单纯脊髓受累型多发性硬化患者视觉网络的脑功能及结构研究

Study on brain structure and function of visual network of multiple sclerosis patients with simple spinal cord involvement

目的联合应用静息态功能MRI(RS-fMRI)及基于体素的形态学(VBM)方法探讨单纯脊髓受累型多发性硬化患者(MS-SSCI)脑功能与结构改变。方法对19例MS-SSCI(MS-SSCI组)及18名年龄、性别相匹配志愿者(对照组)行3DT1WI及RS-fMRI,用独立成分分析法(ICA)提取并比较2组视觉网络功能成分的差异;再用VBM方法对比2组FC有差异脑区及全脑的体积,分析MS-SSCI功能、结构参数与临床扩展残疾状态量表评分及病程的相关性。结果与对照组相比,MS-SSCI组左侧小脑6区功能连接值明显减低,左侧枕中回、右侧楔叶、左侧楔前叶、左侧额中回功能连接值明显升高;MS-SSCI组全脑体积无明显差异,右侧楔叶,左侧楔前叶体积明显萎缩(P<0.01)。MS-SSCI右侧楔叶的功能连接值与病程呈正相关(r=0.507,P=0.027)。结论RS-fMRI和VBM方法显示MS-SSCI视觉网络存在功能和结构异常。

Objective To assess the changes of the function and structure in visual network of multiple sclerosis patients with simple spinal cord involvement（MS-SSCI）using resting-state functional magnetic resonance imaging（RS-fMRI）and voxel-based morphology（VBM）.Methods 3D T1 WI and RS-fMRI data were acquired from 19 MS-SSCI（MS-SSCI group）and 18age-and gender-matched normal controls（control group）.The fMRI data was analyzed by using independent component analysis（ICA）,and visual network activation component were extracted and compare between two groups.The volume of these regions that had a significantly different functional connectivity（FC）and total intracranial volume（TIV）were compared between the two groups by VBM.The relationships between the expanded disability states scale（EDSS）scores,disease duration and changed parameters of structure and function were further explored.Results Compared with the control group,FC in the left cerebellum decreased,and FC in the left middle occipital gyrus,right cuneate lobe,left precuneus lobe,left middle frontal gyrus increased in MS-SSCI group.The TIV of MS-SSCI were not significantly decreased,but the volume of right cuneate lobe,left precuneus lobe showed significantly decreased（P〈0.01）.Positive correlation between disease duration and FC was found only in MS-SSCI right cuneate lobe（r=0.507,P=0.027）.Conclusion Structural and functional abnormalities in visual network of MS-SSCI can be showed by RS-fMRI and VBM.