基于体素的静息态fMRI观察复发-缓解型多发性硬化患者全脑度中心度改变

Voxel-based resting state fMRI observation on changes of degree centrality of whole brain in patients with relapsing remitting multiple sclerosis

目的采用基于体素的度中心度(DC)探讨复发-缓解型多发性硬化(RRMS)患者功能网络局部DC的变化特点。方法对28例RRMS患者(RRMS组)与28名年龄、性别相匹配的健康志愿者(正常对照组)行静息态fMRI(R-fMRI)扫描及扩展残疾量表(EDSS)、进步式听觉累加测试(PASAT)和修正的疲劳影响尺度(MFIS)评分,在Matlab平台上采用基于体素的DC(阈值为0.25)方法分析R-fMRI数据;采用t检验比较组内、组间参数,对RRMS组差异脑区的DC值分别与临床参数进行相关性检验。结果与正常对照组比较,RRMS组双侧楔前叶、双侧颞下回、双侧内侧前额叶、左侧额上回、小脑前叶DC值明显增高,双侧前扣带回、双侧顶下小叶、双侧楔叶、双侧尾状核DC值显著减低(P<0.05,AlphaSim校正);右侧顶下小叶DC值与PASAT评分呈负相关(r=-0.443,P=0.018),与MFIS评分呈正相关(r=0.557,P=0.002)。结论 RRMS患者存在DC异常改变,且右侧顶下小叶DC值与认知功能下降及易感疲劳相关,表明DC改变是导致临床症状的可能机制。

Objective To analyze functional network local centrality characteristics in patients with relapsing remitting multiple sclerosis （RRMS） by the utility of voxel-based degree centrality （DC）. Methods Twenty-eight patients with RRMS （RRMS group） and 28 matched healthy controls （control group） were enrolled. All subjects underwent resting state fMRI （R-fMRI）, and were evaluated by expanded disability status scale （EDSS）, modified fatigue impact scale （MFIS） and paced auditory serial addition test （PASAT）. Data of R-fMRI were measured on Matlab station by using degree cen- trality method （threshold value 0.25）, and intraclass and interclass differences were analyzed. Correlation analysis was per- formed for regions with DC value statistically different in RRMS group with clinical parameters. Results Compared with control group, significantly increased DC was found in bilateral precuneus, inferior temporal gyrus, medial prefrontal cor- tex, left superior frontal gyrus and anterior lobe of cerebellum, as well as significantly decreased DC in bilateral anterior cingulated gyrus, inferior parietal lobule, cuneus and caudatum in RRMS group （P〈0.05, AlphaSirn correlation）. DC value in right inferior parietal lobule negatively correlated with PASAT （r=-0. 443, P：0. 018） and positively correlated with MFIS （r=0. 557, P：0. 002）. Conclusion Differentiation of DC value is found in RRMS, which is correlated with cognitive dysfunction as well as fatigue in right inferior parietal lobule, indicating tha＇t the changes of DC value might lead to clinical symptoms.