs group, FC in RRMS group between left putamen and left middle frontal gyrus, right inferior frontal gyrus as well as left in- ferior parietal lobule increased, while FC between left putamen with bilateral limbic lobes, left parahippocampal gyrusas well as left middle temporal gyrus decreased. FC between right putamen with left superior frontal gyrus, left inferior tem- poral gyrus and left limbic lobe decreased. There was no correlation between the brain regions with abnormal FC and the course of RRMS, expanded disability status scale score nor paced auditory serial addition test score （all P〉0.05）. Conclu- sion Abnormal FC are found in bilaterally putamens, where have persistent abnormal functional connectivity in RRMS pa- tients, which may be related to motor and cognitive dysfunction of RRMS patients.