复发缓解型多发性硬化患者默认网络亚区成本整合初探

Altered Sub-Regional Cost-Integrate of Default Mode Network in Patients with Relapsing-Remitting Multiple Sclerosis: A Preliminary Study

目的采用图论衍生的成本整合(CI)分析对复发缓解型多发性硬化(RRMS)患者默认网络(DMN)亚区间(内)相互关系进行研究。方法采集24例处于缓解期的RRMS患者及相同数量健康对照组静息态功能磁共振(R-f MRI)和高分辨率T1WI数据。R-f MRI数据处理助手(DPARSFA)基于Matlab2012a平台进行数据预处理,提取DMN核心和双侧亚系统区20个感兴趣区信号,Pearson相关计算功能连接系数为边,计算并比较两组维持网络不碎裂条件下,DMN亚区间(内)的CI值的改变,及与临床参数如临床扩展残疾量表(EDSS)、同步听觉连续加法测验评分(PASAT)、脑实质分数(BPF)、T2WI可见病灶体积和病程的相关性。结果最小网络密度(Dmin)条件下,RRMS患者DMN功能网络左侧颞中叶(MTL)亚系统区成本整合(0.80 vs.0.30)较对照组显著增高(P=0.006),且和BPF之间呈负相关(r=-0.414,P=0.045)。结论处于缓解期的RRMS患者,存在和脑萎缩相关的DMN亚区成本整合增高改变。该方法为理解疾病状态下的功能整合机制提供了新的视角。

Objective By using the integrated cost graph derived（ CI） analysis to investigate the internal relationship among sub-regions of default mode network（ DMN） in patients with relapsing-remitting multiple sclerosis（ RRMS） and to compared it with that of the matched healthy control subjects at resting-state.Methods Twenty-four patients with RRMS（ in remission stage） and 24 age-and sex-matched healthy controls were examined by resting-state functional MRI（ R-f MRI） and 3D-T1 WI with a Trio 3.0T MR scanner.The f MRI data preprocessing and processing was performed by using the Data Processing Assistant for Resting-State f MRI Advanced Edition（ DPARSFA）.Then,the default mode network was constructed by computing Pearson’s correlations in blood-oxygenation level-dependent temporal fluctuations in 20 regions of interest（ ROIs）.The regional cost-integrate of inter- or intra-subsystem of DMN was measured.Finally,the relationships between the altered cost-integrate indices and the clinical parameters,including the expanded disability status scale（ EDSS）,the paced auditory serial addition task（ PASAT）,the brain parenchymal fraction（ BPF）,the T2 WI white matter lesion load and disease duration,were evaluated.Results In minimum network density conditions,the sub-regional integrating cost of DMN in patients with RRMS on the left middle temporal lobe was significantly higher than that of the control group（ 0.80 vs.0.30,P = 0.006）,and a negative correlation existed between the integrating cost and BPF（ r =- 0.414,P = 0.045）.Conclusion In patients with RRMS at remission stage,the DMN sub-regional cost-integrate is increased,which is related to brain atrophy.This method provides a new observation way for the further understanding of the mechanism of functional integration related to the neuronal activity in disease condition.